The most common theme I work with in therapy is complexity. I am not sure if 'complex' has become more frequent over the years, if the modern world has opened up scope to it (we are surviving much more), or something else.

'Complex' used to be the term I was familiar with when anyone used the NHS had 2 or more chronic physical or mental health conditions, particularly when their treatments could interact with each other. The treatments required extra consideration and care. The term I have seen more recently is 'multimorbidity'. I have had some point out the death part of the word 'morbid', but these terms seem to come and go!

More interestingly I find, is that those who have complexity, or many who I work with, for example with Ehlers Danlos Syndrome (EDS), vestibular disorders, hypermobility syndromes, tinnitus, early deafness / hearing loss / tinnitus, certain ataxias, brain injuries and so on; have often faced multiple diagnoses and see their lives as totally normal and not 'complex'.

What is complex, is the barriers they face within services, professionals struggling to manage the different systems; preferring to box off the brain from the gut, from sensory input and from mental health. People talk of brick walls, being medically gaslighted and dismissed. Far from being complex, to me, their stories make a lot of sense. This is very different to the complexity you might see with pharmaceutical interactions with large numbers of medications, the intensive care procedures and so on. This is people living with long term conditions and disabilities, some who are quite young, and it is their norm.

It takes a special professional to hone in on the problem and be confident to speak up. I had an otoneurologist who agreed with my rejection of an ENT consultant's diagnosis (I simply did not meet the NICE guideline criteria). I never imagined what he was going to suggest however; it took him a confidence to say that my background was unique enough that he was willing to suspect what it was. It worked. It has meant long term management for me, but he referred me on to an equally experienced professional who spotted the dynamics in me as a person, and how I was juggling my conditions.

To be on the receiving end of sensitive care led to extremely short number of sessions required (2), more empowered strategies for living and a sense of how I want to empower others to understand how the mind and body work together. Complexity really can be in the eye of the beholder sometimes.