What Is The Symptom "hiding"?

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Video: What Is The Symptom "hiding"?

Video: What Is The Symptom "hiding"?
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What Is The Symptom "hiding"?
What Is The Symptom "hiding"?
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The language is not used in all communications

Joyce McDougall

The article deals with the situation when the client “brings” his symptom to the therapist as a problem. In general, this is a fairly common practice for therapy. When a client himself comes to a psychotherapist / psychologist with a symptomatic request, he, as a rule, already suspects that his symptom is related to his psychological characteristics and is ready to work in the psychological paradigm of symptom formation.

In this article, a symptom is considered in a broad sense - as any phenomenon that gives the client himself or his close environment inconvenience, tension, pain. In this case, a symptom can be understood not only as somatic, psychosomatic, mental symptoms, but also behavioral symptoms. (See the concept of a symptom as a complex systemic phenomenon.)

The psychologist / psychotherapist, by virtue of his professional competence, deals with psychosomatic, mental and behavioral symptoms. Somatic symptoms are the area of professional competence of the doctor.

Somatic and psychosomatic symptoms are similar in clinical presentation, they are manifested by the client's complaints of pain in various bodily organs and systems. Their difference is that psychosomatic symptoms are psychogenic in nature (psychologically conditioned), although they manifest themselves bodily. In this regard, psychosomatic symptoms fall into the field of professional interest of both psychologists and physicians.

Mental symptoms are more often associated with the discomfort they cause. Examples: phobias, obsessions, anxiety, apathy, guilt …

Behavioral symptoms are manifested by various deviations in the client's behavior and to a greater extent interfere not with the client himself, but with other people. For the same reason, most often it is not the client himself who turns to the specialist, but his relatives with a request "Do something with him …". Examples of this kind of symptoms are aggression, hyperactivity, deviance … Behavioral symptoms, due to their "antisocial" orientation, place great demands on the therapist's professional and personal position, "challenge" his resources of understanding and accepting the client. ()

Symptoms are not always pain-related. Sometimes they are even pleasant, such as compulsive masturbation. However, the conscious attitude of the client himself and (or) his immediate environment towards them is always negative.

The symptom is characterized by the following:

· Comparatively strong influence on others;

· He is involuntary and cannot be controlled by the client;

· The symptom is fixed by the environment, the client acquires a secondary benefit due to the symptom;

· Symptomatic behavior may be beneficial to other family members.

When working with a symptom, you need to remember a number of rules. These guidelines are the result of my psychotherapy practice with clients who are symptomatic. Here they are:

The symptom is a systemic phenomenon

Often, in working with clients, there is a temptation to consider a symptom as something autonomous, devoid of any semantic connection with the system (organism, family system).

However, the symptom should always be viewed not as a separate phenomenon, but as an element of a wider system. The symptom never occurs autonomously, it is "woven" into the tissue of the system. The symptom is necessary and important to the system during this period of its existence. Through it, she decides some important function for herself. The system possesses vital wisdom and “chooses” the symptom least dangerous at this stage of functioning for its life. A psychotherapeutic mistake would be to view the symptom as a separate, autonomous phenomenon and try to get rid of it without realizing its significance for the system. The symptom should never be attacked directly by the therapist. Such elimination of the symptom often leads to psychotic disintegration of the client, withdrawal of the symptom deprives him of a vital protective mechanism (see in more detail G. Ammon. Psychosomatic therapy).

A symptom is a figure growing in the field of relationships

The symptom does not occur in an "inhuman" space. He is always a "borderline" phenomenon. The symptom arises at the “boundary of the relationship”, marks the tension of contact with the significant Other. One cannot but agree with Harry Sullivan, who argued that all psychopathology is interpersonal. And psychotherapy of a symptom is, therefore, interpersonal both in its aims and in its means.

When we undertake work to reveal the essence of a symptom, it is necessary, first of all, to actualize the essence of its influence on the people around us: How does it feel? To whom is it addressed? How does it affect the Other? What is his message, what does he want to “say” to the Other? How does he mobilize a response? How does he structures the field of meaningful relationships?

Behind every symptom is the shadow of a significant person

This Other for the client is a person close to him. It is to close people that we have the most needs and, accordingly, complaints in the event of their frustrations. It is with loved ones that we have the greatest intensity of feelings. An outsider, an insignificant person does not cause emotions, claims, their strength increases as they approach the person. It is to a loved one that a symptom is directed as a way to draw attention to some important unmet need for him.

A symptom is the phenomenon of a failed encounter with the Other

Our needs are addressed to the field (environment) and most of them are social. Consequently, the field of needs is often the field of relationships. The symptom marks a frustrated need that, as noted above, is directed towards a significant person. Through a symptom, you can satisfy some of your needs, which for some reason cannot be satisfied in relationships with loved ones directly. There is always a need behind the symptom. And although the symptom is an indirect, roundabout way of satisfying this need, nevertheless, this way is often the only possible way to satisfy the need in the situation that has developed for a person. It is the impossibility of meeting with the Other, in which it would be possible to satisfy a need important for the client, that leads him to an indirect, symptomatic way of satisfying it.

A symptom is not a pathology of the psyche, but a pathology of contact

This idea is most vividly presented in gestalt therapy, which is focused not on the structure of the client's personality, but on the process of his functioning.

