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© NOVA NOVEMBER 2010
Why we do
'The person-centred approach doesn't ignore symptoms;
rather it looks beyond them.'
As in so many
other fields, our
of mental health
benefits from a
Sounds like a song title doesn't it?
But seriously have you ever
wondered why we do the things we
Our collection of life experiences
contributes to the making of us. We are
who we are and we do the things we
do based on the residual effects of the
things, circumstances and memories of our
past.Close your eyes for a minute and think
of a memory.
What is the first one that pops into
your head? Is it a strong memory? Is it a
good memory or is it a bad one?
Now consider your frame of mind --
right now: Are things going really well for
you or, perhaps, not so well. How are you
processing what's going on for you -- right
now? With an optimistic attitude or with
a negative bent?
Think back again to the memory
you just brought to mind and consider
whether what you do, or how you do what
you do, could be driven by underlying
unresolved life issues.
Where there seems to be a consistent
pattern of things not going well, it may
not just be one but many unresolved life
issues that have stacked up, one on top
of the other -- just like a precariously
balanced pile of pancakes.
You're coping quite well until, bang,
the pancake stack topples and you just
can't function as well as you would like,
let alone see yourself going anywhere else
but further down.
Many mental health practitioners
appear to approach providing care to their
clients from a standpoint of applying a
diagnosis, which then points them in the
direction of various treatment approaches
relating to the diagnosis. A cynical view
here could be that this can amount to a
pigeon holing of clients and a subsequent
railroading of treatment.
A person-centred approach rather
than a diagnosis-driven treatment plan
can open up a holistic view of the person
when seen in the context of their life
history. In this way, any relevant and
important contributory issues can be
considered rather than running the risk of
them being overlooked or even ignored.
Mental health practitioners who
find themselves overly oriented towards
diagnosis can lose sight of the individuality
of the person. It's that idiosyncratic
collection of experiences and circum-
stances that bring the person to the
symptoms with which they present.
An example of this could be the DSM-
IV (Diagnostic and Statistical Manual)
diagnosis of PTSD (post traumatic stress
disorder). In order to be diagnosed with
PTSD, one needs to exhibit a certain
combination of 17 symptoms. This can be
a legal rather than a mental health issue as
to whether one is suffering PTSD or not.
In preference, let's talk about traumatic
stress which includes those who may tick
the right boxes for PTSD, but also many
others who might not tick the right boxes
but are still distressed and have the quality
of their lives adversely affected.
Some things that can be very distressing
and traumatic for some people may not
affect others in the same way. This is
sometimes referred to as sub-syndromal
traumatic stress and it is a very useful way
of thinking about these disturbances.
In fact, unresolved traumatic stress,
among other things, can be important in
tipping vulnerabilities into symptoms. A
vulnerability to addictions may manifest
as, for example, problematic drinking.
A vulnerability to anxiety may underlie
the life-interrupting experiences of panic
Numerous academic studies support
the notion that traumatic events are
really quite common. There is universal
acceptance in the mental health world,
for example, that sexual abuse (in a
defined way) is part of the experience of
something between 25 and 30% of
women before the age of 18.
And that is just sexual abuse. What if
we look beyond that to, say, physical
abuse and emotional abuse?
As well as these categories of abuse
through an act being committed, there
is also abuse by omission, such as
neglect, abandonment and emotional
unresponsiveness by primary caregivers.
A diagnosis-driven focus usually leads
to primary attention being directed at
"symptoms". When we don't adequately
consider the individual, some very
important and relevant contributory
factors or issues can get ignored. This can
result in relative inefficiencies in regard
to treatment. Issues from a person's
psychosocial history -- not only the sorts
of abuse referred to above, but also
experiences of loss and disruption when
they remain unresolved -- can often be
at the basis of their problems.
The person-centred approach
doesn't ignore symptoms; rather it looks
beyond them. We can deliver treatment
more efficiently by viewing symptoms as
resulting from vulnerabilities the person
may have to various disorders. It's the
existence of life issues and experiences
that may remain unresolved that can tip
vulnerabilities into symptoms.
By adopting a bottom up approach
of identifying and effectively treating any
unresolved life issues, we can address
the symptoms with greater success.
One of the major obstacles to adopting
this kind of approach is that conventional
approaches to resolving traumatic stress
can often be expensive or painful, leading
to a high drop out rate.
In psychology today there are
emerging therapeutic modalities that can
be used to calm the emotional distress
associated with underlying life issues in
a gentle, non-invasive and efficient way.
Modalities such as Thought Field Therapy
(TFT) and Eye Movement Desensitisation
and Reprocessing (EMDR) can be very
effective in removing the negative charge
from memories of life events, usually very
So in considering seeking treatment
for an emotional disturbance, ask yourself,
"Why do I do the things I do?" and just
check whether there are any underlying
unresolved life issues that may be
contributing and bring them up with your
mental health practitioner.
Clinical psychologist Christopher Semmens MAppPsych;
BSc; BPsych; DipClinHyp; TFTdx has more than
20 years experience in the field. He uses TFT among
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