Articles

Posted in
Neuropsychological Assessment

Why Context Matters in an Ailing World

By
Elliott L. Conklin, Psy.D.
November 2, 2022

The outdoors was an important part of my childhood. On a fairly regular basis my family would head out to a state park and set up camp for a few nights. Whenever it was time to clean up the campsite, my father always repeated the same instruction: “leave the place better than how you found it.” I say the same thing to my kids now, and they grumble back just like I did.

As the time goes, it’s getting harder to feel like we are, collectively as a society, leaving the place better than we found it. There’s a growing sense of unease in the air, the feeling that something is very wrong. I get it from my clients, and I’m sure you feel it too. I feel it myself.

And it’s not just the pandemic, it’s the growing hostility in our public discourse and among our political leaders, the gulfs that exist between groups of people. It’s the rapacious destruction of our environment and biodiversity loss. It’s the digital hijacking of our attention spans, our declining physical and mental health. It’s war, and it’s rampant inequality. Young people coming out of college are opting out of, or “quiet quitting,” the traditional workforce because they don’t want to participate in the world that’s been offered to them.

Whether we like it or not, we are part of this complex fabric of systems, and we are here because we want to make people’s lives better. In the gestalt school of psychology, there’s a return to that ancient wisdom that the whole is greater than the sum of its parts. An object is always part of a context, the figure part of the ground, the signal part of the noise. That context is so important.

Photo Credit: Juliette Fradin

We are at our best when we broaden our conceptual boundaries to include more than just the client, more than just a bag of symptoms. One of my personal heroes is the environmental scientist Donella Meadows, who, among her many noble accomplishments, wrote a treatise called Thinking in Systems. In this book she demonstrated how we fail to solve problems, and even make them worse, when we look too narrowly for solutions.

We see this any time clinicians get stuck looking for a diagnosis instead of looking for a person, or when we attempt to close achievement gaps without noticing the systems that impact education. Our training taught us to look at the symptoms and make a diagnosis, but then we scratch our heads when diagnoses like Oppositional Defiant Disorder are disproportionately given to children of color. We observe a child struggling in a classroom and fail to consider that maybe it’s the classroom that needs a diagnosis.

Our profession of psychological assessment has a sordid history, which includes doubling down on discrimination, dehumanizing poverty, and even profiling individuals for eugenics. Some of that history lives on. When psychologists evaluate individuals without context, when we look at the figure and not the ground, we get a false picture. In our work, getting a false picture is not only unhelpful, it’s harmful, so it’s important for us to learn and remember how to see that context.

The privilege and beauty of what we do is that we get to see our work help others in real time. We are witnesses, and we get to know people in a deeply personal way. It is also a privilege to receive services like ours. What a luxury to have someone focus all her attention for a period of time on you or your child, for that person to laboriously think about your needs and how you can fulfill them.

We have a little experiment going at the Kingsbury Wellness & Learning Group. We’re trying to answer this question: How can we make high quality psychological services affordable and accessible to everyone? This is our big hairy audacious goal. Psychological services are an investment, and when families choose us, they know that their investment goes toward their future and someone else’s. We believe all people deserve access to these services, and we spent our first three years exploring different ways to fulfill that mission. We have found a lot of ways that don’t work, but we are a tenacious group, and I am confident our successes will grow.