To See and Not to See: The Consequences of a Strengths-Based Perspective A Commentary on Victoria Fitton's Case Study

I am pleased to respond to the paper “A case study: A discussion of depression, ambivalence, attachment, and culture portrayed in the therapeutic environment” for two reasons. As we are drawn into the first several pages, we correctly anticipate that this is to be a well-written paper. With great clarity, and virtually no jargon, this sensitive author uses wonderfully evocative language that permits us to witness and experience what it might be like to work with such an interesting and difficult case. Moreover, we are privileged to see the work of a clinician who is unusually kind and caring under the most trying of circumstances.

The second reason: My response allows me an opportunity to address a long-standing concern of mine (Meyer, 2000) about the problems inherent in a perspective that is identified as “strengths-based.”

Let us get right to the case. From the beginning, the author realizes that Susan and her son are in a far more complicated relationship than what appears within the unremarkable referral description of “maternal depression and mother-infant deficiencies.” The author reminds us that “lives are not lived in neat, straightforward, and orderly lines,” but rather that “life is often messy, full of crashes and afflictions.” We, as readers, are then poised to await discovery of just who this Susan is: a nonbonding

mother of a six-month-old son, whose afflictions seem so severe that they evoke for the author images of the Bible's most cursed human being.

We are initially given only limited information about Susan, but we soon discover that what is not told is more compelling than what is. In the beginning of the paper, we learn that Susan is from a middle-class family and that she ran away from home at the age of 15. We also learn that at 18, following the birth of her baby, the husband to whom she was never legally married, has left her widowed. (We presume that she identifies herself as a widow.) Subsequent to his death, Susan returns from thousands