Wait... I'm the Problem?

The radical power of personal responsibility in an age of victimhood

"I need to tell you something," she said, sitting down with an unusual energy in our first session. "I've been in therapy before, lots of it actually. But I had this realization recently that completely changed how I see everything."

She leaned forward, her words carrying the urgent need to share something profound. "In my previous therapy, every session was the same. I'd talk about how everyone in my life was causing my problems – my mom, my friends, my boss. The therapist would nod along, telling me my feelings were valid, that I was brave for surviving it all. She helped me see how my ADHD and past trauma explained everything – my relationship issues, my work struggles, my impulsive spending. It was comforting, you know? Having a diagnosis that explained why nothing was really my fault."

Her background wasn't simple. Her mother's alcoholism had created a childhood where stability was foreign and emotional needs went chronically unmet. The ripple effects played out predictably: school struggles, turbulent relationships, employment difficulties. Each challenge seemed to confirm her narrative – she was a victim of circumstances, perpetually at the mercy of others' behaviors and choices.

"But last month," she continued, her voice taking on a different quality, "I was sitting in my car after another fight with my mom, rehearsing what I'd tell my therapist about it. And suddenly, I just stopped. It hit me like a ton of bricks – wait... I'm the problem."

She straightened in her chair, her eyes bright with the residual electricity of her discovery. "Not in the way my mom always said I was. Not because I'm wrong or broken. But because I've been choosing to stay stuck. I've spent years perfecting my story about how everyone else needs to change, collecting evidence for how I've been wronged, using my diagnosis to explain away everything difficult in my life."

A small laugh escaped her, half amazement, half relief. "Don't get me wrong – my mom's still an alcoholic. My childhood was still a mess. I still have trouble not blurting out my thoughts. But I've been using all of that – the trauma, the diagnosis, everything – as a script for why I can't change. I go into every interaction already wounded, already defensive, already expecting to be hurt or dismissed. I've been so invested in being right about how everyone's wronged me that I never considered I might be choosing to stay in this pattern."

She paused, gathering her thoughts. "All those therapy sessions... they felt good, really good. Having someone validate everything, understand my pain, tell me none of it was my fault. But you know what? I left each session feeling exactly the same. Nothing ever changed except I got better at explaining why nothing was my fault."

The paradigm shift was palpable. This wasn't self-blame or denial of her past trauma. This was different. This was liberation.

"I don't want another therapist to just validate me," she said firmly. "I've been validated. I've been understood. I've been diagnosed. I took their drugs. And none of it has helped me actually change my life. I need something different now. I need to figure out how to stop being the victim in my own story."

Are We Creating Perpetual Patients?

There's a dark irony in how our mental health system operates – one that transforms people seeking healing into lifelong patients. By the time my client found her way to my office, she carried an impressive collection of psychiatric labels: ADHD, PTSD, Borderline Personality Disorder, Depression, Generalized Anxiety Disorder, Bipolar II Disorder. Each diagnosis had arrived like a gift-wrapped explanation for her suffering, each one promising to unlock the mystery of why her life felt so persistently difficult.

"For every problem, there was a new diagnosis," she explained. "Trouble focusing at work? ADHD. Unstable relationships? Borderline Personality Disorder. Mood swings? Bipolar II. Each label came with its own drug, its own treatment protocol, its own way of explaining why I wasn't responsible for my life's chaos. It was oddly comforting, having professionals tell me that my brain was just wired wrong, that chemicals were the problem, that pills were the answer."

The mental health industrial complex has perfected the art of creating perpetual patients. It's not malicious – it's simply the inevitable result of a system that views human suffering primarily through a lens of pathology. Every emotional reaction becomes a symptom. Every coping mechanism becomes a disorder. Every struggle becomes evidence of an underlying condition requiring indefinite treatment. The system excels at validating pain while inadvertently stripping people of their agency.

"I tried all the medications they prescribed," she continued. "Nothing helped, just a range of drug reactions. But none of them were ever going to address the real problem. Instead, they kept me feeling exactly like I did in childhood – powerless, dependent, waiting for someone or something else to make things better. The drugs became another way of avoiding responsibility for my life, another way of staying stuck."

The mental health system operates on a formula as seductive as it is simple: validate, diagnose, medicate, repeat. Each step presents itself as the height of compassionate care, wrapped in the authority of science and professional responsibility. And there is profound truth here – validation can be healing balm for someone whose suffering has been dismissed or denied, especially in the wake of genuine trauma. That initial moment of being truly seen and heard can crack open the door to healing.

But too often, that door never swings fully open. Validation becomes not a beginning but an end in itself, therapy reduced to an echo chamber where pain is reflected but never transformed. Week after week, session after session, the same stories are told, the same wounds examined, the same emotions validated – creating a perfect closed loop of understanding without growth. What begins as necessary acknowledgment calcifies into a ritual of stagnation, keeping people trapped in the very narratives from which they seek to escape.

"Looking back, I needed that initial validation in therapy," she reflected. "I needed someone to hear me, to acknowledge that what happened wasn't okay. That part was healing. But then... it's like they didn't know what to do next. Instead of helping me move forward, they just kept adding diagnoses, prescribing more medications, keeping me trapped in this cycle of being a patient. I became attached to my diagnoses – they became my identity, my excuse, my way of explaining why I couldn't change."

