Working with Medically Unexplained Symptoms in Psychological Therapy

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Somatisation is understood as "a tendency to experience, conceptualise and communicate psychological states as bodily sensations, functional changes or somatic metaphors” (Lipowski, 1968). Despite the frequency of somatisation and other medically unexplained symptoms presenting in physical and mental health settings, there is little consensus on the mechanisms by which these symptoms emerge. However, it is generally agreed that psychological problems play a role in the development and maintenance of these apparently medical symptoms (Mobini, 2014). Working with clients with somatic symptoms in psychological therapy involves various challenges, including developing a solid therapeutic alliance and establishing a shared understanding of the client’s experience of symptoms that does not alienate them or dismiss the distress associated with their symptoms.

This presentation will consider the range of ways in which physical symptoms may present in psychological therapy, and outline different ways of approaching this in treatment, using case studies.

Dr. Hannah Sugarman is a UK-trained Clinical Psychologist working with adult clients at Central Minds and The London Medical Clinic. Prior to moving to Hong Kong, she worked in a physical rehabilitation service in London, working with a range of neurological illnesses and other long term physical health conditions. Her areas of clinical interest include neuropsychology and working psychologically with physical symptoms.