The Prescription is Meaning
I’m peering over the paper blanket and into the doctor’s face between my feet. A big frustrated sigh moves through me.
“Everything looks normal and healthy,” she reports.
I am not relieved.
“You are completely fine” is the last thing I want to hear – I’ve been suffering increasingly for years.
I get a diagnosis, but one that means: strange and inexplicable by the medical system – vulvodynia – chronic vulvar pain with no identifiable cause, treated with pain medication or nerve blocks. I don’t have to spell out why those are red flag prescriptions (Numbing the pleasure portal? Fuck that!), which didn’t prevent me from trying in desperation.
That was 2021. Today, I am pain-free and bow to the force that caused my suffering because it utterly transformed me.
Intractable troubles are dependable messengers of the soul.
Vulvodynia was one of my major initiations into this worldview: that symptoms are FOR us, not against us. I discovered this by chance, really, and only made sense of it looking back.
I was not happy with the doctor’s diagnostic stand-in for “I have no damn clue what’s causing this.” I did my own research and became convinced I had, in addition to vulvodynia, a skin condition called lichen sclerosis. My research led me to one horrible next step. Everything I read repeated: if you only do ONE thing, don’t eat gluten.
At this point, I was still thinking literally (vs. symbolically) about my situation. Gluten has some mechanism in the gut, which causes the immune system to overreact and the nervous system to send pain signals when nothing is actually happening. The thinking goes.
I did give up gluten, and I did get better, but that was not the mechanism of action.
It was difficult to stop eating gluten. My favorite food is still toasted sourdough with butter. Second favorite is a croissant. Gluten-containing foods are fucking delicious and I took full advantage of them, eating them with almost every meal. It was a major lifestyle shift to cut it out.
But what was even harder, and unexpected, was the difficulty of insisting that others accommodate me. And the process of learning to truly accommodate myself.
Until then, I had an “I eat everything” type of personality. Go with the flow. Everything is fine. I’ll take what I can get.
I had built an entire life around that philosophy, and consequently, had a garbage disposal, left-overs kind of existence: living off the dregs of other people’s dreams, settling for a bland but reliable relationship, accepting what seemed fine but felt bad.
This became the symbolic exploration that led to my healing. My vulvodynia insisted I live my life for myself, declare my place in the world, and claim my deservingness to be honored.
This took shape in many ways.
I developed other dietary preferences and became what I had previously deeply rolled my eyes at: a picky food bitch.
It seems ridiculous now, but it took a long time to learn that it doesn’t matter if clothes are marketed as comfortable, or seem like they should be comfortable – they have to actually BE comfortable, for ME. This means I had to give up jeans, which sucks because jeans are the clothes parallel of bread, but I had to stop pretending I was someone else and start honoring the sensitive-crotched creature that is me.
I also left my marriage, sought therapy, and started taking control of my future.
Symbolically, I was working on a central theme through this growth: boundaries and self-respect.
People who met me after this transformation often define me by those qualities! But actually, I learned them, because my vulva demanded it. Listening to my painful skin taught me how to perform the symbolic function of skin psychologically and interpersonally.
Symptoms are our locked away power trying to embody.
When we learn to listen to them symbolically we make room for their full and profound expression, which isn’t suffering, but way wider aliveness. This process is much deeper, more transformative, and more satisfying than taking a pill – what we often wish we could do to make hard things go away.
The Symbolic vs. The Literal
Speaking of pills, let’s talk about when they’re made of sugar: the placebo effect.
The placebo effect is the thing prescription drugs need to outperform to be called effective. It is measured against because its effect is quite powerful.
Why is it that people often get better even when they are taking an inert pill?
Because the pill is a symbolic expression of the power of the medical system and one’s own hope in healing. That symbol is then taken in, swallowed. Literally, the pill is doing nothing because it is made of sugar. Symbolically, it is doing some HEAVY lifting. Ask anyone who took the placebo and got better: that pill is real.
Here’s another example.
In a podcast recently, a woman shares when she has to cross the aisle from the baby section to the kids section at Target. Crossing that threshold brought her to tears: grief over her child growing up, how short life is, how precious. That aisle was a powerful symbol for a transition underway in her life. Crossing into the kid’s section was a tangible, in-the-shared-physical-word representation of something huge for her psychologically.
I imagine her heart dropping, as she looked up at the section sign, her feet suddenly leaden. The weight of this transition was probably building in her for quite some time, perhaps mostly unconsciously. The world gathered up all her grief and love and pressed it into the symbol of that aisle, so it could finally crash into her, so she could cross that threshold meaningfully.
Literally, that woman was simply walking through Target. Symbolically, she entered a new relationship with her child. The symbolic is what carried weight for her in that moment, which is what brought the intense emotion.
Why does this matter?
My vulva wasn’t trying to hurt me or sabotage my pleasure. It wasn’t against me.
It ran out of quieter ways to get my attention.
Once I listened—not just literally, but symbolically—the pain no longer had to do the talking.
Sometimes what medicine calls unexplained is simply a language it was never designed to translate.
The question isn't whether symptoms have biological causes. Of course they do, sometimes.
The more interesting question is whether they also have meaning.
What if your panic isn't only nervous system dysregulation, but an unlived life trying to reorganize itself?
What if your chronic pain isn't only an error signal, but an invitation to become someone who can no longer tolerate abandoning themselves?
I'm not interested in romanticizing suffering. I'd rather none of us had to hurt.
But when suffering arrives anyway, we have a choice. We can spend all our energy asking, "How do I get rid of this?" Or we can also wonder, "What is this asking of me?"