Psychosomatics
When the body carries what the mind has not yet put into words
Some physical symptoms stay even after the tests come back clear, or they get worse whenever life gets heavier. Therapy can be one part of looking after them, next to your doctor.
Psychosomatic symptoms are real physical complaints, such as pain, digestive problems, fatigue or muscle tension, where stress, emotions or long-term strain play a part. A doctor first checks for medical causes. Therapy then looks at how the symptoms connect with what is going on in your life, while medical care continues in parallel.
People often reach this page after a long road. The stomach reacts before every important meeting, the back hurts although the scan was clear, and sleep does not fix the tiredness. After several doctors and several tests, someone says it might be stress, and that can feel like being sent away. It is also where my work can start, as long as your doctor stays in the picture.
What psychosomatic symptoms can look like
When we live under pressure for a long time, swallow anger, carry grief or keep going without rest, the body often registers it before we do. Common examples:
- pain in the back, neck, shoulders or head
- digestive trouble, nausea, a "knot" in the stomach
- fatigue and exhaustion that rest does not ease
- muscle tension, a clenched jaw, shallow breathing
- a racing heart or a tight chest in stressful moments
The NHS page on persistent physical symptoms lists many of the same complaints and says plainly that these symptoms are real, not "all in the head". I agree with that. A psychological component does not make a symptom less real or less worth taking seriously.
Medical examination comes first
Before we start, your symptoms should be examined by a doctor. I am a psychologist, not a physician, so I do not diagnose physical illness, prescribe medication or rule out an organic cause. If a symptom is new or changes while we work together, I will ask you to go back to your doctor. I work alongside doctors, never in their place: you keep your GP or specialist, and our sessions add a place to look at what the symptoms are connected to.
When to see a doctor, a therapist, or both
| Situation | Doctor | Therapist | Both |
|---|---|---|---|
| A new symptom, or one that is quickly getting worse | First, and soon | Not yet | Later, if it makes sense |
| Chest pain, fainting, blood, sudden weakness or numbness | Immediately, or emergency services | No | No |
| Tests are done and do not explain the symptoms fully | Keep your follow-ups | Yes | Usually the best fit |
| Symptoms rise and fall with stress, conflict or overload | To check the body | Yes | Yes |
| You worry about your health so much it fills your days | To check the body | Yes | Yes |
Where this experience comes from
From 2014 to 2020 I worked at ESET, a psychotherapeutic and psychosomatic clinic in Prague, and from 2023 to 2024 at the Psychosomatic Centre Prague. Before that, from 2012 to 2014, I was at the Department of Clinical Psychology at Motol University Hospital in Prague. Part of that work was crisis intervention and supportive therapy for patients in hospital, including on the spinal surgery ward, and I took part in research on fear related to pain. In 2013 I co-authored two papers with colleagues in a Slovak journal on palliative medicine and pain treatment, one of them on cultural aspects of managing cancer pain.
How I work with this
I am a psychologist, psychotherapist in training (Gestalt, Institut Dialog), working under supervision. I offer individual sessions for adults, 50-minute sessions, in person in Prague 1 or online, in English, Czech or Slovak.
Gestalt is a humanistic approach. In practice we start from what you bring and from what you notice as we talk, and that includes the body. We might slow down at the moment your shoulders lift or your breathing gets short, and look at what was just being said. Over time we can explore what the symptom shows up next to: a role you cannot step out of, an emotion that has no room anywhere else, a pace you have been keeping for years.
I believe we all carry the potential to heal and grow. What matters most to me is a safe, trusting relationship in which you do not have to prove that your symptoms are real.
Physical symptoms often come together with other things. The tension may be part of anxiety or panic, or of holding everything together for so long that it resembles high-functioning depression. If the pressure comes mostly from a constant sense of not being good enough at work, see imposter feelings. Parents whose worry is about a child can book consultations for parents of teenagers.
When this is not the right place
- Acute crisis. If you are in danger or thinking about harming yourself, please do not use the contact form. Use the crisis lines on this page.
- Medical emergencies. Sudden chest pain, fainting or new neurological symptoms belong with emergency services or a doctor straight away.
- Medication. Questions about starting, changing or stopping medication belong with your doctor or a psychiatrist. I will not advise on them.
- Children and teenagers. I work only with adults. If your child has physical symptoms that seem linked to stress, start with their paediatrician.
If you are not sure which kind of help you need, when to seek help goes through the options. When you are ready, write to me.
Last updated 1 October 2026
Questions and answers
Can stress cause physical pain?
Stress and long-term strain can show up in the body, for example as headaches, back pain, a tight jaw or stomach trouble. That does not mean the pain is imagined. It still needs a doctor first, because the same symptoms can also have a medical cause that should be treated.
Why do I have symptoms doctors cannot explain?
Sometimes the examinations do not find a clear physical cause, and the symptoms stay anyway. The NHS describes these as persistent physical symptoms that are real, not faked. Looking at stress, emotions and the way you live with the symptoms can be one useful part of the picture, together with ongoing medical care.
Do I need to see a doctor before I come to you?
Yes, please. I am a psychologist, not a physician, so I cannot examine you or rule out a medical cause. Before we start, your symptoms should be examined by a doctor. If a new or worsening symptom appears while we work together, it goes back to your doctor.
Will therapy make my symptoms go away?
I cannot promise that. What we can do is look at what the symptoms are connected to and how you live with them. That can make them easier to live with, but I cannot say in advance whether or how much they will change.
Related pages
Would you like to talk it through?
Write a few lines about what is happening, without detailed medical information. I will reply and we can agree on a first session.