Why I Became a Clinical Psychologist—Maybe

What influences our career choices?

Posted Dec 31, 2019

As a college professor, I typically sign up to teach classes as early as 8 o'clock in the morning. Getting the teaching out of the way frees up the rest of the day for research, writing, and seeing patients.

But as an undergraduate, I would seek out course sections that met as late as possible. The abnormal psychology course I had as an undergrad met from 6 p.m. to 8 p.m. This was in northern California and many students, sometimes even the instructor, would trickle in late, due to traffic. We all understood.

The instructor was an adjunct. I got the sense that she was teaching the class to pick up a little extra income—she had a daughter about to go away to college. She had a full-time job already, at a hospital about an hour away (traffic permitting). I don't imagine that her daily life left her much time to prep for the course, and it showed—like when she gave a take-home test based on questions from an earlier edition of the textbook, so that not even the most diligent student could ascertain the correct answers. 

But this lack of preparation was the best part of the course. She would walk in, a couple of minutes late and a bit out of breath from the walk from the parking lot, look at us, smile, and ask, "What are we talking about today?" Some would-be "A" student would look at the syllabus, check their watch for the date, and say, for example, "Anxiety Disorders." 

"Ah," the instructor would say. "Good. Let me tell you about a patient I saw today..."

And so it began, with some brief identifiers (altered to protect confidentiality), e.g., "middle-aged White male employed as a plumber." She then presented the chief complaint ("I can't sleep"), history of the present illness (When did it start? Has it been getting worse?), diagnostic assessment (What do we call this form of psychiatric disorder?), and treatment plan (What are we going to do to help him?). She would tell us about the patient, or about some other, real-life person from her extensive clinical experience, in the same manner she would present the case to a colleague or supervisor. 

After a couple of class sessions of these impromptu case presentations, which always sparked a lively class discussion, I summoned the courage to approach her after class and to ask, "What is it exactly that you do again?"

"I'm a clinical psychologist," she said.

"And how would I go about becoming one myself, if you don't mind my asking?"

She smiled and gave me the name of her doctoral program, a free-standing school of professional psychology in the area. "Check out what they have to offer, and if you have any questions, let me know."

I didn't end up attending the program she did, but she did write me (apparently effective) recommendation letters to several other programs. About six years after taking that abnormal psychologist course, I had a Ph.D. in clinical psychology myself. 

Now imagine that the only section of abnormal psych offered that semester was at 10 a.m. She wouldn't have been able to teach it, due to her work schedule, and I wouldn't have sought it out, due to my preference for later meeting times. What if the instructor's daughter had gotten a full-ride scholarship—would she have declined the invitation to teach? What if I had taken abnormal psych with someone who wasn't a practicing clinician, or whose clinical experience was limited to their graduate training and supervision years?

I often thought, as I sat around a seminar table in graduate school, participating in a discussion of, say, borderline personality disorder and self-harming behaviors, that I could have been, by some subtle and unpredictable shift of fate, sitting instead in an equally well-appointed graduate school classroom, but discussing Constitutional law or initial public offerings. I always assumed that I was most glad to be where I was, discussing what was at hand—but who is to say that the alternative routes would have seemed as dismal in the long run as seemed to me then? Life, as they say, does not provide you with a control group. 

Happenstance is a terrifically underappreciated element in our lives. The work we do, who we end up surrounded by, whether or not we have children, where we end up living, all of these things are deeply affected by chance. When we look backward at our lives, we trick ourselves into discerning a sensible progression toward this endpoint. But things could always have turned out far, far differently—not necessarily better or worse, just different. Perhaps as we look to the years ahead, we should pay closer attention to the small moments, the minor interactions, the little things. We attend to acceptance letters and commencement ceremonies, to engagements and weddings; maybe we should give more notice to those brief, encouraging words spoken in kindness after the end of a class.