Rethinking Psychology

How to shed mental health labels and create personal meaning

Replacing Psychiatrists and Psychotherapists

As the debate continues about the legitimacy of "diagnosing and treating mental disorders," the question must be asked: is it time to replace psychiatrists and psychotherapists with another sort of mental health provider? Read More

Moral obligation

I think we already endure the human experience. We wake up every morning with a purpose and a goal. Is not easy following goals, is very difficult. Part of the human experience is to love through it. If you have never been sad, you have not experienced life at its fullest. Emotions are like the stars in the sky. Sometimes they are beautiful to look at.

I believe todays experts feel like they are doing the right thing. Their passion and commitment is a testament to their drive to make people's lives better and productive. A couple of days ago, I read a good explanation about what is the psychotherapists ultimate goal(I apologize if I forgot your name): think, feel and act good. Honestly, I feel like psychotherapsts or psychoanalysts are not a true science anymore, because I feel the practice has evolved with human progression. Heck, psychotherapy may have been in existence well before philosophers started writing books of wisdom. In many ways, we are all psychotherapists. You are a psychotherapist, your friend is one, your teacher, etc. Your parents may have been the greatest psychotherapists in your whole life. For some people, situational or social support is all the inspiration they ever need. For others, licensed psychotherapists is the answer. There's no wrong answer.

But it goes beyond big pharma or money. Take my sister for example. When my nephew was diagnosed with cancer, she fell into an ugly depression. Didn't talk to the family. Did not feel like talking, and ignoring her own family was her way of not inflicting the pain even further. In her eyes, she was protecting herself. To us, she was ignoring our bond and trust. Because if she did not want to talk to us, who else would she talk to? As it turns out, a psychologsts. I think she's in some form of group therapy, where other people in similar circumstances share their thoughts and feelings about their dilemnas. And look at her now: she's way better. She talks to us now, she's herself, she's happy, and most importantly, she talks about my nephews cancer. Is a big deal for us, because not long ago she was ignoring her own family. Sometimes, caring is not enough for someone like my sister. This is why mental health is important.

We all have our own ways of coping with tragedy and loss. Many of us cope it right, without much external help. Others, do need help. The fact that we want to help proves that the mental health system is working. If we all helped, why need psychiatrists, psychologists, etc? If we were machines or computers, who are immune to tragedy, why even bother with a field like psychology? Why exist if we are mindless machines without any form of purpose or motivation? This is not a fairytale or a Harry Potter book. These mental health disorders exist because people feel discomfort about them. Families, parents, scholars, erc want to learn because they want what's best for their loved ones. You can have the best and the brightest trying to help them out but it may not be enough. You can have your loved ones help out and is still not good enough. And that's important. Is important because is real, is real because we feel it. If it weren't for psychology, my sister would probably still ignore us til this day.

Wow

You absolutely hit the nail on the head! Bravo!

In my late 20's (I'm now 50), I decided to confront the effects of my traumatic childhood and the havoc it was wreaking on my life. Although I had managed to graduate from law school and accomplish other goals, I was suffering psychically in every way. Although I wasn't contemplating suicide with an active plan, I naively checked myself into a psychiatric facility for what I thought would be some intensive treatment. Ha! What a joke that was! First, for the facility to gain reimbursement from my insurance company, they had to indicate in my chart--despite my protestations--that I was actively suicidal. Second, I saw a psychiatrist once or twice for about 15 minutes. He thereafter diagnosed me with several "disorders" and later ordered me to take several "tests" in my room when I felt like it. Those psychometric tests, of course, allegedly affirmed his diagnoses. I was prescribed several different types of medication and released within 72 hours. Believing naively that I was going to be there for several weeks and would be receiving intensive therapy, I was shocked when my three days was up, and I was "released."

Having never taken antidepressants before, I became quite ill. I have always been extremely sensitive to all medications (and typically take children's doses, despite my physical size), so the side-effects were debilitating. I began to see a therapist, who ignored my complaints about the medication and assured me that (a) the side-effects would subside in a few weeks and (b) the medication would begin to "work" within a month or so. What!? Meanwhile, I had a very demanding, very stressful job for which I needed to be extremely high functioning. While clinical depression had sent me to the hospital for what I thought would be a type of rehab, I could no longer perform my duties at work, because the side-effects were unbearable. And neither wanted to talk about the relationship problems I was having because of my total lack of sex drive. Ultimately, I complained to my treating psychiatrist, whom I saw once a month for 15 minutes, and thereafter switched medications, which only changed the type of side-effects, but not their degree.

