On Symptoms and Causes in Psychotherapy - A LinkedIn Post by Aruna Gopakumar

When I was young, I saw my parents haggle with autorickshaw drivers for a ten-rupee reduction, sometimes standing on the street for half an hour. I would walk away simmering with anger at what I saw then as miserliness.

Years later, in the field of psychotherapy, I learnt to look more kindly at such scenes. Obsessions like this one - haggling for every rupee - are often rooted childhood where there was nothing to spare — a panic shaped by years of stretching every grain of rice, now transformed into an adult vigilance around money. The vigilance and lack of trust of others are the symptoms; the early deprivation is the cause.

Much of psychotherapy is precisely this gentle re-visioning. Symptoms are the visible protests of an unseen history. A persistent headache may be the body’s memory of anger that was never allowed. The feeling of being perpetually hungry, may be tied less to food and more to the experience of growing up in an emotional or material famine, where “never enough” became a way of life.

Symptoms announce themselves loudly. Causes are buried deep in memories, often forgotten. Therapy becomes meaningful when we stop scolding the symptom and begin to listen to it. It turns out that our distress is rarely irrational; it is logical once we know what it is trying to protect.

The work of psychotherapy is look for the causes rather than stay at the level of symptoms. And when the cause is finally understood — named, held, made sense of and grieved — the symptom often loosens its grip. 

It is then that lasting change is possible.

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