#15. Three levels of a problem

This text about the layers of psychological issues will take you 9 minutes to read

When people come to a counselor, they tend to bring problems. Not many come to a session to brag about their perfect life, and if they do, it usually means they have a lot of problems. Some come without a particular problem in mind, not having focused on a specific request, but that doesn’t mean there aren’t problems in their lives; it means there are many of them, and they’re hard to prioritize. So interpreting problems, understanding what a problem is, what it consists of, and how to go about resolving it is a paramount skill for a counselor.

So what is a problem? Well, a client usually conceptualizes a problem as a situation that frustrates his needs. A constellation of circumstances, arranged in a way that, in their opinion, prevents him from fulfilling his desires in an acceptable manner to him. There are a few things to point out in that understanding.

One is that the problem might not completely preclude a person from achieving their goal, but just raise the price above their expectations. Jack is a carpenter who wants more money. He is completely capable of earning more by working more, but see, that’s the problem: he doesn’t want to work more. He can get what he wants, but there’s a price that he’s not happy with - and that is enough to consider the situation a problem. Sometimes people see the price as too high, in a way that most can get behind. Jill wants to be with Jack, but she is a liberal atheist, and Jack wants his paramour to be a devout Christian. It’s not impossible for Jill to become, or at least fake being religious, but most would agree with her assessment of it as too high a price. Sometimes people don’t want to pay any price at all. Jack isn’t willing to increase his workload one bit; in fact, he aims to reduce his hours, feeling he’s already working too much, so any additional work is seen as excessive. The point is, there is no need for an immovable obstacle for a person to see the situation as a problem; a discrepancy between expectations and the reality of price is enough.

The second point here is that the inhibition in question, however small, may not even exist. “In their opinion” is an integral part of the discourse. A person may think they have a problem when in reality they don’t. Jack could just raise the price for his services—and achieve both of his objectives: lower the workload and increase the earnings. But he doesn’t even consider that option, or does, but doesn’t believe it to be viable. Hence, Jack “has a problem”, which he may even bring to a counselor. And if he’s convincing enough and the counselor isn’t versed in carpentry pricing, they may both take the notion that raising prices is off the table as granted and spend time looking for ways to either motivate him to work more or let go of the dream of higher earnings.

But the third, and the most crucial aspect of that way of conceptualizing a problem, is the situation, external to the person’s psyche. Please pay attention, because it’s going to get tricky. It’s one thing when a person blames obviously external circumstances: the state of a market, politics, other people’s actions, weather, wars, what have you. In these situations, it’s not hard to spot the shift of responsibility: the person is attributing their suffering to something else. Which may be entirely valid, in some cases. And entirely neurotic in others. But what’s harder to notice is when the person includes part of themself as external to their will situation. “Oh, I’d earn so much if I weren’t so lazy!” wails Jack. This is the tricky part. At first glance, you might fall under the illusion that Jack here is taking responsibility. He’s blaming himself, doesn’t he? No, no, he doesn’t, nor really. If you watch the logic of his complaint or his emotional profile closely when he makes it, you’ll notice he doesn’t see his laziness as part of himself. He - the part of himself he identifies with - is a good, working, disciplined, and ambitious person. And that honorable, goal-oriented part is suffering from the pernicious laziness that possessed him, like a noxious fiend. He’s not emoting like a person, seeing their own flaws; he’s feeling like a person, hurt by external forces - injured, irritated, angry, indignant. How dares this vile laziness spoil his good life! Even in this framing, where the culprit is geometrically part of himself, he still emotionally processes the situation as a victim of forces outside his control.

So, this is the gist of what a client brings to counseling on his own. Now, from the counselor’s point of view, a problem is a different thing.

The first layer of the problem, in the eyes of a psychologist, is a behavior. Yes, even of a psychodynamist. As I’ve explained already, we still talk about behaviours in psychodynamics; we just do not limit our understanding of them to external actions. Internal processes - thoughts, emotions, attitudes, defences - are also behaviors.

So, to a counselor, a problem isn’t a passive “situation”; it’s something that the client does that hurts them. Oh, but what about all the external factors, you say? What if the person’s suffering isn’t caused by their neurosis, but by the horrible, unfair, ruthless world around them? Well, in that case, we can’t help them, can we? A psychologist, fittingly, deals with psychological problems. Now, we do believe that, barring extreme circumstances like war, prison, or terminal illness, a person is always capable of improving their life. But that’s more of a philosophical point than psychological. You can think of it as a prerequisite for counseling on the client’s side: by virtue of coming to counseling itself, the client tacitly agrees to the paradigm that their problems are psychological, and not, say, political or economic. And if you believe that you can improve your life by psychological means, conversely, you must accept that at the moment your life isn’t as good as it could’ve been due to psychological reasons.

