Q: I’ve felt “spacey” for a year and a half, and I’ve had every medical test imaginable. Have you ever seen people with this symptom? Did they ever get over it, and if so how?

A: Yes, many people have reported or demonstrated “spaciness” when they came to see me.

When there is no medical answer for a symptom, a therapist can investigate by asking:
1) When did it start?
2) What was going on in your life at the time it started? Any major changes in work, relationships, etc.?
3) What improves the spaciness (even slightly) during an average day?
4) What seems to make the spaciness worse (even slightly) during an average day?

You and the therapist would be looking for a pattern in your answers.

For instance, you might find that you took on a much more challenging job when it started, it gets better when you’ve completed a tough assignment, and it bets worse when you are given a tough assignment.

Another example might be that you lost a loved one around the time the symptom started, it gets worse when anyone is angry with you, and it gets better when you feel close to someone.

If a pattern is found, you would then work on the core of the problem. (In my first example you’d need to overcome anxiety and improve your self-image and sense of competence. In the other example you’d look at facing the loss of the loved one and learning that you can still thrive without the person.)

You are wise to have checked out all of the medical possibilities. And, yes, I’d suggest now that you talk with a therapist about the psychological possibilities — even if you believe you have answered my four questions and can’t find any connection. (If you’ve had this problem for a couple of years and if there is a psychological basis for it which you’ve never realized, there might be some denial going on.)

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