Are We Asking the Wrong Question About Mental Health? Trauma-Informed Counselling

by Kate (integrative counsellor)

"The curious paradox is that when I accept myself just as I am, then I can change." – Carl Rogers

Mental health conversations are everywhere. We're encouraged to talk more openly about anxiety, depression and trauma than ever before, and that's undoubtedly a positive step. But as our conversations evolve, I sometimes wonder whether our understanding has kept pace.

Recently, I read Sexy but Psycho by Dr Jessica Taylor, and it challenged me to reflect on a question that sits at the heart of counselling:

Are we too quick to ask, "What's wrong with you?" instead of, "What happened to you?"

As a person-centred counsellor, I find this question incredibly important.

Taylor argues that psychiatry has historically viewed many women's responses to abuse, violence and oppression as symptoms of mental illness rather than understandable reactions to trauma. Whether you agree with all of her conclusions or not, the book gets us to think critically about where our ideas of "normal" come from and who has historically defined them.

One of the most significant examples she discusses is the Victorian diagnosis of hysteria. Women could be labelled mentally unwell simply for wanting more independence, pursuing education or leaving unhappy marriages. Looking back, these diagnoses seem absurd. Yet Taylor asks us to consider whether some of the underlying attitudes still exist today, albeit in more subtle forms.

As I read, I found myself thinking about Carl Rogers' person-centred philosophy. Rogers believed that if we rely too heavily on labels and theories, we risk seeing the diagnosis before we see the person. Instead, he encouraged therapists to understand individuals within the context of their unique lives and experiences. The structures we live in influence everything, including what we have access to, how we are perceived, treated and the language we use, which gives power to the narratives people listen to in everyday discourse. Taylor argues that systemic abuse should not be pushed to the side in therapy and that it should be very much in the room.

Every person's story makes sense when we take the time to understand the context.

In fact, some trauma responses were clever ways for people to survive and manage the abuse they were subjected to at that time. Trauma changes people. It affects how we think, feel, relate to others and experience the world around us. Yet those responses are often viewed in isolation, as symptoms to be managed, rather than adaptations to experiences that were once overwhelming or unsafe. Taylor argues that trauma is far more common than we often acknowledge. It isn't limited to catastrophic events.

Trauma can develop through childhood neglect, domestic abuse, sexual violence, discrimination, bereavement, bullying, relationship breakdown or prolonged periods of stress. When we begin to see distress through this wider lens, our understanding naturally becomes more compassionate.

One of the book's strongest messages is the importance of validation.

For many survivors of abuse, the deepest wound is not only what happened to them but the experience of not being believed, being minimised or feeling blamed for their own suffering. A trauma-informed approach begins by acknowledging that a person's emotional responses often make sense within the context of what they have lived through.

That doesn't mean every mental health difficulty is caused by trauma, nor does it mean medication or diagnosis are never helpful. For many people, psychiatric care and medication are life-changing, and sometimes life-saving. Mental health is complex, and biological, neurological and psychological factors all play important roles.

But Taylor encourages us not to lose sight of context.

Reading Sexy but Psycho didn't leave me questioning whether mental health exists. Instead, it reminded me why I chose to train as a counsellor.

Behind every diagnosis is a person.

Behind every behaviour is a story.

And sometimes the most healing thing we can offer isn't another label but the opportunity to be seen, heard and understood.