The Common Meanings and Functions of Illness
Illnesses may simultaneously express a person's distress and represent an attempt to relieve that distress. It is often useful to consider any benefits an illness may bring as a means of understanding its possible function. In Getting Well Again, a. P. Tarcher, Los Angeles, 1978), the Simonton group describes the five most common benefits their cancer patients listed when they were asked to identify positive things about having cancer. These are: (1) Having permission to get out of dealing with troublesome situations or problems; (2) receiving attention, care, and nurturing from others; (3) having the opportunity to regroup psychologically to deal with a problem or find a new perspective; (4) finding incentive for personal growth or for modifying undesirable habits; (5) not having to meet the high expectations of themselves or others.
Whether these factors play a role in the formation of cancer is unknown, but they are certainly important in the development of many other common illnesses. Further, even if they are not causative, benefits derived secondarily from illness may interfere with your motivation to recover. Identifying the possible advantages of having your symptoms or illness lets you begin developing healthier ways to accomplish the same objectives.
At worst, if you recognize any benefits that come with being ill, you can make the best use of them.
Other potential benefits of illness have been identified by many clinical observers. Gerald Edelstein, M.D., is a psychiatrist and hypnotherapist in the San Francisco Bay area. In his book Trauma, Trance, and Transformation, he reviews and paraphrases the work of another well-known psychotherapist, Leslie LeCron, who suggested that there were seven common unconscious reasons for the development of symptoms. These are:
The symptom may be a symbolic physical expression of feelings you are otherwise unable to express. This can be called "organ language"--a broken heart, a pain in the neck, not being able to stomach something, getting cold feet, feeling weak in the knees, putting something behind you, and so on.
The symptom may be the result of an unconscious acceptance of an idea or image implanted earlier in life. Thus, the message "you're a bad girl, and no one worthwhile could ever love you" repeated often or under particularly emotional circumstances could result in poor self-image, depression, self-destructive behavior, and difficulty in relationships later in life. In a real sense, we are all hypnotized as children. We look to our parents, and later to teachers and peers, to define our sense of self. The images we form of ourselves in these early years often form the unconscious basis for patterns of feelings, behavior, and physiology later in life.
The symptom may result from traumatic past experiences that have been highly emotional and then generalized. Edelstein feels that such experiences are often at the base of phobias. Someone badly frightened by a dog, for example, may expect all encounters with dogs to be similarly bad. While these symptoms tend to be behavioral or psychological, they may also manifest physically, as in the case of the asthmatic delivery man discussed in Chapter Seven.
The symptom provides benefits or solves a problem, as the Simonton list indicates. If so, the focus needs to be on ways to enjoy the benefits without having to be sick.
A symptom may be the result of an unconscious identification with an important, beloved person in your life. The "anniversary illness" is a well-known phenomenon in medicine. People may fall sick on or near the anniversary date of someone's death. Frequently, the symptom is similar to the symptoms the deceased person experienced. The identification may also be with people still living, or with historical or fictional roles. One patient of mine with cancer was shocked to find through her imagery that, as a child, she had always imagined herself as an actress playing roles where the heroine dies a tragic, dramatic death. She was struck by the similarity to feelings she was experiencing about her current illness and its effects on the people around her, and began imagining herself instead as a heroine who overcame and survived adversity.
A symptom is often a manifestation of an inner conflict. There may be an unmet need or desire that is forbidden by family, friends, society, or one's own inner judgments. The symptom may prevent you from carrying out a forbidden action, or may allow you to fulfill the desire symbolically. Sometimes it does both at once.
A priest I once saw as a patient had an extremely painful, immobile right shoulder. It prevented him from using his right arm and had not responded to extensive conventional treatment. He said it was so painful that he wasn't able to carry out his responsibilities as a priest and had asked his superior for a sabbatical leave. In an imagery session he saw himself angry, righteous, and carrying a placard in his upraised right arm. The anger and placard spoke directly to grievances he had with the church bureaucracy, but hadn't been able to express effectively. As he began to share these feelings, he saw how his painful shoulder simultaneously allowed him to stop doing work he didn't believe in and express his pain and anger to his organization. He also saw, however, that the message was disguised, unclear, and less effective than it would be if he were to articulate it openly. He realized the need for him to come to terms with the issues involved. Over the weeks that followed, he was able to clarify his own values and bring his grievances to the proper authorities. His physical healing paralleled his psychological and emotional healing in an almost linear manner.
Symptoms may be a result of an unconscious need for self-punishment. This often results from the "childhood hypnosis" mentioned in the second dynamic above, where you have unconsciously accepted a message that you are bad and need to be punished. It may also be an unconscious attempt to atone for a traumatic event for which you feel responsible, or an attempt to prevent something from happening again. Children often feel they are to blame for their parents' unhappiness, illnesses, alcoholism, or divorces. They may carry this unconscious sense of guilt until it is unearthed and worked through. Disguised and under the surface, it may manifest in many ways in their lives--as physical pain' illness, failed relationships, or underachieving.
There may be more than one reason at work in the formation of a particular symptom. When you explore your own imagery, any of the above dynamics may become apparent, or there may be other needs or functions represented by your symptoms. For now, notice whether any memories, images, or strong emotions were triggered by any of the dynamics mentioned above. They may be helpful clues as you continue to explore the personal meaning of your symptoms.
The Saving Grace of Illness--A Personal Experience
The first time I was aware of the possible benefits of an illness was when I was at the University of Michigan Medical School. I had just started my three-month rotation on pediatrics, and had been assigned to the university hospital ward where the sickest children were treated. As we made rounds with the chief resident, he told us each child's history, both medical and personal. I felt increasingly depressed as I heard the stories of these small children with serious illnesses. I had at that time very little awareness of my own emotions. I was learning to be a doctor, and in the 1960s medical students and doctors I knew didn't talk about their feelings in the face of illness. Then, a remarkable thing happened. As we sat around the conference table after rounds, the chief resident put his head in his hands and began to cry. His crying turned into deep sobbing, and through his tears he was saying, "I can't take it anymore . . . I can't stand to see one more kid die...." The attending staff physician told us to go home for the day as he moved to comfort the chief The next day, the chief resident quit. The day after, I developed severe nausea, a fever, and extreme weakness.
I underwent the kind of medical work-up that is only possible in a university medical center. My liver was enlarged, and my liver enzymes were abnormal, but everything else was normal. I had some type of hepatitis (the cause never was identified) and was not allowed to return to the wards until my lab tests were normal. I was very ill for a few days, then moderately ill for a few days, and felt fairly well after that, though I tired easily. My liver function tests remained elevated, however, for two and a half months. I had my first normal lab panel the weekend my pediatrics rotation ended.