Chris Madden

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Many therapists describe their work through a list of diagnoses. While this can be useful in signalling familiarity with certain forms of distress, it rarely captures what actually takes place in therapy. For this reason, I prefer not to define my work too narrowly by diagnostic categories or rigid notions of “scope”. People seek therapy because they are suffering, and that suffering does not always arrive in recognisable or well-contained forms.

I am cautious of the assumption that particular experiences must always be directed to specialist sub-fields — that questions of sexuality belong only with a sex therapist, or grief only with a grief counsellor, for example. While specialist training can certainly deepen a therapist’s knowledge, suffering does not wait for ideal conditions or perfect referrals. As therapists, we often have to work with what emerges in a person’s life as it emerges, rather than only with what neatly matches a predefined category.

Diagnostic language can tell us something about the type of difficulty a person may be facing, but it says very little about how that difficulty functions in their life, what it is bound up with, or what it means to them. Two people may share the same diagnosis while living radically different experiences of it. In practice, therapy is less concerned with the label itself than with the particular history, relationships, conflicts, and meanings through which a person’s distress has taken shape.

From this perspective, there is no such thing as a generic problem. A person presents with anxiety, depression, grief, trauma, or relational difficulty because of a highly specific constellation of circumstances. Sometimes these circumstances are immediate and visible; at other times they are part of a longer personal or even intergenerational history. What feels unbearable in the present may carry traces of experiences that were never given language, recognition, or space to be thought about.

Often, suffering becomes fixed under a name long before it is understood. Therapy offers an opportunity to slow this process down — to move beyond what something is called and toward what it does, what it disrupts, and what it may be attempting to express. My work is guided by the idea that meaningful change becomes possible not through fitting experience into pre-existing frameworks, but through attending carefully to what is singular, unresolved, and unheard in each person’s story

Available

In Person: Asphalt Books, Nicholas Building, Level 4, Room 23, 37 Swanston Street, Melbourne

Online: Via secure video call

Phone: If preferred

Get in touch to organise a free 15-minute consult