by Dr. Allen Bonner, DPC, LPC
Counseling sessions with different clients are always just that….different! No client or counselor is the same, but one conversation that usually comes up, at least in the therapy room with me, is “What came first? The chicken or the egg?” This question is always a good conversation starter because it gets the client to open up about their past, and it can give the counselor much insight especially in regards to distinguishing between their primary concern and the possible root of the cause of their struggles.
When clients come for help, it is crucial to understand the importance of dissecting what is potentially causing their current issues- whether it be depression, anger, anxiety, or any number of other struggles. One of the counselor’s roles is to also help the client distinguish between a situational stressor or a possible larger, undiagnosed issue. For example, does someone currently have depression, anxiety, or anger issues because of a situation they are currently facing? Or are they having trouble dealing with the situation, this phase of life, because of not knowing the real root of the problem? Seeing past the metaphorical trees in front of our face and trying to look at the whole forest is crucial.
During a counseling session, I always bring up the “pie chart of life.” There are aspects that contributed to the person they are today and could possibly help connect the dots to their present problems. The pieces of the pie chart that I usually bring up are:
- genetic predisposition
- family dynamics (which could include their upbringing and current issues)
- trauma or abuse
- biological/physiological factors
- current life situations/struggles.
Sometimes clients may have a clear diagnosis and may have had it for quite some time, but for other clients the concept of a diagnosis can be quite unnerving and one in which they do not know how to navigate. When conducting therapy, I ask the client to think about their family history, if they know of it. “Do you remember or were you ever informed about a parent, grandparent, or any other family member who struggled with some sort of mental illness, such as depression, anxiety, bipolar disorder etc.” This question may not relate to some, but to many others, it helps them start to put the pieces of the puzzle together. I also ask clients to consider their upbringing. Was there blatant trauma or abuse, or was there possibly neglect or tension in the household? Our brains develop until we are 25 years old, and when our brains are under constant stress, there is an overproduction of cortisol which can affect the way our brain develops. This, in turn, affects our emotional and cognitive development. Even if trauma or abuse did not directly maladaptively effect our brain development, we also could have learned maladaptive life and coping skills based on familial interactions and behavioral examples. When considering biological factors, a client should consider the last time they had a medical exam. Could any of what they are struggling with be due to a medical diagnosis or physiological or hormonal issues? There are many medical problems which can make one’s behavior seem related to their mental health when the root of the problem is actually a medical problem.
At this point in therapy, we have covered much information, but I always like to ask about the client’s family dynamics. Maybe we are not dealing with a diagnosable issue on their part but possibly someone in their family which in turn could have caused unhealthy dynamics and learned behaviors that are not necessarily realized until later in life. And of course, a client could have just experienced a major loss like a death in the family or the end of a relationship thus they may be dealing with depressive or anxious “symptoms” and not necessarily meet all the criteria for a diagnosis.
When going to a counselor for therapy, it is crucial to approach the experience from a holistic perspective.
There could be many variables that have contributed to a present life issue. Being willing to open up about one’s past is important. A counselor will be able to provide an unbiased perspective and help a client see things through a different lens. Sometimes problems in the past have been dealt with and may not be directly affecting a current life problem. But with every new chapter in life, problems may be seen or dealt with by us differently. As our body changes and grows, so do various hormones and chemicals. We all need to be able to take a step back, look at the big picture, uncover every stone, and consider all of what is possibly contributing to our current problems and state of mind.
March Christian Counseling offers therapy, medication management, and psychological evaluations.