Embodied simulation, body language, and symbolization: understanding somatic symptoms in psychoanalysis

TL;DR

This paper explores how somatic symptoms in psychoanalysis arise from failures in symbolization and communication, using embodied simulation and clinical examples.

Contribution

The paper introduces a novel integration of embodied simulation theory and clinical vignettes to explain somatic symptoms and intercorporeality in therapy.

Findings

Somatic symptoms emerge from failures in mentalization and symbolization, manifesting as bodily distress.

Therapeutic interactions involving somatic enactments can be understood through intersubjective communication and embodied simulation.

AI lacks bodily resonance, making it unsuitable as a substitute for human-based therapeutic processes.

Abstract

Classical psychoanalysis has traditionally focused on uncovering unconscious conflicts through language—the so-called `talking cure`. However, contemporary research underscores the importance of embodied simulation, body language, and their symbolic representation in understanding and addressing patient’s somatic symptoms. This occurs particularly when individuals seeking psychological help are unable to use spoken words to express their feelings, which is why communication between patient and therapist takes place at a pre-verbal level, within the space of “intercorporeality.” In this paper we explore the interplay between early development, mentalization, language acquisition and somatic disorders as failures of symbolization that manifest in bodily distress. In psychoanalytic psychotherapy these processes can be studied as transference-countertransference interactions. We describe the observed clinical phenomena in terms of intersubjective communication grounded in embodied simulation theory, showing how bodily symptoms emerge when mentalization fails and countertransference is enacted at a concrete, somatic level. For this, a clinical vignette illustrates how severe deficits in mentalization produce concrete somatic enactments and embodied countertransference in the therapist, suggesting a neurobiological substrate in pathological intersubjective resonance. We also compare a clinical vignette to human interaction with an AI as a vivid illustration of what happens when there is ‘nobody’ (or ‘no body’) as a human counterpart in communication. LLMs lack bodily resonance and therefore cannot substitute for the therapeutic processes that rely on embodied simulation. Thus, our paper describes phenomenological observations of interbody communication in therapy caused by symbolization failure, integrates several theoretical and experimental approaches (intersubjectivity, embodied simulation, interbrain synchronization) to explain it, points at further directions of scientific research and indicates potential dangers for therapists and patients using modern AI technologies.

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