Psychologist Anna Heal

Luna, your experience of intermittent chest pain during high-pressure work meetings, despite a clean bill of physical health, strongly suggests a psychosomatic response-a physical manifestation of psychological stress. At 21, entering a demanding professional environment can trigger subconscious anxiety, particularly if the role feels overwhelming or tied to deep-seated fears about performance, failure, or even your sense of identity in this new chapter of adulthood. Let’s break this down to understand what might be happening and how to address it.

First, it’s important to recognize that psychosomatic symptoms are not "imaginary"-they are real physical reactions to emotional distress. Your body’s stress response system, governed by the autonomic nervous system, may be activating in these meetings, leading to muscle tension in the chest (which can mimic sharp pains), rapid heart rate, or even hyperventilation. The existential dread you describe-especially when discussing future projects-hints at a deeper layer of anxiety. This could stem from fear of the unknown, pressure to prove yourself, or even an unconscious resistance to the expectations placed on you (or that you’ve placed on yourself). The irritability you’ve noticed is also a classic sign of chronic stress, as your nervous system remains in a heightened state of alertness.

Your subconscious might be reacting in several ways. One possibility is that this job represents a major life transition, and the chest pain is a somatic way of expressing unprocessed emotions about this shift-perhaps excitement mixed with fear, or a sense of losing control. Another angle is performance anxiety: if you associate these meetings with judgment or high stakes, your body may be signaling a need to "escape" or "protect" itself, even if your conscious mind is determined to push through. There’s also the chance that the pain serves as a distraction from the emotional discomfort of feeling exposed or evaluated in these settings. Ask yourself: Does this role align with my values, or am I ignoring internal conflicts about my career path? Sometimes, physical symptoms arise when we suppress such questions.

To manage this, start by acknowledging the mind-body connection. When you feel the pain emerging, pause and ask: What am I feeling emotionally right now? Name the emotion-whether it’s fear, frustration, or inadequacy-and validate it. This simple act can reduce the intensity of the physical symptom. Grounding techniques can also help: try the 5-4-3-2-1 method (name 5 things you see, 4 you can touch, etc.) to anchor yourself in the present moment and interrupt the stress cycle. Over time, this rewires your brain’s association between meetings and danger.

Longer-term strategies should focus on reducing the overall stress load. Prioritize boundaries: can you schedule short breaks before or after meetings to decompress? Even five minutes of deep breathing (inhale for 4 counts, hold for 4, exhale for 6) can signal to your nervous system that you’re safe. Cognitive reframing is another powerful tool. Instead of viewing meetings as threats, try seeing them as opportunities to learn-shift the internal narrative from "I must perform perfectly" to "I’m here to contribute and grow." If the existential dread persists, journaling about your fears (e.g., "What’s the worst that could happen if I don’t meet expectations?") can help dismantle their power.

Consider whether perfectionism or imposter syndrome are at play. Many high-achieving young adults experience these, and they can manifest physically when the pressure mounts. Remind yourself that you’re still learning, and mistakes are part of the process. If the symptoms persist, exploring therapy modalities like somatic experiencing or cognitive-behavioral therapy (CBT) could help you unpack the subconscious triggers and develop coping mechanisms tailored to your needs. These approaches address the root causes of psychosomatic symptoms by integrating body awareness with emotional processing.

Lastly, pay attention to your lifestyle foundations: sleep, nutrition, and movement. Chronic stress depletes your body’s resources, and neglecting these basics can exacerbate physical symptoms. Gentle exercise, like yoga or walking, can release trapped tension, while adequate sleep supports emotional regulation. If the chest pain continues despite these efforts, return to your doctor to rule out any emerging physical factors-but given your tests so far, the mind-body link is the most likely culprit.

Remember, your body is communicating with you. Rather than fighting the pain, listen to it as a signal to slow down, recalibrate, and approach your work with more compassion for yourself. This isn’t just about managing symptoms-it’s an invitation to build a healthier relationship with stress and your own expectations.