NCE Study Guide Podcast

Listener Essay Case Studies: The Problem of Good

Host: Glenn Ostlund
Release Date: October 23, 2025

Overview of the Episode

This episode of the NCE Study Guide Podcast explores a listener essay originally submitted to the Infants on Thrones podcast, using it as a rich case study to examine philosophical, existential, and therapeutic questions about suffering, empathy, and the search for meaning. The essay delves into the "problem of evil"—how people try to reconcile suffering with the notion of a loving God—and then flips the script to present the less-discussed yet provocative "problem of good." The episode uses this narrative to provide a deep-dive clinical analysis, ideal for counselor exam prep and personal reflection.

Key Discussion Points & Insights

1. The Listener Essay: Flipping the Problem of Evil

[05:29–14:29]

• The essay centers on a famous 1993 photo by Kevin Carter showing a starving Sudanese child stalked by a vulture. The author describes how this image triggered a profound, lifelong emotional response and questions about suffering, morality, and the nature of God.
• The essay then systematically lists ten classical theodicies (explanations for why a good God might allow evil) and cleverly inverts them, suggesting that these same arguments could be used to defend a malevolent deity if one simply flips the logic.
• Notable Quote (Listener Essay, 12:57):
  “Each attempt to reconcile the existence of evil in the world with a loving God can at the same time harmonize the presence of goodness in the world with a wicked God.”

2. Clinical Commentary & Case Presentation: David's Story

[14:29–25:09]

• The episode pivots into clinical analysis, introducing “David,” a composite client representing the kind of deep moral injury and existential despair described in the essay.
• David, a sensitive, thoughtful writer and father, is haunted by the suffering he witnesses and the image of the child. He experiences “moral fatigue”—not from bad choices, but from being overwhelmed by empathy and a sense of helplessness.
• His coping mechanism is intellectualization: trying to solve suffering as a philosophical puzzle, which morphs into a sense of trapped, intellectual despair or “meaning collapse.”
  • Notable Quote (Therapist, 16:14):
    "A soul deep exhaustion. He links it directly to trying to intellectually grapple with the sheer scale of global suffering."

3. Biopsychosocial Case Analysis & Presenting Problem

[20:47–25:45]

• Biological: David’s distress is not just mental but embodied—he experiences physical symptoms (throat tightness, blurred vision) signaling profound stress (polyvagal theory, mirror neurons, trauma response).
• Psychological: He uses intellectual defenses (over-thinking) to shield himself from overwhelming feelings, which ends up trapping him in existential despair. The episode introduces “moral injury”—psychological damage caused by witnessing or being unable to prevent acts that contradict one’s core values.
• Social/Spiritual: David’s background in a structured faith (e.g., Mormonism/Christianity) provided clear schemas for meaning. When these collapse, he experiences deep isolation and cognitive dissonance.
  • Notable Quote (Co-host, 23:10):
    "For David, just witnessing the kind of suffering represented by that photo... that can create a moral injury, a sense that the fundamental rules of fairness or goodness have been shattered.”

4. Developmental & Theoretical Frameworks

[25:53–36:02]

• Diagnosis: Provisional diagnosis of Adjustment Disorder with Depressed Mood (F43.21), contextualized by Z65.8 (Religious or Spiritual Problem) as per DSM-5-TR. The distinction from Major Depressive Disorder is emphasized—David’s despair is focused, situational, and related to a specific worldview collapse.
• Faith Development: Parallels with James Fowler’s stages of faith. David is likely in the transition from “conventional” to “individuative-reflective” faith—marked by personal responsibility for belief, the absence of easy answers, and willingness to hold paradox.
  • Notable Quote (Therapist, 24:39):
    "He's pushing towards individuative, reflective faith, where you take personal responsibility for your beliefs, or maybe even conjunctive faith, where you start to hold paradox and ambiguity."
• Ethics: Counselors must uphold ACA Code of Ethics—especially regarding spiritual neutrality, unconditional positive regard, and thorough suicide risk assessment, given the parallels to Kevin Carter (photographer who died by suicide).

5. Therapeutic Approaches and Rationale

[36:02–40:56]

• Existential Therapy:
  Central for helping David confront existential givens; suffering is reframed as a doorway to meaning and proof of values.
  • Notable Quote (Co-host, 31:27):
    “It shifts the core question. Instead of being paralyzed by ‘why does God allow this?’ the focus moves to: given that this is the reality, what meaning can I choose to create in response?”
• Cognitive Behavioral Therapy (CBT):
  Identifies and restructures cognitive distortions—overgeneralization from one event, catastrophizing, and emotional reasoning.
• Person Centered Therapy (PCT):
  Emphasizes the healing potential of unconditional acceptance; may help David reconnect to his own inner wisdom.
• Acceptance and Commitment Therapy (ACT):
  Teaches acceptance of painful thoughts/feelings, values clarification, and committed action despite existential uncertainty.
  • Notable Quote (Co-host, 35:11):
    “Not as literal commands or objective truths. Helping David shift from ‘the universe is evil’ to ‘I am having the thought that the universe is evil.’”

