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This paper is written by a general practitioner with an interest in psychotherapy and psychosomatic medicine. It describes his response to the physical eye symptom ‘my eyes are misting over’ of a 10-year-old patient who was brought to the surgery by her mother who worried that her daughter might have an eye infection. This response was based on the recognition that emotions have physical components which sometimes are experienced in isolation and cannot be made sense of unless the emotional context in which they appear is understood. One of the commonest psychosomatic symptoms is tears, and unless the patient also feels the sorrow of which they are an integral part, he may not realise that he is crying, but may complain of misty vision, watery eyes, runny eyes, etc., and demand referral to an eye specialist.
In this case the initial understanding of the physical symptom as an expression of the crying response which was suppressed, was followed by three longer sessions during which the patient's emotions were explored. This was done by using Winnicott's squiggle method of communicating with children. This approach did not alter the family dynamics, or cure the patient, but helped her to understand and accept her symptom as an integral part of her emotional world, and guided her mother to accept that psychotherapy was probably the most appropriate way to deal with her daughter's problems.