I learned in grad school the idea that, oftentimes, the identified patient or problem, is almost never the identified patient or problem. Or for short, the IP is hardly ever the IP.
Examples of this would be: a parent brings in their elementary school aged child saying their child has problematic behaviors, teachers are having issues at school with them and their child needs therapy. So, the child is the IP. But we know that the IP is almost never the IP. If we dig a little deeper, we’ll most likely find stressors in the home or family life or maybe parenting struggles that are causing these issues in the child.
Another example could be a couple walks into therapy saying their sides of the issue, indicating the IP being one another or maybe a joint issue of communication. They’re probably right to some extent, both sides playing a part into the conflict and communication being difficult. At the same time, what they believe is at the center of their issues oftentimes is blind to them. That there is a deeper meaning and “dream within their conflict” (Gottman).
I share this to remind our hardworking clinicians of this basic tenet, remember, if you’re stuck, usually the IP isn’t the IP. What else is going on systemically?
I also share this with those who want to step into therapy, or who are in therapy, of course, come in with what you believe is the issue in your life that you want to work on. We as clinicians need your insights as well. At the same time, just know that you might be taken on a route in treatment that isn’t what you initially expected. That’s part of the process. We, as therapists, are trained to be “systemic thinkers”. Meaning, we are interconnected with many different spheres in our lives that all have an impact on us.
So, to fully grasp and understand the complexities of our issues, we operate under the guideline from the start that the IP is almost never the IP.