!. I think there is unexpressed emotion. But often the emotions are there and expressed, only focussed on the somatic issues,e.g saddness,anger,fear about knees,backs, throats,etc. I don't think it's a fear of weakness. they often present as weak and helpless. There is an automatic denial of pschological issues.
2.We have to monitor stmptoms because these are what the patient relates to. However, we must move past their comlaining to their compliance with our behavioral plan.
3. I think we can consider it, but it must remain largely none of our business. The patient either complies or not, gets better or not we refer on if they do not benefit. We can't see in they're heads, though there are some tests for malingering. It's very difficult to find our proper boundaries with these patients, but it's important to be kind yet clinical.
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