“The doctors say they can’t find anything wrong, but why am I still so bad then? If I’m not ill then I must be going mad mustn’t I?” Rachel* was crying, and dabbed at her eyes with a tissue. “Look”, she said to me, “I’m shaking now – why do they think there’s nothing wrong?”
Rachel had asked to come to see me for help with a constant tremor in her hands. I’d asked her if she had a diagnosis for what was causing them, and it was the fact that nothing had been found that started her crying. Clearly things were more complicated than they first looked, and I asked her to tell me about her tremors from the very start.
“It’s been going on for seven years now. I’ve had all sorts of tests and scans, a lot of them twice, and they still can’t tell me what’s wrong. In fact they’re washing their hands of me. They’re telling me that it’s all in my mind, and there’s nothing wrong with me at all”.
Rachel’s troubles had started soon after she started what had been her dream job, working for a charity. After a few months she noticed pins and needles in her hands and arms, which she thought might be because she was using the computer a lot more. The pins and needles gradually went away but then she noticed pains down her arm and wrists. This is when the visits to her doctor, and referrals to specialists, started.
At first Rachel was told it was RSI, but she wasn’t convinced. It didn’t respond to treatment, and in fact she noticed that her grip was sometimes weak, and she was aware of her hands feeling ‘wrong’. As her symptoms changed and developed she was sure that she had MS, but tests and scans ruled that out.
Then she was convinced she had MND, again ruled out by tests and scans. Then a rare form of epilepsy, again ruled out, and just recently Parkinson’s, ruled out again. Rachel had been assured that there was no physical cause for her tremors, and had been referred to a psychiatrist.
I told her that there not being a physical cause for her tremors didn’t make them not real. They were real, and they were causing her distress. In fact her anxiety about her health, and the constant visits to doctors and hospitals, had been distressing her for the last seven years.
Treating her was about two ideas. The first was helping her learn to stop focusing on her physical symptoms. They were signs of stress, and the stress was caused by her anxiety about her physical symptoms. The second was looking for the underlying psychological cause, a process that I encouraged her to start by promising to see the psychiatrist.
* Rachel’s real identity has been protected, and she is happy to share her story.
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