Functional symptoms are physical problems that arise from the way the nervous system is functioning, rather than from disease or structural damage. These are common, often misunderstood, and can be as disabling and painful as illnesses with a clear physical cause.

Neurological: Non-epileptic seizures, functional weakness or paralysis, sensory disturbances (numbness, tingling), tremors, dizziness, visual changes.

Gastroenterological: Irritable bowel-type symptoms (bloating, pain, diarrhoea or constipation), nausea, indigestion.

Respiratory: Shortness of breath, tight chest, hyperventilation, chronic cough or throat tightness (often called Inducible Laryngeal Obstruction or functional breathing pattern disorders).

Urological: Urinary urgency, frequency, pain without infection, retention.

Before considering psychological treatment, it is essential that any physical symptoms are fully investigated by medical professionals. This ensures that any underlying medical conditions are identified and treated appropriately. Only when these have been ruled out or clarified is it appropriate to explore psychological assessment and potential treatment.

Research has shown that while many psychological treatments focus on managing symptoms of functional disorders, Intensive Short-Term Dynamic Psychotherapy (ISTDP) is the only psychological approach with an evidence base for actually reducing symptoms, not just helping people cope with them.

ISTDP is a psychodynamic therapy that focuses on identifying and processing unconscious emotional processes that can drive physical symptoms. Many functional symptoms arise when the nervous system becomes overwhelmed by stress, emotion, or unresolved trauma. In some cases, this distress is outside of conscious awareness. ISTDP helps bring these emotional patterns into focus and resolve them, offering the possibility of real change—not just management.