Struggling With Unexplained Medical Symptoms
Unexplained Medical Symptoms
With the advance in healthcare, people recover from severe health conditions such as 'coronary heart disease' or cancer because once a diagnosis is usually established, doctors can adopt a problem-solving approach to set out a treatment plan. Some resume their daily activities. They are able to embark on a gradual return to work. Others present their health complaints to their doctors who are seemimgly unable to have the right treatment because the tests fail to elicit a diagnosis. So, they do not have a specific treatment plan. These are reportedly called ‘unexplained medical symptoms’.
NHS Choices (15th July 2016) issue guidelines for people facing this unusual dilemma. The main complaints are exhaustion, pain, heart palpitations, depression or anxiety disorders. Other people have symptoms that reflect Chronic Fatigue Syndrome, or Irritable Bowel Syndrome or Fibromyalgia – which can cause bodily pain. Therefore, ‘medically unexplained symptoms are present among a fifth of all GP consultations in UK. It seems that both doctors and patients are struggling with the task of understanding the symptoms. In the absence of the diagnosis, it is difficult for doctors to formulate a treatment plan.
Doctors have, therefore, no choice but to engage the patients in exploring all the aspects of the health problems and involve them as partners to deal with the difficulties. Doctors may prescribe medications to relieve distressing symptoms. When the patients do not obtain symptomatic relief, they sometimes face despair, anxiety and frustration. Health Coaching can be another resource in these circumstances. Patients usually respond positively if they feel that their complaints are being heard. Their concerns may be validated. Doctors and health coach can work together to reach out people experiencing unexplained medical symptoms.
To improve doctors’ consultations for people struggling unexplained symptoms, Stone (2014) offered some suggestions:
- Make empathic connection
- Validate the patient’s subjective experience, their distress and frustration.
- Establish common ground by agreeing on the nature of the problem and the goals.
- Offer bio-psych-social explanations of the symptoms using language that the patient understands.
- Focus on care rather than cause or cure.
- Establish clear boundaries around each consultation.
Anxiety and Depression
The overriding difficulties are anxiety and depression. Talking therapy such as Cognitive Behaviour Therapy through Improving Access to Psychological Therapies (I.A.P.T) is recommended to enable the patients to gain more control over the symptoms. But if the patients have a long history of unresolved psycho-social difficulties from early years, health coaching may help them to ventilate their feelings, fears and concerns, increase their coping skills and encourage them to set some treatment goals. The coach uses non-judgmental approach, genuineness and positive regards in order to enhance the patients’ sense of being valued and respected, increase their sense of control over their health, and life.
Stone. L. (2014) ‘Blame, Shame and Hopelessness: Medically unexplained symptoms and the ‘Heartsink’ experience’. Volume 23, No.4, pages 191-195. Australian Family Physician.
Author: Nadir Mothojakan
Date: 20th July 2016