What both he and my therapist failed to understand is that it took an ENORMOUS leap of faith (and courage) to check myself into a psychiatric facility, particularly as a practicing attorney who worked in a small government agency. By the time I decided to go, I was in dire need of serious intervention. What I got was an emergency room triage, a sample of medications to go, and a few nifty (not!) art projects I completed. Once out on the street, what I received in the way of "therapy" were suggestions to meditate and exercise and eat whole foods and listen to spiritual music and burn incense and drink tea and get a massage and all of the other feel-good things that "normal" people do to be happy. Neither really LISTENED to me talk about the stress in my work and life, my unfulfilled needs, or my anxiety at the state of the world. What frustrated me the most was that my therapist wanted to dig into the childhood trauma that I experienced as a child and then, when the 50 minutes was up, send me out the door, while I writhed in pain from having ripped the scab off my deep, deep wounds while having few functional coping skills to manage that pain. It seemed so cruel to me at the time and barbaric now.

Out of shear frustration and total hopelessness that therapy and medication would lead me to normalcy, I overdosed on prescription medication a few months later and found myself back in the hospital for another 3-day vacation. Once again, the joke was on me. Art therapy failed to inspire a miraculous recovery.

Over the next ten years, I would be involuntarily committed to a psychiatric facility three more times. I would be given seven different diagnoses by different clinicians. I would see eleven different "therapists." I would take NINETEEN different medications, singularly or in combination (SSRIs, SNRIs, Tricyclics, Mood stabilizers, Anti-psychotics, Anti-anxiety, and Anti-Convulsant). None were effective. I finally gave up.

In my experience, the medical model is crap. To be labelled as having an illness, disorder, or disease was, for me, self-defeating. I tended to adopt and internalize the symptoms to my diagnoses. I became those diseases. I have since come to understand and believe (on my own) that, while I may have some dysfunctional coping skills and personality characteristics that could be improved, I also have NUMEROUS functional ones that I focus on to keep myself moving forward in what has proven to be a very difficult life. I choose to focus on the positive, rather than the negative, aspects of who I am as a whole person. I could easily view my difficulties in life as "failures," accept that I am fundamentally "broken," and blame my family and myself and everyone else for my "illness," but what good does that do? Personally, if I ever feel the need to reach out for help, I'm going to hire a life coach. At least they will help me move forward, toward positive goals, and not leave me to wallow and writhe in the trauma of my past like every therapist I have ever had. Nor will they suggest that I poison my body with toxic chemicals that leave me hyper- or hypo-somnolent, cognitively numb, ravenous, stupefied, and anorgasmic.

Sadly, I believe you're right. The "industry" of mental health is too invested in the medical model, which generates billions for therapists, psychiatrists, MD's, and big pharma. And let's not forget that insurance companies control the purse strings. Every practitioner has to be able to provide a billing code to get paid and, of course, billing codes are tied to diagnoses and treatment plans!

Thank you so much for this post! It says EXACTLY what I have been thinking for years!

Thank you

Thank you for your comment,

As a therapist myself, reading your experience really struck a nerve. I'm saddened that I cannot do anything for you personally, but I will take your experiences with me today as I go about my work. I will remind myself to sit and really listen to where my patients are at today.

Thank you for that reminder.

Thank you, in return

You actually HAVE done something for me personally. You heard me. You also took the time to acknowledge me and let me know that you heard me. My point in sharing my experiences (as a comment to this post and others on PT) is (a) to experience catharsis for myself, as I continue to struggle through life, and (b) to perhaps help others, either practitioners like yourself or your clients.

I was a public defender for many years. My indigent clients were the saddest, most marginalized people on the planet (save, perhaps, for the elderly and all of the other poor people around the globe). They wanted more than anything for me to listen to them--truly listen. I could help them only with their legal issues, which were only a small fraction of their overall problems in life, but even so, their greatest need/desire was for me to listen and to CARE about them as an individual person in the context of their life, regardless of the quantity and quality of poor choices they had made in relation to their underlying life circumstances. While you're not necessarily counseling the indigent, I believe I can say with confidence that your clients feel marginalized within the context of their life circumstances, too. They just want to be heard and to know that they matter as individual people struggling through life.

