Does Counselling and Psychology Pathologize the Individual?

Having been a counselor for 25 years (the last 11 in Victoria, BC) I have
noticed a shift in how I see the field of counseling and the study of
psychology.  That shift has involved moving away from seeing the client as
someone who has something “wrong” with them to seeing them as being more
sensitive to a disconnected, competitive, polluted, materialistic and
fearful environment and “culture”.  The way the modern world has changed
so dramatically since the industrial revolution has put an exponentially
increasing pressure on individuals to adapt to their environment.  The
theory of evolution with its “survival of the fittest” mantra emphasizes
survival.   I am not convinced that individuals who are most successful in
a toxic, uncaring, short-sighted and self-absorbed environment are the
ones we should be cheering for to propagate our species.

At times in our lives we have all been told to “toughen-up”, “suck-it-up”,
“don’t cry”, “don’t complain”, “get over yourself” as a response to our
deeper wisdom that something is wrong or unhealthy in our external
world/environment.  After a while when we keep mentioning the “elephant in
the room” and no one else wants to talk about it, we stop mentioning it
and eventually we stop seeing it. Historically, the main institutions for
control of the populace have supported that notion.  Religion, government
and schools all advocate or threaten compliance to their doctrine, dogma,
policy and ideas of “truth” while often times flagrantly disregarding
their own codes of conduct (dishonest politicians, clergy who sexually
abuse, wars for economic gain etc.)  The human individuals are left to try
and survive and idealistically thrive in this environment of oppression,
brainwashing and moral gymnastics.  When ultimately we cannot succeed to
thrive in this environment we face a crisis in belief.  During times when
these institutions cannot answer the questions and disappointments that
they create, we seek guidance and help.  If our relationship ends, if we
lose our job, if our mood and feelings cause us on-going distress, if we
develop sickness and disease, if we act out violently, and if we develop
unhealthy coping mechanisms that become habitual and problematic . . . we
get stuck and in our stuckness we turn to a counselor for help and
guidance.  The dominant cultures and institutions support this approach as
it pathologizes the individual for not being able to cope with these life
dilemmas instead of acknowledging the many other factors that contribute
to human suffering other than what the individual brings to the table.
What do counselling and psychology have to offer?  The answer to that is
not straight-forward or consistent as there are many theoretical
frameworks that guide individual counsellors and even more
modalities/techniques of counselling that we use to help people.  I do
believe that all too often counselling, in general, only scratches the
surface of the nature of reality for the client.  Counsellors who use
“Brief Psychotherapy” or “Solution-Focused Psychotherapy” are mainly
interested in not talking about the elephant in the room but in how the
individual can learn to tolerate and cope with the elephant and hopefully
not get squished or step in a big pile of elephant  $%&*#$!  Counsellors
who are employed by an “employer- funded” Employee/Family Assistance
Program (EFAP) or insurance companies are subtly and not-so-subtly
pressured to use as few sessions as needed to get an employee back to
work.  So the goal of counselling then becomes about returning to work and
not the deeper issues and multi-faceted factors that contribute to most
people’s problems.  What if the job, work environment, colleagues,
supervisors, corporate behavior, wages/benefits are part of the main
problem for the individual?  Here is a radical thought . . . “What if
spending 40 plus hours in an office, with unnatural light, poor air
quality, doing less-than-meaningful tasks for a company/organization or
government that is doing harm to individuals, communities or the
environment is the major cause of a person’s “dis-ease”?  What if behaving
in ways that are in conflict with one’s values, morals and ethics are
generating so much stress that someone can’t cope well anymore at work?
(Anyone just about ready to yell out those old familiar refrains of
“suck-it-up” or quit complaining” yet?)  Anyone who chooses to opt out of
this “matrix” of materialistic, consumer-culture competition gets to be
marginalized  and stigmatized, in society, as sick and weak and are deemed
to be lazy or even immoral for not pulling their weight.  On the issue of
morality, from an environmental perspective at least, the modern-day
hunter-gatherers are the most moral people on the planet (well at least in
the modern industrialized world).  They consume the least amount of
resources due to their poverty. They reuse, recycle and are very
resourceful with what they have in surviving in an environment of
scarcity.  Repeat this to a CEO of a big corporation and they might laugh
at you.  Maybe your own family might as well.

The canary in the coal mine analogy is appropriate to this topic.  Before
the advent of modern day technology to detect noxious gases in mines,
miners used to lower canaries into the mines first to see if they would
die or not from the existence of any noxious gas.  No one ever suggested
to the canary that it should not have died from the gas or that it should
suck-it-up or toughen- up.  I might suggest that the most vulnerable
people in our society (homeless, mentally ill, sick) are the most
sensitive people in our culture and that their sensitivity should be
respected and used as a stark warning about the health of our natural
environment as well as our social and political structures.  The word
sensitive is defined as delicate, conscious, knowing, precise psychic,
tuned-in and understanding.  The opposite for sensitive is heartless,
indifferent, insensitive, numb and unfeeling.  Are these the “qualities”
we truly want to value and promote in our society?

As counsellors I believe it is our responsibility to name the “elephants
in the room” each and every time we are supporting and guiding our clients
through their life’s journey.  To not name it, to not acknowledge it and
to not validate that reality for ourselves, our clients and our fellow
humans makes us complicit to the suffering that touches everyone.  To not
name the elephant in the room is the real sign of insanity.  To perpetuate
the delusions/illusions that our collective way of living on this planet
is healthy and sustainable is unethical and unprofessional.
To model, advocate, lobby and affect real change that shifts our current
way of being on this biosphere is a responsibility that I believe we all
have, especially as professional helpers.

We can aspire to heal people and prevent illness, not just treat symptoms
of a never ending dis-ease.  Ultimately, if we do our profession well, we
will make ourselves obsolete.   I look forward to that day.

Be well,
Jim Kragtwyk M. Ed, CCC, ICADC
Medicine Moves Movement Psychotherapy and Counselling Services
www.medicinemoves.ca
Victoria, BC