From putting out fires to understanding causes: the depth of individual therapy

Do you know that sequence? A conflict blew up at work — you read three articles on communication and smoothed it over. Anxiety came before a presentation — a breathing exercise, camomile tea, somehow you got through. Another argument at home — a conversation, an apology, peace. You put out every fire separately. And yet you have the feeling that you are standing with a hose in the middle of a landscape that keeps catching light — always in a new place, always from the same wind.

That feeling matters. It tells you that the distinction this piece is about is not academic: the distinction between relieving symptoms and structural change — between putting out fires and understanding why things burn. Individual therapy can do both, and both have their place. But I would like to show you what happens when a process is given enough time and safety to go beneath the symptom: how the pattern that lit all the earlier fires too emerges from “stress at work”.

Two levels of help — and why neither is “worse”

First a distinction without value judgements. Symptom relief aims at what hurts now: it calms anxiety, sorts out sleep, smooths over conflict, puts a tool for the moment of distress in your hands. It works relatively quickly and its effect is measurable — which is why it is often the first and entirely legitimate goal.

Structural change aims deeper: at the pattern that produces the symptoms. It does not only ask “how do I calm down”, but “why does my system go off so often in the first place”. Its currency is not techniques but changed relationships — to yourself, to those close to you, to your own needs. It takes longer, it is less linear and its fruits ripen slowly; but as a rule they stay. Research picks up this difference over time as well: with in-depth, pattern-oriented therapies the measured effects not only persist after treatment ends but often keep growing in follow-up studies (Shedler, 2010) — as if the process, once started, carried on by itself.

Why techniques alone often do not hold

You have probably noticed this phenomenon in yourself or in others: a new technique works — for two weeks. The breathing exercise helps until a really bad day comes. The resolution “I won’t keep pleasing everyone” holds until your mother is first offended. Then everything reverts, and with it settles the feeling “I can’t even manage this”.

This is not your weakness, and the techniques are not bad either. The problem is how far a technique reaches: it regulates the response but does not touch the belief that triggers the response. If deep inside you stands “I am worthy as long as I don’t disappoint”, then every situation that smells of disappointing someone will set off the alarm — and no breathing pattern will permanently calm an alarm that, from your system’s point of view, has a good reason. Behavioural science knows this phenomenon with symptoms themselves: if you remove only the symptom while the pattern stays, the system often finds a new outlet — tension that is not allowed to show as anger shows up as insomnia; insomnia that you “fix” with a routine speaks up as irritability. So the question that separates firefighting from understanding is always the same: what does this symptom serve? What does it protect me from, what does it make possible, what do I not have to feel as long as I have it?

Six signs that you have spent recent years only firefighting

Because the line between the two is blurred in everyday life, here are some fairly reliable indicators. You do not have to recognise all of them; two or three already say enough.

• The same themes return under new names. Last spring it was your manager, this year the neighbour, and in between your partner’s mother. A different person each time, the same inner position each time: helplessness, swallowed anger, the sense that you have to make yourself small so there will be peace.
• Techniques work for shorter and shorter stretches. The first exercise helped for a month, the second for a week, the third until the next bad day. That is not a sign that the exercises are bad — it is a sign that they are stacking up on top of something they do not address.
• You spend more and more energy for the same result. To stay calm you now need a morning routine, a midday exercise and an evening walk. Peace that has to be produced anew every day is not peace — it is maintenance.
• After each fire is out, the same verdict about yourself speaks up. “I couldn’t cope again.” “I’m too sensitive.” “Other people manage without all this.” That sentence is often a more precise indicator of the pattern than the event itself; who is speaking it inside you I have set out in the piece on the inner critic.
• Life slowly rearranges itself around fire prevention. You skip certain gatherings, you do not open certain topics, you avoid certain people. The space narrows — and you feel the narrowing as safety.
• People and circumstances change, but the feeling stays the same. You change jobs and six months later you are back where you were. You change partner and two years later the two of you are arguing about the same thing as before.

The last point is the most interesting, because it is the one people resist most — it sounds like an accusation, as if to say “it’s your own fault”. It is not. The psychologist Constance Hammen showed in a series of studies back in the nineties that with our habitual responses we partly co-create the very circumstances we find ourselves in: she called it stress generation (Hammen, 1991). Someone who cannot say no gets more work. Someone who withdraws when afraid gets more distant relationships. Someone who flees from conflict gets unresolved resentments that come back bigger a year later. This is not blame — it is mechanics. And mechanics can be changed far more easily than character. If you recognise yourself in this and are at the same time worried that you are already past the limit of your capacity, have a look at the piece on the signs of burnout: the body often gives warning before the mind does.

The well and the roots: two metaphors for the same truth

Imagine a well with cloudy water. You can scoop and strain it every day — that is symptom work: necessary, useful, but tomorrow the water will be cloudy again. Or you can climb down into the well and look at what is running into it — that is structural work. There is nothing spectacular about it; mostly it is a slow descent down a dark shaft. But once you find and close the inflow, the water clears by itself.

Or, in a gardening image: you can cut the weeds back — and you will be cutting them back every spring. Or you can dig them out by the root. Cutting is not a mistake; sometimes it is all there is time and strength for. But only digging changes the garden.

How therapy gets from the fire to the wind: one path by way of illustration

What does this look like in practice? Let me sketch a hypothetical path — assembled from typical features of many processes, not a description of an actual person.

