Objective: We examined whether the treatment effects from a previous RCT of Internet-delivered Emotional Awareness and Expression Therapy (I-EAET) for somatic symptom disorder were maintained 12 months after treatment.

Method: 12-month assessments of self-reported somatic symptoms, pain severity, and several secondary outcomes were compared with baseline and post-treatment levels within the I-EAET condition only, given that the waitlist control condition had already received treatment. Twenty-eight out of the original 37 participants (76%) in the I-EAET condition provided follow-up data.

Results: The beneficial effects of I-EAET on somatic symptoms observed at post-treatment were maintained at the 12-month follow-up (d = -0.22, 95% CI: -0.72 to 0.28), as well as for pain intensity (d = -0.02, 95% CI: -0.52 to 0.48). From pre-treatment to 12-month follow-up, there was a medium effect on somatic symptoms (d = 0.74, 95% CI 0.23 to 1.24), and a small, non-significant effect for pain intensity (d = 0.43, 95% CI -0.06 to 0.93). Response rates (at least 50% symptom reduction) at 12-month follow-up were 25% for somatic symptoms, and 12% for pain intensity.

Conclusion: I-EAET seems to have positive long-term effects for somatic symptom disorder. Larger studies with controls and comparisons to other treatments are needed.

Functional Somatic Disorders (FSD) present a significant challenge in the health-care system, characterized by persistent, distressing physical symptoms without sufficient medical or psychiatric explanations. This conceptual analysis explores the psychodynamic approach to understanding emotional factors influencing FSD, proposing a new psychological specifier. While current diagnostic frameworks, such as DSM-5’s Somatic Symptom Disorder (SSD) and ICD-11’s Bodily Distress Disorder (BDD), incorporate psychological components, they do not fully address emotional dynamics. This paper advocates for integrating emotional factors into diagnostic criteria. The proposed specifier focuses on emotional factors such as unresolved grief, trauma, and unmet needs, which can exacerbate or cause somatic symptoms. Six signs indicative of emotional influence on somatic symptoms are discussed, emphasizing a collaborative investigative approach. Incorporating this specifier could enhance diagnostic accuracy, treatment planning, and patient outcomes by acknowledging the interplay between emotional and physical health.

This text explores the evolution, efficacy, and unique challenges of psychodynamic teletherapy, tracing its roots from historical epistolary methods to modern internet-based treatments. Psychodynamic teletherapy, particularly in its synchronous (e.g., video conferencing) and asynchronous (e.g., guided self-help) forms, has garnered increased attention due to its potential to bridge geographic barriers and enhance accessibility. Despite these advantages, concerns persist regarding the translation of psychodynamic principles—such as the therapeutic relationship and the exploration of emotions—into a virtual setting. Evidence suggests that while teletherapy can be effective, it may pose challenges in fostering deep emotional connections and replicating the in-room therapeutic experience. This text examines psychodynamic teletherapy outcome studies, therapist and patient experiences, and the necessity for adapting psychodynamic interventions to maintain therapeutic efficacy in remote formats, especially by creating tele-presence, or the feeling of a shared reality despite the remote setting. The text also highlights the need for flexibility and new skills to navigate the evolving landscape of psychodynamic treatment at a distance.

There is a growing interest in clinical interventions targeting emotion regulation difficulties across mental health conditions. Experiential dynamic therapies (EDTs) are transdiagnostic, affect-focused, short-term psychodynamic therapy models that emphasize in-session emotional processing. This review provides a 10-year update on the efficacy of EDTs for mood, anxiety, personality and somatic symptom disorders in adults and children/adolescents. A comprehensive search identified 57 randomized controlled trials (n = 4330) conducted in Western (k = 38; n = 3178) and non-Western countries (k = 19; n = 1152) between 1978 and 2024. Random-effects meta-analyses on primary outcomes indicated large, significant effects for EDTs compared to inactive controls at post-treatment (Hedge's g = −0.96; k = 41) and follow-up (g = −1.11; k = 20). Compared to active controls, effects were small and non-significant post-treatment (g = −0.17; k = 27) but became significant at follow-up (g = −0.40; k = 19), suggesting a potential modest long-term advantage of EDTs. Despite substantial heterogeneity (I2 > 75%), results remained robust in sensitivity analyses. Moderator analyses revealed few significant findings, indicating relative consistency across diagnostic groups, treatment formats and active comparators. Non-Western and lower quality studies reported larger effects compared to inactive, but not active, controls. While cautious interpretation is warranted due to unexplained heterogeneity, findings support EDTs as efficacious transdiagnostic interventions for emotional disorders, with sustained benefits over time. Future research should prioritize large-scale, methodologically rigorous trials that explore mechanisms of change, optimize treatment delivery and identify moderators of long-term outcomes.

