Some few quotes:
Until the 19th century, a unitary view of illness prevailed, and diagnosis often meant diagnosis of the patient rather than of a disease. The replacement of this unitary view by the notion of diseases having a bodily location led eventually to the conceptual separation of mind from body.
For the 18th century patient there was no separation between the emotions and the body. Nor was there a distinct boundary between the physician’s diagnostic vocabulary and the feelings of the patient. To an 18th century patient, the idea of the emotions being "in the head" would probably not have occurred.
The language used to discuss somatization suggests that the expression of emotion in bodily symptoms is abnormal; that cure requires that the mental causes of the symptoms be acknowledged, verbalized and resolved; and that symptomatic treatment is not appropriate. The requirement that the physician convince the patient of the mental origin of his or her symptoms may create grounds for irreconcilable conflict; why should patients acknowledge something that they do not feel? A diagnosis of somatization, especially when associated with the idea of primary or secondary gain, carries with it the implication of moral failure, with all its subsequent stigmatization and breakdown of relationships.
We should reject the idea of somatoform disorders as diagnostic entities and learn that a symptom may be an embodied emotion; indeed, all symptoms, whatever their origin, have some affective coloring.
Many of these problems would be avoided if physicians and patients became less concerned with cause and more concerned with care. Once remedial causes have been ruled out, many illnesses must be managed without knowledge of their cause. Even when no specific remedy is available, wise physicians have always tried to help patients by paying attention to the particulars of the illness: diet, rest, sleep, appropriate exercise, treatment of symptoms, and emotional support. The support of the physician is crucial. This is what patients regarded as somatizers often lack. Building trust is especially difficult when patients have experienced rejection from their physicians.
We must recognize that the patient’s experience of illness is primary. Our own system of diagnostic abstractions, although very powerful, is secondary. In the patient’s experience, there may be no separation into mental and physical. Illness is a disturbance in a person’s ability to relate to and function in the world whether or not it is associated with identifiable organic pathology. The biopsychosocial model and the patient-centered clinical method require that the clinician attend to the emotions as a routine part of the clinical inquiry.
All significant illness is a disturbance at many levels, from the molecular to the personal and social. This implies that some of the skills that are at present considered psychiatric will need to be developed more generally in all clinicians, especially those working in primary care, where so much general, undifferentiated illness is seen.
Annals Int. Med. May 1, 1997; 126: 747-50 Essay, first author from Univ. Of Western Ontario, London, Ontario, Canada.

Comment:
Reassurance is basic to good care. Telling a patient "It’s all in your mind (head)" is not reassuring—it’s counter productive. RTJ