Positive Health Online

In the last issue of Positive Health (Issue 41), the problem of headaches was discussed from the Gestalt Therapy standpoint.

Fritz Perls outlines his approach in his major book, Gestalt Therapy (Julian Press, New York, 1959; co-authored with Paul Goodman & R. Hefferline).

The basic theory is that by concentrating on the headache, and allowing it to develop into awareness, one may find that the pain is self-inflicted due to muscular squeezing. By taking responsibility for the pain, a person will reach greater awareness of how to deal with problems in his life which produce the background tension.

In practice, this means helping the patient to focus on his headache in the here and now, while the therapist maintains a "witness" attitude, merely helping the person to stay with it.

Now this technique of curing headaches is by no means new; it is in fact part of ancient knowledge. One sees a similar example in the novel The Razor's Edge, by Somerset Maugham. A philosophic young man gives up his socialite life to seek wisdom in India. He returns to Paris after some years and meets an old friend who is plagued by headaches. He shows his ailing friend how to get rid of the headache by allowing himself to feel it, which is described as an old Indian trick. But it is by no means necessary to put this in the context of Eastern philosophy or mysticism. As Paul Goodman used to say – modern psychotherapy needs to be a "yoga for the west", without the excess baggage of psychoanalytic abstractions and reified terminology. A therapy based on experiential self-knowledge.

Here are some further concrete examples of applying the technique in the more realistic and complicated world of psychotherapy.

The first: a pleasant woman of about 40 visits my office to complain that she has been on sick leave for the past eleven years. She is a music teacher, but has suffered such terrible headaches that she was forced to stay home from her job. In fact, she has not played the piano for years, although she loves music. The first two sessions were exploratory, but when I saw her for the third hour I felt we had built up enough rapport to try an experiment. I asked her to focus on her headache. She followed my instructions diligently and was quite pleased that the pain diminished after a few minutes. We continued on, my role being that of a guide, or "witness"; she was doing all of the real work: concentrating on her headache. Paying attention to what was previously deliberately avoided. The experiential work on her headache was partially successful, but did not completely eradicate her pain.

So I tried the next level – I asked her if she would like to give the headache to somebody else. Being a very polite and somewhat shy person, she of course could not think of anyone in the entire world who she would punish with these terrible headaches. I tried a slightly different approach. I asked her what events had taken place just before she started getting headaches eleven years earlier.

She thought about her life, and then I saw an "a ha" experience light up her face. Her eyes sparkled. Yes, she recalled, it was just about eleven years ago that her mother-in- law moved in with her and her husband. And now it's clear that her headaches began a short time thereafter. No, she didn't want to hurt her mother-in-law, and in fact always went out of her way to be extra kind to her!

But it did not take long before she began to grasp the connection between her headaches and the unwanted visitor, and the following week when I saw her, she told me that she had thrown out the "guest" and her headaches had completely disappeared. She had even begun to play the piano again and would soon return to her old job.

It may sound as though it all took place extraordinarily easily. But the hard work of looking at reality, accepting one's feelings, and expressing them when necessary had already been accomplished.

Here's another study of the headache and its dissolutions. It is an example that my gentle readers should not attempt to copy. I very seldom in my private life get involved in people's problems, but this one time I must admit I felt tempted to assist.

I was invited to a very fine dinner party at the home of a sophisticated couple, I was the visiting foreigner, as usual. Just after the coffee, our hostess mentioned that she had a terrible headache and needed to retire. I didn't want to lose her company, or perhaps under the influence of the wine I just wanted to impress everyone, so I suggested that I often deal with headaches in my capacity as a psychologist.

She showed interest in working on this, so we left the rest of the party and went off to her quiet study. Here she was able to relax and focus on her headache, as I suggested. After just a brief time, following my guidance, she gave her complete attention to the area of pain, and suddenly it vanished. She seemed surprised though not especially happy.

Previously, she had told us that she had been bothered by these headaches which come and go intermittently since she was an adolescent. Naturally, there was a long recital of visits to various doctors, clinics, pain treatment centres, chiropractors, etc. But nothing had helped. She was in fact currently visiting a physical therapist weekly for treatment.

The fact that I had "cured" her headache in less than 10 minutes did not please her at all. I had a sense that she felt she had betrayed herself in giving it all up so easily. She would visit her physical therapist the next day, as scheduled, and discuss what had happened.

I was a bit disappointed, expecting to be thanked for my curative powers, and always in need of effusive praise, I shirked back to the party, wondering what I had done wrong.