The Meaning of Illness

Over the last thirty years practising as a clinical psychologist I have been privileged to help many individuals who were in deep inner turmoil, but there were many who also presented with mild to severe physical illnesses. Some of the illnesses presented were back pain, migraine headaches, asthma, eczema, Chron’s disease, irritable bowel syndrome, colitis, heart disease, ME, MS, MN, cancer, brain tumour – indeed, all of the most prevalent illnesses. Naturally, these individuals were receiving medical intervention and that is how it needs to be. However, there is an embarrassing source of riches to show that illnesses are more than purely biological realities and that an effective response requires a serious consideration of the psycho-social contents of the persons who suffer illness. Medicine has developed some amazing technological and chemical treatments for particular illnesses and continues to pursue rigorously the causes of illness, particularly the two current greatest killers – heart disease and cancer. However, in spite of the recognition within medicine of the psychosomatic and psychophysiological nature of most illnesses, the medical practice continues to focus on ‘cures’ and detecting causes. This essentially biological approach – whilst praiseworthy in its efforts – fails to consider that a particular illness may have an individual meaning for the person who is ill. A recurring political reality is the never-ending crises in our health services and the challenge to provide an effective and efficient service for what appears to be a relentless escalation in the demands for medical services. It is a worrying reality that in spite of the wonderful medical achievements that the rate of illness has not even been reduced by one per cent!

My own belief is that in addition to medical interventions that a deeper understanding of illness is required and that the search for the intentions of illness needs to be as intense as it is for the causes.

  • What do I mean by intentions?  This question is best answered by posing and attempting to answer several other questions:
  • How is it that men are far more prone to heart disease than are women?
  • Why is breast cancer so prevalent among women?
  • Why is back pain the most common complaint and accounts for most absenteeism from work?
  • How is it that single men and those in unhappy marriages are 64% more likely to suffer a stroke?
  • How is it that individuals who experienced profound abandonment experiences in childhood die two to three times faster than those who have been more fortunate in terms of early nurturing?
  • How does a serious life-threatening illness suddenly disappear?
  • How can a sugar pill (a placebo) be as effective as a specific chemical compound?

There are endless such questions that deserve consideration and, indeed, there are medical and psychological-social practitioners who have examined these questions. Their conclusion has been that there is a meaning to illness that needs to be detected so that a comprehensive bio-psycho-social intervention can be devised with the creative co-operation of the person presenting with a particular illness at a particular time in their lives, within unique circumstances (for example, death of a spouse, loss of job, death of a child, marital breakdown, bullying at work). There is strong evidence too that the location of the illness (for example, ‘blocked’ arteries, ‘splitting’ headache, ‘crippling’ back pain, ‘recurring’ nausea) has a particular meaning for the individual as does the nature of the symptoms, for example, chest pain, stomach pain, feelings of weakness, loss of power in one’s limbs, loss of voice, recurring infections). What is particularly vital is that the illness is an unconscious creation that has the intention of getting the person to do for themselves what they would need to have been doing and to stop doing what is threatening to their overall well-being. If you are feeling confused by what is being said, then this is not surprising because the search for the intentions of an illness is every bit as complex as searching for the causes. For example, a man who has been diagnosed with either ‘blocked’ arteries or ‘hardened’ arteries is compelled by his illness to either attend to his severe emotional blocks – the fear of emotional expression – or how he has ‘hardened’ his heart to himself and to others. Whilst a by-pass operation is critical to resolving the blocked blood flow to his heart, it is equally urgent that he gets help to resolve his long-standing emotional repression, a common psycho-social reality with men. If the heart dis-ease gets the person afflicted to talk about his heart albeit at a substitute level, what does it stop him from doing? It cleverly stops him from being ‘heartless’ because he is now very much aware that he has a heart after all! The psycho-social work needed is to bring to consciousness the emotional repressions and support him compassionately to talk in a real as opposed to a substitute dis-ease way about his feelings. The sad reality is that for many men having a heart attack is far less threatening than expressing how they feel. The terror of being ridiculed, laughed at, emotionally abandoned is a far more serious psychological dis-ease than the blocked arteries and the by-pass operation.

What I have written above gives a flavour of the contents of a new book The Compassionate Intentions of Illness written by myself and my wife and colleague Dr. Helen Ruddle.  The launch of this book is at 6.30 p.m. at the Aula Maxima, UCC on Tuesday, 27th April to which your are invited to attend.