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Zone 1 - Understanding the 3 P's

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Want to try developing a ‘story’ for your illness?

Some key points !!

Every story is different.

All sorts of things can come into them.

We have to cast the net wide.

And most important of all….

Nearly all illness or health problems are MULTIFACTORIAL, that is, the illness is set off by a number of factors coming together at the same time.

Example One

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There is a truck on the roadside.  A man wants to push it off his driveway.  He pushes and it won’t move.

Another person joins him and it won’t move.

Finally with 4 people it moves.

Illness can be like that.

Though some factors causing illness are enough on their own many require several factors to come together.

Illness is like this too.

Example Two:  The Law Student Turned Ecologist

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A student is doing law studies at University.  He really wants to do ecology but the family tradition points to law.  He struggles through the year hating the course though finds this hard to admit to himself or the family.  He is tired and tense, and gets his assignments in at the last hour.  As exams approach he finds it difficult to get to sleep.  The student health service suggest more exercise and a better diet.

Two weeks before the exam he gets a virus which may be influenza.  He recovers just enough to do the exams but gets low grades.  His health does not completely recover.  He has muscle aching, night sweats, headaches, backache, and severe fatigue.  He has investigations and nothing is found.  Antidepressants are tried to no effect.  He goes back to university but cannot attend all the classes.  He is given a diagnosis of Chronic Fatigue Syndrome. Assessment at this stage uncovers the underlying drive to do ecology, the family pressures, the influenza, the sense of failure, and the effects of uncertainty about what is wrong with him.  This is all pointed out.

He abandons law and starts courses relating to ecology, does some counseling, takes antidepressants for a while, the family is asked (by him) to back off a bit—and his health recovers.

THIS CASE SUGGESTS MANY FACTORS COMING TOGETHER TO TRIGGER AND MAINTAIN ILLNESS.

The factors CONTRIBUTING to illness fall roughly into 3 groups:

THE THREE P’S

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There are PREDISPOSING factors - those factors which make us prone to illness.

There are PRECIPITATING factors - those factors which seem to start the illness

There are PERPETUATING factors - those factors which seem to keep the illness going

Take the law student for example

For his illness

The PREDISPOSING factors were

  1. the family tradition of law and pressure as he saw it to be a lawyer,
  2. the chronic tiredness and tension of the year
  3. his inability to fully recognize his feelings of ‘hating’ law,
  4. the growing emotional crisis as the exams loomed.

The PRECIPITATING factors were

  1. the influenza virus-this was the main physical factor
  2. the actual stress of the exams

The PERPETUATING factors were

  1. his continuing hate of law
  2. the burden of bewilderment of ‘what is happening to me?”
  3. the failure of the doctors to give a diagnosis except for one which has a bad outlook
  4. continuing failure to attend and perform at university

Your Story

It’s all very well listening to other people’s ‘stories.’ Now it is your story!

To get your story you must fulfill a very important condition.

You are the ‘expert’ when it comes to your story.

YOU MUST TRUST YOUR THINKING, FEELINGS, AND MEMORY.

If you listen to yourself carefully you may be surprised at how quickly you can reach an answer.  This needs some explaining.

Listening to Myself

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Your thoughts, feelings, and memory lead you to the truth—so you need to trust them and follow them.  How can we understand this?

Everybody knows that the tip of the iceberg is connected to a huge mass underneath the water.  To find the rest of the iceberg you clearly must start at the tip, start with that which is poking out.

So it is with story and illness.  The answer lies in what you allow to come to the surface.  I have learned to listen very carefully to what people say, because the meaning of their illness is often right there on the surface.  Or, if we pick up on that which is at the surface, we come quickly to that which is important.

So you are going to need to listen to yourself very carefully.  And please don’t dismiss anything as unimportant or trivial.

What is Important and What is Trivial?

Example: The woman who developed a rash because her father wouldn’t wear his hearing aid.

A few years ago I saw a woman with a very severe problem with urticaria-extremely itchy welts on the skin.  She had had it for 6 months when I first saw her.  I was impressed with the personality and stability of this woman and decide not to pursue the ‘story’ aspects.

For a further 6 months we struggled, with no improvement. Eventually I sat down with her, dug a little deeper, and discovered after an hour that she was rather frustrated with her father for not putting his hearing aid in.  I felt frustrated myself.  This was surely not important.

She rang me two hours later to say the urticaria had disappeared for the first time in 1 year.  6 weeks later she was back suffering again and had forgotten about the hearing aid which was again not being worn.  Reinstallation led to recovery and this time permanent.  The hearing aid was the tip of the iceberg.  The patient had always lived with her father and had never been assertive with him and now at 89 years time was fast running out.

The Message

Don’t write off anything as too trivial. If a detail comes into your head be friendly and curious towards it - it just might lead somewhere!

NOW ALL THE PRELIMINARIES ARE OVER LET’S GET GOING!

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