a Centre for Emotions & Health, Department of Psychiatry , Dalhousie University , Halifax , Canada.
b Clinical Trials and Population Studies , Plymouth University Peninsula Schools of Medicine and Dentistry , Plymouth , UK.
Psychother Res. 2019 Jan;29(1):86-98. doi: 10.1080/10503307.2017.1300353. Epub 2017 Mar 13.
Evidence of the contribution of emotional processes to the emergence, maintenance, and experience of medically unexplained symptoms (MUS) suggests that clinical approaches which target these processes could be beneficial. In this study, qualitative methods were used to examine patients' perspectives and subjective experiences of emotional processes in the context of a psychotherapy assessment and treatment service for MUS provided in a hospital emergency department (ED).
Seven semi-structured interviews were conducted with ED patients presenting with MUS who received a course of intensive short-term dynamic psychotherapy treatment.
Interpretative phenomenological analysis was employed with three superordinate themes emerging: Barriers to examining emotional processes; reflections on the therapeutic process; psychological change; and improved well-being. Obstacles to clinical engagement in treatment for MUS were described in relation to patients' and therapists' ability to identify, address, and utilize emotion processes. Specific elements of this work were identified as integral components of the psychotherapy change process for MUS.
Directly observing the physical effects of emotional experiencing in MUS provides sensory evidence that can enable patients to make mind-body connections. Psycho-emotional processes warrant further study to explore the applicability to other conceptual models for assessing and treating MUS. Clinical and methodological significance: In this article, we highlight that Medically Unexplained Symptoms (MUS) are a priority area for both physical and mental health care services. We present findings relevant to the effectiveness of a novel psychotherapy innovation within a hospital emergency department (ED). The use of interpretative phenomenological analysis to study the experiences of ED clients with MUS offers an established qualitative method for exploring the processes underlying therapeutic change. The results provide new insights around obstacles to engagement alongside potential solutions when addressing the psychological needs of clients with MUS. Although emotion processes have been described as a potentially important change process for MUS and in psychotherapy more generally, little empirical research has studied these two areas collectively.
情绪过程对医学无法解释症状（MUS）的出现、维持和体验的贡献的证据表明，针对这些过程的临床方法可能是有益的。在这项研究中，使用定性方法研究了在医院急诊部（ED）提供的 MUS 心理治疗评估和治疗服务背景下，患者对情绪过程的观点和主观体验。
对因 MUS 而在 ED 就诊并接受强化短期动态心理治疗的患者进行了 7 次半结构化访谈。
采用解释现象学分析，出现了三个上位主题：检查情绪过程的障碍；对治疗过程的反思；心理变化；以及幸福感提高。描述了与患者和治疗师识别、处理和利用情绪过程的能力相关的 MUS 治疗障碍。这项工作的具体要素被确定为 MUS 心理治疗变化过程的组成部分。
直接观察 MUS 中情绪体验的物理影响可以提供感官证据，使患者能够建立身心联系。需要进一步研究心理情绪过程，以探索其在评估和治疗 MUS 的其他概念模型中的适用性。
本文强调 MUS 是身体和心理健康护理服务的重点领域。我们提出了在医院急诊部（ED）内进行新型心理治疗创新的有效性相关的发现。使用解释现象学分析来研究 ED 患者的 MUS 体验为研究治疗变化背后的过程提供了一种既定的定性方法。研究结果围绕着在解决 MUS 患者的心理需求时遇到的参与障碍以及潜在的解决方案提供了新的见解。尽管情绪过程已被描述为 MUS 和心理治疗更普遍的潜在重要变化过程，但很少有实证研究将这两个领域结合起来进行研究。
