Looking Beyond the Individual: Why I Believe Psychotherapy Needs a Wider Lens

Looking Beyond the Individual: Why I Believe Psychotherapy Needs a Wider Lens

Over the past few years, conversations around trauma-informed practice, neurodivergence, anti-oppressive practice, and mental health awareness have grown significantly within counselling and psychotherapy. As both a practitioner and educator, I think this is incredibly important progress.

At the same time, I have found myself increasingly reflecting on whether, as a profession, we are doing enough to integrate what we are learning about trauma, neurobiology, chronic stress, intergenerational trauma, racialised experience, and neurodivergence into the way we understand distress.

Traditional psychotherapy training has given many of us valuable foundations. We are taught to think about attachment, relational dynamics, unconscious processes, thoughts, emotions, behaviours, and the therapeutic relationship. These frameworks still matter deeply.

Yet in practice, I have often found myself wondering whether some client presentations are being understood too narrowly.

For example, what happens when what looks like depression is actually nervous system exhaustion after years of chronic stress? What happens when a client described as resistant or disengaged is actually experiencing autistic burnout, sensory overwhelm, or shame? What if some of the emotional dysregulation we encounter in the therapy room is not simply a “behaviour”, but a nervous system responding exactly as it learned to through years of unpredictability, trauma, or survival?

These questions have stayed with me for a long time.

When Distress Is Misunderstood

Many clients arrive in therapy carrying years of hypervigilance, emotional suppression, masking, chronic stress, burnout, and relational trauma. Some have spent much of their lives adapting themselves in order to survive within environments that did not always feel emotionally, psychologically, culturally, or physically safe.

In the therapy room, this can show up in so many different ways; exhaustion, anxiety, perfectionism, shutdown, people-pleasing, emotional overwhelm, chronic self-monitoring, irritability, numbness, or difficulties trusting others.

Sometimes clients themselves do not fully understand why they feel the way they do. They may have spent years believing they are “too sensitive”, “lazy”, “angry”, “dramatic”, or “emotionally unstable”, when in reality their mind and body may have been adapting to prolonged stress for a very long time.

I think this becomes especially important when working with marginalised and minoritised communities, particularly Black and Brown communities, where distress may not only exist at an individual or family level, but also within broader historical, cultural, racialised, and systemic experiences.

For some people, emotional distress cannot be separated from experiences such as racism, migration stress, discrimination, cultural dislocation, poverty, community violence, family separation, or the pressure of constantly needing to adapt in order to survive or belong.

Over time, these experiences may shape not only emotional wellbeing, but also nervous system responses, relational patterns, identity formation, and the way safety is experienced within the body itself.

The Emotional Cost of Survival Adaptations

In my work, I have also become increasingly curious about the emotional cost of certain survival adaptations that are often normalised within communities.

For example, many people will recognise narratives such as the “strong Black woman” or “strong Black man”. These identities can absolutely hold strength, resilience, pride, wisdom, and survival. Yet they can also carry emotional cost when vulnerability becomes unsafe, exhaustion becomes normalised, and support feels inaccessible.

I have worked with clients who feel unable to soften, unable to rest, or unable to ask for help because strength has become tied to survival, identity, and safety.

For mixed heritage clients, or clients living across multiple cultures, there can also be deeper questions around belonging, identity, visibility, and self-understanding.

How does someone make sense of themselves when they have spent years moving between cultures, expectations, languages, family narratives, or versions of themselves? How might that affect attachment, self-worth, anxiety, or the ability to feel emotionally safe in relationships?

These are the kinds of questions I believe therapy sometimes needs more space for.

Holding a Wider Lens

As practitioners, perhaps part of trauma-informed and anti-oppressive practice involves learning to hold a wider lens.

Not just asking “What is wrong with this person?”, but also asking:

“What has this person experienced?”

“What has this person adapted to?”

“What survival strategies were necessary within their family or environment?”

“What may have been carried across generations?”

“What was happening in the family system before this client was born?”

