Psychosoma in crisis: an autoethnographic study of medically unexplained symptoms and their diverse contexts

ABSTRACT

In this study, we examine autoethnographic data from three critical incidents as experienced by the first author demonstrating the importance of context in understanding medically unexplained symptoms, their incidence and underlying patterns. We make the case for ethnographies as a crucial research strand in discerning the finer aspects of the patient or client experience; aspects that might be missed where people are directed along protocolised pathways of care. The article describes care as fragmented and depersonalising, leading to disembodied exchanges, as reflected in other autoethnographic studies, particularly those that highlight the complex relationship and controversies surrounding diagnostic uncertainty. We observe that psychological therapists, given the quality of the therapeutic relationship and sustained attention to the person’s experience, are well placed to assist in the necessary processes of re-contextualisation and re-embodiment.

KEYWORDS:

• Psychosomatic pain
• medically unexplained symptoms
• trauma
• patient narratives
• depersonalisation
• autoethnography

Notes on contributors

John Hills completed his MA in Counselling and Psychotherapy at the University of Leeds in 2014. He is a practicing counsellor, BACP registered, and since submission of his dissertation has been presenting his research in various conference and CPD settings, and has begun his Ph.D. research in October 2016.

John Lees is senior lecturer in Mental Health at the University of Leeds. He is a UKCP-registered psychotherapist and a BACP senior-accredited practitioner, has edited a Routledge journal, a book series and four books and has written numerous book chapters and peer reviewed articles. His research interests include the microphenomena of clinical practice, psychosomatics, the interface between therapy and CAM, creative qualitative research methodologies and anthroposophic psychotherapy.

Dawn Freshwater is Professor of Mental Health at the University of Leeds and Senior Deputy Vice Chancellor at the University of Western Australia. She is a nurse, psychotherapist and a researcher, with interests in psychological therapies research and offender health. Dawn is an experienced author, research supervisor and educator with an international reputation for developing transformational research approaches.

Jane Cahill is a senior research fellow at the School of Healthcare, University of Leeds. She has published widely in the field of psychological therapy effectiveness and continues to work and publish within the field of mental health. Her current programme of research supports the mental health research programme within the School having an especial focus on the therapeutic alliance, practice-based evidence approaches, workforce mental health issues, and complementary and alternative approaches to mental health.