In this issue


Medically unexplained symptoms
How could our healthcare system change to treat more patients with psychosomatic symptoms?

Miracles of mindbody medicine
Exploring the mindbody connection and how psychological treatments can help those who suffer from chronic pain

The art of moving
The philosophy behind parkour which has helped young offenders in St Petersburg adapt to mainstream life

Facing the future
Reflecting upon the visionary thinking and dynamic concepts discussed at March’s Big Idea conference

DIY therapy
Should counsellors empower their clients to become their own therapists?

Mindfulness in context
How meditative practice can inform therapeutic practice leading to greater awareness between therapist and client


In practice
Kevin Chandler: Whither pride

In the client's chair
Emma Munro: In the flow

In training
Martin Halifax: The wrong hoops

Colin Feltham

The art of coaching
Linda Aspey

Day in the life
Christine Murray

Cover of Therapy Today, April 2010

Articles from this issue are not yet available online. Members and subscribers can download the pdf from the Therapy Today archive.


Up to one third of people consulting a GP will have medically unexplained symptoms (MUS) – from breathing attacks to chronic back pain – as part of their problem. The financial burden of MUS is phenomenal – around 16 per cent of the total cost of healthcare services in the developed world – and much of this is being wasted on unnecessary and inappropriate tests and treatments. Psychiatrist Tim Webb gives his perspective on why our healthcare services have failed to deal effectively with MUS for so long and why that may be about to change.

Given that the NHS is being asked to shave 15 per cent off its operating costs by this time next year, our healthcare services may be forced to give serious consideration to rethinking how to tackle MUS. Any transformation in approach would involve major changes in how clinical staff are trained and deployed to create a system that positively identifies and treats the psychological causes of these problems. For therapists working in healthcare, Webb suggests, this would offer ‘unlimited possibilities’. But while doctors would need to be trained in how to recognise when a patient’s ‘physical’ illness has its basis in anxiety or depression, so therapists would need a working knowledge of the signs and symptoms of underlying physical disease.

When patients are given a diagnosis of tension myoneural syndrome (TMS), they are not told that their pain is all in the mind; they are told that it is real but is caused by a physical response to a psychological process rather than by structural damage. Alan Gordon argues that when our coping mechanisms are overwhelmed and the emotions too painful to experience, the body attempts to protect the psyche by experiencing the pain physically. In treating TMS, one of the primary goals is to help clients reframe the meaning of their pain and to use it as a guide to introspection. When Dr John Sarno introduced the concept of TMS in the late 1970s, the mind and body were widely viewed as separate entities. Now at last mainstream medicine is embracing the mindbody connection.

Sarah Browne