We have long known that our body experiences everything with us. It reacts to stress, the ways we give and receive love, the conflicts we avoid, and all that we leave unspoken.
More than a century ago, psychoanalysis introduced the understanding that when emotions are not expressed, they find another path and often appear in the body. Later, psychosomatics began to study how prolonged internal tension affects specific organs and systems. Research on trauma shows that experiences do not remain solely in memory but are imprinted in the nervous system. Today, neuroscience complements this understanding by revealing the physiological effects of stress on the nervous system, immune response, hormonal balance, and pain sensitivity.
Mental stress in women can remain in the pelvic region, which is closely linked to intimacy and reproduction. Chronic tension and inflammatory processes can therefore be seen as part of the body’s overall response to prolonged stress, where physical reactions signal imbalance.
The Female Body as a Carrier of Experience
In her book Psychosomatics, Dr. Maria Velichkova presents the reproductive system as a symbol of creative potential and the ability to “give birth” — not only to children but also to ideas, projects, and new beginnings. She frames it as an expression of the relationship with oneself, the sense of femininity, and the connection to intimacy and partnership.
Many women with endometriosis report feeling “out of place” in work, relationships, or in relation to expectations. In psychosomatic terms, the tissue growing outside its proper place mirrors the internal experience of lacking a safe inner space.
The uterus symbolizes a place of security — the “home” we carry within ourselves. When this space is filled with unexpressed pain, anger, fear, or a sense of injustice, the body may react with inflammation, pain, or tissue growth. Prolonged living under this burden, feeling that one must cope alone and cannot allow weakness, leads to constriction and the embodiment of accumulated distress.
Unexpressed Internal Tension
Modern research on stress shows that prolonged psychological load puts the nervous system into a state of constant alertness. It remains mobilized as if danger has never fully passed. Peter Levine and Bessel van der Kolk describe how unresolved stress and trauma “linger” in the body, which continues to react even when we consciously believe all is well.
Chronic overload activates inflammatory processes and heightens pain sensitivity. While the psyche adapts, the body reacts independently, sending the message: “There is something here that has not been heard.”
Joyce McDougall frames symptoms as a stage on which unexpressed experiences are enacted. In endometriosis, this expression is localized in the pelvis — our area of vulnerability.
The Body as a Mirror of Inner Conflict
From a psychosomatic perspective, bodily symptoms are not the enemy but messages. Liz Burbo complements classical psychoanalytic views, emphasizing that every illness has physical, emotional, and mental dimensions. Disease arises when a person persistently denies or suppresses a deep experience.
Regarding the female reproductive system, Burbo highlights conflicts related to attitudes toward motherhood, relationships with one’s mother, acceptance of femininity, suppressed anger, and trauma from injustice.
Desire and Fear: Two Sides of the Same Coin
For women with reproductive challenges, the desire for a child often coexists with fear — fear of change, loss of control, or repeating family patterns. Wanting a child while feeling anxious is entirely natural. Difficulties arise when these experiences remain unnamed, leading to chronic internal mobilization that continues beneath the surface.
Fear of Losing Control
Motherhood involves surrender, vulnerability, and change. For women who struggle to relinquish control, this can be frightening. The psyche may signal, “I’m not ready,” “I don’t feel safe,” and the body responds with symptoms that obstruct conception.
Connection to Motherhood and Femininity
Female identity is shaped through the first mother-daughter relationship. If the mother was emotionally unavailable, overwhelmed, a victim of her own circumstances, or carrying unresolved pain or loneliness, the daughter may unconsciously absorb this burden. A strong internal resistance may develop: “I don’t want to be like her,” “I won’t repeat her fate,” which can block the free experience of femininity.
Unexpressed Anger
Many women with chronic pain are responsible, strong, and used to handling challenges alone. The nervous system works at high alert with no rest, but the body has limits. When these limits are exceeded for too long, it begins to signal.
Both psychoanalysis and Liz Burbo highlight suppressed anger. Women with chronic gynecological issues often struggle to express anger, set boundaries, or voice needs. If aggression cannot be directed outward, it turns inward, and the body can act self-aggressively. In endometriosis, this can be seen as a symbolic “attack” on one’s internal environment.
A Sense of Injustice
Reproductive health is not only biological; it is connected to identity, femininity, and the ability to create and carry life. Tension in this part of the body reflects conflicts that exist long before the physical manifestation.
Burbo links gynecological disorders to deeply felt injustice - the sense that a woman has not been allowed to fully inhabit her femininity. If unprocessed, these experiences manifest physically.
How Psychotherapy Helps
Restoring dialogue between psyche and body changes the relationship with a diagnosis. Instead of fighting the body, understanding its signals and cultivating self-compassion can emerge. Healing may begin with questions such as: Where in my life have I been strong for too long? Where do I not allow myself to express my pain? Where do I fail to set boundaries? What am I afraid of, even if I cannot admit it to myself? The body is not against us; it is on our side. Sometimes it speaks louder because it has not been heard in time.
Psychotherapy provides space for awareness and integration without replacing medical care. Unspoken emotions can find words, and underlying conflicts can be recognized and understood. In therapy, the symptom is not an isolated defect but part of a personal story. Work often focuses on boundaries, suppressed anger, fear of vulnerability, and internal conflicts related to motherhood. Naming the unspoken allows the nervous system to calm, altering the perception of pain and the relationship with the body.
Psychosomatic insight adds another dimension - our inner reality - because the body reacts to how we live and perceive the world. Viewing symptoms as messages opens the possibility for deeper self-understanding, replacing struggle with dialogue and self-blame with curiosity. The first step is often learning to “feel” oneself. In this process, there is no room for guilt, only awareness - the beginning of holistic self-care, not only medical but also psychological.
References:
Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.
van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, NY: Viking.
McDougall, J. (1989). Theaters of the Body: A Psychoanalytic Approach to Psychosomatic Illness. New York, NY: W. W. Norton.
Bourbeau, L. (2007). Your Body’s Telling You: Love Yourself! Malvern, Australia: Hay House.
Velichkova, M. (2020). Psychosomatics. Sofia.