A tentative theory of human problems

An excerpt from my first semester of grad school

Photo by Xuan Nguyen on Unsplash

This fall, I began a 3-year graduate program in clinical mental health counseling at Northeastern Illinois University (thus the pause in my writing). The profession of counseling started with vocational “guidance counselors” helping students and urbanizing workers find employment, but has evolved over time to run parallel to the work of social workers, clinical psychologists, and psychiatrists. Confusingly, there is now a proliferation of credentials (LSW, Psy.D, LPC, MD) all calling themselves “psychotherapists”, an unregulated word. There’s an interesting history to be told about the evolution of the various mental health professions, intertwined with industrialization, secularization, world wars, civil rights legislation, and changing conceptions of wellness. I hope to write about some of these things over time, at least between trimesters of school.

My program involves a lot of writing and personal reflection. I figure I might as well adapt some of it for public consideration. The following essay was written in response to the prompt:

Describe your philosophy about how problems emerge, how people make changes in their lives when they experience problems and get better, and what role counselors can play in helping these individuals (how counselors can facilitate the process for individuals they work within a variety of settings). Explain what counseling theory or theories seem to align with your personal beliefs about change.

Humans have been contemplating this type of question for a long time. The Buddha framed his teaching of the Four Noble Truths in exactly this way, probably imitating the diagnostic style of doctors in his time:

1) Life is inherently problematic (unsatisfying, painful).

2) These problems have a root cause (attachment to impermanent phenomena)

3) This suffering can end (existential pain is resolvable, a big claim!)

4) There is a method for doing so (the Buddhist 8-fold Path)

I appreciated that my professor asked us to articulate our own theory of suffering and its amelioration, while also being keenly aware that I am treading in territory already explored by sages far wiser that me. One of my motivations for entering the world of counseling is the potential for therapist and client to make contact with these fundamental questions when there are real stakes, rather than just philosophize about them. I don’t know exactly what my future practice will look like, but I intend to keep teaching weekly classes and ensure the continuation of Grateful Yoga.

With that preamble, here’s what I wrote:

A tentative theory of human problems

I am skeptical that any one model can represent all sources of human distress. But, my broadest perspective is that mental health problems arise when momentarily-successful adaptations become structurally encoded, so that when the context changes, what was once an adaptive strategy becomes detrimental but is difficult to change. This plays out on many scales.

As individuals, even before we are born, our developing bodyminds assess the safety of the maternal environment and tune metabolism and neural networks to accommodate the anticipated environment (Cozolino, 2024). In our early years, well before language, we form attachment schema that color future intimate relationships (Bowlby, 1969). The coping strategies we learn over our long childhoods become solidified into our identity. To change these habitual behaviors and cognitions feels like a mortal threat to the ego, so often we prefer to suffer rather than risk changing. In the same way, family and social systems that depend on individuals behaving in predictable ways will exert negative feedback if members try to change (Neukrug, 2022).

There is a quote often misattributed to Anais Nin, though it likely was written by Elizabeth Appell (Vitali, 2021):

…and then the day came
when the risk to remain tight,
in a bud,
became more painful
than the risk it took to blossom…

For me, this summarizes the situation when someone begins therapy or any process of transformation. At some point the shell of our old habits and circumstances becomes so tight and ill-fitting that our discomfort drives us to risk changing. Problems are resolved when inner and outer structures are updated to align with present moment realities and future aspirations. In this view, mental health is a good-enough alignment of inner and outer realities, a reasonable fit between demands and capacities, and the ability to adapt as situations (inevitably) continue to change.

Life is complex, and it’s not always clear what isn’t working, and what options there are for change. This is where counseling can be of service. A counselor facilitates a process of clarifying problems, what gets in the way of change, and what possibilities for change exist. Change can happen internally, such as adjusting self-image or revealing false beliefs, or externally such as beginning or ending a relationship, setting personal boundaries, establishing new habits, or gaining access to needed resources. The counselor ideally offers a warm, empathic space where it feels less risky to explore new possibilities, much as a parent provides a holding environment for a child (Winnicott, 1960). The counselor has faith that change is possible, that no problem is permanent or intractable, even though they cannot tell the client how to fix things. At best, the counseling relationship serves as a catalytic space for the transformation that is ready to happen.

Given the above perspective, it is not surprising that I find myself most drawn to humanistic and existential theories of counseling. I have long been a fan of Carl Rogers, whose philosophy deeply informed the Phoenix Rising Yoga Therapy school where I trained from 2007-2011. I have personally witnessed, in myself and my clients, how the impulse for self-understanding and healing emerges when there is unconditional positive regard, empathy and genuineness (Neukrug, 2022). I am also a lifelong student of Buddhist philosophy, which is primarily concerned with existential questions of human suffering and meaning. I also find evolutionary and historical perspectives on the human condition very compelling, particularly in the way they undermine the notion of a single true meaning or purpose to the world. Instead, we are each given the opportunity (and burden) of figuring out what to do with our motley inheritance of urges and impulses, how to make meaning in this miraculous and deeply contingent life. This existential challenge lies beneath any particular problem, and for me, it seems vital to include - if just as a background flavor - in any act of counseling.

References (I’m so fancy now!)

Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. Basic Books.

Cozolino, L. (2024). The neuroscience of psychotherapy: Healing the social brain (4th ed.). W. W. Norton & Company.

Neukrug, E. (2022). The world of the counselor: An introduction to the counseling profession (6th ed.). Cognella Academic Publishing.

Vitalie, D. (2021, November 3). Can we stem the proliferation of misquotation? 190Days. Retrieved November 25, 2024 from https://190days.com/2021/11/03/can-we-stem-the-proliferation-of-misquotation/

Winnicott, D.W. (1960). The theory of the parent-infant relationship. The International Journal of Psycho-Analysis, 41, 585–595.