The Crutch of Why: How fixating on the source of a mental illness can delay treatment
It has been said that I spend too much time being overly analytical. While a lot of people go about their daily work with an organized mindlessness, just trying to finish up what they are doing and go home, many people are caught up in the “why” of daily tasks and interactions with coworkers, our families and sometimes even strangers. Why did my coworker slam her office door this morning, or for that matter nearly every morning? Why did that lady think it was okay to adjust her pantyhose in front of everyone in the elevator? Why is it that every night I come home and take my socks off my dog has to immediately procure and run off with them? In aforementioned scenario’s it’s probably not crucial to understand the why. Some times things just happen, if they don’t affect us in some permanent and/or life altering way, then we should probably just forget them and move on with our day.
In life there are some things we shouldn’t really spend too much time worrying about, but is this the case in determining causes for addictive behaviors and other mentally incapacitating problems? One clinician, Dr. Satel writing for the NY Times says that while it’s important that patients would ask why they have a problem, the belief that someone can reliably identify the roots to a problem is “highly overrated”. In an article posted December 19, 2006 in the Mental Health section of the NY Times and titled “Sometimes the Why Really Isn’t Crucial”, Dr Satel discusses the advent of patients getting too caught up in the why of an issue rather than actually deal with the problem.
In the article Dr Satel discussed the plight of several of her patients. She points out the futility in relying on the crutch of why in her recap of one patient’s treatment, Joe, a heroin addict. Joe spent many of their sessions discussing his relationship with his father and how it drove him to his addiction. When Dr Satel tried to steer the conversation into topics of current job stresses, which Joe linked to heroin cravings, Joe reportedly stated “he’d rather ‘do psychotherapy'”. Dr Satel identified Joe’s want to discuss his past as a way of not having to make practical changes in the present. When Dr Satel discussed this theory with Joe he admitted that she could be right, but in future sessions Joe still tried to delve into his past searching for answers rather then deal with making changes. A few months later Joe died of accidental overdose.
Dr Satel believes that “insight has no guaranteed relationship to change”. A thought she believes is exemplified in one woman;
A colleague of mine treated a 45-year-old woman, Joan, who came for therapy because she hated her chunky body. Joan firmly believed that once she discovered The Reason for her overeating she would stop.
After a few months, Joan told my colleague that her father had developed cancer the year she went off to college.
“You know, I never made the connection until now,” she announced triumphantly, “but I started overeating when he began to waste away. It’s like I was trying to nourish him through myself.”
A poignant metaphor, yes, but months later she hasn’t lost a pound.
In conclusion Dr Satel believes that it is more important to deal with organizing the chaos surrounding the problem and take steps to deal with the problem itself rather then focusing on the “why” of the issue. As she points out, some people just don’t have any time to waste in dealing with the “why” of the issue, which was the case exemplified by Joe.
What I gathered from this article was that Dr Satel means that patients should be focusing on the “How” as in; how do I stop this addiction or how do I solve this problem? Rather then focusing on why the problem exists. I tend to buy into what Dr Satel about it not being fruitful to fixate on the past, and on the why. Most of what Dr Satel had to say in this article mirrored my own experience in the mental health field; those patients who focused on dealing with the problem itself rather than fixating on the source of the problem generally had more success in alleviating some of their problems and those who spent time delving into the past for long periods of time, didn’t make much progress.
Bechdel, J. (2006). The Crutch of Why: How fixating on the source of a mental illness can delay treatment. Psych Central. Retrieved on July 28, 2015, from http://psychcentral.com/blog/archives/2006/12/25/the-crutch-of-why-how-fixating-on-the-source-of-a-mental-illness-can-delay-treatment/