“If existence is no longer supported by spiritual forces, it becomes unbearable in the impossibility of even comprehending its meaning, a person rushes into his illness, which, like something foreseeable, covers him and protects him.” I recently came across this quote from Karl Jaspers from “The Phantom of the Crowd” somewhere on the Internet and was amazed at how accurately she describes such a mysterious phenomenon as psychosomatics. A person rushes into illness. How true this is. How accurate is that? And how creepy. Run into self-destruction, go downhill, defend yourself not with strength, but with weakness. “Disease by choice” becomes a clear enemy, by fighting which you can justify your inaction, lack of development, work, relationships, success, etc. Avoid the shame associated with this . And get respect. Together with other secondary benefits of the eternal “beneficiary”. How does this happen? Illness by choice becomes a form of creative adaptation, that is, a way of coping with difficulties. Let's imagine a child who is not very successful at school in terms of academics and perhaps relationships. At the same time, he receives little support from his family. Or doesn't receive it at all. Can't talk about his difficulties. He is being shamed. They devalue experiences. “Well, why are you so weak! All children are like children!” Or something else like that. He can't leave school. But he might get sick. This is an excellent circumstance that is appreciated by everyone. Mrs. Good Reason: At first, a child may just pretend, and then get really sick. You don’t have to go to school, your parents start caring, feeling sorry for you, giving you treats, indulgences, and hugs. School problems remain behind the bastion of the disease. Somewhere. In the soothing “later.” They won’t decide that way, of course. But for a child, not seeing means not having. With what he has, it's an effective strategy. The body gets sick to preserve the integrity of the individual. Such is the paradox. The child becomes an adult. But he continues to face various life difficulties. Still without basic support, he can run away into illness, according to the old technique that has proven itself in battle. In those moments when it seems to him that he cannot cope, cannot bear it, cannot stand it. But there is no inner figure who would say “you can handle it” and “it’s okay, you’re still good.” And then illness can truly become a refuge. Leading activity. Lifestyle. The entire space beyond the disease, symptoms and known actions is filled with anxiety. Life narrows down to illness, to an understandable framework with which a person can cope and, at the same time, maintains this condition so that it does not end. Therefore, treatment of people who are ill by choice is often not effective. Illness as a way to live. This life has everything: fatigue, joys, sorrows, victories, failures, hopes, aspirations, communication, the area in which you understand. But, unlike life outside of illness, this does not involve competition with other people or assessment of your skills. Your abilities here, in illness, will always be judged well, because you are doing well and coping with adversity. And of course, it all comes to fruition powerful repression. After all, to realize means to accept responsibility for your life, for what is in it and for what is not. And this is exactly what a person diligently protects himself from. Therefore, it is difficult to help such people. Since it is difficult for a person himself to see a problem in this. And the disease again becomes a form of resistance and justification for all inactions. And in therapy too. But difficult does not mean impossible. If a person is best at being sick, then so be it for now. Why take away something that supports you so well? But in parallel with this, you can look for something else that could give you the feeling of “I did it” and turn into a positive experience. Pay attention to this, protect it from depreciation, learn to appropriate small achievements and rely on them. Patience, time, faith, support, acceptance - still the best doctors I know.