Focusing On Growth Or Focusing On Dysfunction
There is no clear-cut answer as to whether clinicians should focus their attention on growth, on helping clients develop their potentialities, or focus it on dysfunction, on helping clients to cure their ill-being. But there is a qualitative difference between dysfunction and what we could call a baseline level of functioning. Symptoms of dysfunction cause a lot of suffering and sometimes paying attention to those symptoms, trying to help clients find ways to get relief from them, is a necessary first step before any conversation about growth or expansiveness can or should take place.
These days you hear a lot of grumbling about the clinical attitude of focusing on dysfunction, as if it’s antiquated and misguided, but reducing human suffering is an admirable vocation and clinicians who have spent their careers doing it, focusing on clients whose symptoms are so pressing and distressing that getting relief from them is all they can think about, should be proud of their work.
However, for those who land at that qualitative baseline stage we were talking about, it’s usually a mixed bag, there are some negative areas to correct and some positive areas to encourage. The danger becomes focusing on the first while neglecting the second. In these cases focusing on dysfunction can be counterproductive because clients aren’t grateful for it, they don’t necessarily even attach their suffering to the areas you perceive as dysfunctional, and for them the process will be negatively reinforcing, an aversive experience where they feel bad about themselves and their situations, like they’re not doing well enough.
And by simply switching the strategy to helping clients recognize and activate their potentialities, all their productive qualities, a lot of the dysfunction goes away all on its own because growth and dysfunction are largely incompatible states of being. You can’t be happy and sad at the same time, focused on doing really well and focused on everything that’s going wrong.
As in all things, the ultimate well-being of clients has got to take center stage when deciding whether to focus on growth or dysfunction. There are some things that are so pressing that they just can’t be ignored, areas of visible distress that clients desperately need help with. They’ve got to get to a baseline level of functioning before they can even be expected to pay attention to the more expansive elements of their existence.