People commonly ask Counsellors what the difference is between Psychiatrists and Psychotherapists. In simple terms, Therapists are not medically trained, so do not ‘diagnose’ or prescribe medications whereas Psychiatrists are, and do. But as professionals working in the field of Mental Health, it is interesting to consider areas in which a therapeutic approach may meet that of the medical profession’s. In Epilepsy specialist Dr Suzanne O’Sullivan’s book It’s All In Your Head – True Stories of Imaginary Illness, the experiences of patients presenting with medically unexplained symptoms are considered holistically, within a psychological as well as a medical paradigm. The relationship between mind, body and experience is explored via gripping real-life stories that illuminate the purpose (and sometimes the cause) of psychologically-borne illness.
How does someone with ‘Epilepsy’ cope with discovering their fits are ‘ conversive’ and, as such, perhaps a useful way to deal with anxiety (and generate care and attention) following a difficult childhood? Why does a young woman with a “history of leukaemia” introject her sister’s experience to the degree that she convinces doctors she herself was the child who nearly died? Why does a blind woman imagine her lack of sight is ‘irreversible’ when, in fact, there is no damage to her eye function? Symptoms are no less real for self-diagnosed case of ‘MS’ than for those who actually have the disease and yet, despite having no medical markers for the condition, a patient presents with paralysis. Despite the psychological origins of these illnesses, for some a pill – even as placebo – can make a difference to wellbeing. For others, discovering they do not have a physiological illness could prove a disappointment – for whatever reason, their illness either meets a need or defines who they are in that moment of experience.
Therapists working with illness may encounter clients who show signs of ‘Somatism’ in the counselling room. In some ways it makes little difference whether or not a client holds the ‘belief that emotional and mental disorders are of physical origin’ – and it is not the Therapist’s job to decide whether or not they are right or wrong about their condition. Medicine is not an exact science, and neither is Therapy.
As Humanistic Therapists we aim to work with any client as they are and with their experience as they, subjectively, perceive it. This is the nature of Phenomenology. Without empathy and trust, Therapy simply does not work. ‘Unexplained’ symptoms of pain, fatigue and emotional lability are not (except in extremely rare cases) ‘made up’ – whatever the cause, they are real to the person endures them.
What matters is that people feel and believe they are listened to and understood. And, more importantly, that they are.