Relationships: Prescribing the Symptom

"Sam whines and complains to me a lot, and then expects me to be turned on to him and make love with him. When I don't want to, he gets angry," said Jackie in our first telephone counseling session. "I have become more and more shut down. I don't want our marriage to end, but if we keep going this way, that is what is going to happen."

"Jackie, what happens when you try to talk with Sam about this?"

"He just gets defensive and blames me for his unhappiness. I just don't know what to do."

"It sounds like Sam wants control over you, but is very resistant to anything you have to say, and then the two of you get into a power struggle. What I think might help is doing what I call 'prescribing the symptom.' Let's do some role-plays so you can see what I mean. You be Sam complaining and I will be you."

(Jackie being Sam, using a whiny voice) "Honey, I just couldn't sleep last night, and I'm feeling so anxious about work. Maybe tonight we can be together."

(Me, being Jackie) "Sam maybe if you whine just a little bit more and try to make me feel really guilty, I will feel turned on to you!"

"Wow," laughed Jackie, "that might work!"

"Let's try some other role-plays."

"Okay. (Being Sam, yelling) You know what Jackie? I've had it with you. I don't feel loved at all. Why should I stay in the marriage?"

(Me, being Jackie) "Sam, you are not being angry and threatening enough. Maybe if you yell even louder and threaten more you can have control over getting me to love you."

"Oh, I love this! I think that Sam is the kind of person who will really get this!"

In our next session Jackie had much to report.

"This was a terrific week! I prescribed the symptom at least three times! Each time Sam looked at me like I was crazy and then started to laugh. He is really getting how ridiculous it is for him to think that whining and complaining and yelling will get me turned on to him. Near the end of the week he was much lighter and happier and I actually felt turned on to him! We made love for the first time in months."

Prescribing the symptom is an excellent way for some people to gain awareness of what they are doing that is not working well for them. When you are prescribing the symptom, it is important to:

1. Speak in a light, joking way, with no judgment.

2. Describe the behavior, encouraging the person to do it even more.

3. Describe the intent behind the behavior. For example, the intent of Sam's whining and complaining was to make Jackie feel guilty enough to give in. The intent behind anger or complaining is to have control over getting what the person wants. It is very helpful to articulate this intent to control, as I did in the role-play by saying, "Maybe if you yell even louder and threaten more you can have control over getting me to love you."

Many people are resistant and hate it when someone tells them what to do. When you tell a resistant person to do exactly what they are doing, and in fact to do it even more, they are likely to resist you and stop doing what they are doing - whether they are children or adults. After all, when someone is whining and complaining or getting angry, he or she is being a controlling child who wants to be in control, but does not want to be controlled.

Sometimes, prescribing the symptom can work wonders!