Invalidating symptom definition

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Sufferers strive to become ‘good’ patients: strong, in spite of illness and disability and not ‘crazy, lazy, illness-fixed or weak'.The doctor–patient relationship has undergone significant changes in recent decades.They often describe feeling blamed for their own distress.Because of this, they can experience deep feelings of worthlessness and shame.Patients are more informed and able to access and discuss extensive medical information online.

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Management includes validating their suffering, helping them construct appropriate explanations for their distress and providing empathic interpersonal care, while minimising the risk of iatrogenic harm.

We recognise their suffering, but at the same time struggle with the feelings they trigger in us. Without a diagnosis they lack a narrative or vocabulary to make sense of their own suffering.

This article explores some of the challenges faced and strategies utilised when managing patients with medically unexplained symptoms.

Doctors and patients often experience frustration and helplessness in consultations around medically unexplained symptoms.

Without a diagnosis, patients lack social legitimacy as ‘sick’ people with ‘real’ illnesses.

As his general practitioner (GP), Matalon struggled with feelings of worthlessness, frustration, anger and guilt.

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