By Dr. Philip Holder
(Copyright 1996 – 2013)


headproblemsThere are times when people can be their own worst enemy. If someone has low self esteem or a poor self image they may actually sabotage their relationships, successes and more. We manifest in our lives what we think we deserve. If someone feels undeserving or unworthy they will subconsciously only allow the level of success they feel worthy of having. The power of our minds can also be a significant factor with experiencing physical ailments.

What is a “Functional Symptom”. In short, they are symptoms that unconsciously serve a purpose. The functional symptom is usually a byproduct of some underlying emotional and/or psychological issue. As well, this symptom usually has no actual physical pathology. The symptom is generated unconsciously by the client or patient.

The importance of detecting and addressing a functional symptom is simple… Without knowledge that a functional symptom exists, any effort of a therapeutic nature to fix the problem will likely be pursued under a false premise. If that occurs, the therapy will either be totally ineffective or it will lack durability. For example, if a person is experiencing pain as a result of an underlying functional symptom, even if a therapist is able to provide the client or patient with temporary relief from the pain using standard pain management techniques, the pain will return if the underlying cause (the functional symptom) is left unresolved. (Later in this article I’ll be describing such a case for your added clarity.)


Let’s say that a patient goes to their doctor complaining of head ache, back ache, intestinal distress, neck pain or some other symptom. The physician then orders the appropriate tests only to have all tests come back with no indication of any problem. Symptoms with no pathology or diagnosis may often have emotional or psychological origins (e.g. psychosomatically induced pain). There are two primary issues that need to be considered;

1. It is often said that, “What the mind can’t deal with will manifest in the body”. Emotional pain can manifest as physical pain when an individual fails to deal with the underlying emotional pain, anger, guild, resentment, self-loathing and so on. When such emotions are suppressed… pushed into a dark little room in the back of someone’s mind and never dealt with or resolved, that emotional pain may manifest as physical pain.

2. What is the unconscious “Pay-Off”?: People generally make choices based on benefit to themselves. I don’t mean this in a selfish or mercenary way. It’s human nature that we make our choices because of the benefit those choices bring us. For example, Mother Theresa is credited with doing wonderful things to make the world a better place for all humanity. Without taking away from her contributions, there is a reason that she did all of those wonderful altruistic deeds… Doing them made her feel “closer to God”. In the final analysis she, like everyone else, did those good deeds because there was something in it for her. It made her feel closer to God.


A functional symptom is present because it provides a payoff. It is providing some benefit now, or has at some time in the past provided a perceived benefit. The subconscious mind has locked onto this benefit and holds tight to it even when the payoff is at too great a cost, or after the original benefit is long gone.


The subconscious mind is like a little kid. Tell a little kid, “Clean your room and I’ll take you for ice-cream”, the child will willingly clean the room.

In all likelihood someone whose issue is the product of a functional symptom has already solidly imbedded the perceived benefit of a reward derived from that symptom within their subconscious.


A woman came to my office, on a referral from her physician, with chronic back pain. Over a period of years her physicians had given her every possible test and examination. All tests had come back normal. She had been to an orthopedist, general practitioners, pain clinics, chiropractors, massage therapists, for acupuncture and on and on. Nothing worked. Her physician suggested that she try hypnotherapy, and referred her to me.

Her husband wanted to sit in on the intake and first session and according to him, to give me his feedback. It was fine with her so I allowed him to be present. After the intake, I knew instinctively that the picture was not complete but no additional information was being revealed. I induced hypnosis and did quite well in session. When she returned for her second session nothing had held. Before continuing with hypnosis I asked the husband to wait outside. I asked her… Is there anything else you need to tell me? She paused and said, “Remember when you asked me if anything traumatic or unusual had occurred about the time I began experiencing the pain. “Please don’t tell my husband that I told you this but”… And then she proceeded to tell me that her husband had had numerous affairs when they were younger and that she had stayed with him only for the benefit of the children. Virtually the day the last child moved out of the nest her back pain began. The emotional pain, anger, and frustration that she experienced and had held within for so many years had manifested as physical pain. Furthermore, there was a payoff. Every time housework or any activity that she did not want to do was eminent, the pain would come on full force. If, however, a friend were to come over to socialize etc. the pain would suddenly vanish. She was now in a position of power. The underlying emotion was… “You did me wrong, years ago in our marriage, and now you’re going to make up for it by being my servant and treating me like gold”.

The problem with this outcome was that her home life was becoming more and more dysfunctional because of the stress her sporadic pain brought into the relationship and the restrictions it placed on the activities that they should both be enjoying, now that they had an empty nest. For example, vacations would be disrupted or cancelled when the wife would “bring on” her pain, in a moment of anger or frustration with her husband.


Once aware of the “Functional Symptom” and the pay-off for its existence, I needed only to offer the “Ice-cream” that was of greater value to the “heartbroken young lady within”. One of the “ideas” that I had her lock on to, for example, was that the best way to make someone who has done you wrong pay penance, is for you to be incredibly happy despite their actions. She loved that idea.


Never cover up a problem. Address the source of the problem, not the superficial symptom. There are many cases where a functional symptom is the entire root of the problem. There are other cases where it may be a contributor to the problem. It’s like I’ve told my students for years, “”Getting the right answer to the wrong question is no more useful than getting the wrong answer to the right question”. The mind is a powerful thing that can easily manifest intent within the physical body. Although tests and examinations don’t always find a problem and there may in fact be a pathology that goes undetected, more often, absent any discovery of a medical pathology, consider the possibility of a functional symptom.

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