Working Non-pathologically Does Not Negate Pathology, it Depathologizes it.
February 26th, 2007 |
I received a message about non-pathological based therapy from an anonymous mental health professional. He wrote the following commentary about me and my like-minded colleagues:
“Without saying so explicitly, you are implicitly judging psychopathology as an indicator of some pervasive ‘badness’ that is incompatible with the goodness of a human being. The trouble doesn’t lie with psychotherapists who recognize psychopathology, but with therapists who judge psychopathology as bad. It is no solution to blind yourself to 100 years of literature on psychopathology and it is no solution to blind yourself to the ‘whole’ human being, pathology included, who is sitting right before you. The solution is to face up to the covert declaration that you’ve made regarding psychopathology, namely, that allowing yourself to see patients’ pathology would make them bad in your eyes.”
I believe this well-meaning and bright individual is jumping to conclusions about what it means to work non-pathologically. I thought it would be useful to others who may jump to the same conclusions to share my response to him. Here’s what I wrote:
“Dear Dr. Anonymous, Your first sentence which suggests that I and my community of ‘non-pathologizing’ therapists are somehow judging psychopathology as some pervasive badness, couldn’t be further from the truth. Actually, it’s just the opposite. S— happens in life and no one gets through unscathed. Protecting ourselves with depression, phobia, addiction or any other defense comes with the territory of being human. We are all vulnerable, we all suffer, and we all develop strategies to survive. What I am declaring is that ‘pathology’ is adaptive and that it is possible to heal, change, and transform.
It is my experience that parts/strategies/ego states/defenses/pathos are truly benign at the heart of it, not malignant. A quick example of this is how the man with the high profile 100 hour a week job who endlessly strives to be the best, to be the most successful, may really be attempting to cover and compensate for childhood feelings of worthlessness. In my view the striving part of such a man is a ‘good’ part in that it’s trying to help. The man couldn’t have survived his worthless feelings without it. Yes, the striving is destructive to him and his family, but it’s all he knew how to do…. This is one example of thousands. So this is why I describe my approach as non-pathologizing, because it sees the good intention behind what you label as “pathology.” Thus, it’s not that I’m blind to pathology…. I may disagree with you about the origin of pathology and the potential for healing pathology, but I am not blind.
Furthermore, recognizing ‘pathology’ in another human being does not make one bad in my eyes, as you write. In fact it’s just the opposite. Seeing protective parts, defenses, and wounds within people opens my heart and evokes compassion. The only hope people have of healing is developing understanding, compassion, and acceptance for their defenses and wounds. If a therapist can’t open their heart to their client’s defenses and wounds it becomes less likely the client will be able to open their heart to themselves.”
Is there anything you would add in a response to the anonymous professional? Please comment and let us know.
© Copyright 2007 by http://www.GoodTherapy.org Therapist Boulder Bureau - All Rights Reserved.
Pathology is a way of understanding and treating maladaptive behavior. It also provides therapist, counselors, psychologist etc. with some of the most effective ways to intervene with clients. However, if we spend more time in sessions educating our client’s on their pathology e.g. DSM IV, maybe as a therapist we are putting the client in a pathological box that we think or feel competent to treat. When this happens it often results in treating the pathology, not the person.
It is useful to understand and treat pathology we are indebted to those who have provided us with a wealth of information and understanding about human behavior. However, once the pathology is “Re” “Cognized” the client only has a better understanding of an aspect of who they are. They are not their “pathology” In the profession, we treat person with pathology we do not treat the Pathology which happens to manifest itself in a person.
Thank you for these thoughtful words.
One more thing to consider is the interpretation of the term “pathology”
-logy means study of/knowledge.
Pathos means feeling, passion, suffering, undergoing. In the ancient Greek, it generally carries a sense of “being done to” (usually by some God).
Now, put somewhat crudely, we could take “pathology” to mean being whacked over the head once again, by yet another god, this time an academic/medical god: “You have an illness. It is called body dysmorphic disorder. I have studied this illness. Here’s what you need to do.”
Or — an unhappy person can sit down with someone interested in him who can mention, at some point, “You’re a great guy, and you’ve got lots going for you. And you’ve told me that this confusion about how you look really troubles you. I’ve talked to and read about other people with similar problems, and how they’ve dealt with that. If you’d like me to, I’ll tell you about it. But first of all, tell me what it’s like for YOU and what YOU think might work.”
Pathos (suffering) and logia (knowledge/study) in both situations. Expressed and experienced very differently.