When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

Five main psychological dimensions of a person: feelings,
hopes, abilities, relationships with others, and behavior

We see right away that, for the same reasons that there are specialties in medicine—e.g., orthopedy for bones, neurology for nerves, dentistry for teeth—there should be special approaches that focus on different psychological dimensions of the person.

Something else you may see is that the five dimensions in the model are not isolated from one another. They interrelate and overlap a good deal. Just as a dentist must know about the orthopedy of the jaw and skull and the neurology of the teeth a neurologist and an orthopedist are expected to know something, though not in great detail, about dentition. Each of us is a unity of what all the medical and psychological specialties study in different ways, plus a good deal more, as artists, writers, theologians, and musicians make evident.

That more than 130 distinguishable therapies have now been developed may perhaps strike us, even so, as excessive. But efforts are being made to unify many of these approaches, and this book is one of them. Rather than talking about 130 different approaches, we will center our attention on the main categories into which the many approaches can be sorted.

One of the interesting and hopeful things that can be said about the multiplicity of approaches to therapy and counseling is that treatment by any one of them can often be of some help. For example, Helen may wish to stop drinking (a habit in the behavior category), and she may be helped by means of behavior modification. She may then find that, as a direct result, her self-concept (feeling category) has grown stronger, while her marriage (relationship category) has also improved. Or, Ralph may go to a vocational counselor who helps him define a direction (hope category) in keeping with his interests and aptitudes. Ralph goes back to school and develops a background (abilities category) that reflects these aptitudes and interests. The sense of direction he has gained helps Ralph stop using drugs (behavior), reduces his hostility and anxiety (feelings), and improves his relationships with others. In other words, a helpful change in one direction can often lead to noticeable changes in others.

However, there also are risks that we should not ignore: Sue goes to an analyst and learns over a period of months that her marriage to Fred was based on a sense of inadequacy Sue learned during her childhood. Her father was so highly controlling and critical of her that she was never able to develop a sense of her own value. Her husband, Fred, is also domineering and authoritarian, and he abuses Sue frequently, usually mistreating her through criticism, but he has sometimes also beaten her physically. Sue has accepted this without question for a long time, but due to the emotional support received from her analyst, she is beginning to develop a sense of self-esteem. As her self-esteem grows, she comes to realize that her marriage is a self-destructive relationship and decides to divorce Fred. Her therapy has been helpful to Sue, but it has, indirectly, resulted in a breakdown of her admittedly unhappy marriage. A change in one dimension can sometimes lead to an initially unintended change in another area.

IF IT HURTS, DON'T PROCRASTINATE!

One of the marvelous things about human nature is the ability to feel pain. This may seem like an odd thing to say, but reflect for a moment. Pain is frequently what spurs us on from an unsatisfying and even destructive situation to a better future. Pain tells you to jerk your hand away from a hot stove. A different kind of pain tells you it is time to get on with living, time to initiate some positive changes. Anxiety, sleeplessness, irritability, resentment, depression—they all can be painful inner feelings that tell us that all is not well in our inner selves.

It is well-known to counselors and therapists that, in general, the longer these signs of need are ignored, the longer it may take to help a person resolve the difficulties that have been pressing for attention. Distress is not easily buried. When suppressed, it tends to pop up again later, sometimes with increased severity.

We can, ironically, choose to be "strong" and ignore these messages from within, or we can listen to our feelings, pay attention to our hopes, develop needed abilities, seek to improve our relationships with others, and work to change some ways we behave that block our happiness.