“How has culture, migration, racism, neurodivergence, chronic stress, or systemic neglect shaped the way this person experiences themselves and the world?”

I do not believe these questions remove personal responsibility or agency. Rather, they help us understand distress within context.

Neurodivergence, Burnout and Misread Presentations

This wider lens also feels important when working with neurodivergent clients, particularly autistic and ADHD clients.

I think many practitioners are becoming increasingly aware that chronic masking, sensory overwhelm, executive functioning difficulties, shutdown, emotional exhaustion, and burnout can sometimes be misunderstood through purely psychological frameworks alone.

Clients may present with anxiety, low mood, irritability, emotional dysregulation, or avoidance, while underneath there may be years of nervous system exhaustion, chronic adaptation, or environments that were never fully supportive of who they were.

In some families, patterns of hypervigilance, anxiety, emotional shutdown, impulsivity, perfectionism, or overwhelm may also exist across generations, sometimes alongside undiagnosed neurodivergence or unresolved trauma.

This is why I think curiosity matters so much in therapeutic work.

When a client speaks about anxiety, are we looking only at the individual, or are we also becoming curious about family patterns, inherited fear, parental stress, cultural expectations, or possible undiagnosed neurodivergence within the wider system?

For me, holding this broader curiosity can help practitioners avoid unintentionally pathologising responses that may once have been necessary for survival.

Anti-Oppressive Practice Beyond Buzzwords

Anti-oppressive practice has become an increasingly important conversation within counselling and psychotherapy, rightly so. Yet I sometimes wonder whether the language risks becoming disconnected from lived experience if we do not also explore how oppression is carried emotionally, relationally, psychologically, and physically.

Historical trauma, racism, migration trauma, poverty, ableism, gender-based violence, homophobia, transphobia, and systemic neglect do not simply exist as abstract concepts outside the therapy room.

Clients may carry these experiences in the body, in relationships, in identity, in nervous system responses, and in the ways they have learned to survive, protect themselves, or relate to others.

For anti-oppressive practice to feel meaningful, I believe it must move beyond theory alone and help us think more deeply about how wider systems and environments shape emotional wellbeing.

The Development of the IERA-Therapy™ Model

These reflections are part of what eventually led me to develop the IERA-Therapy™ model.

IERA-Therapy™ is an integrative, trauma-informed, relational framework exploring the relationship between attachment, trauma, neurobiology, epigenetic science, relational experience, and survival adaptations formed through intergenerational patterns.

The model emerged gradually through clinical work, personal reflection, teaching, and noticing recurring gaps between contemporary trauma research and the ways distress is sometimes formulated within therapeutic spaces.

Rather than viewing distress through a purely individualised lens, IERA-Therapy™ encourages practitioners to consider the interconnected relationship between nervous system responses, developmental experiences, family systems, culture, identity, social realities, embodiment, relationships, and survival adaptation.

At its core, the model asks an important question:

What changes in our understanding of human distress when we begin viewing many responses not simply as pathology, but as adaptations to relational, historical, social, cultural, biological, and intergenerational experiences?

Moving Forward

Psychotherapy has always evolved alongside new understandings of human experience. I do not see conversations around trauma, neurodivergence, embodiment, anti-oppressive practice, nervous system regulation, or intergenerational stress as a rejection of traditional psychotherapy. Rather, I see them as an invitation to deepen and expand our understanding of human distress.

Perhaps the question is no longer whether these conversations belong within psychotherapy, but how we continue integrating them thoughtfully, ethically, and compassionately into the way we teach, practise, and understand therapeutic work.

Sometimes healing begins not simply when someone is asked, “What is wrong with you?”, but when they are finally understood within the fuller context of everything they have had to survive, adapt to, carry, and become.

Novena-Chanel Davies is an integrative counsellor, clinical supervisor, author, and founder of the IERA-Therapy framework, exploring the intersections between trauma, neurobiology, attachment, anti-oppressive practice, racialised experience, and intergenerational healing.