Psychosomatic Issues Counselling in Melbourne

Medically unexplained symptoms account for up to 45% of all general practice consultations (RACGP), and approximately 1.7 million Australians have both a 12-month mental health condition and a physical condition (ABS 2020–22). Psychosomatic issues — physical symptoms that have psychological origins or are significantly influenced by psychological factors — are among the most common and least acknowledged presentations in modern healthcare. Persistent headaches, chronic pain, gastrointestinal disturbance, skin conditions, fatigue, and many other physical experiences can be mediated or substantially exacerbated by psychological states. At my practice at 96 Elgin Street, Carlton, I work with clients in Melbourne whose physical symptoms have not been fully explained by medical investigation, or whose physical health is clearly entangled with their emotional life.

What does “psychosomatic” actually mean?

The word “psychosomatic” has unfortunately acquired connotations of dismissal — as though being told that a physical symptom has a psychological component means that no one believes you’re really suffering. That is not how I approach it. The physical experience is real. The pain is real. The fatigue is real. The stomach cramps are real. What a psychosomatic understanding adds is the recognition that the mind and body are not separate systems, and that emotional states can produce genuine, measurable physical effects.

Stress activates the body’s alarm system. Chronic anxiety keeps the nervous system in a state of sustained arousal that affects digestion, immunity, musculature, and pain sensitivity. Grief that cannot be expressed can produce symptoms that medicine finds no organic basis for. Trauma held in the body can generate physical pain long after the original event. These are not metaphors — they are physiological realities with a growing evidence base in psychoneuroimmunology and neuroscience.

Common psychosomatic presentations

In my Melbourne practice, I work with clients whose psychosomatic presentations include:

• Chronic pain — including back pain, headaches, and widespread musculoskeletal pain that persists beyond what physical investigation can fully explain
• Irritable bowel syndrome (IBS) and gastrointestinal disturbance — one of the most well-documented mind–body connections, with stress and anxiety consistently implicated in symptom severity
• Chronic fatigue — exhaustion that does not resolve with rest and which is frequently entangled with depression, anxiety, or the physical toll of prolonged stress
• Skin conditions — including eczema, psoriasis, and hives, which are frequently triggered or worsened by emotional states
• Tension headaches and migraines — where the relationship to stress, repressed emotion, and relational conflict is often clear once explored
• Medically unexplained symptoms — physical complaints for which thorough investigation has found no organic cause, leaving the person without a diagnosis and without validation

The psychodynamic understanding: the body speaks what the mind cannot

From a psychoanalytic perspective, the body can become a site of expression for feelings and conflicts that have not found other outlets. This is not a new idea — Freud’s earliest clinical work was with hysterical symptoms that had no organic basis but that resolved when their psychological meaning was found. Contemporary psychodynamic thinking has deepened this understanding considerably.

Psychosomatic symptoms often appear precisely in people who are highly functional and outwardly composed — people who have learned to suppress emotional expression, who carry significant stress without apparent distress, or who have not had the opportunity or permission to grieve, rage, or fall apart. The body, in such cases, says what the person cannot.

Therapy for psychosomatic presentations in my Carlton practice involves paying close attention to what the symptom might be expressing — exploring the emotional landscape around it, the timing of its onset, its relationship to stress and to relationships, and what has been left unsaid or unfelt. This work often benefits from close collaboration with the treating physician, and I am comfortable working alongside GPs and specialists. No referral is needed to see me. Sessions are $120. Book a session or message me on WhatsApp.