Dr. Allan Abbass is a medical professional, but he often witnesses what are akin to miracles.
Over the past 15 years, Dr. Abbass, a psychiatrist and the program co-ordinator for the Centre for Emotions and Health at the QEII Health Sciences Centre, has watched more than a dozen patients come into his office in a wheelchair, and leave treatment walking.
“It is about recognizing and changing how the body handles emotions. Due to adverse life events, people lose ability to experience emotions or were never able to develop that ability in the first place,” says Dr. Abbass.
Since 2002 the centre has been helping people with emotional and psychological disorders using a form of treatment called intensive short-term dynamic psychotherapy. Struggling with everything from maintaining relationships to poor physical health, most of the people who come to the centre have bounced around the healthcare system for years, often ending up in the emergency room with painful, medically unexplained symptoms.
In Halifax, one in six emergency room visits and one in 12 hospital stays are due to medically unexplained symptoms, says Dr. Abbass. The patients’ pain and symptoms are real and include everything from depression to irritable bowel syndrome to memory loss. Doctors treat the symptoms, often with medications, but are left searching for a deeper cause because magnetic resonance imaging (
“Everyone can relate to having physical symptoms related to stress,” says Dr. Abbass, referring to the common problems such as tense shoulder or jaw muscles when under stress. In most situations, when the stress is removed, the symptoms usually go away.
For patients who come to the centre, the symptoms haven’t gone away — they have worsened. Referred to the centre by a specialist, the typical patient Dr. Abbass sees is about 40 years old and has suffered from physical and emotional problems since teenage years. They are often on medication for their physical symptoms, he says. These symptoms are so debilitating that as many as one third of the close to 250 patients the centre sees annually are on disability and unable to work.
The good news, says Dr. Abbass, is that studies have shown that intensive short-term dynamic psychotherapy reduces both medical and hospital costs dramatically. Treatment, consisting of an average of seven talk sessions with a psychotherapist, costs about $500, but results in a $12,700 reduction in hospital costs and doctors’ visits, he says. After treatment, 80 per cent or more of the patients who were unable to work, return to the workforce. Often a noticeable change in the patient can be seen after three sessions, he adds.
Using the intensive psychotherapy, Dr. Abbass and his small team at the centre help patients view psychological disorders through the lens of attachment. As children, many of the centre’s patients experienced the death of a parent, abuse or neglect and were left with pain, intense anger, and guilt about the anger. Fearing these emotions, they learned to avoid them and also to avoid closeness with people. As adults, these blocked emotions often show up as anxiety or medically unexplained symptoms.
When these emotions are unblocked and experienced, patients often feel an immediate drop in tension, anxiety, and other physical symptoms, says Dr. Abbass, who teaches the intensive psychotherapy around the world and has more than 175 publications. In 2015, he published a book called
One adult woman, who suffered horrible abuse and abandonment in her life, came to Dr. Abbass with an inability to speak. She hadn’t spoken a word for several weeks. In the first meeting, Dr. Abbass helped her to recognize and feel some of her feelings about recent stress and she was spontaneously able to speak. In a short treatment course, when she could feel strong emotions without fear of acting out and hurting someone, she was able to maintain a strong voice and advocate for herself.
Another patient came to Dr. Abbass with severe back pain on long term disability. In the first meeting they explored the patient’s anxiety and helped him feel his suppressed emotions of anger, guilt, and grief that were being triggered by the illness of his mother.
“When he felt these emotions, the emotional tension left his body, his back pain ceased immediately,” says Dr. Abbass.
The relief was so dramatic he returned to work soon after.
“Although every person doesn't respond to the treatment approach, the fact that many respond quickly and inexpensively means talking therapy like this should be a first treatment with medically unexplained symptoms. A lot of people don’t know they have an option to talk about these things so they seek medical care instead,” says Dr. Abbass.