ABSTRACT
Whilst most psychoanalytic psychotherapy within the National Health Service (NHS) is practised in `traditional' psychotherapy settings, i.e. psychological therapies services or psychotherapy departments, or sometimes by some general practice (GP) counsellors, there are large numbers of troubled patients who present to their doctors with physical symptoms for which no medical cause may be found, or where the severity of symptoms is out of keeping with the medical ®ndings (Stern, 2003). These patients rarely ®nd their way to psychoanalytic psychotherapy, and their distress and symptoms are managed by medical management (medication, `reassurance', investigations and sometimes surgery), by mainstream psychopharmacologic treatment (anti-depressant medication), by a psychological intervention (usually a brief therapy, e.g. cognitive behavioural therapy (CBT), stress management) or one of the many `alternative' therapies.
