Every symptom has its story.

Nevertheless, symptoms are, especially in the name of professional efficiency and profitability, often marooned from their story, leaving them in the position of being little more than receptors “needing” and therefore legitimizing various interventions, pharmaceutical and otherwise.

Ahistorical symptoms are perhaps most commonly -- and unquestioningly -- conceptualized, used, and given reputable approval in the DSM-IV, the massive, precisely ordered assembly of diagnostic and statistical criteria generally employed by the psychiatric profession. And why? Because running through a quick checklist of such symptoms leads to a quick diagnosis, quick prescriptions, and quick bucks.

However, even when symptoms are given a sympathetic, biographically-sensitized ear, the history that belongs to -- and provides fitting sense for -- for such symptoms usually is missing more than a few pages. Key passages may be blurred, inaccessible to everyday articulation, out of order, or placed between misleading or otherwise unsuitable covers.

There may be a desire -- and not necessarily just on the part of those with the symptoms -- to rewrite or recast the story in whole or in part, to eliminate certain sections, to put the entire thing in the grasp of an internal editor who at best is only superficially known by us. We might even, with sufficient motivation or “professional” encouragement, make up -- or take up residence in -- a tale in which the eradication of symptoms is equated with well-being: If we, so the story goes, can just get far enough away from a troublesome symptom, then we can, perhaps with medical aid, literalize it as a mere thing, a kind of superimposition or inconvenience that we need only subject to, say, psychiatric know-how (which, as epitomized in the DSM-IV, apparently doesn’t need to know causes in order to produce cures).

However, suppression of a symptom is not necessarily equivalent to a cure. Confusing symptoms with what they are but the presenting surface of may bring us some relief, but does not heal us of our real trouble.

It’s not news that the satisfaction provided by suppression is only a partial or superficial satisfaction. A reduction or apparent erasing of symptoms may at times be of real use to us, but more often than not only isolates us from what we may in fact actually need to openly feel and be with. There are times when escaping from our pain is useful, but real healing takes place when we turn toward our pain, with compassion, undivided attention, and minimal numbness.

If we insist on only treating our symptoms as problems, then we will likely overabsorb ourselves in their apparent solutions, and therefore will also probably not recognize (and use) them as opportunities, tailor-made entry points -- or fittingly personalized portals -- into the very pain that we need to face, feel, and integrate.

Put another way, real satisfaction will very likely remain out of our reach until we significantly encounter, embrace, and make wise use of our dissatisfaction, letting neurosis itself serve as a doorway into what underlies and sustains it.

Connecting symptoms with their roots -- getting as close as possible to their birthing coordinates -- is not just a matter of psychological sleuthing, but is also a spiritual undertaking, a journey into and through raw, unedited need and feeling and trauma-imprints, a passage from here to a deeper here. To thus enter our pain is to at last make room for it, compassionate room. The more intimate we are with our pain, the less we suffer.

Every symptom has its story, but some -- or even most -- of that story may be held not in everyday memory, but rather in sinew and tissue (as well as in our neural and spiritual “anatomy”), needing in many cases some preverbal articulation (or at least one that is only secondarily verbal) and whatever else helps the body speak its mind.

Consider Daniel Schreber, perhaps Freud’s most famous case, who displayed many unusual symptoms, not the least of which were tactile hallucinations -- assaults against his eye and eyelid muscles, coccygeal pain, severe compression of his chest, even a head-compressing machine -- all of which reflected his having been literally encased during his childhood in various pediatric devices by his father (an influential pediatrician and “expert” on child-rearing). Freud labeled Schreber -- whom he never met -- as paranoid, suffering from delusions of persecution.

