One of the principle ideals behind the concept of good therapy is that it should be non-pathologizing; that is, difficulties faced by clients should not be seen as intrinsic, inescapable diseases, nor should treatment focus on “healing” an issue in such a way. There are many reasons why a departure from pathologizing therapy is beneficial, both for the client and for the mental health professional (not to mention the field at large). But recently, psychotherapist Tammie Fowles published an op-ed piece that describes, if incidentally, a particularly important idea in the argument against pathologizing.
Fowles notes that all too often, approaches to therapy seek to internalize emotions, transforming knee-jerk reactions and emotional reflexes into complex ideas about what is wrong with the self. In this way, the experience of fear at the sight of someone being assaulted or the emotional reactions sustained during a store robbery might be turned on their head and used to reflect something maladaptive or insufficient within the client. Yet while the examination of why we react as we do has the potential to enlighten and heal, attributing our feelings to being a certain kind of person or having an emotional “script” that we follow based on some internal problem can not only disrupt the healing process, but can ignore the greater picture.
That greater picture, suggests Fowles, is that society as a whole is far from being perfect, and many of the more common challenges we face day to day are reflections of the society of which we’re a part. Pathologizing as a treatment modality, then, can sometimes make individuals responsible for those attributes of society that aren’t so positive. Though Fowles has many scathing points to make in her exploration of the modern face of therapy, this subtle nod towards a more proactive and realistic approach has been welcomed by many.
© Copyright 2009 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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