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Communication blocks and the power of rethinking
  1. Abi Berger
  1. General Practitioner, London, UK
  1. Correspondence to Dr Abi Berger; journal{at}

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I’ve been feeling a bit stumped recently. I think of myself as a good detector of psychosomatic illness – by which I mean those instances where real physical illness is driven by life experience or psychosocial distress and not by organic pathology. There are few areas where I encounter more of this than in sexual and reproductive healthcare. I am interested in offering patients suffering from ‘mind-body’ illness appropriate forms of support, rather than inappropriate treatment and investigation. But recently, I’ve found the strategies I employ to explain what I think is going on to patients in this situation have not been working as well as they usually do, and wonder why not.

With over 20 years of clinical practice behind me, I’ll request investigations where they are …

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