CBT for FND – understanding the missing link
CBT for FND – understanding the missing link
Cognitive Behavioural Therapy 101: the ‘hot cross bun’ formulation is the bedrock of therapy sessions following a CBT model. It is a starting point for understanding people’s difficulties and something that is referenced throughout the course of treatment. Four key elements are discussed:
– First, the emotions a person is feeling – commonly sadness, anxiety and anger are what being people to therapy.
– Second, the actions or behaviours that people are doing in the moment in response to or as an attempt to manage or change some of their feelings.
– Third, the thoughts that go through a person’s mind at any one time that influence their interpretation of events or situations.
– Finally, and, most importantly in terms of this article, the physical sensations that a person experiences.
These physical sensations are in the body but, as captured in the CBT ‘hot cross bun’ formulation, are intimately connected with the mind. But, unfortunately, for many people, including people with functional neurological disorders (FND), there is a missing link. This missing link between the mind and the body is, historically, inherent to our healthcare culture. We have divided physical health services and mental health services. And while this may be shifting, this division, without the acknowledgment of the mind body link, as in the CBT ‘hot cross bun’ formulation, means that people with physical sensations that are not explainable by pathological mechanisms in the body, such as people with a diagnosis of FND, can fall through the gaps in our healthcare service provision. Now, I am not saying that these, sometimes very uncomfortable physical sensations (such as pain), are ‘all in the mind’, but what CBT proposes is that the mind communicates via the body. And this means that mental pain can sometimes manifest as physical pain. Understanding this missing link is crucial when it comes to treating conditions such as FND with psychological treatments, like CBT. If we can help someone reintegrate their mind and body, we may be one step closer to finding ways in which a person can manage the things about their health that they find challenging. This might mean exploring the thoughts or interpretations of symptoms such as pain; it might mean drawing out the emotions that are triggered or associated with the uncomfortable physical sensations; and, the hopeful message is, that tapping into our minds can can prompt us to do things that take away some of the distress.
At The London Neurocognitive Clinic we have clinicians who work with people suffering from FND to help improve their quality of life, please get in touch if you feel you could benefit from this help.