"I could have stayed in that system forever," she said, her voice carrying a mix of gratitude and regret. "Part of me wanted to. It was comfortable there, being understood, having everything explained away by diagnoses and brain chemistry. But I started to recognize that I was becoming exactly what the system wanted me to be – a perfect, perpetual patient. Someone who needed endless treatment but never quite got better."

The truth is, we've created a mental health system that often confuses capability with culpability. Acknowledging someone's agency in their life doesn't mean blaming them for their circumstances or diminishing their genuine struggles. It means recognizing their power to shape their future, regardless of their past.

"I had to make a choice," she concluded. "I could keep collecting diagnoses, keep explaining away my life as a series of symptoms and disorders. Or I could reclaim my story. Not by denying what happened to me, or pretending I don't struggle with things – but by accepting that I'm the author of my life now”

Identities Are Only Stories We Tell Ourselves

The most profound damage often occurs in the spaces we least expect – in the very systems designed to heal. Young people enter mental health treatment at crucial moments in their identity formation, when their understanding of self and their place in the world is still malleable, still taking shape. What they encounter there shapes not just their current experience, but the very lens through which they will view their entire existence.

Consider what happens when we hand a 19-year-old a psychiatric diagnosis. We're not just giving them a medical label; we're giving them a framework for understanding themselves. That diagnosis becomes a lens through which they interpret every struggle, every relationship difficulty, every moment of self-doubt.

"I can't maintain friendships because I have Borderline Personality Disorder." "My impulsive decisions are because of my ADHD."

"My intense emotions are my Bipolar Disorder acting up."

This framework is further reinforced by a therapeutic culture obsessed with validation at the expense of transformation. Each therapy session becomes another opportunity to rehearse and reinforce their story of victimhood, to focus attention on all the ways they've been wronged, all the ways they're broken, all the ways their diagnosis explains their struggles. The very act of paying attention to these aspects of their experience strengthens these neural pathways, making this narrative more deeply ingrained with each retelling.

What's particularly insidious is how this clinical process now intersects with broader cultural shifts that make victimhood not just comfortable, but advantageous. In educational institutions and workplaces, the emphasis has moved from achievement to disadvantage, from capability to accommodation. Young people, keen observers of social dynamics, quickly learn there's social capital in struggle. A diagnosis isn't just a medical label anymore – it's a passport to understanding, accommodation, and often advantage.

The mental health system, in its current form, excels at helping people understand why they're suffering but often fails at the more crucial task of helping them transform beyond that suffering. ADHD becomes not just a description of attention difficulties but a coveted identity that explains away academic struggles. Anxiety transforms from a challenge to overcome into a badge that grants special considerations. Depression isn't just a state to move through but an identity that demands others adjust their expectations.

What's particularly troubling is how this affects those with more serious mental health challenges. Their experiences become simultaneously validated and trivialized – validated by broader cultural acceptance of mental health struggles, but trivialized by the inflation of every normal human difficulty into a diagnosable condition. The currency of victimhood becomes devalued by its abundance, while the path to genuine growth becomes increasingly obscured.

We're creating generations of young people who are experts in their own pathology but novices in their own potential. They can eloquently describe all the ways they're broken but struggle to envision how they might be whole. In trying to help them understand their pain, we've accidentally taught them to build their identity around it, and our current cultural framework offers them little incentive to do otherwise.

We must ask ourselves: How do we encourage young people to embrace personal responsibility when the systems they navigate often reward its opposite? How do we promote resilience when identifying with fragility provides immediate benefits? We need a framework that can honor genuine struggle while promoting agency, that can acknowledge systemic barriers while fostering personal responsibility. The stakes couldn't be higher – we're not just talking about individual therapy outcomes, but about how an entire generation understands themselves and their place in the world.

Radical Accountability

Here's a truth that many modern therapists have become afraid to speak: The path to healing often lies not in perfecting our understanding of how we've been wounded, but in claiming radical responsibility for our lives despite those wounds.

I've sat with survivors of unspeakable violence, witnesses to profound cruelty, victims of systematic abuse – and without exception, those who truly transformed their lives did so not by denying their past trauma, but by refusing to let it dictate their future. They held two truths simultaneously: "This happened to me" and "My life is my responsibility now."

Our current therapeutic culture, paralyzed by the fear of invalidating someone's trauma, too often stops at the first truth and never guides people to the second. In our desperate attempt to be trauma-informed, we've become transformation-averse. We've created a system that incentivizes perpetual woundedness, that rewards ongoing dysfunction, that mistakes acknowledging pain for healing it.

Here's what decades of clinical work has taught me: It's not compassionate to hold someone's past suffering so precious that we deny them their future potential. It's not kind to validate someone's pain so completely that we blind them to their power. True healing – profound, lasting, transformative healing – begins the moment someone looks at their life, with all its scars and unfair wounds, and declares, "From this moment forward, I choose to be the author of my own story." Any therapeutic approach that stops short of this, that keeps people eternally processing their trauma without moving toward transformation, isn't just incomplete – it's actively harmful. The most radical act of compassion we can offer as therapists is to believe in our clients' capacity to transcend their wounds, even when they don't yet believe in it themselves.

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