Listening

I think you have pinpointed it right there - everybody needs to be heard for themselves - that their experience is unique, that it cannot be pigeon-holed for easy diagnosis and concomitant treatment package, or, for that matter, stuffed into a shape in order for the bureaucracy to believe it is legitimate.

My experiences, I think, have paralleled yours in many ways, except that I have been far luckier, mostly, in the help and level of listening I got from the psychiatric and psychological services, and medications did and do help me enormously in many ways. But I do often wonder - would a life-coach, fewer environmental pollutants, and being born to a less materialistic and status-centred culture not have possibly rendered then completely unnecessary?

Kudos on pulling yourself up by your own bootstraps, and despite the system failing you so badly. I doubt I would have done as well

These people you speak of,

These people you speak of, they are called pastors. I saw the comment about throwing in gratuitous gods, but any pastor worth their weight doesn't do that. Any real pastor has an MDiv, which is more training than most marriage and family therapists, and tends to the hearts of many more than just people who agree with them about God. Show your post to any seasoned pastor (the ones straight out of seminary might not yet understand), and they will tell you that when they aren't preaching, this is what they do. All the time. For everybody. Without hesitation.
Just something for you to think about.

Pastors

Interesting that you should suggest that. I am currently in the midst of a major depressive episode precipitated by traumatic life events. I reached out to a pastor who also has a master's degree in psychology and who has been doing grief counseling through the church for many years. While she was a good listener and VERY empathetic, she couldn't resist proselytizing during each meeting. She knew that I was spiritual, but not religious, but just had to convince me through books and meetings and such that a devotion to God was the answer to all of my life's problems. Oy. I thanked her for her time and moved on.

I suppose you will claim that she "wasn't worth her weight," but I would disagree. I believe that she has ably counseled many, many people. She was very helpful to my mother when my father died. She just wasn't my cup of tea. But thank you for the suggestion.

Agreed

Just wanted to also say this is a great post and encapsulates pretty well what I've been thinking as I graduate from a psychology degree (already holding one in sociology).

I also can't help but think that many in health care want not just to help, but also the prestige of helping. I've been in counselling, and I find the relationship inherently problematic, similar to the relationship with my family doctor. These are supposed to be "experts," but they really are people who come from a particular field of study, a particular perspective, who are trained to look for what's _wrong_ with "the patient." These professions attract a particular personality type. I have decided not to pursue health care as a career because I feel burnt out before I've begun. Coming from a difficult background, people raised in institutions (religious ones) there are a lot of psychological problems present in my family. I know how difficult and taxing these issues are to deal with. I find it insulting to think we can "fix" people, or that we _should_ fix them. It makes sense to work _with_ individuals, give them the benefit of a particular perspective and the tools that have been developed and _may_ help. I think people do the best they can to cope with the challenges of life. Often psychological and psychiatric techniques to make us "happy" and "mentally healthy" or "typical" (whatever that means) in a less than fulfilling and satisfying, or even pleasant, life are doomed to fail or fall terribly short.

I think one thing that's unwritten in your post is the cultural problem of individualism. So many problems are caused by loneliness and low social support. Prestige-seeking is a product of individualism. If we weren't all so intent on hierarchy, we could work together more, and maybe be a little more psychologically healthy, get what we really crave - connection - instead of needing to always set ourselves apart, and ideally above, each other.

If psychology and psychiatry, and the medical profession too, don't move in a more egalitarian, frankly possibly more technician- or facilitator-like direction, society will develop other means of filling that need. As the previous commenter already noted, religious counsellors have filled this need in the past. I can imagine a post-religious/agnostic/atheistic/existential "religion" that puts humanity in the centre. Our shared interests are surely something to pay attention to. Whether our individualistic, consumerist cultural landscape takes notice or not, we are all interdependent, and helping each other is actually pretty self-interested. Even Catholic confessionals, that anonymity and the simple way to make amends, has something to teach us about healing and coping. The current weight on the fields of psychology and psychiatry is an outcome of, by many, a turn away from spirituality to "science." The DSM and psychological categorization are just another way to help us get comfortable with our anxiety, in this case about how to deal with people who don't fit in, and ourselves too, when we do not.

