Some Thoughts on Somatization

By Anthony Wilson

Many years ago a hero of mine claimed he never caught colds and ‘flu because he didn’t want to. He maintained he was too busy enjoying life to be ill. Later when my hero, a lecturer in Liberal Arts, had faded from my life, I worked as a teacher. I had a mighty row with my boss and resigned from a secure teaching post, and then walking into a “supply” (or substitute) job at a super school. This convinced me I had been right and my previous boss was a fool. I got on well with my colleagues. I respected my headmaster. With my negative father complex, this was an untypical thing for me to do at that stage of my life.

A big drawback in being a “supply” teacher was that you didn’t get sick pay. You can probably guess what happened next. I went down with a stink­ing cold. But I couldn’t afford to be ill and off work. Morning after morning I’d dose myself with aspirin and, armed with a big box of Kleenex, would pass on pearls of learning and common cold virus to children all day long. Immediately I came home every afternoon, I’d stagger into bed and be surrounded by hot water bottles, with my loving wife to minister to me. Thus I gathered what strength I could to venture out the next day to bring home the bacon. I didn’t take the hint that nature was giving me even then. It was only some eleven years later, after more rows with bosses, that I real­ized that being a schoolteacher was not what I was meant to do with my life.

The Message in the Illness

So what was my ‘flu telling me? Was it “just a bug” I’d picked up, just when I didn’t need it? Or was this seemingly random happening more significant than I realized at the time? Perhaps an unconscious part of me trying to ex­press itself? Was my cold a result of the stress I was experiencing? Stress that the conscious part of me ignored while eager to get on with my career and earn money? At that time I was nowhere near becoming conscious of the complexes that acted upon me or the symbolism I was acting out. It took some more years of incubation.

Clients Who Miss Their Sessions

Jung said, I no longer seek the cause of a neurosis in the past, but in the present. I ask what is the necessary task the patient will not accomplish?¹ So let’s forget “cause”, forget “effect” and consider “purpose”. Your client telephones to cancel because he fell over this morning (cause). He says he sprained his ankle (effect). Therefore he cannot drive to your consulting room this after­noon (another effect). But how about “purpose”? Maybe he won’t have to continue talking about the way he feels, or recite last night’s dream, or sit there in silence with “nothing” to say. He would doubtless deny an uncons­cious wish to avoid therapy. Motivation is frequently not conscious. The assimilation of the contents of the unconscious psyche is the aim of therapy. A former supervisor of mine used to say, “Resistance is there for a reason, and we have to respect it.” Jung wrote in one of his letters, The opus consists of three parts: insight, endurance and action. Psychology is needed only in the first part. A missed hour can often be either a refusal to acknowledge insight or a failure at the second part of the work, endurance. If the client can acknowledge the resistance, feel the anxiety, accomplish the task, s/he can move forward. No pain, no gain.

Stress Related to Change

The Holmes Scale is a test which tries to measure the quantity and quality of change that takes place over a short period of time. It asks respondents to tick off events and changes in their lives during the last six months. Each change has a score assigned to it. As you might expect, big items like death of a spouse, or marriage, or birth of a child, score very highly. An increase or decrease in family rows or in the number of times you make love, would score less highly, as do terms in prison, or Christmas, or vacation, or being fired. According to the Holmes Scale theory, the result of a lot of changes occurring in a short time is likely to be a physical illness. The implication is that we like things to stay the same; that too many changes cause stress and that our reaction to stress is often illness. We need to have the right amount of stress to keep life interesting – not so little that we fall asleep, nor so much that we explode.

Trauma Theory

Thomas H. Holmes’ Scale is like stretched-out Trauma Theory. There’s some truth in it, but, it isn’t the whole story. By implication trauma is something that “happens to us”. But it is not true to say that burnout or illness is a reaction to stress which itself is caused by the external environment. Jung says that the trauma, the ostensible cause of the illness, is no more than an occasion for something previously not conscious to manifest itself 2 (He makes exceptions however, for “genuine” cases of trauma like shell-shock and railway spine.) There is often a message in what happens to us, if we wish to hear it. The unconscious contents of our psyche must be acted out by the world around us, if they cannot be made conscious and assimilated or integrated into our consciousness in other ways. Since we cannot apprehend the unconscious psyche except through symbol or projection, the world must often be either a passive screen or an actor.

Analyst Hilda von der Heyde made a telling point in the movie, A Matter of Heart. She said she was glad that she could give herself permission to be old. She often asked Jung why he had stopped doing certain things and he would respond that he was too old. He used to say to her, “If you can’t take a hint from Nature, Nature will hit you.” She did not understand this until one day she fell and broke her hip.

Although he was a physician, Jung was tough on illness. “Neuroses,” he wrote, “like all illnesses, are symptoms of maladjustment … One shrinks from the difficulties which life brings and thus finds oneself back in the world of the infant.” 3 So all those years ago with my cold, as I sank back into the womb of my cosy bed each afternoon, drowsy with aspirin and hot whiskey, I failed to get the message.

References

1. Jung, C.G., Psychoanalysis and Neurosis in Freud and Psychoanalysis, in Collected Works (CW) vol 4, para 570, Routledge.

2. Jung, C.G., Psychoanalysis in Two Essays on Analytical Psychology, in CW7, para 13, Routledge.

3. Jung, C.G., The Philosophical Tree in Alchemical Studies, in CW13, para 473, Routledge.

Anthony Wilson, a psychotherapist in private practice, is a partner at Asklepios Psychotherapy Centre, Dublin 16, telephone voice/fax 01-294 0601.