Why Does Social Context Matter?
Systemic Realities in Professional Counseling & Psychotherapy
The words on the page danced like indecipherable holographic runes, refusing to yield their secrets. Each attempt was met with snickers that cut deeper than any pencil mark, casting a shadow of doubt that would follow me far beyond the institutional windows of that second-grade classroom. I didn't know then that my struggle wasn't a personal failure, but a reflection of a system fundamentally misaligned with human diversity.
Years later, as a psychotherapist, I've come to understand that my childhood experience was never just about me—it was about a broader, more systemic failure to recognize and support the intricate ways humans learn, feel, and exist. What began as a personal journey of confusion and self-doubt has transformed into a professional mission: to challenge the narrow, individualistic narratives that too often blame people for struggles born from complex social and systemic contexts.
This is not just my story. It is the story of countless students who have been told they are not trying hard enough, who have internalized a sense of personal inadequacy when the larger more powerful issue lies in the systems surrounding them.
It would take years of feeling like a phony TV ad for some silly product, an imposter, of knowing I was articulate yet internally struggling and maintaining a facade of competence, of “performing.” Decades of healing through therapy, and eventually earning my master's degree in counseling psychology helped me to understand the reality: my struggles weren't just about individual genetically determined differences, but about larger systemic failures. After all, I wasn't that different from my peers.
Maybe it wasn't just about me.
Today, as a mental health professional I carry this memory into every session, and I will take it to my grave. While therapy can help with individual coping, many of the challenges my clients face— like the ones I faced as a struggling second-grader —are products of systems that weren't built for the vast spectrum of human diversity and everyone’s well-being. Years later, with the help of therapy, I realized I wasn’t clinically depressed, I had been demoralized.
I had wondered if I was experiencing clinical depression because that’s the word most people use for deep emotional struggles without an identifiable external source. That it was ME. But over time, I realized it wasn’t just an internal struggle—my experience was a demoralization. It wasn’t just a persistent emptiness; it was a response to the world around me—to the social context, the people in my life, and the ways larger systems and relationships shaped my sense of agency and meaning.
That shift in understanding altered my approach. Instead of seeing issues as something solely within me, I began to recognize how my (hyper-individualistic American) environment played a role in either supporting me or undermining me, and what that meant for healing and change. This early experience shaped my understanding of mental health, eventually leading me to write the following:
As a psychotherapist, it is my responsibility to acknowledge that while therapy can help with individual coping, many of the challenges you face are also a product of a system that undermines mental health and well-being. I want you to know that recognizing these systemic issues can be empowering.
I wrote the above statement to express a growing shift in perspective, one that moves beyond the traditional focus on individual pathology to encompass the broader social context within which mental health constructs implied in the Diagnostic & Statistical Manual (DSM) unfold. By defining what is “disordered” it implies that the absence of those disorders, allows for healthy function, but doesn’t define what mental health is. While individual therapy and responsibility remain valuable, it is crucial to acknowledge the influence of larger systemic forces that shape our experiences.
For too long, the dominant narrative surrounding mental health has narrowed our understanding to individual responsibility and internal factors. This approach, while acknowledging biological predispositions, systematically overlooks the profound impact of socio-political and economic structures on our well-being. It's a narrative that too often blames victims and perpetuates stigma. We live in a world increasingly marked by wealth disparities, systemic inequality, and relentless pressures—conditions that collectively contribute to a pervasive climate of stress, anxiety, and despair.
The weight of individual responsibility, so deeply ingrained in our productivity culture, often obscures the broader systemic forces shaping our mental health. Meritocracy tells us that success—and failure—are entirely personal, fueling anxiety and depression when reality doesn’t align with this myth. In truth, many of the struggles we face are not just internal battles but responses to a world that demands more than it gives, rewarding relentless performance while eroding well-being.
Consider the rising tide of anxiety in our society. While individual factors certainly play a role, we must recognize the broader systemic triggers: economic instability that erodes financial security, social isolation intensified by digital technologies, and the constant bombardment of disinformation and stimulation characteristic of modern life. These are not merely individual struggles, but collective challenges that demand comprehensive, systemic solutions. Even when examining neurological differences like ADHD or Autism, we must remember that genetic predispositions are not predetermined outcomes—the environment and societal structures profoundly shape how these traits manifest and impact an individual's life.
The neurodiversity paradigm offers a critical lens for challenging purely individualistic approaches to mental health. This perspective fundamentally rejects traditional medical models that pathologize neurological differences, instead recognizing these variations as natural human diversity. Neurodivergent individuals frequently encounter significant challenges not from their inherent differences, but from systemic barriers that create disability. Rigid educational systems, inflexible workplaces, and widespread lack of understanding marginalize those who process information differently. By acknowledging these larger systemic issues, we shift from a deficit-based model of "fixing" individuals to creating more inclusive and equitable spaces that recognize and value diverse cognitive experiences.
In professional counseling and therapy, this systemic perspective translates into a more holistic and empowering approach—not a "victim mindset" as some might fear. Instead of focusing solely on individual coping mechanisms, we can explore how external systems impact our clients' lives. Consider anxiety: it often emerges from two interconnected sources—how individuals are treated externally (perhaps within their families or workplaces) and how they perceive themselves internally. By helping clients develop a critical awareness of these forces, we can empower them to challenge stigmatizing structures and advocate for meaningful change. Contrary to claims that examining systemic influences promotes helplessness, a critical examination of these forces is actually the first step toward reclaiming personal agency.
This is not to diminish the power of genetics, individual agency, and resilience. Therapy can provide individuals with the tools and support they need to navigate challenging circumstances and build strong fulfilling lives.
However, it is essential to recognize that individual efforts or personal “willpower” alone are not necessarily enough nor should it be our sole focus. We must also work collectively to create communities that promote mental health and well-being for us all.
By acknowledging and including the systemic context of mental health, we can move towards a more just and compassionate understanding of human experience. This perspective not only empowers individuals but also calls for a collective commitment to creating healthcare systems where everyone has the opportunity to thrive. In doing so, we move past the individualistic stigmatizing and pathologizing view, and toward a stronger and more sustainable paradigm of understanding and advocacy for everyone’s mental health.
Disclaimer: This article reflects the personal experiences and professional observations of a licensed counselor. It is intended for informational and educational purposes only and does not constitute professional counseling advice. The perspectives shared are based on the author's current understanding and professional practice, aligned with the American Counseling Association (ACA) Code of Ethics. Readers are advised to consult a qualified mental health professional for personalized guidance regarding their specific mental health concerns.
John, Grand essay that I will restack. I may have said this before about therapy and your gift of taking that on: As a creative, hypersensitive personality, I worried that therapy would interfere with "flow"--what I experience when writing. But when I had a major loss in my life, I went. Although other stories and works preceded (Re)Making Love: a memoir that is fully up here on Substack and got picked up by a publisher, it was two therapists (one retired) who helped me with the self-discovery that released the memoir that is the good, the bad and the foolish, all willingly on the page in a series of lyric essays (not sure why the essays turned out that way) but they make up the nonfiction telling that only nonfiction would be believable. xx