Individual Deficits or Relational Problems?

Lately I’ve had a number of clients come through my door with stories that bare striking similarities to one another.  They’ve all described accounts of problems that consist of them “struggling with anxiety for many years”, or “having depression since I was young”, or “really having a hard time managing panic attacks”.  From my experience of living in the world – not even just as a counsellor – these are pretty common descriptions of problems people face in daily life.  They also leave out some very important details that I try to bring to the forefront in my therapeutic practice.

One thing that I find to be particularly interesting about the people who have made these statements to me recently is that they’ve all made considerable effort to find relief from these problems before coming to see me.  They’ve also all explained to me how at least one stop along their journey has involved time spent in specialized groups for anxiety and depression, or counselling approaches geared toward changing the so-called “irrational beliefs” that they’re told are causing their suffering, or medications designed to help regulate their emotions.

These and other similar approaches are among the most accessible interventions for people experiencing distress.  Although I’ve had many clients say that these interventions were at least somewhat helpful, I’ve also come to see how they fall short in some key ways.  When we describe people as “depressed”, “anxious”, having “low self-esteem”, or “anger issues” (just a few of many examples), we’re missing out on an enormous number of other details about those people.  Particularly, we’re failing to account for the contextual factors that support people in feeling the way they feel.  The descriptions I listed above all contain an implicit assumption that the problem resides within the mind and body of the individual.  If we understand problems in those terms alone, our only option is to try (often in vain) to “fix” people’s brains, or change the way they think.

I prefer to look at people’s problems in relation to things going on in their lives.  I know that may sound simple (like, duh!), but it’s a perspective that I think often gets overlooked when people seek help or go for counselling.  For example, if we understand unhappiness or depression as a response to some unfavorable circumstances, all of a sudden the emotional experience itself might not look all that problematic.  From where I stand, it makes a lot of sense to have uncomfortable emotions in the face of adversity, yet most of us are taught that we’ve deviated from what’s considered “normal” by feeling unhappy or distressed when things aren’t going well.

A number of theorists and writers whose ideas inform my therapeutic practice go into far more detail about these and other related notions, and I could write for days about these topics.  However, for the purpose of this blog post, my hope is to invite people to consider more of the context that their problems exist in relation to.  A simple way to do that is to ask questions like “in relation to what?” when someone (yourself included) talks about feeling depressed, anxious, bored, overjoyed, or any other emotional experience.  This shifts the spotlight away from the mind/brain of the individual, toward the social context, which can then be addressed to make things more livable.