From that perspective, Jack’s problem isn’t a lack of money. It’s not even his laziness. The real problem is his belief that he is a victim of external factors, where “external”, once again, means “external to his will”, not his cranium. And since we agreed to consider psychological phenomena to be behaviors, “a belief” is also a behavior, and we can call it the problem.

If I were a cognitive-behavioral therapist, at least of the first or second wave, that would’ve been the end of it. We’ve established the automatic thought that creates the issue - hurray, let’s change it and call it a day. But I’m not. So after we’ve established the first level of the problem, we go deeper.

The second level of interpreting the problem is the reason the behavior exists. This is where all those sources of resistance I’ve been writing about live. Maybe Jack sees himself as incapable of earning more because his current earnings qualify him for state-provided aid programs. Perhaps he’s not ready to realise that he could’ve raised his prices ages ago and missed out so much. Maybe he doesn’t want to humiliate his friends, carpenters, with his success. Perhaps he doesn’t want his wife to splurge on a new car she’s poised to buy once he starts bringing more. Maybe it’s any one of countless other subconscious reasons people shoot themselves in the foot. But whatever it is - that’s the real problem, once you go deeper than just “this is the behavior that makes you hurt” interpretation.

But we’re not done yet. You’ve read the title, you know there’s one more level to go. The third level of the problem - stay with me on this one - is the reason the person overlooked the cause of his behavior. Let’s unpack it.

So, once again, Jack comes to a counselor and complains about a lack of money. That’s how he presents the situation. The first level of psychological re-interpreation is behavioral: “the problem isn’t lack of money, the problem is you don’t feel like you’re in control of the amount of your money”. The second level - the reason for that behavior, for example: “the problem is that you’re not willing to accept that raising prices is an ethical, allowed tool of earning, and not some toxic capitalist form of exploitation”. Now, the third level - the reason of that reason, for example: “the problem is that you’re codependent with your capitalism-hating father.” And that shows the whole trajectory: as a boy, Jack rose in a family with a father who kept talking about how greedy capitalists are the worst. Not having separated from his father, Jack is now unwilling to accept raising prices as a tool of achieving his goal. Not willing to use this tool for the income he wants, he feels helpless and sees his lack of money as a function of his situation rather than his own personality.

A question may arise, even if you didn’t get lost in the logic of the previous paragraph, why? Why go to such lengths, why dig so deep, why excavate childhood and parents? Why not stop at “you’re not helpless, there is stuff you can do” and fix the situation on that level? I’m glad you asked. There are two reasons.

Reason one is that neurotic symptoms can come and go. Even the most lenient studies of the cognitive approach show that a varying but significant percentage of seemingly treated problems recur over time. The usual metaphor here is of a plant that was ripped out, but left its roots. The cause, the reason the symptom appeared in the first place, is still there if you limit yourself to cognitive interpretation only. Or might be, at least. Sometimes it’s not. Sometimes the symptom is a residual vestige of a problem long gone, and after cleaning it up, the client goes on to live happily ever after. But then again, about a third of neuroses go into spontaneous remission even without counseling or therapy. But some don’t. Some don’t go into spontaneous remission and don’t stop at the cognitive level. Even if the same symptom doesn’t return, another may appear in its stead if the initial cause wasn’t addressed.

Reason number two is that a single cause usually produces more than one symptom. Coming back to a plant metaphor, imagine you follow a leaf of a weed to the root and destroy the root. Chances are, there was more than one leaf sprouting from that root. Jack’s codependency with his father likely didn’t limit itself to hindering his relationships with pricing tactics. He probably had many issues stemming from these relationships. Problems with self-esteem, romantic relationships, personal boundaries, and healthy emotional processing - who knows where else his lovely dad left his fingerprints? So by going this deep, you’re not wasting time, you’re saving it - instead of running after each symptom separately, most likely exhausting yourself after dealing with the few most annoying ones and learning to live with the rest, you get a chance to address symptoms in bulk, by dealing with their common source.

Until next week,
Konstantin Kunakh

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