How are bodily states experienced, differentiated and translated into symptoms? A qualitative study

Substantial research in symptom perception demonstrates symptoms are influenced by a wide range of psychological factors. However, there is limited understanding of the broader milieu of bodily states within which symptoms exist, including emotions, sensations and “pre-symptoms”. Furthermore, little is known about how bodily states are experienced and translated into symptoms. Semi-structured interviews with 12 participants explored how individuals experience, describe and understand their bodily states in addition to how bodily states are translated into symptoms and how this transition was experienced. Thematic Analysis described four main themes in relation to; i) “The qualia of bodily states”, individuals’ description and understanding of how bodily states “feel”; ii) “Attending to bodily states”, how attention to bodily states could differ between individuals and in certain contexts; iii) “Becoming symptoms”, understanding of normality and its deviations and finding meaning could play a role in transition of states to symptoms; iv)“Reifying symptoms”, how individuals communicated, verbally and non-verbally, abstract lived experience of bodily states to the self and others. A transcending theme, “A series of thresholds” encompassed how bodily states surpass a threshold to become a symptom and the involvement of individual differences such as attention, emotions, expectations and finding meaning. Symptoms may arise when a bodily state surpasses a series of thresholds which may be lowered or raised. There is a critical need to consolidate understanding of bodily states and symptoms within a research context and for greater appreciation of the nuanced, complex and varied nature of bodily states beyond “symptoms”.