Family Therapy with an Epileptic Girl Showing Hysterical Symptom for Manipulating Family Members

Abstract

　　It is not rare that an epileptic child uses symptoms to manipulate its family members. The epileptic child can easily find out that it can utilize its illness by stimulating parent's sense of guilt, and may become a tyrant in the family. It is a paradoxical situation that a young and helpless child has the biggest power over the family members. The effort of the parent to stop the symptoms of the child often brings adverse results. Family members begin to take parts of the drama triangle, persecutor, victim, and rescuer. The roles are changed by members, but they can never stop this game within the family.

　　The presenting problem of the identified patient of this case, a 12 years old epileptic girl, were talking deleriously after the attack, calling forth vicious ghosts, and cursing her parents. Most of her symptoms were thought to be hysterical ones.

　　Her medical records indicate following episodes. She got severe head injury at the age of 14 months old when she was cared in a day nursery. It was reported that she fell down into the bathtub accidentally. However, the nurse who was in charge seemed to have abused her and gave her severe injury. Aftereffect of head injury included partial paralysis of her right side of the body, loss of sight in the right eye, and narrowing of her range of sight. The paralysis of the body recovered through 4 months physical rehabilitation at the hospital.

　　At the age of 8, she had her first attack of epilepsy, and 3 years later she was reffered to our educational counceling center. She controlled her family members by using symptoms, claiming to be manipulated by vicious ghosts.

　　The therapist gave this IP and parent family therapy for 3 years, by using paradoxical intervention approach. The therapist gave them a positive reframe by stating that it was very effective for the family to admit her ghosts, and praised IP's power of inspiration. She also encouraged them to cope with ghosts through praying to God. A conjoint family interview was conducted for disclosing the facts of injury caused by the accident. IP was released from her suspicion to the parent who might have covered from her an important truth.

　　The family began to show more intimacy each other and restored loving relationship. Parental coalition became strong and each member showed their warm and kind consideration to others. IP increased her tolerance against using hysterical symptoms, and began to establish her autonomy.