Downstream Effects:

Living Fossils, Josh:

"Take my client Juan. About a year ago, he moved from outside of Denver to Boston and began having panic attacks. Because he had moved for his girlfriend, and had long dreamt of living in a big city, he decided to tough it out. He came to see me a few months ago for help with his now-contentious relationship, stress at work, and a host of physical problems related to anxiety, such as GI breakdowns, fatigue, and rashes. He was also still having panic attacks daily.

Now, if I took Juan’s situation at face value, there would have been plenty for us to work on. But after talking through his past, I realized that there was only one Major Problem: his environment was too much for him to handle. Overload was the basis for all his subsequent issues. But it would have been easy to miss the forest for the trees by focusing on his presenting problems instead of the underlying one. Hell, if I were a couples’ therapist, I might have interpreted Juan’s agony as due to his unstable relationship. If I were a CBT therapist specializing in anxiety, I would have went to work on reducing his panic response. Instead, as a therapist more and more guided by common sense, I told him he should move. “It’s just not the right environment for you.”¹

The point is, people adapt—or think they’ve adapted—to root causes, which continue to create downstream effects. Eventually, these downstream effects dominate the problem landscape, and the root cause is forgotten."