The guilty person: when the head is tortured (migraine)

Helen, a 49 year old woman, was a well known professor, who had suffered from migraine headaches for about ten years, treated with various procedures giving only temporary relief. Although she was taking the most modern drugs for this illness, at least three times a month she was unable to work or even open her eyes.

During an acute migraine incident Helen was asked to close her eyes and increase the pain in her head. She grew redder and redder and the veins on her forehead became very prominent. Suddenly she opened her eyes saying: “…. I was in a village, being judged in a public square. Someone squeezed my head with a tourniquet to make me confess my guilt.”

Returning to active imagination Helen returns to the torture scene and screams to all that she is not guilty. But she rids herself of the tourniquet only when she denounces the truly guilty party: her mother. As she does so her analyst, is surprised to see the colour of Helen’s skin return to normal and the immediate relief from her migraine.

The patient had a deep maternal wound because at 14 she had discovered that she was the daughter of her mother’s lover. She recollected that even as a small child she had noticed her mother’s affairs. She was always terrified that her “lawful” father would discover them and murder her mother, because he had a violent personality. Her mother had forced her to be her silent accomplice, a fact that was hard for her to reveal even in analysis. She refused to get married but had many affairs, always breaking up the relationship upon falling in love with another man.

During analysis she was able to work through her hatred of men and her mother. She had a strong seductive defence mechanism but at the same time unconsciously identified with her mother. The therapy lasted three difficult years with much psychological instability. The terrible repressed suffering and terrible fear of what discovery of the betrayal might entail. Helen remembered that on coming home at night she was so afraid that her father might discover the truth that she would hide in the bed with terrible headaches. She hated men and blamed them for the anguish in her life but at the same time used her seductive powers (gained from her mother) to get money and destroy her companions.

The migraine remained the best symbol that expressed her complexes that revealed her constant telling of lies. The lying behaviour was a defence mechanism which protected the patient from a potential death situation. For, within her perception, due to her complicity she would be killed along with her mother. While involuntary, this complicity, even though it protected her mother, generated an unconscious of guilt that tortured the patient. Her organic symptom could only be relieved when she denounced the original conflict using active imagination repeatedly. Permanent relief took a long time because the defence mechanism surrounding the symptom protected the patient from deeper pain: that of being herself betrayed by her mother, who used and abused her love and loyalty.