Free information session
Blockage of psychological and emotional processes can interfere with the normal flow of internal regulatory processes affecting respiratory, cardiovascular, gastrointestinal, musculoskeletal, neurological and dermatological bodily systems and result in psychophysiological pain conditions (PPC). In addition, experience of anxiety related to strong emotions can be experienced in the form of painful physical symptoms, where the intensity of the avoided emotions corresponds to higher anxiety and more debilitating the symptoms.
Psychophysiological presentations, which have both medical and underlying psychological needs, are frequent in primary care, and as a result of their complexity, cause frustration and anxiety for many doctors (Fink, 1999; Kroenke, 2003; Town, 2013; RCPSYCH), as traditional medical treatment approaches appear to be insufficient to result in significant long term improvement (RCPSYCH).
The common psycho-physiological presentations include, but not limited to: tension headaches, migraines, choking, chest pain, back pain, neck pain, foot pain, fibromyalgia, chronic abdominal and pelvic pain, repetitive strain injury, irritable bowel syndrome, chronic fatigue, erectile dysfunctions, vaginismus, insomnia, myofacial pain syndrome.
There is an emerging body of evidence on the long term effectiveness of the Intensive short-term dynamic psychotherapy (ISTDP) approach for treatment of PPC (Abbass, 2008; Cooper, 2017; Town, 2013).
The ultimate goal of ISTDP is to help the patients to experience their previously avoided feelings and to resolve processes of emotional blockages, which result in medically unexplained symptoms, along the way (Davanloo, 1978).
ISTDP highlights that each emotion had a specific neurobiological pathway of experience, which is different from experience of other emotions, and anxiety and somatisation pathways. In addition there is four pathways for anxiety discharge, and each of these pathways determines immediate therapy tasks (Abbass, 2005, Abbass, 2015). Understanding of these pathways is critical in order to successfully diagnose and treat psycho-physiological presentations.
Melbourne Health Psychology Centre is passionate about promoting awareness about complex relationships between physical and mental health and as a part of our promotion campaign we offer local medical practices free information sessions on the topic of psychophysiological problems.
In this session we will outline main groups of psycho-physiological problems according to the pathway for anxiety discharge. These include problems resulting from striated muscle anxiety discharge, smooth muscle anxiety discharge, conversion, cognitive perceptual disruption, and will also touch on other problems associated with anxiety (e.g. sleep problems and chronic fatigue). She will also explain psychological mechanisms responsible for the development of psych-physiological problems and will give an overview of what needs to take place to help the individual to heal at both physical and mental health levels. All of the information provided in this session has a solid evidence base.
The duration of the session is 30 min, however it is not uncommon for the interesting discussion to take place at the end of the presentation, so for the best experience it is recommended that 45 min of total time is allowed for this session.
Please let us know if you would like to arrange this free psychoeducational session at your practice.
References:
Abbass, A. (2005) Somatization: Diagnosing it sooner through emotion-focused interviewing, The Journal of Family Practice, 54(3):231-9, 243.
Abbass, A. (2015). Reaching through Resistance: advanced psychotherapy techniques. Kansas City, MO: Seven Leaves Press, pp 11-30
Abbass, A., Lovas, D., & Purdy, A. (2008) Direct diagnosis and management of emotional factors in chronic headache patients. Cephalalgia, 28:1305–1314.
Cooper, A., Abbass, A., & Town, J.(2017). Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting. Journal of clinical medicine 6(12).
Davanloo, H. (1978) Basic principles and technique in Short-Term Dynamic Psychotherapy, Spectrum, NY, 1978 In H. Davanloo (Ed): Short-Term Dynamic Psychotherapy, J. Aronson, NY , pp 51-52
Fink P., Sorensen, L., Engberg, M., Holm, M., & Munk-Jorgensen, P. (1999) Somatization in primary care: prevalence, health care utilization, and general practitioner recognition. Psychosomatics, 40, 330–338.
Kroenke, K. (2003) Patients Presenting with Somatic Complaints: Epidemiology, Psychiatric Comorbidity and management, International Journal of Methods in Psychiatric Research, 12(1):34-43.
Royal College of Psychiatrists, UK https://www.rcpsych.ac.uk/mental-health/problems-disorders/medically-unexplained-symptoms
Town, J. & Driessen, E. (2013) Emerging Evidence for Intensive Short-Term Dynamic Psychotherapy with Personality Disorders and Somatic Disorders , Psychiatric Annals, 43, 502–507.