6. Specific Interventions & Techniques

[36:36–40:56]

• Existential Meaning Reconstruction: Using Frankl’s approach to turn despair into evidence of caring values and meaning.
• Mindfulness & Somatic Grounding: Breathing, body scans, focusing on the present to downregulate nervous system panic.
• Cognitive Restructuring (CBT): Collaborative identification and examination of catastrophic or overgeneralized thoughts.
• Values Clarification (ACT): Shifts focus from cosmic questions to personal, actionable goodness—anchors meaning in concrete behavior.
• Narrative Externalization: Personifies the problem (e.g., “the vulture of despair”) to gain distance and perspective.
• Culturally Responsive Integration: Engages with David’s spiritual language, validating faith background without judgment.

7. Embodied Experience & Polyvagal Theory

[41:07–45:37]

• Polyvagal Theory: Throat constriction reflects a “dorsal vagal freeze” response—an ancient defense against overwhelming threat.
  • Notable Quote (Co-host, 42:55):
    “When David visualizes the suffering child, feeling utterly helpless to intervene, his nervous system interprets that as inescapable threat... The throat constricts as part of that primitive immobilization defense.”
• Mirror Neurons/Vicarious Trauma: David’s highly empathetic mind simulates the suffering he sees, leading to secondary trauma.
• Therapeutic Goal: Help the nervous system learn to coexist with moral distress without collapse—grounding, safe presence, and regulated exposure to pain.

8. Therapy’s Role & When to Seek Help

[46:43–49:49]

• Therapeutic Core Offers:
  • Sanctuary: Safe space for moral sensitivity.
  • Containment: Shared holding of grief and meaning loss.
  • Co-regulation: Therapist’s presence helps recalibrate client’s nervous system.
  • Agency Restoration: Redirect philosophical despair into meaningful present action.
• When to Seek Therapy:
  When reflection becomes rumination, empathy leads to paralysis, or when existential questions impair day-to-day function and wellbeing.

9. Key NCE Concepts Recap

[49:43–50:55]

• Moral Injury: Distress from violation of core beliefs.
• Differential Diagnosis: Adjustment Disorder vs. Major Depression.
• Z Codes: Contextualizes spiritual or religious struggle; avoids pathologizing.
• Cognitive Distortions: CBT skills in identifying/wrangling unhelpful thought patterns.
• Integrative Therapy & Trauma-Informed Care: Use of existential, person-centered, ACT, and polyvagal theory.
• Suggested Study Resources:
  • Viktor Frankl’s Man’s Search for Meaning
  • Irvin Yalom’s Existential Psychotherapy
  • ACT texts by Stephen Hayes
  • ACA Code of Ethics
  • Porges’ Pocket Guide to Polyvagal Theory

10. Concluding Metaphor: Infants on Thrones

[51:24–53:26]

• The “infant on the throne” symbolizes the struggle between vulnerable, feeling self (the infant) and the powerful, analytical intellect (the throne). Growth requires integrating the two—transforming existential pain into wisdom, action, and connection.
• Notable Quote (Co-host, 53:07):
  “It’s about harmonizing the brilliant analytical mind, the throne, with the deeply feeling, morally sensitive body and heart... helping the infant learn to skillfully operate the throne.”

Memorable Quotes & Timestamps

• “Each attempt to reconcile... can at the same time harmonize the presence of goodness in the world with a wicked God.”
  – Listener Essay, [12:57]
• “A soul deep exhaustion. He links it directly to trying to intellectually grapple with the sheer scale of global suffering.”
  – Therapist, [16:14]
• “For David, just witnessing... that can create a moral injury, a sense that the fundamental rules of fairness or goodness have been shattered.”
  – Co-host, [23:10]
• “He’s pushing towards individuative, reflective faith... starting to hold paradox and ambiguity.”
  – Therapist, [24:39]
• “What kind of body feels this? What does this feeling tell me about what I value and what am I capable of doing with this feeling?”
  – Co-host, [46:13]
• “When David visualizes the suffering child... The throat constricts as part of that primitive immobilization defense.”
  – Co-host, [42:55]
• “It’s about harmonizing the brilliant analytical mind... with the deeply feeling morally sensitive body and heart.”
  – Co-host, [53:07]

Useful Links

• NCE Study Guide Podcast: ncestudyguide.transistor.fm
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This episode provides a masterclass in integrating existential philosophy, trauma-informed care, and evidence-based psychotherapy. It is both educational for NCE candidates and deeply validating for anyone struggling to find meaning in the midst of suffering.