Although I had some traditional medical model training in my earlier years in which I was taught to use the DSM as a bible of sorts, I have tended to find that my sociological degree provides a fuller perspective; especially when navigating trauma. I would consider my ontological lens social constructionist, which in turn has heavily informed my therapeutic practice. Social constructionism tends to view the continuous, evolving and symbiotic relationship between a person and their social exchanges as playing a fundamental role in identity, and well -being. It highlights how ones sense of self is always in a state of becoming, no beginning or ending, as it shifts through changing cultural and historical contexts.
For a person struggling with feelings of being a failure for example, the therapist would always situate, and address the relational aspects. In many ways this helps the person untangle what is in fact theirs to own, and what is in essence being imposed upon them from a deficient environment (poor parenting, abusive partner). This may seem obvious but with more traditional models that view the person in a vacuum, one may not truly zoom out far enough to notice when the person un- situates, their feelings of being re-traumatised for example, are lowered exponentially.
The theoretical under- pinning's of social constructionism are from symbolic interactionism; a sociological outlook that acknowledges how humans impose their own unique interpretive spin (meanings) on all social interaction. These unique subjective meanings truly dictate how we perceive ourselves in relation to others', how we act towards others', and our overall selfhood evolves accordingly. For example a person raised in a family of violence and chaos, imposes meanings on others' that may pre-empt an expectation of violence; for instance they may hyper tune into intonation of voice that is raised, or view certain gazes as being judgmental or aggressive. Those meanings are deeply ingrained and imposed along their life journey, however if they are able through expanded consciousness to zoom out, seeing themselves as situated in deficient contexts, or alternatively seeing themselves imposing false meaning on safe contexts, their trauma experience will gradually lessen in time.
Also Charles Horton Cooley, a symbolic interactionist, in his notion of the looking glass self possibly offers a powerful perspective to therapeutic practice. We are always perceiving ourselves through the eyes of how we imagine others to see us. If for example a child raised with abuse perceives her primary care-givers to view her as "not good enough", this reflects back as a looking glass " marginalized" self. In therapeutic practice it can be exceptionally useful to make a genealogical journey of the self moving through shifting contexts, and in turn reflecting back . Of course the ultimate aim is for the therapist to almost use a counter transference technique in becoming a validating looking glass self which can be extended to the generalised other.