Background: Persistent physical symptoms (PPS), including (primary) pain, can, according to Emotional Awareness and Expression Therapy (EAET), be precipitated, perpetuated, and prolonged by emotional processes related to unresolved trauma and psychosocial conflicts. EAET is a novel, short-term, psychodynamic- and emotion-focused psychological treatment that targets these etiological factors, intending to substantially reduce or eliminate pain and/or somatic symptoms. Objective: This article provides an overview of EAET’s theoretical background, core treatment principles, and empirical evidence from randomized controlled trials (RCTs) in alleviating somatic symptoms in people with PPS. Moreover, the potential of EAET and future research directions are discussed. Methods: We report a selective literature review synthesizing the foundations and treatment characteristics of EAET and the findings from RCTs investigating EAET since 2017. Results: Grounded in psychodynamic theory, with influences from affective neuroscience and emotion-focused therapy, the core treatment principles are reframing symptom explanations, fostering emotional processing, and facilitating corrective interpersonal experiences. EAET has been implemented in various formats, including individual therapy, group therapy, and internet-administered self-help. Since 2017, seven RCTs have been published, demonstrating efficacy in reducing symptoms, which appears superior to cognitive–behavioral therapy. Conclusion: EAET is particularly effective for treating chronic (primary) pain conditions such as fibromyalgia and musculoskeletal pain. However, further studies are required to evaluate its long-term efficacy, determine patient characteristics associated with positive outcomes, and better understand its most active mechanisms.

Hintergrund: Anhaltende Körperbeschwerden, einschließlich (primärer) Schmerzen, können – gemäß der „emotional awareness and expression therapy“ (EAET) – durch emotionale Prozesse bei unbearbeiteten Traumata und psychosozialen Konflikten ausgelöst und aufrechterhalten werden. Die EAET ist eine neuartige psychodynamische und emotionsorientierte Kurzzeitpsychotherapie, die auf diese ätiologischen Faktoren fokussiert, um Schmerz und/oder die somatische Symptomatik erheblich zu reduzieren oder zu beseitigen.

Ziel: Der vorliegende Beitrag bietet einen Überblick über den theoretischen Hintergrund der EAET, die zentralen Therapieprinzipien und die empirische Evidenz aus randomisierten, kontrollierten Studien (RCT) zur Linderung somatischer Symptome bei Patienten mit anhaltenden Körperbeschwerden. Darüber hinaus werden das Potenzial der EAET und zukünftige Forschungsfragen diskutiert.

Methode: Wir präsentieren eine selektive Literaturübersicht, welche die Grundlagen und Therapiemerkmale der EAET sowie die Ergebnisse von RCT zur EAET seit 2017 zusammenfasst.

Ergebnisse: Auf Grundlage der psychodynamischen Theorie und mit Einflüssen aus der affektiven Neurowissenschaft und der emotionsorientierten Therapie sind die zentralen Behandlungsprinzipien das Reframing des Krankheitsmodells, die Verbesserung der Emotionsverarbeitung und die Förderung korrigierender interpersoneller Erfahrungen. Die EAET wurde in verschiedenen Formaten umgesetzt (Einzeltherapie, Gruppentherapie und internetbasierte Selbsthilfe). Seit 2017 wurden 7 RCT veröffentlicht, die eine Wirksamkeit hinsichtlich der Symptomreduktion zeigen, die der kognitiven Verhaltenstherapie überlegen zu sein scheint.

Schlussfolgerung: Die EAET ist besonders wirksam bei der Behandlung chronischer (primärer) Schmerzstörungen wie Fibromyalgie und Schmerzen des Bewegungsapparats. Es sind jedoch weitere Studien erforderlich, um die Langzeiteffekte zu bewerten, Patientensubgruppen mit besonderem Therapieansprechen zu identifizieren und die wichtigsten Wirkmechanismen besser zu verstehen.

Patients with functional somatic symptoms or medically unexplained symptoms are very common in the healthcare system but they do not always receive adequate care or treatment. These patients struggle with a low quality of life and constitute a high cost to the healthcare system. Cognitive Behavioral Therapy is a relatively common treatment intervention and helps many patients, but not all. Short-term psychodynamic therapy has recently been evaluated in several meta-analysis and have been found to be clearly effective. A major focus of short-term psychodynamic therapy is on emotional processing of stressful or traumatic life events. At present, these psychodynamic short-term therapies are not offered in regular care, despite the solid research support that exists. Short-term psychodynamic therapy should be considered a complement to the range of treatments that already exist for patients with functional somatic symptoms.