In Gestalt therapy, a symptom is not some kind of foreign formation that needs to be eliminated - it is a way of contacting a person who is significant for the client.

Every symptom is historically something that was once a creative adaptation, and then turned into a conservative, rigid one. This is an outdated, at the moment inadequate form of adaptation to reality. The situation that provoked the symptom has long since changed, but the frozen form of the response remained, embodied in the symptom.

A symptom is a way of communicating

“It was an important discovery for me when I discovered in my patients an unconscious need to preserve their diseases,” writes Joyce McDougall in his book Theaters of the Body.

The above function of satisfying important interpersonal needs through a symptom was discovered by Sigmund Freud and was called the secondary benefit from the disease. A person resorts to it when, for some reason (shame to be appreciated, fear of being rejected, not understood, etc.), he tries to communicate something to another person not in words, but through a symptom or illness.

In order to understand the problem of secondary benefits of disease, there are two main tasks to be solved in therapy:

· Determination of needs that are met thanks to the symptomatic method;

· Search for ways to satisfy these needs in a different way (without the participation of a symptom).

Any symptom:

· "Gives permission" to the client to get away from an unpleasant situation or from solving a complex problem;

· Provides him with the opportunity to receive care, love, attention of others, without directly asking them about it;

· “Gives” him the conditions to reorient the psychic energy necessary for solving the problem or to revise his understanding of the situation;

· Provides the client with an incentive to reassess himself as a person or change habitual behavior patterns;

· "Removes" the need to meet the requirements that others and he himself impose on the client.

A symptom is text that cannot be pronounced

A symptom can be viewed as communication, when one person tries to communicate something to the other not with words, but with a disease. For example, there is no way to refuse something (indecent), but if you get sick, then everyone will understand. Thus, a person disclaims responsibility for what he communicates to another, and it is almost impossible to refuse him.

A symptom is a phantom, behind which some reality is hidden, and at the same time - a part of this reality, its marker. A symptom is a message that at the same time masks something else, which at the moment is impossible for a person to realize and experience. The symptom miraculously organizes the behavior of the members of the entire system, structures it in a new way.

Thus, a symptom is a rather strong way of manipulating the Other, which, however, does not bring satisfaction in intimate relationships. You never know if your partner is really with you or with a symptom, that is, he loves you or will stay with you out of guilt, duty or fear? In addition, over time, others soon get used to this method of contact and no longer react with such a readiness to satisfy the thus organized need, or “figure out” its manipulative essence.

A symptom is a non-verbal message from the unconscious mind

The client always speaks two languages - verbal and somatic. Clients resorting to a symptomatic method of contact choose a non-verbal method of communication for communication. The most common mode of contact is body language. This method is ontogenetically earlier, childish. He is leading in the pre-verbal period of the child's development. In case of certain problems in the contact between mother and child (see more about this in J. McDougall's book "Theaters of the Body"), the latter can form a psychosomatic organization of the personality. A well-known phenomenon of a psychosomatically organized personality is alexithymia, as the inability to describe one's emotional states through words. Those clients who are not psychosomatically organized, resorting to a symptomatic way of resolving the conflict, as a rule, regress to the stage of pre-verbal communication.

The symptom is a messenger with bad news. By killing him, we choose for ourselves the path of avoiding reality

A symptom is always a message, it is a sign for others and for the client himself. What is born in us is our response to the influence of the outside world, an attempt to restore balance. Since there is a problem in every symptom and there is a solution to this problem, it is important not to ignore these messages, but to accept them and realize their meaning in the context of the client's personal story.

Freud and Breir found that the symptoms of their patients lost their irrationality and incomprehensibility when they were able to connect their function with the biography and life situation of the client.

The symptom, as mentioned above, has an important protective function. The client, resorting to the symptomatic mode of functioning, does not directly (but still) satisfy some significant need for himself. Therefore, in no case can one get rid of a symptom without realizing the frustrated need behind it and without offering the client in psychotherapy another way to satisfy this need.

Therapy does not relieve the patient (simply understood as the bearer of the symptom) from the symptom by amputation through surgical or pharmacological intervention by a physician. Therapy becomes an analysis of the client's experiences and behavior in order to help him become aware of the conflicts he does not realize and involuntary repetitions of behavior that determine his symptoms.

As G. Ammon writes, a simple elimination of symptoms can give nothing and cannot make a lived life out of an unlived life.

The symptom does not allow a person to live, but it allows him to survive

The symptom is associated with unpleasant, often painful sensations, discomfort, tension, anxiety. Almost any symptom saves from acute anxiety, but in return makes it chronic. The symptom saves from acute pain, making it bearable, bearable. The symptom deprives a person of the joy in life, making life filled with suffering.

A symptom is a kind of way of life that allows a person to partially resolve a conflict without solving the problem itself and without changing anything in his life.

A symptom is a payment for the opportunity not to change something in your life

Using the symptomatic way of functioning, the client avoids important experiences in his life, shifts them into the area of worries about his symptom. Instead of asking "Who am I?" connected for the client with existential fear, the question "What's wrong with me?" appears, to which he is constantly looking for an answer. As Gustav Ammon writes in his book Psychosomatic Therapy, the question of one's own identity is replaced by the client with a question about his symptom.

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