2020 Volume 24 Issue 3 Pages 215-220
In this issue, we discussed the better psychotherapeutic approach to patients with psychosomatic disease or medically unexplained symptoms (MUS) in the busy outpatient clinic. Patients with MUS who visits our psychosomatic outpatient clinic have often remained unsatisfied with the explanation or treatment in precedent medical consultations. We also cannot always take enough time to listen to patients’ precise story. However, it is not necessarily bad we don’t have enough time. That will make us focus on important issues. And it will prevent patients from becoming excessively dependent. The therapist should speak less to let the patient speak more. That will make her feel satisfied. We can expect her improvement even for short-term consultation through a continued consultation. A structured stable therapeutic relationship itself have power of improvement. A recommended approach to MUS is described as below. 1. To ask the patient’s understanding model (What is she worried about?), 2. To assure the patient status based on physical or other examination, 3. To follow up her with symptom targeted treatment, 4. To regulate the patient’s autonomic nervous function through good daily life rhythm, 5. To guide the patient can shift her daily life from symptoms-centered one to her original one. We should facilitate her positive activity. 6. To be always conscious that the patient should take the leading role in her therapy.
