Alison lived alone with her disabled father for years, taking care of him by cooking and cleaning after coming home each evening as a care worker in a nursing home. Although she was not paid well for her work, she did take some satisfaction in helping people who were clearly worse off than she was and sometimes seemed truly grateful for the attentive way she cared for them. By contrast, her father never appreciated her efforts, for he did little but watch television and drink cider all day and seldom spoke to her except when he wanted something done. Even so, she knew he needed her and when he died unexpectedly of a heart attack she felt the centre of her world had suddenly collapsed. Although Alison tried to carry on at work and did show up dutifully, she felt as if she had to make her way through an emotional fog in which nothing seemed to make any sense. Her work suffered as a result, but her employers were hardly sympathetic. For they ignored her grief, but did notice that she had become irritable and somewhat forgetful. She began to draw the worst shifts and was forced to deal with the most difficult residents in an apparent attempt to drive her out of her job. It worked. One day, during a particularly gruelling shift, she lost her temper in dealing with an old man who reminded her of her father, not so much by the way he looked, but more by the gruff way he always demanded her help. Although her outburst was unprecedented and quite uncharacteristic, she was sacked. Consumed by shame, Alison came to see me for what she considered to be her anger issue. It was only after several sessions that she began to look at the possibility that sadness and anxiety might have figured into her expression of anger. But she never considered that her stressful working conditions might have played a part in losing her job.
A case like Alison's would present a rich text for interpretation for virtually every psychotherapeutic orientation. Psychoanalysis, for example, might begin by examining her attachment to her father and her inability to form an adult relationship with anyone. Another approach could point out that her loneliness and need to please others suggest low self esteem. CBT would probably identify a number of deleterious beliefs that keep her trapped in a pattern of emotional frustration. Each perspective might be true as far it goes. But there would be a major flaw in any approach if it failed to recognise the malign influence of her working conditions in making her feel unworthy of respect or love. Indeed, by overlooking those conditions therapy would be tacitly condoning them. Yet, both psychotherapy and Buddhism often seem reluctant to express opposition to social injustice. There appears to be good reason for such reticence. Both might insist that unfairness is simply an intrinsic feature of life and that it is far better to learn how to deal with it than try to eradicate it. Moreover, Buddhism has always recognised the folly of trying to construct a perfectly just society and believes that pursuing even such noble ideals as justice and fairness can turn out to be just another form of grasping. From its position, therapy often has to deal with massive wrongs for which finding justice or retribution is simply impossible. For what can be done when an abuser disappears and escapes justice or an unfaithful romantic partner has run off and found love with someone else? Learning to cope with such misfortunes can develop resilience and the ability to adapt to unfairness. In the best cases, finding the resources to deal with emotional loss can lead to wisdom and compassion for the misfortunes of others. Even so, in the case of someone like Alison, therapy shouldn't regard her as the sole or principle agent of her misfortune. Much of the blame must fall on a society that values profits over the welfare of people which creates the conditions that magnify the problems of Alison and countless others like her. For she is hardly alone, even though loneliness is an intrinsic feature of her suffering.
Psychotherapy should never deny that life can often be brutally unfair in spite of the best human efforts to ameliorate it. But when free market capitalism exploits the inherent unfairness of life to further the advantage of those who prosper from it, psychotherapy must observe the inversion of values that this represents. In a better world, the obscene idea that wealth is a sign of moral superiority would receive nothing but scalding ridicule. Yet, in the global society that we now live in, it has become the governing ethos that guides the actions of politicians and statesmen, financiers and bankers and corrupts us all. Wealth created by the privileged, we are told, "trickles down" to the rest of us. In fact, apart from increasing the disparity of wealth between rich and poor, such an inversion of values erodes our faith in the possibility of making a more just and equitable society. We lose out not just materially, but also psychologically. Psychotherapy must recognise that life will always be unfair. But it must also recognise that we become better by trying to make it fair.