Seeing the voice of the patient lets you view their physical symptoms more clearly.  But you have to put on your metaphor goggles and take the lid off the metaphor jar.  Does this make any sense?  Not until you listen to the literal message within the figures of speech the patient is saying to you.

Globus Hystericus in other words... Case One: Teddy.  Teddy came to the clinic with a "swallowing disorder" diagnosed by the ENT specialist.  He had so much difficulty swallowing even his own saliva at times that he would have to leave meetings where he worked in a major computer corporation.  In taking his history he spoke of relocating from Wisconsin where his fiancee still lived.  He was in the superior range of intelligence, yet could not come up with any reason or even suspicion of where these symptoms came from. In our Mind-Body Clinic, I had the Fellows and residents put on their metaphor goggles.  

One asked, "What do the symptoms feel like?"  Teddy said, "it feels like there is something stuck in my throat that I can't get out."  He went on to describe this "lump" in his throat that the specialist called a swallowing disorder.  I asked him, "What is so hard to swallow?"  He became tearful, very tearful and then started sobbing in to a near-hysterical state.  He was assured that he could "cough it out" safely with us now.  We induced a light relaxing trance to calm him down.  He then said that he calls his financee every week and that he misses her.  With a little hypnotic regression assistance, we asked him to go back to the conversation that is so hard to swallow.   He told us the phone call when she called off the engagement.   We learned this was many months ago and it coincided with the onset of the difficultly swallowing.   Bottom line was that he consciously stilled believed or wanted to believe he was engaged to the love of his life, but his subconscious protected him by expressing the emotional reaction physically with the "Lump in his throat" and the difficulty swallowing.  He cleared his throat, his symptoms cleared spontaneously within days and some follow-up discussion (counseling).

Urticaria just itching to erupt... Case Two: Alice Ann.  For two years Alice Ann had been suffering from urticaria (hives) that were spread across her back.  Dermatologist provided steroids, anti-histamines, bath salts, and other medicines without any significant relief.  When she arrived in our clinic she was calm, poised, and clearly stated her history with the hives that began after she returned from vacation two years ago.  She had her entire history neatly organized and printed out for us.  She liked the idea of being referred to our clinic for medical application of hypnosis as she had already found favorable articles on the internet.  She came for hypnosis and wanted hypnosis.  So we taught her a standard induction method using relaxation.  While she was in a relaxed state I asked her permission for us (Fellows/residents and me) to put on our metaphor goggles.  She laughed and said, "Sure, whatever that means."

The questions asked of her had nothing to do with her neatly printed history of medications and symptoms.  She was advised not to speak until we asked her subconscious mind a few clarifying questions.   She heard,

  • "What or who is getting under your skin?"
  • "Who is rubbing you the wrong way?"
  • "What are you itching to say or do?"
  • "What is erupting or coming to the surface that you cannot speak of?"

 Alice Ann kept her eyes closed but whispered, "John."  We then alerted her from the light trance and asked her who is "John?"  She immediately looked angry and said, "He is the monkey on my back at work, my boss."  She went on to describe a situation of being re-assigned upon her return from vacation two years ago.  She spoke at length about how angry she was toward him yet could not say a word without risk of jeopardizing her position at work.   One of the physicians said, "It sounds like you have been itching to tell him off."  She lit up with the recognition about the origin of her hives.  She was asked to go back into trance and suggestions were offered to release the physical symptoms now and to discover a way to release the emotional energy.  Involuntary finger movements called ideomotor signals (another blog topic to come) made by her subconscious affirmed or ratified the acceptance of these suggestions.   Her hives cleared in two weeks, and whenever they would begin to recur, she would repeat her emotional-release excise with successful results.

Angina Pectoris and getting a load off... Case Three: Henry.   After exhaustive cardiac workup, Henry was referred to the Mind-Body Clinic to learn relaxation to help ease the angina or chest pain he was experiencing.   He was open to the idea of learning to relax and we proceeded to teach him a self-hypnosis induction method that he could use whenever he wanted to relax the tightness and pain in his chest.  When it was suggested that sometimes emotions can cause these symptoms, he was very resistant to the idea.  He said his life was perfect; he had a great career, wealth, success, a 20-year happy marriage, a wonderful daughter who is the greatest joy in his life and that she is now in graduate school.  The best clue he gave us was that "everything is perfect" and that his youngest daughter just moved out of the house for the first time to attend graduate school out of state.

I suggested, "Before we teach you some self-hypnosis, would it be all right if we asked you a question or two?"  He responded, "Sure, fire away."  I nodded for the others to don their metaphor goggles and then I asked him to tell me, "What do you need to get off your chest?"  He shook his head.  I then asked him to tell me what it was like to see his daughter off to graduate school last year.  He replied with the university she is attending, how proud he is of her, and that it is a good thing.  We asked him to specifically tell us how it felt the day she left and as he watched her drive away from the house.  With an outpouring of tears he said that he went back into the house, and was drawn to her bedroom, but couldn't step in or even look in.  He went on to say that even though they talk on the phone, and it has been months since she left, he cannot step into her room with bursting into tears.  We asked him to why he thinks this has been so hard for him.  He said, "It just breaks my heart to know that she is gone... I miss her so much," spoken with uncontrolled tears.  We talked with him about how some of the phases of life can be painful yet perfect or desirable at the same time.  He talked about how he had encouraged her to accept the out-of-state offer to study... "And yet it still breaks my heart."   We went on to teach him the relaxation which included hypnotic suggestions for him to go into her room and feel the joy of the years, let the tears flow until his heart is perfectly mended and in-sync with the happiness and pride for her achievements in graduate school.  His chest pains resolved within a week or two and later called to say, "Thank you so much for helping me get that off my chest."

It is a mind-body.  Everything we experience in mind has an effect on the body.  That is why we refer to it as a mind-body now.  When the emotional energy or the situation is beyond our immediate control, the subconscious will take it on and express it for us.  So, the emotional event may be "out of mind" but not necessarily "out of body."  Although the cases presented here portray the more interesting psychodynamic aspects of symptoms, we also use mind-body methods to simply focus on the symptomatic treatment (when there is no underlying emotional issue) by changing the words, ideas and images of symptoms.

Tell us your experience.  I would love to have you post any of your "mind-body" stories of symptoms, health, and the metaphor that may have been expressed by body.  Take the lid off of your mind-body metaphor jar and post it in this blog.

On the lighter side of metaphors.  Check out this link to metaphors found in high school essays by clicking here.  Or what do cats and refrigerators have in common? (click here)

Steven Gurgevich, PhD, Director - The Mind-Body Clinic, Az Center for Integrative Medicine, University of Arizona Health Sciences

About the Authors

Tieraona Low Dog

Tieraona Low Dog is the Director of the Fellowship at the Arizona Center for Integrative Medicine.

Rita Benn

Dr Benn is the Director of Evaluation and a Research Assistant Professor at Arizona Center of Integrative Medicine, University of Arizona College of Medicine.

Steven Gurgevich

Dr. Steven Gurgevich is a Clinical Assistant Professor of Medicine specializing in Mind-Body Medicine and the Director of The Mind-Body Clinic at the Arizona Center for Integrative Medicine.

Victoria Maizes
Dr. Victoria Maizes is Associate Professor of Medicine, Family and Community Medicine and Public Health and Executive Director of the Arizona Center for Integrative Medicine at the University of Arizona.

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