A symptom is a kind of motif. A repeating pattern. A ritual.
Think about ritual- all cultures, all religions (that in aware of) have their rituals, repetitions, the practices they return to over and over, some every day. “When I am in my darkest, scariest moments, I return to prayer, meditation, a few repeated words...” It’s worth thinking about symptoms in a similar way. “When I am in my moments of fear, I respond with my familiar way of holding myself. My familiar ritual. I constrict. I depress. I shut something down in myself. I say familiar words to myself.”
Maybe it seems strange to call this a ritual. I’m aware that people don’t often feel like they’re choosing their symptom, that it’s something that just comes over them, like a morning storm. But if we think about how a symptom is made- it is usually the best adjustment available in a challenging moment. And often we are very young when we make it. Imagine a child of six, finding the handiest, most helpful, most creative response they can muster to a situation that feels overwhelming or unsafe. Maybe those harsh words you say to yourself was the prayer of that 6 year old. The repeated way we hold ourselves. The repeated way we manage relationships. Om.
That was our prayer, our mantra, our worry stone and our Om. That was the ritual that soothed us and kept us safer in a chaotic or frightening world.
And here is something interesting: we often cannot predict what will happen in a situation that unnerves us- but we can almost certainly predict our symptom. How we will meet it? What will come? Maybe that is the point. In a world that cannot be controlled, the symptom offers a strange and painful form of certainty. It is the one thing we know how to make. The one thing we can count on.
A repeated recognizable form. An Amen.
This raises another question. If we view the symptom as ritual, a logical conclusion to draw could be that to remove an unwanted symptom, one could create another ritual, some approaches to therapy are akin to this. “Replace those negative thoughts with these words of affirmation”. And maybe this works for some, or works as a part of a larger strategy.
But in Gestalt we understand that that symptom points to a world (and a world points back)- not just a past struggle, but a world one expects to find. “I ritually avoid contact because I know I will be intruded on and then I’ll be defenseless”- past, present, and future. “I ritually apologize because my difference will be an affront to you”- past, present and future. So we don’t require another ritual as much as say another “world”. A field perspective in therapy looks at this self-making, world-making capacity. It’s not just “what kind of world was I originally responding to?” it’s also “what kind of world am I expecting to find in each new encounter?”
Our symptom ritual is a kind of support to carry us through, making the passage to the next moment, and it can certainly help us navigate a familiar world with terrain that we know. But faith and hope in a new world is something different. Rather than a closing off, putting up the walls and closing the gates, turning back to our old ritual, it requires an opening and a bit of faith. And for some folks, hoping is just too dangerous, because it holds too much dread at its core. I end this with a question that probably has a larger relevance- what does it take to disrupt a world?
This isn’t rhetorical. This question is required of all of us, especially therapists.