How do you approach patients who identify so strongly with being sick or with a particular diagnostic label that it makes up a significant portion of their identity?

In many cases, the point at which this question is being asked is one at which the train has already left the station, and sickness as a way of life/career has set in. Unfortunately, with functional somatic syndromes, there is data suggesting that self-rated quality of life and functioning are lower...

I ask patients who are stuck in a pattern, such as over-identifying with an illness I ask them three questions. Each one requires in-depth work.

1. Do you want to change?
2. Do you believe you are capable of change?
3. Will you commit to working toward change?

Going through these may take several sessions,...