When symptoms continue without clear answers

Psychological therapy isn’t simply what happens once medicine has reached the limits of what it can currently explain or treat.In practice, many people come to see me once medical investigations have largely been completed, but their symptoms continue to affect their daily life. They often describe feeling stuck. They’ve seen specialists, had tests, and been told that nothing serious has been found, yet they still don’t have an explanation that makes sense to them or a clear plan for moving forward.For people with these symptoms, psychological therapy may offer a different perspective, helping you understand how your brain, body and nervous system are interacting, and finding practical ways to reduce the impact symptoms have on your life.If you’re still developing new symptoms or undergoing ongoing medical investigations to rule out serious conditions, I would usually encourage you to continue with these alongside considering whether therapy might also be helpful.

No - and I cannot stress this enough.I understand why many people worry about this. By the time they come to see me, they’ve often been told that medical tests haven’t found a clear explanation for their symptoms. It can feel as though the conversation has shifted from “something physical is happening” to “it must be psychological instead”. I don’t find this to be a helpful way of understanding symptom experiences.The reality is that our healthcare system is still largely organised around a distinction between physical and mental health. That works well for many conditions, but it becomes much more difficult when symptoms don’t fit neatly into one category or the other.Sometimes medicine reaches the limits of what it can currently explain or treat. That doesn’t mean your symptoms aren’t real, and it doesn’t mean anyone thinks you’re imagining them. It simply means you’ve reached the point where a different kind of understanding may be helpful.Psychological therapy isn’t a consolation prize after medicine has “failed”. It’s an evidence-based way of understanding how the brain, body and nervous system work together, helping people make sense of persistent symptoms and find practical ways to move forward.

Definitely not! Psychological therapy is one part of quality medical care, not an alternative to it. When supporting someone with ongoing physical health symptoms, a multidisciplinary approach is often the gold standard. This means that therapy sits alongside the expertise of whichever health professionals are involved in your care. Depending on your needs, this might include your GP, medical consultants, specialist nurses, physiotherapists, occupational therapists, speech and language therapists, or other allied health professionals.I am used to working as part of multidisciplinary teams, and in my experience the best outcomes often come when professionals work collaboratively. With your permission, I am always happy to liaise with others involved in your care to ensure we’re working towards the same goals.

For some people, symptoms improve significantly. For others, the biggest change is that symptoms become less frightening, less disruptive and take up less space in their lives.While symptom improvement is always welcome, it isn’t the only measure of progress. Therapy focuses on helping you better understand what’s happening, reducing the impact symptoms have on your life, and helping you build a life that isn’t defined by them.Many people find that, over time, shifting the focus away from constantly trying to eliminate symptoms and towards living a meaningful life can be an important part of recovery.In other words, we work on putting you back in the driving seat of your own life.

As a clinical psychologist, I am trained in a range of evidence-based psychological therapies. Some of the specific therapies I use are Acceptance and Commitment Therapy (ACT), Compassion-Focused Therapy (CFT), Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Psychologists are trained to use formulation (our way of making sense of a person’s unique experiences and difficulties) to determine the best approach for your unique situation. Rather than following a fixed programme, I tailor therapy to the individual sitting in front of me, taking into account your symptoms, experiences, preferences and goals.

Appointments are 50 minutes long.My clients usually attend either weekly or fortnightly. When we meet, we would discuss an appropriate frequency for effective therapy, taking into account your schedule and budget.

I work Monday to Thursday.I see patients in person on Wednesdays at Central Health London, a multidisciplinary clinic in Marylebone. This setting is particularly well suited to supporting people with persistent physical symptoms, as it enables collaborative working with other healthcare professionals when appropriate.I also offer home visits for neurorehabilitation clients in the community. These appointments are arranged on an individual basis and include travel charges.Alongside face-to-face appointments, I offer online therapy for clients throughout the UK and internationally where appropriate.

It depends on the condition, and I’ll always be honest with you about what we know and what we don’t.For chronic pain that isn’t explained by another condition, NICE guidance in England recommends psychological therapies such as CBT and ACT as part of managing pain, alongside exercise. For functional neurological symptoms, research is still developing. In the largest UK trial of CBT for functional seizures, adding therapy to specialist medical care didn’t significantly reduce the number of seizures, but it did bring benefits on other measures that matter to people’s lives. This is one reason I describe therapy as one part of your care rather than a replacement for it.If you’d like to read more about the evidence for your own symptoms, I’m happy to talk it through or point you towards good sources.