Amazingly, even though Freud was familiar with the elder Schreber’s pediatric principles, he apparently saw no connection between them and the psychosis of his son, presumably because of his belief that reports of childhood abuse by patients were simply fantasy, mere paranoia. If Schreber had been skillfully guided into the deeper feeling of his childhood straitjackets (physical and otherwise), and had been given room to openly feel and express what he had not dared to feel and express about his father, he may not have had to spend so many years locked up in an asylum. No one actually told him he had been abused by his father. Perhaps those simple words, spoken firmly but with care, would have helped unlock him from his “solution” to his long-ago (yet still emotionally and somatically present) persecution.

And what was that “solution”? Schreber created a framework of symptoms that could both contain and permit some expression of what was torturing him without, however, necessitating him having to directly confront and recognize it. The spectacularly bizarre -- yet ultimately coherent -- nature of his experience and behavior was an eloquent confession of just how unbearable his inner situation actually was. Schreber was stuck in the hell of his childhood, where he had been surrounded and pervaded day after day, month after month, year after year, by the grossly authoritarian dictates of his father (whose obsession with the ultra-strict disciplining of children was a fertile precursor for Nazi obedience). Rebelling was not an option for Schreber, just as it isn’t for abused children in general. His commitment to not letting himself recognize the roots of his persecution complex drove him mad. We go mad when we have to lie to ourselves.

And when we have to house what is toxic to us.

Just as we, as a collective social body, have to now store or contain enormous amounts of radioactive waste in firmly sealed, densely walled receptacles, so too does our body (in intimate conjunction with our mind) have to similarly store or contain -- and keep as far away as possible from our everyday consciousness -- whatever traumatic imprints it has not been able to release. (Secondary releases -- sexual and otherwise -- may make us feel a bit better, but only briefly and superficially relieve us of the “outer” stress resulting from the pressure and rising presence of underlying trauma.)

Storing pain that cannot be handled at the time is not just something that we do. It’s a survival strategy that goes way back. Consider the amoeba. Put it in water that’s been polluted with India Ink granules, and it’ll actually absorb them and store them in vacuoles (tiny self-contained cavities in the protoplasm of a cell). Then put the amoeba in water that’s clean -- a healthy environment -- and its vacuoles will move to the edge of the cell membrane -- like surfacing trauma in a healthy therapeutic setting -- and discharge the ink granules.

Our capacity, physical and otherwise, to isolate and encapsulate trauma (so that the rest of our system can adequately function) until we are in a truly safe environment continues to amaze and move me. It isn’t so much that the trauma isn’t markedly influential up until it surfaces as itself, but that its very containment, however neurotically managed and compensated for, has permitted organismic and personal survival. We may have to “eat” it, we may have to swallow it, we may have to act as if it’s not tearing at our insides, but we do not have to digest it.

Our “vacuoles” aren’t literal containers -- though they may appear to have specific bodily locations -- but rather inner psychophysiological mechanisms that make possible the repression of pain, especially unbearable pain.

The longer we wait -- or have to wait -- to open the cell doors of such pain, the more compensatory layers of “gatekeeping” we will likely have to penetrate, including any identification we might have formed with one or more of our survival strategies. That is, if we are sufficiently invested in being the “I” that is playing jailer, then any serious intent to release -- or even to contact --what’s in the dungeon is probably going to be threatening to us.

“Every morning I wake up feeling sick.  Every morning...”  Karen’s lips writhe in disgust as she describes her nauseous sensations.  It’s our first session.  She isn’t on any medication, isn’t pregnant, and does not actually vomit.  Morning sickness, mourning sickness -- a flicker of wordplay zips through me, disappearing into Karen’s dark-rimmed, haunted eyes.  Her gaze flutters spasmodically, like a broken-winged bird, while her body sits unnaturally mobilized, almost stonily mute, as if having swallowed its testimony.

I ask her what she feels sick about.  She replies that she doesn’t know, except for the fact that she’s been feeling depressed for quite some time.  Depressed about what?  She doesn’t know.  She sits slumped, as if bearing an enormous weight, complaining that her body feels numb.

