In one direction of usage, these are images and metaphors that express our awareness of ourselves in the world. We use words from our physical experience of life to describe aspects of our relationships with our mental, emotional and spiritual interactions with the outer worlds. We use these body language words because they are familiar, readily understood by others, and aptly describe how we relate to aspects of our lives.

Coming in the opposite direction, these same images may become lenses of usage which color our habitual perceptions of the world. If I am constantly bellyaching, then I may perceive many of my experiences with the world as a pain in the (neck� butt� etc�).

Through repeated patterns of perception and use, these metaphors may actually shape our inner worlds in many ways and on many levels.

It is not surprising to learn that in different countries there may be different distributions of common psychosomatic problems. For instance, placebos have been enormously helpful to German people with stomach ulcers (up to 60 percent rates of healing), but far fewer respond in Brazil (7 percent). However, placebos are relatively ineffective in Germany for hypertension relative to responses in other countries (Moerman).

Anna Fels shares yet another cross-cultural perspective on body language. A fellow psychiatrist once told me an anecdote I have never forgotten. He was at a conference about depression in developing countries. The essence of the lectures was that people in those areas commonly expressed depression as physical symptoms. They "somaticize" their depression, to use the medical parlance, complaining of malaise, stomachaches, dizziness and other symptoms that are hard to pin down.

Techniques were discussed for dealing with the patient who insists her only problem is a heavy head or a squeezing sensation in the belly, but who is clearly depressed.

Toward the end of the meeting, a doctor from India stood to speak. "Distinguished colleagues," he said, "have you ever considered the possibility that it is not that we in the third world somaticize depression, but rather that you in the developed world psychologize it?"

Moerman, D. (2002). The Meaning Response: Rethinking the Placebo Effect, Cambridge Univ Pr 2002.

*An expanded version of this article appears in Benor, DJ, The Body, International J of Healing and Caring � on line, www.ijhc.org September, 2002, 1-18.