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  • Writer's pictureElena Dasgupta-Tsinikas, LCSW

The Iceberg: A Metaphor for Healing

Updated: Feb 9, 2019

Often people ask me why, if my practice is located in sunny Southern California, do I use an iceberg graphic to represent my private practice? As this is my very first blog post, I figured what better topic to begin with than my very favorite therapy metaphor!

The Tip of the Iceberg

"The tip of the iceberg" is a phrase commonly used to refer to situations in which we are seeing only a small part of what is really a much bigger issue. This metaphor is meant to communicate that there is much more "below the surface" to be known or explored.

Surface Symptoms

As a metaphor for trauma treatment, the portion of the iceberg that is visible above the surface of the water consists of a patient's "presenting symptoms." These might be, for example, feelings of depression, nightmares, irritability, anxiety, dissociation, difficulty sleeping, difficulty concentrating, relationship problems, and more.

If we treat only these presenting symptoms, it is possible to see some progress in therapy and some symptom relief in the short term. However, what lies below the surface? What is it that is causing these symptoms in the first place?

The Trauma Beneath

If unresolved trauma or grief are below the surface of our day to day interactions, contributing to and exacerbating our symptoms, then over the long term, these symptoms are likely to continue. If we don't address the trauma, then by extension, the rest of our symptoms will never be fully addressed.

More simply put: if we focus only on the tip of the iceberg (our present day symptoms), we are ignoring the enormous mountain of ice (past trauma) that lies beneath the surface of the water and is keeping everything else afloat.

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