Many therapists describe their work
through a list of diagnoses. While this can be useful in signalling familiarity
with certain forms of distress, it rarely captures what actually takes place in
therapy. For this reason, I prefer not to define my work too narrowly by
diagnostic categories or rigid notions of “scope”. People seek therapy because
they are suffering, and that suffering does not always arrive in recognisable
or well-contained forms.
I am cautious of the assumption
that particular experiences must always be directed to specialist sub-fields —
that questions of sexuality belong only with a sex therapist, or grief only
with a grief counsellor, for example. While specialist training can certainly
deepen a therapist’s knowledge, suffering does not wait for ideal conditions or
perfect referrals. As therapists, we often have to work with what
emerges in a person’s life as it emerges, rather than only with what neatly
matches a predefined category.
Diagnostic language can tell us
something about the type of difficulty a person may be facing, but it says very
little about how that difficulty functions in their life, what it is bound up
with, or what it means to them. Two people may share the same diagnosis while
living radically different experiences of it. In practice, therapy is less
concerned with the label itself than with the particular history,
relationships, conflicts, and meanings through which a person’s distress has
taken shape.
From this perspective, there is no
such thing as a generic problem. A person presents with anxiety, depression,
grief, trauma, or relational difficulty because of a highly specific
constellation of circumstances. Sometimes these circumstances are immediate and
visible; at other times they are part of a longer personal or even
intergenerational history. What feels unbearable in the present may carry
traces of experiences that were never given language, recognition, or space to
be thought about.
Often, suffering becomes fixed
under a name long before it is understood. Therapy offers an opportunity to
slow this process down — to move beyond what something is called and toward
what it does, what it disrupts, and what it may be attempting to express. My
work is guided by the idea that meaningful change becomes possible not through
fitting experience into pre-existing frameworks, but through attending
carefully to what is singular, unresolved, and unheard in each person’s story.
With all that said, below is a list of some common problems that people come to therapy with:
Persistent anxiety, unease, or a sense of internal pressure without a clear cause
Low mood, emotional flatness, or a loss of meaning or direction
Repetition of painful patterns in relationships, intimacy, or work
Experiences of loss, grief, or absence that have not adjusted with time
The effects of overwhelming, disruptive, or traumatic experiences, past or ongoing
Difficulties with identity, self-concept, or feeling “at home” in oneself
Conflicted or troubling thoughts around sexuality, desire, and intimacy
Shame, guilt, or harsh self-criticism that interferes with daily life
A sense of being stuck, blocked, or unable to move forward despite effort
Questions that feel difficult to articulate, or problems that resist easy explanation
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