When The Problem Isn't The Client: A Liberation-Focused Case Story

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You've seen this scenario before. A student gets referred to school counsellor for "behavior issues" or "attitude problems." The intake forms list symptoms. The treatment plan targets what's "wrong" with the young person - their aggression, their defiance, their inability to regulate and their aggression in class.

But what if the young person isn't the problem? What if they're responding exactly as you'd expect to a system designed to silence, punish, and marginalize them?

This is J's story. And it might change how you think about trauma therapy.

When "Support" Reinforces Harm

J was 16 when he first showed up at a public outpatient clinic in southern Brazil. The referral came from his school psychologist, and the complaints were familiar: anxiety, learning difficulties, behavioral problems. He'd been labeled "aggressive" after failing two years of school and being violently assaulted at 15. After the assault, he started using drugs and alcohol, skipping school, withdrawing from relationships.

The school counsellor had offered BIP - anger management, focus techniques. J tried them. They didn't work. Not because J wasn't capable, but because the strategies missed the point entirely.

J explained it himself: he felt anxious and got into fights because he felt frustrated by his teachers' negative attitudes and the school counselor's emphasis on his "agitation" and "inability to focus." He believed students from the shantytown, students who "looked poor", were more likely to be sent to the psychologist simply because of who they were.

In other words, J wasn't describing symptoms. He was describing oppression.

But his initial "care" never named it. Instead, it pathologized him further. Treatment became another arm of the same system causing harm, focused on making J more compliant, more manageable, more willing to accept conditions that were fundamentally unjust.

A Different Kind of Therapy

When J met Dr. M., a psychiatrist at the community clinic, something shifted. Dr. M. practiced what's called dialogic praxis - an approach inspired by educator Paulo Freire that centers power, oppression, and systemic harm as legitimate clinical concerns.

Instead of asking "What's wrong with you?" Dr. M. asked different questions:

• What's been going on in your life?
• Who has power in these spaces? Who doesn't?
• How do the structures around you shape what you're experiencing?

These weren't abstract philosophical inquiries. They were clinical interventions that reframed J's distress as a response to conditions, not a personal defect.

Dr. M. didn't position himself as the expert diagnosing J's pathology. He showed up as a collaborator. J's perspective and analysis mattered. His anger made sense. His withdrawal was strategic. His "agitation" was clarity about injustice.

The therapeutic relationship itself was restructured. Dr. M. openly acknowledged he had "no idea what it was like to live J's life" and admitted the limits of his own understanding. This wasn't self-deprecation - it was an intentional shift in hierarchy that created space for J's expertise about his own experience.

From Shame to Agency

As therapy progressed, J's internal narrative transformed. He moved from "I am the problem" to "I'm being impacted by harmful systems." That shift wasn't just cognitive - it was embodied. J described feeling less anxious, more hopeful. He developed what he called "consciência" - consciousness, self-worth, and the ability to act in the world.

But here's where the story diverges from traditional trauma treatment outcomes.

J didn't just develop coping skills or symptom relief. He got involved. He joined the student council. He advocated for better teacher-student relationships. He participated in initiatives to foster democratic teaching practices and student participation in school governance.

The treatment didn't help J adapt to an unjust system. It helped him see the system clearly, and then supported him in working to change it.

After a year of intermittent therapy, J summed up the most significant change in his life: "I feel more like a person with value now."

What This Means for Your Work

If you've ever worked with a client labeled "non-compliant," "resistant," or "unmotivated," you know the frustration. You offer evidence-based interventions. You teach skills. You build insight. And still, something doesn't shift.

Maybe that's because your client isn't only recovering from past trauma. They're living inside current oppressive structures, in schools, workplaces, immigration systems, policing, healthcare itself.

And if we never name that, we risk reinforcing the exact message causing harm: you are the problem.

Many of the young people, adults, and families we work with are navigating racism, classism, ableism, and other forms of systemic violence every single day. When we treat their distress as purely individual pathology, we're not just missing context. We're participating in their oppression.

Small Shifts, Big Implications

You don't need to overhaul your entire practice to begin integrating this lens. Start small:

In assessment: Add questions about institutions and power. "Who has decision-making authority in your workplace? Your school? Your home?" "What rules feel unjust to you?" "Who gets punished, and who doesn't?"

In conceptualization: Make space to explore how systems like racism, poverty, and marginalization live in the trauma story. Not as background context, but as active agents of harm.

In relationship: Position yourself as a collaborator, not the expert. Your client knows their life. You're there to help them make sense of it, together.

In goals: Consider whether healing only means helping clients adapt to unjust conditions, or whether it might also mean helping them see and, when possible, change those conditions.

An Invitation

Think of one client whose distress might make more sense when viewed as a response to systems, not just individual struggles. What would happen if you named that explicitly? What if you asked them about power, about institutions, about who benefits from the conditions causing them harm?

Healing doesn't have to stop at symptom management. It can include dignity. Agency. The capacity to see clearly and act accordingly.

That's not just therapy. That's liberation.

Want to go deeper? Our course Anti-Oppression and Liberation in Trauma Therapy offers structured frameworks and practical tools for integrating liberation-based approaches into your clinical work. Learn how to shift from pathologizing to politicizing- without abandoning the evidence-based foundations of trauma treatment.