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If I am a non-salaried mental health professional in a capitalist society (that is, if I am an entrepreneurial independent professional in the United States) I need patients or clients in order to make money.
That’s just how it is.
Such a mental health professional needs patients or clients in a way that firemen do not need fires. A fireman performs a service in this society that society has decided is needed whether or not the service is actually needed on a given day. It is fine for a given fireman to wax his fire engine and he will be paid; it is fine for a soldier to clean his rifle and he will be paid; it is fine for a policeman to have an easy day, crime-wise, and he will be paid. But a non-salaried, entrepreneurial mental health professional needs clients or patients if he is to be paid. Without clients or patients there is no roof, no clothes and no food.
This means that a mental health professional has a real incentive to support a system that helpfully creates mental disorders and clients or patients.
If, on the other hand, he is salaried or in some other way connected to an entity that pays him to see those clients and patients, then a second economic pressure is set upon him. Like any capitalist entity, that HMO or hospital will want him to see clients or patients fast and infrequently, since that improves their bottom line. If he can treat his client or his patient in just a few sessions or just with a pill (including, if it were legal, a pill that was nothing more than a placebo), so much the better for his “capitalist bosses.”
Thus we arrive at the common formula that we see everywhere today: “You have the mental disorder of generalized anxiety (or clinical depression, ADHD, etc.); and your mental disorder can be effectively treated in six sessions using our sturdy XYZ technique coupled with medication.”
This sentence has virtually nothing to do with a human being’s reality of difficulty and suffering and everything to do with a poor soul with professional aspirations (a psychiatrist, psychologist, psychotherapist, clinical social worker, counselor, etc.) caught up in a capitalist system. He has had to buy the notion of mental disorders, in order to have clients or patients; he has had to accept the bullying of his ultimate boss and create “treatment plans” of exactly four sessions each or six sessions each; and he is obliged to align himself with the idea that certain powerful chemicals “treat mental disorders.” Such is his lot in our capitalist society.
Nothing about this should surprise you.
What ought we to do instead? Well, one isn’t obliged to provide an alternative model for society in order to point out problems with capitalism, any more than one is obliged to explain the formation of the universe before announcing that surely it wasn’t created by Zeus or Thor. However, here are some needed changes in a nutshell:
1. Focus on distress relief and not the “diagnosing and treating of mental disorders.” If a person comes in upset about his boring job, his sleepless nights, and his sense that life is a cheat, work with that. Those are his actual problems. Don’t switch the game, count up symptoms, and give him a diagnosis. Actually focus on his distress and on what might serve to reduce it.
2. Forget about “abnormal psychology,” as “abnormal” in this context is a political or cultural word and not a medical or psychological word. Focus on the human challenges that a person presents, whether those are best conceptualized as “cognitive,” “behavioral,” “deep,” or something else. If you want to claim that the presenting issue is actually biological or medical in origin, prove it. Run a real test—until you can, please limit your claims.
In a capitalist society, if it turns out to be profitable to “diagnose and treat mental disorders” then you will see exactly such transactions, just as you will see artisan bakers producing special breads and government workers doing exactly what is required of them to receive their paycheck, whether or not the work is useful or sensible.
People who suffer should get help and be given help; but the reality of the profit motive surely alters the game, prodding those with the power to name to continually add new mental disorders, just as travel agents must find us new, wonderful destinations and car salesmen must convince us that our next vehicle should be able to ford small rivers.
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Eric Maisel, Ph.D., is a psychotherapist, bestselling author of 40 books, and widely regarded as America’s foremost creativity coach. His latest book is Rethinking Depression: How to Shed Mental Health Labels and Create Personal Meaning (New World Library, February, 2012) and is available here. Dr. Maisel is the founder of natural psychology, the new psychology of meaning. Please visit Dr. Maisel at http://www.ericmaisel.com or contact him at ericmaisel@hotmail.com. You can learn more about natural psychology at http://www.infinitemeaningclass.com.
