Megan is a 28 year old single woman who has been referred to you for evaluation. She tells you. “My doctors wanted me to see you because

Megan is a 28 year old single woman who has been referred to you for evaluation. She tells you. “My doctors wanted me to see you because they think all my problems are in my head. They tell me they can’t help me anymore.” She tells you she has had abdominal and pelvic for about a year to 18 months. She has seen 6 different providers and specialists about these issues. She has had multiple medical tests including bloodwork, xrays, CT scans, endoscopies, colonoscopies, and a pelvic laparoscopy. All of these test have been normal and showed nothing that could be the cause for her pain and other symptoms. She also has been on multiple medications for pain and her other symptoms. She describes her physical symptoms as “belly and female pain.” She reports abdominal bloating, nausea, no vomiting, alternating constipation and diarrhea, irregular and painful menses, no vaginal discharge. She rates the pain as “15 out of 10.” The pain occurs daily, she cannot really relate anything specific that causes the pain, but nothing seems to help. She tells you “I worry about the pain and what’s wrong with me all the time and what is going to happen

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