Are Psychotherapists Getting Too Distracted by Presenting Issues and Not Relating to the Deeper Issue?
- Billi Silverstein
- 2 days ago
- 2 min read
Young woman sitting on a sofa having an intense conversation with her therapist
From a trauma-informed and psychodynamic perspective, symptoms rarely appear in isolation. They emerge from historical pain, relational wounds, and unconscious In contemporary clinical practice, there is growing concern that psychotherapists may become too focused on the presenting issues clients bring into therapy. While it is both ethical and necessary to attend to immediate distress, this focus can sometimes obscure the deeper dynamics that sustain suffering. The presenting issue often serves as a symptom, a signal from the psyche seeking recognition. When therapy remains at the level of what is visible, the opportunity for true transformation may be lost.
defences that once served to protect but now limit growth. In this sense, the presenting issue represents the psyche’s attempt to speak through distress. If the therapist listens only to the literal story, there is a risk of joining with the client’s defensive system, seeking to fix rather than understand. This may bring short-term comfort but often leaves the underlying wound untouched.
Supervision offers an essential reflective space in which this dynamic can be explored. It invites the therapist to slow down, to notice what is being communicated beneath the surface, and to reflect on how the therapeutic relationship itself may be echoing earlier experiences of the client. Through this process, the clinician can move from doing to being, from reacting to relating, and from managing symptoms to understanding what they symbolise.
This deeper way of working is not about dismissing the presenting issue but about expanding its meaning. A trauma-informed stance views the symptom as an entry point into the client’s unspoken story, not something to be eradicated but something to be listened to with care. When therapists hold this dual awareness, they create space for both symptom and self to coexist. The deeper issue then becomes accessible, and therapy moves from mere containment toward integration and growth.
Ultimately, psychotherapy is not only a process of resolving difficulties but one of re-encountering the self beneath them. The challenge for clinicians is to resist the pull of immediacy and remain open to the layered complexity of human experience. Supported by reflective supervision, this depth-oriented approach allows therapy to become not simply a means of relief, but a pathway to restoration and transformation.
In psychotherapy, we explore diversity of experience with empathy and without judgement.
Contact me for your Clinical Supervision needs.
Get in touch today to consider your options.
Comments