1. Psychosoma in the consulting room: an ethnographic study of medically unexplained symptoms as experienced by both therapist and client
John Hills
Postgraduate Research Student, University of Leeds
Supervisors: Dr Jane Cahill, Dr John Lees, Prof Dawn Freshwater
@johnhillsmusic
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2. Medically Unexplained Symptoms
Somatic symptoms, functional symptoms, conversion disorders etc.
Chronic pain, fatigue, digestive, dermatological, vestibular, neurological
Psychosomatic disorder if ‘there is evidence of psychological factors influencing such symptoms’ (Yasky et al, 2016)

3. Autoethnography
Bridging MA autoethnographic study and PhD Wounded healer (Sedgwick, 1994) - ‘Look into the soul’ of the therapist - Fantasies of cure (Totton, 2003)
Somatic experiencing
- Woman, 60s, PNES – defences (syntonic)
- Woman, 70s, sickness – empathic
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4. Methods – Ethnography, Indexicality
Diaries, case notes, dream material and biographical events Ethnographic concern for meaning making and local context
Indexicality (Peirce, 1903) – information contained in a sign
Change Process Research e.g. Innovative Moments (Gonçalves et al, 2011)
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5. Psychosomatic profiles
Recreating an internal milieu (Brown and Reuber, 2016)
- The Body Remembers e.g. Quinn et al (2012)
- profile of my own chronic pain
Relational dimension: attachment and role-strain e.g. (Theodoratou-Bekou et al 2015)
Rothschild (2000) technique of ‘shuttling’ between A and B
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6. Patterns of change
Any illness narrative better than no illness narrative (Deary et al, 2004)
Illness-centric orientations superseded by life affirming-orientations (e.g. living well with chronic illness)
Shifts in interpretations of symptoms (e.g. not catastrophising) – improving subjective experience
Actual alleviation from symptoms (e.g. in reduction in incidence, skin area covered etc.)
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7. Thanks for listening! John Hills hc11j3wh@leeds.ac.uk @johnhillsmusic
Brown, R.J. & Reuber, M Towards an integrative theory of psychogenic non-epileptic seizures (PNES). Clinical Psychology Review 47 (2016) 55–70
Deary, V., Chalder, T. & Sharpe, M The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review. Clinical Psychology Review, .27
Gonçalves, M.M., Ribeiro, A.P., Mendes, I., Matos, M. & Santos, A Tracking novelties in psychotherapy process research: The innovative moments coding system, Psychotherapy Research, 21:5,
Hills, J., Lees, J., Freshwater, D., & Cahill, J Psychosoma in Crisis: An autoethnographic study of medically unexplained symptoms and their diverse contexts. British Journal of Guidance and Counselling
Peirce, C.S A Syllabus of Certain Topics of Logic. Alfred Mudge & Son, Boston
Quinn, M. C., Schofield, M. J., Middleton, W., ID & Scholfield, M. J. O. H. O. O Successful psychotherapy for psychogenic seizures in men. Psychotherapy Research, .22, pp
Rothschild, B The body remembers: The psychophysiology of trauma and trauma treatment, New York, NY, W W Norton & Co; US
Sedgwick, D The wounded healer : countertransference from a Jungian perspective, London, New York, Routledge.
Theodoratou-Bekou, M., Andreopoulou, O., Andriopoulou, P. & Wood, B Stress-related asthma and family therapy: Case study. Annals of General Psychiatry, 11, 10
Totton, N Body psychotherapy : an introduction, Maidenhead, Open University Press
Yasky, J. King, R. & O’Brien, T Resistance, early engagement and outcome in psychoanalyticpsychotherapy of patients with psychosomatic disorders. Counselling and Psychotherapy Research, December 2016; 16(4): 266–276
John Hills @johnhillsmusic
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