Sunday, November 28, 2010

The Purpose of Psychological Symptoms

Symptoms tell us that we can never take back into our ownership the events caused by the little people of the psyche. —James Hillman
Depth psychology recognizes two qualities of psychological symptoms. First, symptoms are autonomous; they show up not through any decision by the conscious ego but by way of unconscious forces deep within psyche. Symptoms present of their own accord, and, when the conscious ego becomes aware of them, the ego formulates the question, "What's wrong?"—thereby beginning what is hoped to be a long and fruitful dialogue with the unconscious.

Second, psychological symptoms have a purposive nature: they reveal the unconscious's drive toward some end, some purpose, that may not be immediately apparent to the conscious mind. As June Singer (1994) wrote:
Looking at a symptom in this way corresponds to Jung's "purposive view" of neurosis. . . . Jung. . . wanted to know where the symptoms might be leading the patient, that is, what unconscious purpose might be operating. He believed that the way to uncover meaning in events and developments was to observe the direction in which they were pointing, that is, to look for the purposive aspect of the symptom. (pp. 36-37)
Whereas the autonomy of the symptom is apparent, its purposive nature is often not so readily recognized. There is no doubt, however, that all symptomsfrom cutting, to hoarding, to addictionhave a purpose. Cutting may be an unconscious attempt to be in control, hoarding an attempt to feel safe, and addiction an attempt to be pain-free. When the conscious mind recognizes the purpose of the symptom, it can go into the underlying unconscious forces that are at work. Symptoms are evidence that the psyche drives towards healing. We could say that the soul reaches out to the conscious mind through the presenting symptom. As depth psychology emphasizes, the integration of unconscious content into consciousness is the healing function, and the symptom is the catalyst for that integration.

Symptoms that present in families and other systems are no different. A symptom that shows up in a child, disturbing the family system, holds a purpose for the family unit as a whole. Therefore, I was surprised to read in Family Therapy: Concepts and Methods: "The idea that symptoms serve a function in families has been discredited" (Nichols & Schwarz, 2008, p. 115). I am curious to know exactly by whom and by what evidence this idea has been discredited. Nichols and Schwarz rightly point out that there is the danger of creating an adversarial relationship between therapist and parents (p. 115) if the therapist tells Mom and Dad that Jimmy's panic attacks and insomnia allow them to avoid their own problems
that they are scapegoating the child by making him the identified patient.

Yet blaming parents for scapegoating their child need not be the conclusion a depth psychotherapist draws when looking at the purposive nature of symptoms within the family. Rather, we recognize that Jimmy's anxiety attacks are not happening in a vacuum; they are an integral part of a larger system where anxiety may be completely repressed or otherwise not tolerated. Jimmy's psyche does not operate independently; it is part of an ongoing exchange of psychic energy, conscious and unconscious, among individuals in the family.

In fact, Jimmy has unconsciously chosen to hold the family pathology for the rest of its members. There appears to be an unconscious compassion at work, a willingness on Jimmy's part to shoulder the burdens of the whole family. The parents' willingness to allow this could be viewed as a kind of unconscious scapegoating (and for two parents who are unable or unwilling to own their own shadow material, this may be true), but it is not necessarily the case. For Jimmy's part, holding the symptom for the family might serve any number of purposes, such as keeping Mom and Dad engaged in him or forcing them to be the strongest members of the family if their own efficacy as parents is slipping.

Psyche operates as a whole among members of a system, and there is a fluid nature in the exchange of psychic content, including unconscious communication among individual members. Just as the individual's symptoms cannot be separated from the family, the purpose of the symptom cannot be separated from the family system either.

Understanding the symptom as psyche's way of making unconscious content conscious
the very process of individuationhelps us to depathologize the individual and broaden our understanding of the complex dynamics within individuals and families.


Nichols, M. & Schwartz, R. (2008). Family therapy: Concepts and methods. (8th ed.) Boston, MA: Pearson Education.

Singer, J. (1994). Boundaries of the soul. New York: Anchor Books

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