Most of the time, our brains like to understand things by analogy—comparing them to something we already know—and by reducing them to seven steps or 3 factors or some kind of manageable number of things to think about. The problem with this method of knowing is that it causes us to think we understand when the situation is much more complex.
For example, media stories, and even some real human beings, like to view psychological distress from a “medical model” perspective: “If something’s broke, fix it.” While this tends to work moderately well in physiological terms, the mind is a much more complex entity than the body. Viewing life problems as “just like a broken leg,” or even, “just like diabetes”(which by the way is an incredibly complex syndrome), gives us the impression that we can look at psychotherapy just like medical treatment.
While this view arises partly from the structure of reimbursement through insurance payment, it gives rise to some serious problems and misunderstandings. First of all, a person has to accept that they are “broken” in order to deserve psychological therapy. Second, it implies that psychological distress is caused by one thing, which, if alleviated, will eliminate the distress. And third, interventions become mechanistic and disembodied to the point that we need “evidence” and “accountability” to make sure no one is getting away with anything.
In fact, most of the time, when someone comes into my office, they do identify a problem. A woman might say, “I’m trying to figure out whether to divorce my husband.” In her mind, she has identified a concrete question, and she just wants to figure out the answer. Most of the time, the initial question is rather easily answered. But with some thoughtful attention, what unfolds is a much more complex situation. What are her assumptions about marriage and about what her husband should be doing? What are his assumptions? Is she comfortable with the deep intimacy marriage entails? Is he?
After the initial question is answered, it becomes a matter of whether that person would like to pursue a deeper connection with him or herself and construct a more optimal life, one that will resonate with his or her deepest ideals. For most people, one answer is enough. It is difficult, time consuming, and costly to insist on doing the best you can do, in any arena. In the extremely complex universe of one’s own inner world, we cannot rely on external measures, other people’s opinions, or theoretical structures. Finally we have to trust our own evaluation of whether a deep relationship with a committed and caring person can help us discover new territory, claim it as our own, and inhabit it with joy. How is that for an analogy?