Men (sic) make their own history; but not on their own terms.

Karl Marx

From counselling to casework to system change.

People and their complex needs lie at the heart of a PIE - as they do to all human social environments. Sometimes this complexity is deeply rooted in past emotional damage, in experiences of rejection, abuse, neglect, or other trauma. Many of the examples that we find on this site of working with troubled individuals illustrate our attempts to engage constructively with individuals with such 'complex needs'.

But there can be many reasons and ways that a person's life can be emotionally complex; and not all of them stem from early experience. Sometimes this 'complexity' is as much a feature and consequence of the circumstances that they find themselves in, in the present day, which may not be of their own making - or at least, only in small part. The understanding of troubled individuals that we will need here must therefore span both the 'psychological' and the 'sociological' or 'anthropological'.

When, in psychotherapy, we are considering individuals with particularly complex or deep-rooted complex needs, it is the more personal and 'psychological' issues that will come to the fore, and the wider societal issues are in the background, the context.  But when we are exploring how services can best respond, and what may need to change, the issues of context and setting become more prominent. In some circumstances it is even the systemic complexity that is the greatest hurdle to progress, both for the individual and for the service.

Part of the re-think of service provision that arose from the UK's social exclusion programme in the early years of the 21st Century - and the social model of disability that pre-dates that policy - entailed looking for ways that the organisation and funding of services (and of research) may unwittingly keep people stuck in their marginalisation and exclusion.

If we think of trauma, attachment or any similar 'psychological model' as a lens through which we might understand people's distress more sympathetically, it is also important to see their circumstances - to have a 'bi-focal' lens - and to see how we can address their more systemic disadvantage.

Further reading/viewing/listening

Relationships and complex needs : HERE

Where did it all come from? : HERE

What psychology? HERE

What is an environment? HERE

The Umwelt : HERE

'Complex needs'? : HERE

The lasting legacy of Supporting People : HERE

Joined up thinking : HERE


Library items

Reaching out; and action plan on social exclusion (SEU report, 2004) : HERE

A Whole New World - Funding and Commissioning in Complexity : HERE

Recognising Complexity - Dept Health commissioning guidance for peersonality disorders  : HERE

Do 'complex needs' need 'Complex Needs Services' ? (Part One): HERE

Do 'complex needs' need 'Complex Needs Services' ? (Part Two): HERE

Three models of the origins of homelessness : HERE

From Sartre to Sen to Wilkinson : HERE

Richard Wilkinson’s Pathways conference presentation :  HERE

The Cynefin framework (video) : HERE