Under the black earth,
I saw hands that arranged roses.
-- Yunus Emre
In psychotherapy the patient is expected to understand his conflicts and his deficits as they relate to his life, and to identify and uproot them. The symptoms the patient experiences are considered the manifestations of these conflicts and deficits. These symptoms are to be cured by working them through via the insights gained in the process of psychotherapy. There is no question that a large segment of psychological problems lend themselves to such exploration and resolution. There are other schools of psychotherapy that may emphasize, to various degrees, emotional or cognitive or behavioral changes, and by their differing techniques attempt to bring about "cures." The most common are sufferings of patients who present themselves with anxiety and/or depression, the anxiety as a fear of impending disaster, the depression as the result of a previous disaster, real or fantasized. There are, of course many other symptoms, ranging from sexual dysfunctions to physiological disturbances, from phobias to obsessions, from low self-esteem to grandiosity. In one fashion or another, nonetheless, anxiety and/or depression come along with the other symptoms.
Listening to Prozac (or Valium) notwithstanding, most therapists try to figure out what causes these symptoms and provide a curative program based on their training and experience, as well as their concept of the patient as a psychophysiological entity. What get lost in the process, though, even if the symptoms are "fixed." Are the signals, the messages that the symptoms are conveying. Frequently these messages contain seeds of spiritual troubles, extraordinary messages from the depths of one's psyche, that one may be on the wrong track, in the wrong profession, in the wrong relations, in the wrong town, even in the wrong house.
In our culture, symptoms tend to imply something bad. The word symptom itself, however, merely means a combination (sym) of accidental happenings that together form a signal of a larger happening, which is inherently related to the larger context. In this way, we can look at a symptom less anxiously, and more simply, as a phenomenon (a word that meant, originally, something that shows, shines, lights up, brightens, or appears to be seen). In James Hillman's words, "A symptom wants to be looked at, not only looked into." A restructuring of perception is what doctors are therefore urged to do, in a light that shifts the valences from curse to blessing.
Battle with an illness generates a certain strength previously unknown to the person afflicted and often changes him so drastically that his intimates are so surprised they may ask themselves, "Is this the same person I knew?" His self becomes transformed to such a degree that he could have a different identity, a different name. In fact, there is a belief among the Inuits that when you fall ill your usual name leaves you. Similarly, Jacob wrestled with the forced (the angel) that inflicted serious wounds on him. Although he limped from the scene, he had been given, in Homeric terms an enabling wound and received a new name, "Israel, the God wrestler."
"You have no idea of the depths of my ignorance, Doctor, and there is no user's guide that comes with life." A patient pleaded. "Is there anything, psychologically I mean, that I should be doing or thinking? Please give me an unconscious hand." A healer may name the illness from its symptoms and make them visible to his patient, but the signals of the symptoms are delivered only to the recipient.
The lending hand of a healer could lighten the burden of the patient, especially if he is already a weight-carrying member of the spiritual community. But, ultimately, the person must first shift the valence of his life from suffering to calling.
In the tragedy Macbeth, Shakespeare writes:
Macbeth: How does your patient?
Doctor: Not so sick my Lord,
As she is troubled with thick-coming fancies,
That keep her from the rest.
Macbeth: Cure her of that;
Canst thou not minister to a mind diseased;
Pluck from the memory a rooted sorrow;
Raze out the written troubles of the brain;
And with some oblivious antidote,
Cleanse the stuffed bosom of that perilous stuff
Which weighs upon the heart.
Doctor: Therein the patient must minister to himself.
T. Byram Karasu, MD is the author of The Art of Serenity
