Patients’ perspective of change processes in affect-focused body psychotherapy for generalised anxiety disorder

Abstract

In a previous study, 61 patients with generalised anxiety disorder were randomised to participate in affect-focused body psychotherapy (ABP) or treatment as usual. In this current study a sub sample, 30 of the patients in the ABP group has been interviewed. A qualitative interview was used in order to investigate how the patients experienced participation in one year of ABP therapy. It was found that an initial open attitude towards the treatment and an understanding of the mind-body unity seemed to be a crucial factor in motivating the patient to take an active part in treatment. Key themes concerning shame and control were found in the material. Getting in touch with one's body eventually gave rise to a feeling of being in control, e.g. noticing muscular tension and being able to influence it as well as understanding the connection between bodily symptoms and emotions. Anxiety signals become transformed into meaningful signals about one's life situation instead of provoking fear. The end result of therapy could be understood in terms of how patients managed to integrate bodily feelings into their perception of themselves, thus attaining a deeper experience of their lived body. The clinical implications of the study are that the therapist should be flexible and sensitive, adjusting the treatment in accordance to the patient's own understanding of the body. The therapist should also initially limit shameful feelings and anxiety by ensuring that the patient understands the meaning of the interventions and what is expected from him/her, thus giving the patient a sense of control.

Keywords:

• affects
• body psychotherapy
• physiotherapy
• interview, qualitative analysis

Acknowledgements

We wish to express our gratitude to the participating patients and to the physiotherapists Ingegerd Johansson, Ingrid Rehnman and Signe Stryjan. The study was funded by grants from Vårdalstiftelsen; L.J. Boëtius’ foundation; from the Centre for Health Care Sciences, Karolinska Institutet; from Stockholm County Council and from Bror Gadelius minnesfond.