But, great post! Spread the word, be more optimistic! I know that the ship can be steered in a more helpful direction. The counsellors and health care workers might want to turn the microscope (and questionaires and EEG and brain imagers) back on themselves for a while though. I've been in both camps (helper and helpee), so I say this with the kindest, least individualistic intentions I can muster.

Thank you and another 2c worth...

A topic that very much needs to be recognised - well done for framing it into a concept.

I too think that we do already have a trained body of people who can do what you suggest, because I have been referred to them in some cases in lieu of an available psychologist and found them fantastically helpful, I have to mention them - Social workers. These people seem, in my experience, to be trained to look at the person and their circumstances, (very much not to look for pathologies), and to look for practical solutions to real problems, and also to be extraordinarily non-judgemental and accepting. Proselytizing for their personal faith would also be considered unprofessional and unethical ;) A problem here is that needing a social worker in your life is considered an admission of defeat - of being a social failure. I think this is unfair, because these people could offer so much to so many, or at least offer a starting point for a "new" group of people, who would initially be lumped in with psychiatrists and psychologists for the cache, to make them socially acceptable to anyone? ;) Lifestyle restructure coaches, or psychological assistives, or emergency phychological interventionist. I'm sure a suitable moniker could be designed.... the problem with that is they might then be priced out of the market, or perceived as an elective, like cosmetic surgery, an thus not be covered by medicaid services, where in fact they would be saving companies and economies billions by preventing lost production, losses due to accidents, and by reducing stress leaves and so on.

I think that some of these "clinical" diseases do exist - and can be precipitated by the problems you mention, that the brain actually ceases to function correctly when it has been over-stressed - like when it has been subject to sleep deprivation.

The pity of it is that, at least in modern western cultures, we need our communities and extended families back to help us through the difficult times, to recover our equilibrium. Or indeed, such people as you suggest. Failing that, whatever the cause, the stress, despair and anxiety felt by so many for whatever reason can become so debilitating that even the kind of person you suggest would not be able to reach them without the help of the medications. I have been there and seen others too often to discount the issue - one gets to the point that the will, the energy to reach up for a helping hand is gone, one is unable to perceive any reason to do so, or to perceive in oneself any value worth preserving, or even the mental capacity to get as far as understanding the need to try. I would not discard the psychiatric / psychological practitioners so easily, or discount what they do easily. But they should ideally be last-line defenders, and the need for them could be hugely reduced by such intervention as you suggest.

The one thing that I find a bit discordant in your very excellent article, is your presumption that people should by default suffer so desperately for not becoming THE star, or THE top golfer etc. There are many who do what they love because they love to do it. Becoming the best THEY can may be the issue to them, or simply being able to do what they enjoy may be the issue. Yes, there are those who find their dreams thwarted, but at the same time I think our CULTURE also has to find a balance point - of not saying that "Coming second is not good enough". Just making it to a major competition is pretty darn good, and being part of the competition is fun too - at least if one doesn't have coaches, family or friends all looking or sounding like they will be desperately disappointed in you if you fail to win. Just having the wherewithal to compete for the love of it is probably enough for many. And how many actors, singers, musicians and other artists are out there coexisting, not heartbroken because they are not "the chosen one"- all wanted, all admired because they all fill needs, provide variety to please different tastes, and provide variety within those tastes, and many just doing it because they cannot imagine doing anything else. You might not be on Voice, or even fulfil dreams of singing to an audience, Also - having unreasonable expectations is often a cause of distress - that can be avoided before the expectations are raised - it is like despairing because you are not Superman. Look for contentment in your sphere. Make expectations in society no more than to make a reasonable contribution to your community, to be a part of your world around you.

I suppose I am saying that that was a poor example in this case is all. ;)

Overall, thank you for the post. You highlight a lack in particularly westernised society that is long overdue to be addressed because of our reduction to nuclear families, and possibly the world over because of the sheer volume of migration away from extended families.

(On migration: one often cannot realise, before uprooting, just how valuable a network built from childhood, however tenuous compared to extended family, or an intimately understood culture are until one has uprooted and dug in elsewhere - and then one is often too poor, or the conditions that forced the move still prevail at home, so one can't go back. And even if one does, the place has moved on without you.)

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Eric Maisel, Ph.D., is the author of forty books, among them Rethinking Depression.

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