It All Goes Together

The current fashion in diagnostic practice is to isolate the emotional from the personal, and both of these from the spiritual or meaning-of-life.  Mostly, the personal and spiritual/meaning-of life issues are ignored, and the focus is mainly on the emotional.  So, for example, a patient may be diagnosed as depressed or bipolar, without further elaboration of their personality functioning or their spiritual or meaning-of-life issues.  We see this in medication advertisements on television, and in the way that diagnosis is usually done.


In fact, while diagnosing people in this way may be better than nothing, because it might lead to treatment decisions that might help with the emotional parts of disorders, it falls far short of a more comprehensive approach to understanding and treating human beings in distress.  In order to understand a human being more completely, we need to understand her/his emotional (“affective”) functioning, personality functioning, and spiritual or meaning-of-life orientation and issues.  And we need to place this understanding within the context of two stories:  the story of the person’s life, and the story of the situation or problem that brought them into counseling/therapy.


Now, understanding these issues doesn’t mean that they must be completely understood; that would be the work of a lifetime.  They just have to be understood well enough for treatment to take place.  And gathering this information, this “data,” is itself part of the treatment, for it encourages the patient/client into sustained reflection on her/his life and self, and builds rapport between counselor/therapist and client/patient.