“In this world there are only two tragedies. One is not getting what one wants, and the other is getting it.”—Oscar Wilde
There is a darkness within desire that haunts most people. In its rawest form, desire is a wild creature whose constant yearning can unsettle both the individual and society. That is why we try to tame it, regulate it, or suppress it. Yet there is a hidden cost. When desire is stripped of imagination and emotional life rather than symbolically transformed, it may not only diminish our psychological vitality, but it may also leave the body more vulnerable to illness. Between unbridled expression and suppression lies a third path: symbolic elaboration, the psychological work that transforms desire into the psychic vitality that helps sustain both mind and body.
The Seduction of Purpose
The evidence for purpose is seductive — and real. In Japan, researchers studying ikigai — roughly, “that which makes life worth living” — found that adults without it had a 50 percent higher risk of dying over seven years.1 A 2026 meta-analysis of nearly half a million participants confirmed the global pattern: Purpose in life was associated with an approximately 30 percent lower mortality risk, even after controlling for behavioral and clinical risk factors.2 Purpose, it seems, keeps us alive. What could possibly be dangerous about it?
Purpose, as Aristotle understood it, was never a goal you set. It was the inner movement of a living thing toward its fullest expression — the telos, an intrinsic drive woven into the organism itself. 3 But the modern science of purpose has replaced this with something thinner: conscious intention, goal-directedness, a reason to get out of bed. The scales that produced those impressive mortality statistics do not measure Aristotelian flourishing. They measure whether you can articulate a plan.4 And a plan, however earnest, is not the same as the deeper psychic vitality that keeps the body alive.
The problem is that purpose and psychic vitality are not the same thing. Clinicians working in psychosomatic medicine noticed this decades ago. Pierre Marty and the Paris Psychosomatic School described patients who were goal-directed, productive, even high-functioning — yet their bodies were at risk. He called their cognitive style pensée opératoire: mechanical, fact-bound thinking stripped of fantasy, imagination, and emotional elaboration.5 It is like a mind running on purpose with only a destination in mind. According to the Paris School, when emotional experience can no longer be processed psychologically, the risk of serious physical illness increases.5
The closely related construct of alexithymia — difficulty identifying emotions, constricted imagination, externally oriented thinking — has been consistently linked to somatization, chronic pain, and medically unexplained symptoms.6 Somatization can thus be understood as the body’s expression of what the mind cannot elaborate symbolically — unsymbolized emotional arousal that finds no outlet in fantasy, language, or relational life.8 A person can have every reason to live and still lack the psychic vitality to do so. What is missing is not purpose. What is missing is desire.
Desire and Its Symbolic Life
If purpose without psychic depth leaves the body vulnerable, what protects it? Marty believed it was the mind’s capacity for symbolic imagination—the ability to transform raw emotional energy into dreams, images, and meaning rather than allowing it to be expressed through the body.9 Rosenberg called this process a “guardian of life,” arguing that when it fails, the body becomes increasingly vulnerable.10
Clinical evidence supports this view. Improving mentalization—the ability to understand one’s own and others’ mental states—reduces depression, anxiety, and physical symptoms during psychosomatic rehabilitation.12 Short-term psychodynamic psychotherapy, which restores symbolic and emotional processing, significantly reduces physical symptoms, with benefits lasting over time.13 Even expressive writing—putting emotions into words—reduces physical symptoms. In one study of 277 kidney cancer patients, it improved physical functioning and reduced symptoms at 10 months.14
The processes that protect the body are surprisingly ordinary. One is daydreaming, which occupies 30 to 50 percent of waking life and, when focused on close relationships, increases happiness, love, and connection.15 They include creativity, intimacy, and naming emotions—the symbolic life of desire that allows the mind, rather than the body, to carry emotional experience.
Wilde’s paradox — that getting what you want is as tragic as not getting it — is not cynicism. It is a precise description of desire’s nature: desire is never finally satisfied, and that is its power. The tragedy is not in wanting. It is in believing that fulfillment will end the wanting, or worse, in ceasing to want at all. What Aristotle called purpose was never a destination — it was the living movement toward fullness. Modern science kept the word but lost the movement. That movement is desire. The prescription is not to abandon your goals but to tend the inner life that sustains them — to daydream, to feel, to let the imagination do its quiet, vital work. Your body is listening.
