A Call to Self-Creation
How these trying times have clarified my mission as a psychologist.
Posted Jul 08, 2020
Throughout my training and career as a psychologist, I’ve struggled to identify myself with a particular “specialty.” This is partly because I have the soul of a generalist, but also because my emerging specialty doesn’t fit neatly within the field’s convention for classifying specialties — usually something along the lines of “I study and treat psychological problems A and B in demographic groups X and Y.” Rather, I study and treat people who defy conventional categories. Such people often come to me seeking to launch themselves in a new direction. This can take many forms, from the teenager living in a conservative religious household and questioning his sexual identity; to the intellectually ambitious college athlete who's torn between "bonding with the team" and pouring herself into her studies; to the middle-aged husband seeking the courage to end a loveless 15-year marriage; to the would-be entrepreneur seeking the resolve to quit her day job and pursue her startup full-time.
To be sure, most of my clients also struggle with psychological problems, sometimes severe ones. Many have histories of trauma and abuse; most have struggled with depression, anxiety, and/or self-esteem issues. But that is not what sets them apart in my mind. Nor is it what distinguishes my evolving therapeutic approach from the standard “empirically supported treatments” (ESTs), on which I draw extensively. What does distinguish my approach is that it addresses the distinct needs of "my kind of client"—needs that today's ESTs were not designed to meet. For instance:
- Beyond “setting more realistic goals,” my clients sometimes need help setting wildly ambitious goals, while being ruthlessly honest with themselves about the low probability of success.
- Beyond “reappraising their catastrophic thoughts,” they need help recognizing when their “reappraisal” is just rationalization of what is in fact a looming catastrophe that needs to be faced and problem-solved.
- Beyond “taking other people’s perspectives,” they sometimes need help disconnecting from other people’s perspectives long enough to work out their own.
- Beyond "asserting themselves," they need help seeking out relationships and communities that offer them closeness without assimilation.
- Beyond “learning mindfulness skills to manage their stress,” they need help recognizing when they're using these skills as a procrastination tool.
- Beyond “scheduling self-care,” they may need help powering through a week without rest for the sake of a valued endeavor.
- Beyond identifying some generic values to guide their choices, they may need help articulating a mission statement that captures the full novelty of their aspirations, while allowing maximum flexibility in execution.
- And, beyond all of these particular skills, they may need help determining which skills they need when—and developing the self-awareness and self-honesty to check their motives for deploying a given skill at a given time.
Why are these needs overlooked by most ESTs? Part of the answer, I suspect, lies in the methodology of developing and validating ESTs with reference to the “average” person with such-and-such DSM diagnosis who enrolls in our research studies. As some critics have argued, this "average" participant is a mythical entity stripped of all the "confounding" complexities and "noisy" idiosyncrasies that make up the individual people enrolled in the studies, much less the people excluded from participating because their struggles did not fit one of our cookie-cutter diagnostic categories.
To be fair, important efforts have now been made to adapt existing treatments for those with more complex or underrepresented needs, such as racial/ethnic and sexual minorities, the recently bereaved, or those with multiple diagnoses or co-occurring medical problems. Yet such efforts have not been extended to individuals whose underrepresented needs stem from, for example, the ambitious and innovative nature of their endeavors. Indeed, the very idea of developing a standardized, experimentally testable treatment protocol for this “group” implies a uniformity in the members’ treatment goals, and in the therapeutic processes that can help them reach these goals. But what unifies the clients I work with is precisely that they defy uniformity: They are struggling to cast off conventional models and social norms, to find their own voice and choose their own way.
They are struggling to self-create.
Part of what I love about working with such clients is that it demands constant innovation of me: there can be no cookie-cutter template for helping someone do something for which there is no cookie-cutter template. Every self-creation process will be different, and will require a different mix of psychological tools and insights and metaphors to support it. There are overarching principles, of course, but there is nothing approaching a “script” for applying those principles to the unique generative process of each wonderfully complex and unreplicable individual.
This also means a need to innovate in the realm of psychotherapy research methods: The current methods either do not adequately capture the individual variability and complexity of the self-creation process, or do not allow for the generalization of broad therapeutic principles that can be flexibly applied to any such process. This is why I have been thinking hard about how to integrate qualitative approaches into my research, while also drawing inspiration from methods of evidence-gathering and theory-building in philosophy and education.
Enter the COVID-19 pandemic and the culture wars gripping our world, and the need to self-create is more pressing for more people than ever before in our lifetimes. People who have understood themselves and their lives in a certain way—as performing artists, as shop owners, as physically affectionate communicators, as healthy, as steadily employed—are now having to give up or radically rethink those identities in the age of COVID-19. Meanwhile, the culture-wide rethinking of our culpability for racial injustice confronts us with the need to think independently about issues that trigger our defensiveness, tempting us to take refuge in whatever party line is nearest at hand.
It is in this context that I have been inspired to create a blog on "the art and science of self-creation." This is a blog for those who want to rise to these challenging times by forging a more thoughtful, daring, authentic version of themselves.
Nothing about this self-creation process will be easy. Those who choose to undertake it will make false starts, and they will encounter some landmines along the way. They will regularly be called upon to rise above other people's hostility and defensiveness without resorting to their own; to stand by their independent judgment even in the face of great uncertainty, social and emotional resistance, and sometimes overt discrimination or ostracism; to notice when they've been pretending to stand by their independent judgment but are really just virtue signaling or trying to save face; to hold themselves accountable in ways that no one else can or will.
On the bright side, the factors that make self-creation scarier and harder today are the same factors that make it more obviously worthwhile. For my part, I've never had more fun self-creating as a psychologist, even despite all the extra grief and terror and rage and despairing loneliness that I've been helping people process, and have sometimes had to process myself. Nearly every client I see is facing a painful new reality and, with it, an opportunity to self-create. Some clients don’t immediately see it this way; they think they are hampered by the loss of their old routines, or by their sudden inability to live up to the expectations other people have set for them. But often it is precisely this departure from old routines and expectations that sets them free to launch in a new direction of their own choosing. My job is to help them see the runway, and to provide them with the psychological resources they need to fuel and direct their self-charted journey.
There is no job on earth I’d rather be doing. And in doing it, I’ve gained some new insight into my own distinctive “specialty” and mission as a psychologist: to empower and inspire self-creation in the people who need and can benefit from it most, in the times when it’s hardest. Thank you for joining me, and let's get to work!