The Patient as Therapist

Abstract

We have already seen that the patient possesses essential capabilities for self-help. Furthermore, we have noticed again and again that an illness and its consequences run their course not just in the individual, but also in the system in which he lives. In this regard, the family occupies the foreground as the primary and most direct relational group. Since a symptom is the expression of existing conflicts with the partner, family, or social group, the conflict takes on a special meaning within the particular group (Framo, 1973; Richter, 1979). Anxiety and inhibitions in a young wife, for example, allow her husband to step forward as her protector and demonstrate his own strength and inner stability. The recognition this brings to her husband enables the wife to forget that she has bought it at a high price, that she has paid for it with her own anxieties and weaknesses. For the wife, the husband’s role as protector does afford her protection and security, but it also produces dependence, the lack of self-reliance, and the continuation of her social fears and inhibitions. There develops an apparent balance, a mutual shoring up that is more easily questioned by the “inhibited” partner—the one considered the patient—than by the other partner, the helper who is equally trapped in the problem (Selvini Palazzoli et al., 1977). This key position occupied by the alleged patient makes it easier to take a self-willed but effective step to change the situation.

We fall down by ourselves, but it takes a friendly hand to lift us up.