Psychological therapy for functional symptoms and syndromes

What are functional presentations?

Functional presentations can include symptoms that affect movement, sensation, speech, cognition, energy, pain, or other aspects of physical functioning, where the difficulties are real and often significantly disabling. Some people will have a diagnosis of Functional Neurological Disorder (FND), while others may experience functional symptoms in other domains, including alongside neurological, medical, or pain-related conditions.

Functional neurological symptoms are increasingly understood as arising from changes in nervous system functioning, rather than structural damage. Many people will, at times, notice physical symptoms that do not have a clear medical explanation — for example, headaches during periods of stress, fatigue after emotional strain, or the body “shutting down” when overwhelmed. These experiences reflect the close and continuous relationship between the brain, body, and nervous system.

Functional neurological symptoms exist within this same mind–body continuum, but are typically more persistent, more disruptive, and less easily reversible. They are not simply an exaggeration of everyday experiences, but reflect patterns within the nervous system that have become more established over time. The symptoms are real, often distressing, and can have a significant impact on day-to-day life.

The language used in this area can be highly personal. Many people have had experiences of feeling dismissed, misunderstood, or stigmatised within healthcare. I aim to understand how you make sense of your symptoms and to use language that feels accurate, respectful, and helpful to you.

How I can help

Psychological therapy for functional symptoms offers space for you to understand the patterns, pressures, emotions, beliefs, and nervous system responses that may be interacting with your experience, while supporting symptom management, adjustment, and quality of life.

Therapy may be helpful if you are living with functional symptoms in any domain, including seizures, weakness, movement disorders, fatigue, pain, cognitive difficulties, or other persistent symptoms that have been understood as functional in nature. It may also be helpful if you are trying to make sense of symptoms that do not fit neatly into a single diagnosis, or if you have felt caught between physical and psychological explanations.

My approach

My work is formulation-led, collaborative, and tailored to the individual. Depending on your needs, therapy may draw on a number of integrative approaches, which you can read more about here. The aim is not to force a particular explanation onto your experience, but to build a shared understanding that supports stability, coping, and meaningful change.

I also recognise that many people with functional presentations have had difficult or invalidating experiences in healthcare. Creating a space that feels safe, respectful, and non-judgemental is an important part of the work.

Who I work with

I work with adults and older adults experiencing Functional Neurological Disorder, functional neurological symptoms, and functional symptoms across other health domains. I also work with people whose symptoms sit alongside neurological illness, injury, chronic pain, fatigue, or other long-term health conditions; which is sometimes called "functional overlay".