Would you be able to tell if
a person's problem is spiritual, emotional or physical?

The simple answer is "yes," sometimes. My answer will likely leave the inquirer wanting more because these three areas present a major can of worms, as it were. Neither lives by itself in a vacuum -- there is much overlapping. Therefore, I am going to err on the side of brevity, otherwise this could turn into a treatise of many pages. Let us first address the spiritual by defining what is meant by "spiritual." There are two common usages of this term within psychology circles.

On the secular side, it has come to mean that part of man that shows itself as hope and or courage. We say a person needs spiritual uplifting when that person is down, depressed, or discouraged -- given up. When their spiritual side is fed, we expect to see a client who is upbeat, optimistic, in love with life and all its beauty, and showing an increased level of endurance.

On the religious side, it is a descriptor of those who have been 'saved' by Jesus Christ -- have been given the promise of eternal life with Him. In this case, certain clues might be detected that would help the counselor to realize that there is a 'spiritual' issue to be treated. What I look and listen for are behaviors or  statements that suggest destructive values that are in clear opposition to the teachings of the Bible. The most common one I come across is idolatry. This is revealed when a client shows a strong ego attachment to possessions, accomplishments, lifestyle, status, or the praise or opinions of valued others. The client is deriving his or her sense of worth and significance from at least one of these, rather than the valuation set by Jesus Christ. In turn, the client 'worships' these by caring for and protecting them above all else, especially at the expense of healthy intimate relationships.

An example of how this might show itself in session is when a couple is having financial difficulties. As a first line of defense, the wife is put out to work to help maintain the ownership of something, or to achieve or maintain a lifestyle. As the burden increases, they begin faulting one another for the pain they experience. When asked about the possibility of downsizing their desires, resistance arises in all its ugliness. If it is a house that is the idol, the response might be, "Oh, our house is not THAT large," or that cheaper homes are in unacceptable neighborhoods. Owning a certain house in a certain area of town is of uppermost importance to the couple, more so than their concern for their children or each other. And holding onto that possession or lifestyle might be the force that keeps them working at jobs they hate.

Turning to the 'emotional' aspect raises the question of whether or not the inquirer meant to use the word psychological rather than emotional. Had that been the case, I could have launched into a discourse of how a person's thoughts, beliefs, evaluations, expectations, and demands made on self and others might be corrupted and thus causing problems.  But the question asks about emotions, so I will attempt to answer that, and in doing so, it will bring us face to face with the physical.

We have five fundamental emotions from which all other more subtle shades of feelings are composed. They are joy, peace, sad, anger, and fear. Obviously clients do not seek counseling for joy and peace, so sadness, anger, and fear are what bring them in to the office. These emotions are brought to life in one of two ways, either they are triggered by conscious thoughts, or they are held within the body as memories and triggered without conscious thoughts.

For those triggered by thoughts, I use my chosen therapeutic approach, cognitive- behavioral therapy, to orient me to listen for errors of thinking previously mentioned. When an error is identified, the client is invited to alter that thinking pattern to a more accurate one that is consistent with the real world. Doing so usually results in a less stressful life as the client's new approach finds cooperation in the real world.

And now, research is revealing that the body can remember emotional events and situations long before a child can speak. These emotional memories are laid down in brain-like cells throughout the body, especially around the heart and stomach, as early as the first 33 months of life. And if we include the developing brain, we must not overlook the amygdala which is the heart of our early warning system to protect us from harm. These body memories can be evoked by outside stimuli and we react with fear, anger, or sadness with little or no idea why. One well documented example is known as 'white coat syndrome." This term is applied to people whose blood pressure, pulse rate, or other fear responsive life sign is elevated upon entering a medical facility. What is happening is that the amygdala remembers a sketchy picture of previous medical facilities in which the client was hurt, maybe by a shot in the butt. Upon entering the facility, the amygdala does its job by alerting the body as though it had been scared -- to be ready to fight, run, or enter a state of paralysis. All this takes place in a couple of heartbeats without the client having a clue as to why. Often times a client will react to his or her spouse with such emotions which seem to come out of nowhere. They are just as powerful as those which have a known history, and the client is unable to explain anything because there is no verbal memory of how they started, only a nonverbal body memory.

So that opens up the issue of the physical. With more and more medical research being passed along to the counseling profession, we are in a better position to watch for signs of identifiable physical causes of distress and make proper and timely referrals. In my own practice I ask clients to list on the intake form medications that they are currently taking. On more than one occasion I have found that a side effect of one of their medications was the cause of the distress that brought them in to counseling. Merely having the doctor change the medication or dosage cleared the problem up, thus eliminating a lot of fruitless counseling. And then there are the marriages that were on the brink of divorce because the wife assumed that the husband was unfaithful, or about to abandon her, when in fact they were experiencing the symptoms of adult attention disorder on the husband's part. When the ADD was successfully treated, the trust returned to the marriage and all went well afterwards.

As counselors become more familiar with medical explanations and causes of emotional or cognitive processing based distress, we will be in a better position to serve clients. Taking some relevant medical history information during the first sessions is good practice policy and often proves to be as helpful as the psychosocial history. So, the answer to your question is yes. And the degree of success in determining which is, or are, the cause(s) of the client's distress is going to depend on the counselor's repertoire of medical, emotional, and spiritual data.