Someone asked me if the problems people come to see me about have changed much over the course of my practice.  I had to think about it, but the answer I gave is basically “no”.   The externals or presenting problems can look very different and how people approach things and what they look for in the way of solutions has changed.  We live in a high stress world but in my view the underlying issues are essentially the same.

The only real difference that I can pinpoint is that people are more open in talking about certain things.  A good example is that people are less reluctant to talk about sexual issues.  Sex in general is talked about more openly.   Sexual orientation and identity are no longer taboo topics.  Adoption and fertility issues are talked about more openly.   Addictions too are not hidden or denied as much.  As a culture I think we are more open and accepting – at least in my neck of the woods.  And so because the culture in general has changed, there is very little that is off limits.  Topics that used to be considered shameful or impossible to even mention, are talked about.  That is not to say that people don’t feel shame and pain.  They do.  But at least the world gives them permission to speak.  I consider that one of the most positive outcomes resulting from the diversity and transparency in our modern world.

Most people can talk about what was once off limits even if it is hard to open up and takes a while.  But the underlying problems regarding relationships, intimacy, self-esteem, trauma, abuse, feelings of loss of control, depression, anxieties, self- hatred –  the list can go on – those remain much the same.  We are all creatures of the human condition and so the problems we experience in our core are still the same.  It’s one of the reasons I believe in psychotherapy.  It’s a methodology that can hopefully reach us in that core.