Case Study: Lacking Purpose

Joe is a young adult who has been in outpatient psychotherapy for some time. In the past he has seen two other counselors and two psychiatrists, and taken numerous prescriptions for antidepressants and mood stabilizers, all without much success. He said the psychiatric medications helped somewhat with his depression, but not his unhappiness. His comment reminds us that depression and unhappiness are relatively independent states, although they overlap. Yes, people can be unhappy without being depressed, but clinically depressed people are invariably unhappy.

Joe’s statement that separates his depression from his unhappiness is typical of those who are ambivalent about living. Joe, for instance, describes himself as “smart, funny and attractive,” yet says, “I can’t get myself to feel these ways.” This a very telling verbal signal that anyone having coping problems should watch for carefully: You feel you have many positive traits, but you don’t really experience them in your daily living.

Joe recalls being, in his words, “normal” until reaching the teen years; at this time in his life he remembers becoming unhappy and introverted. “High school was miserable. I’m glad it’s over.”

During his teens Joe was unable to assert his individuality and identity. Independence frightened him and he found it increasingly hard to make decisions and take responsibility for his actions. He felt alone, and reacted with self-defeating and self-destructive actions. He withdrew from others, became dissatisfied with himself, and developed very low self-esteem. “I really felt guilty because I wasn’t growing normally.”

Joe was adrift and had no clear purpose in life. He admitted to never having any dreams or future goals. He said, “I don’t see myself living a normal life.” During one counseling session he blurted out, “I want to be struck by lightning or have some kind of freak accident.”

When asked, “If you didn’t wake up tomorrow would that be okay?” He replied; “Well, yeah, I’d be dead so it wouldn’t matter.”

Asked, “At the end of a tough day, who can you relate to and reach out for comfort?” he replied, “My cats.”

The thing to note here is that Joe’s drift into a purposeless life began in his teen years. Now in his 30s, he has had nearly two decades of approaching life in this lackadaisical way. A lot of habits have had a chance to strengthen, and they will be difficult for him to confront and modify.

The hard thing about Joe’s case is that there are no glaring early childhood issues that seem to have set things in motion. Joe himself said that until adolescence, his life was fairly conventional, “normal.” However, it is clear that during his teen years, a tough period of storm and stress for nearly everyone, he had no guidance from role models who helped him develop some achievement motivation, purpose, and social adjustment.

There are things to work with, though, notably Joe’s description of himself as “smart, funny, and attractive.” His counseling tasks will involve helping him coordinate these beliefs with his actions, and become more assertive in confronting his life challenges.

As a general rule, remember that effective coping requires honest self-discovery and awareness of your strengths. Unfortunately, if you don’t work at translating those traits into productive actions, you will have no anchor to reality. This process is crucial: If you cannot “translate yourself” into concrete actions, you will feel you have nowhere to go.