“I feel so shitty about myself,” she murmurs, looking down, her eyes filling with tears.  “Like I’m a nobody.”  No body.  It’s as if her body’s housing something that makes her want to vacate the premises, something that literally sickens her.  I have her lie on her back on my bodywork mat, with her knees up, her feet flat, her eyes closed.  Her body is large, yet feels so, so small to me, almost too vulnerable, as if marooned from any protection.  For a while, she simply completes various incomplete sentences I give her.  Then I gently put my hand on her belly, asking her to breathe more deeply.  Her abdomen is swollen and hard, seemingly thickly walled, in contrast to her upper torso, which is thin and bony, frail-feeling.

As she breathes more deeply, with deliberate emphasis on the inhale, I gradually work her diaphragm and hipcrest muscles a little looser, leaving her belly alone.  Her arms lie limply beside her, pale and lifeless.  By contrast, her jaw is tightly locked, as if blocking entry to something.  Or is it preventing an exit, an expression or expulsion of some sort?  As I help her to loosen her jaw and to bring more energy to her arms, her head spontaneously begins going from side to side, and her fingers splay upward, as if contacting a heavy, downpressing weight.

“No!”  Karen is now crying angrily, saying she feels sick.  Her anger quickly grows more intense.  I have her squeeze my wrists as hard as she can, while she screams  “No!” over and over again.  Her abdomen is finally moving, rippling and shuddering, no longer domed so high or tight.  I release her hands, asking her to make fists, hard fists, and to pound down on the mat upon which she lies.  As she does so, I slowly work into her abdominal muscles.  When I simultaneously touch, with moderate pressure, both her solar plexus and her lower belly, she explodes with feeling, her legs shaking uncontrollably, her voice wild and hurt and overflowing with fury, in rough resonance with her now surgingly alive body.

“Who are you saying ‘No’ to?” I finally ask.

“I don’t know!”

“Look more closely.”

“I -- It’s can’t be him!”  Now she is very frightened.

“What do you see?”

“There’s someone standing in my doorway...” Her voice is very high and quite faint.  I hold my hands still, on her belly and forehead.  “It can’t be him...”

“Who?”

“My.... father.”

“What’s he doing?”  Now she is incoherent, crying very hard.  She starts to gag.  As I cradle and turn her head slightly, she spits out a lot of mucus, but doesn’t vomit.  “What’s making you feel sick?”

“Him!  He disgusts me!”

“What’s he doing?”  Now she is scared again, saying that she doesn’t know, and then that she does not want to know.  “How old are you?” I ask.  Three or four, she says without hesitation, adding that she’s being touched “there,” and that “it” is being pushed into her mouth.

Again she gags, then is silent and very, very still.  Her body feels vacant, gutted, deserted.  She’s had plenty for this session; for maybe twenty or thirty minutes, I simply sit beside her with my hands on her forehead and belly as she softly cries and gradually fills out again, her attention following my slowly spoken “reembodiment” and relaxation directions.  The room becomes still, peaceful, soft.

I tell Karen that we’ve just begun, and that it’s a good beginning.  For years, she has worked as a counsellor for sexually abused women, not suspecting (at least very seriously) that she too may have been similarly abused.  We don’t talk about whether or not “it” actually occurred or not -- it is not time for that, and may not be for a while.

 Having a strong sense now of what she feels sick about, she no longer feels any nausea.  Nevertheless, I suspect that she will not stop feeling sick until what she has swallowed and stored deep inside has been allowed to fully surface.  Until then her doorway will be blocked by “it,” and her depression will be the “pressing down” that, however unpleasant, is still preferable to openly feeling that in her which is most directly threatened by “it.”

