Symptom and Significance
Beverley Kane, MD
Copyright © 2004-2021 Beverley Kane
Step 2: Establish the Context
When a symptom can't be banished by a few pills or a few days in bed with extra strokes
from those around us, or when it exacerbates or escalates into a series of ills, it's time to pursue the
deeper level of meaning that informs the unseen infrastructure of our larger entities, or souls.
One of the most important clues about the meaning of a symptom comes from recalling
what was going on in your life when the symptom began. Did you lose your job, graduate from
college, end a long term relationship? Emotionally charged events often leave unfinished business
that erupts as bodily symptoms. As Seth stresses that the Point of Power is in the Present, I also
emphasize: past trauma is significant only if we persist in reliving it through anger, resentment,
self-pity and illness.
A few years ago, I developed a dry cough for no apparent reason. After several months, a
physician friend of mine who trained with Arny Mindell did process work with me. At her
prompting, I grabbed my throat area, exaggerated the cough, and amplified the physical sensation
to one of choking. I recalled that the cough began around the time I set about aggressively editing
chapters in a multiauthor anthology. Because I felt I had to set rigid literary standards for the book,
I was getting into frequent arguments with my contributors, who in turn put a "stranglehold" on my
editorial prerogatives. By co-creating the struggle, everyone was in effect choking each other off. I
thus bridged my cough to constrained freedom of verbal expression.
Step 3: Identify Target Organ Metaphors
Most people accept the fact that stress contributes to illness. But stress is a vague,
nonspecific concept. Specificity comes from examining the nature of the target organ the afflicted
body part. Choice of target organs is often conditioned culturally and by family of origin. A
Filipino physician teaching a multicultural segment of my Family Practice residency taught us that
Filipinos often euphemize depression as feeling dizzy. For women in Japan, neck and shoulder
pain is a more common expression of premenstrual syndrome than the bloating and irritability that
Americans tend to associate with PMS. However, for the most part target organs reference the
symbolic language of the individual's own belief system.
So the third step in exploring a symptom is to ask: What does this organ or part do? What is
it doing in its altered or dysfunctional state?
For example, skin is the boundary between the self and the nonself the outside world.
Allergies are manifestations of extreme reactivity to foreign substances. Both skin rashes and
allergies often suggest underlying concern with protection and boundaries. Symbolically these
conditions may dramatize issues of relationships, trust, and personal territory.
More important than exact anatomical explanations is: what does the organ mean to you?
What do you imagine is its purpose? Personal images and associations are more important than
standard scientific descriptions and stock analogies.
One of my patients, a woman in her early 30s I'll call Melissa, complained of chronic
diarrhea. She had seen several specialists over a two-year period. Although they diagnosed her
condition as colitis, they had been unable to relieve the symptom. As we reviewed other parts of
her history, Melissa described deep dissatisfaction with her job as a software engineer. Her
department had been downsized several times over the previous two years and the remaining