Someone comes because of stress at work: a new manager, more demands, worse sleep, a short fuse at home. The first months are symptom work in the best sense — we sort out sleep, widen the space for rest, build tools for the acute peaks. It helps. But week after week one small feature keeps recurring in the stories: every time the manager extends a deadline, this person says “no problem”. Every time. Even when it is a problem. When we stop at this, reason speaks first: “Well, I have to, that’s the job.” Then, slowly, older images arrive: a father who valued only results; school reports that were the one reliable source of warmth; a child who learned that to disappoint means to lose. And suddenly “stress at work” is no longer a story about a new manager — it is the latest chapter of an old rule: I must not disappoint. The same rule, it turns out, also lights the fires at home: the short fuse is not a lack of love but the exhaustion of a person who is not allowed to say no anywhere.

From here on we work with the pattern, not with the fires. And interestingly: the fires no longer need putting out so often, because there are simply fewer of them. The first “no” said to the manager does more for sleep than all the evening routines put together.

What actually happens in the room during the move from symptom to pattern

“Going beneath the symptom” sounds mysterious, but it is in fact fairly craftsmanlike work with a few recognisable steps. I describe them because it seems fair that you should know what you are buying when you commit to a longer process.

First, one single event under the microscope. Instead of a general “the whole week was hard”, we take one situation, preferably a completely ordinary one: Tuesday, 4.10 p.m., a message from your boss. What exactly was said, what happened in the body (where and when — the throat, the chest, the hands), which thought came first, what you did and what you told yourself about yourself as you did it. This close-up is not pedantry; patterns are visible only in details, they hide in summaries.

Then we look for repetitions. After a few such unfoldings a common denominator starts to show: the same wish (“I would like to be seen”), the same expected response from the other (“I will disappoint them”) and the same response towards yourself (“I had better be even more diligent”). The psychoanalytic researcher Lester Luborsky even developed a measurement procedure for this recurring trio — the core conflictual relationship theme — and showed that in the same person it is surprisingly consistent, whether they are talking about a partner, a colleague or a father.

Then we name the rule. The pattern gets a short sentence, in your words: “I must not disappoint”, “if I relax, everything falls apart”, “my anger is dangerous”. Naming is a turning point, because it turns “this is how I am” into “this is a rule I learned”. The first is identity, the second is something with a history — and something that can be tested.

And then we test it — first in feeling, only afterwards in behaviour. This is where things often get stuck for people who have already understood everything about themselves and yet nothing has changed: insight without emotional experience remains information. The researchers Antonio Pascual-Leone and Leslie Greenberg (2007) showed on recordings of therapy sessions that real change happens when the primary emotion and the need bound up with it break through beneath the defence (anger, hopelessness) — the sadness of a child who was alone; the need to be enough without having to prove it. So in this part of the process we do not explain much; we stop more often, breathe, and allow whatever comes to come.

Finally, a small exercise in the real world. One sentence to your boss. One “I can’t today” to your sister. Half an hour you take without apologising. And the following week a careful review of what actually happened — inside you and around you. It is this last step that brings symptom work and pattern work back together: new behaviour needs the calming tools you learned at the beginning. What sounds like two levels is in fact one single path that deepens.

Why depth takes time — and safety

You may be wondering: why not go straight to the roots? Because roots are not available on command. A pattern like “I must not disappoint” is not an error of reasoning that a good argument could correct — it is a protection built over years, and your system will not hand it over to a stranger at the second session. And it is right not to: first it has to check whether this space really is safe, whether this person really can hold everything. So depth work moves at the speed of trust, not at the speed of insight — what all this means for duration I have described in the piece on how long therapy takes.

And one more honest thing: the way down is not always pleasant. When you first really touch a rule that has guided you for decades, things can get harder for a while rather than easier — the old protection resists, and the sadness that was underneath comes to the surface. That detour is a normal and expected part of the process; why it happens and how we walk through it I have set out in the piece on why therapy hurts first. Here let it rest at this: depth is not a reward for the brave, it is a natural consequence of a process you give time to — and in which we always go only as deep as your system allows.

When firefighting is entirely enough

And now a sentence you may not expect from a therapist: sometimes symptom relief is completely enough. And not as a consolation prize — as a legitimate, good choice.

• When the fire is too big. In an acute crisis — a loss, a break-up, being overloaded to the limit — nobody thinks about roots. First you put out the fire; exploring waits for firmer ground.
• When resources are limited. Time, money, energy with small children or illness: a few months of focused work on the symptom is incomparably better than nothing and often exactly enough.
• When change simply is not your goal. Everyone has the right to come for a tool and leave with a tool. Therapy is not a competition in depth, and nobody is “insufficiently worked through” for having stopped where they feel well.

Only two things matter: that you choose consciously and not out of fear — and that you know the door downwards stays open later too. Plenty of people come a second time, a year or three later, when the fire has passed and curiosity remains: why does it always catch light in the same place with me?

Where on this path are you?

If you recognise your own landscape of fires — and that constant wind you cannot yet name — individual therapy is a space where it is possible to work on both levels: first to put out what is burning now, and then, at your pace, to look beneath the surface. I run sessions of fifty minutes weekly, in person in Ljubljana or online, as a therapist in training in marriage and family therapy under regular supervision; details about the services and about my path are on the My Approach page.

The first step is not a choice between firefighting and roots — that clarifies itself as we go. The first step is only a message: where it is burning and for how long. From there we look together.