title: Frame of reference and the detection of individual and systemic problems.
abstract: This paper briefly explores the following propositions: People usually attend their doctors with complaints of individual functioning. Sometimes these indicate malfunctioning of the individual concerned; this malfunction may be in the somatic domain or in the psychological sphere or may appear to be the former but in reality be the latter. Two other possibilities are also important, namely that a complaint of individual functioning may be occasioned by an external circumstance, or may be an indication of disorder in the family system or some component of it. In these instances it may be more profitable to focus upon the troublesome event or the system disturbance rather than on the individual complaints and if this is done the individual complaints may subside. A procedure is suggested which is different to the one commonly followed but which might be worth exploring. The usual procedure is to examine the possibility of somatic disturbance first. It seems likely that bodily complaints are more commonly indicants of event difficulty or system disorder than of bodily malfunction and when symptoms do not immediately draw attention to a well defined illness process, it is suggested that consideration be given to the possibility of joint meetings with all the relevant persons who may be supposed to be concerned in the systematic disturbance.
mesh_terms: D001143:Arousal / Q000502:physiology; D003071:Cognition; D003863:Depression / Q000523:psychology; D004644:Emotions; D005190:Family; D006801:Humans; D008393:Marriage; D001523:Mental Disorders / Q000175:diagnosis*; D008960:Models, Psychological; D010342:Patient Acceptance of Health Care; D012017:Referral and Consultation