Dear constantwonderer,
Thank you for your post, I was thinking along exactly the same lines. Sometimes we can be so keen to try and help someone we forget to ask the main question: are manual/passive techniques the best approach for this patient? My gut feeling (which it has to be in this case without face to face interviewing) is that this patient needs help by gradually challenging some learnt responses. This in no way is disputing the reality of her symptoms or calling her neurotic. May be she just requires a different approach? Neuroplasticity may explain and help treat some of her symptoms.
Regards,
Monkey