The suppression of symptoms like those of Karen is often indicative of so-called dissociative disorders. Those who endured extreme abuse as children are often capable of, or even prone to, dissociating from their physicality -- that is, vacating that which feels the suffering -- when sufficiently painful difficulties arise. I’ve “seen” some clients almost instantaneously separate from their bodies when old trauma is on the rise, such “parting” involving a radical relocation of attention to “places” where their pain does not have to be felt. For them, healing necessitates, among other things, an ongoing conscious and compassionate reembodiment. Their original “place” of refuge may disappear, being no longer needed, or it may be integrated with the rest of their psyche, perhaps serving -- as is often the case with the psychically gifted -- as a kind of launching pad for deep intuition and visionary treks.

Back to Daniel Schreber: No one at the time questioned his incarceration, nor provided an environment in which he could begin to heal, nor considered that the very conditions under which he was being kept -- including solitary confinement for years -- might be contributing to his insanity. Though Freud did take Schreber’s past into account, he not only viewed it through the lens of his highly speculative assumptions, but also did not -- in a foreshadowing of much of current psychiatric practice -- include the social and historical variables of the times. He related not to Schreber, but rather to those of his symptoms that fit or appeared to legitimize his psychoanalytic theory.

Did Freud actually care about Schreber? Apparently not.

In clinical settings, caring still often remains peripheral to theorizing and classifying, in part because caring is overassociated with the feminine -- or traditionally less rational and thus supposedly less reliable -- and theorizing and classifying are overassociated with the masculine -- or traditionally more rational and thus supposedly more reliable. In the ethical guidelines of the American Psychological Association, there is not one mention of compassion. And so too with the DSM-IV. An oversight? I don’t think so. Compassion is just too “soft” and too qualitative -- and too closely associated with feeling on the part of the clinician -- for the disembodied rationality that dominates the above texts.

The less caring I am toward clients, then the less likely I am to view (and work with) their symptoms in a manner that truly serves their well-being. In the presence of insufficient caring, symptoms -- in conjunction with their interpretations -- tend to take up too much room. The less caring I am (which may masquerade as clinical objectivity), then the less involved I am, and the less involved I am, then the less moved I am to explore more deeply and more creatively the circumstances (both inner and outer) in which my clients finds themselves. It is easier then to rely -- or to overrely -- on what I already know, to cushion myself with knowledge and merely rational probes into what is troubling my clients. It is all too easy to dissect clients’ stories, and to fit the resulting fragments into the handiest classification scheme.

Schreber had little or no caring from those in whose “care” he found himself, so he -- very understandably -- created an exaggerated pseudo-caring for himself (to make it real would have brought him too close to his pain), making himself sufficiently important or visible in his religious fantasies so as to be extremely attractive to many “departed souls.” Not real people, but phantoms, attracted to him, needing him -- what a poignant reflection of his longing to be truly wanted! I wonder how Freud would have fared if he had been locked up and treated as was Schreber. Is it not possible that Freud identified with the elder Schreber and his rejection of his son? Did not Freud, like Schreber’s father, also cling to his authority, rejecting “son” after “son” (Adler, Jung, Rank)?

And, more to the point, do we not all, to varying degrees, tend to reject or ostracize our own madness, treating it as a pathogen (and hence something to pathologize), instead of giving it a compassionate ear?

Every symptom has its story, but we won’t have full access to the essence of the story without actually entering the symptom and connecting -- more than just intellectually -- it with its roots.

However, symptoms cannot be understood simply in the context of inner psychological development (or lack thereof), for they are functions both of one’s inner and outer environments, on many levels. To recognize this means to engage in an ecologically literate dialogue with one’s symptoms, until they are liberated from the stigma of being pathologized as things-to-eradicate. Then what underlies them can receive the focus it deserves. We can’t just bury the garbage somewhere else and then assume that we’ve cleaned up -- what is not working, what is diseased or toxic, is spilling out of therapy chambers into the community at large, demanding more than just more analysis and sanitary engineering.

Will we continue merely designing better umbrellas for acid rain, or will we really listen, taking the necessary journey into and through the unhealed wounds that populate our common asylum?