Treating symptoms

Henry

I have been thinking about the issue of "treating symptoms" and am confused. Isn't it "disrespectful" to ignore a client's request for help with their symptoms? For example, I was recently reffered, a 68 year old woman for treatment for panic and anxiety symptoms. She was particularly concerned that her symptoms signaled some horrible illness. However, as she was incapcitated by theses symptoms she could not have a doctor examine her. For the first three sessions I accepted her claim of the importance of her symptoms. We collaborated on hte design of several cognitive behavioral techniques which she tried and reported no success. Her experimentation with the techniques and our growing relationship (I did not insist that she carry out assignments I would only agree that this technique was not for her.) Soon she began to tell me what was immediately bothering her - her relationship with her daughters. After a sessio or two of exploring this matter she agreed that she needed to experiment with new ways of relating to her daughters. When this issue developed momentum she herself had the insight that her symptoms evolved due to the brutalizing she received from her first husband. Her anxiety grew as she tried to protect her daughters from his brutality. When her daughters left she continued to need to protect them and they rejected her "overprotections." Her still needing the symptoms allows us to continue exploring why she uses the symptom that she has chosen while honoring her self-selected goals.

It seems that if I honor the patient initial request to treat their symptom, I demonstrate the flexibility, collaboration, problem solving and effort the client will need to meet life's challenges. I understand the idea that it is better to "put out the fire" rather than "blow the smoke away", but don't you first have to "see where the fire is ?" My "behaviorist-within" reminds me of the power of shaping procedures (helping a person to gradually and systematically reach their goals).

Replies:

Re: Treating Symptoms, by Henry Stein, 4/26/97 Re: Treating symptoms, by Pete Gambino, 4/28/97 Re: Symptoms and Change, by Henry Stein, 5/1/97

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