Atrophy. That's the word I think of when it comes to the results of so much of the practices of psychology/psychiatry over the last 100 years. There has been a lessening of personal responsibility and of personal belief in ones own strength to overcome.
Before I get too caught up in the descriptions of what I see that is going wrong I actually want to talk about positive changes, some positive trends. As you could probably guess from my previous posts I'm not a huge fan of diagnosing. I understand the point of it, particularly in providing direction for treatment. But, I just don't like labeling people especially at a young age as being dysfunctional. One of the newer modalities that I really like is positive psychology. Not long ago a new assessment tool was released to help "diagnose" character strength and virtues. I really appreciate this tool and its focus. By using it clinicians can identify with their clients those strengths and attributes that will help that individual overcome the problems they are currently facing. Human beings are equipped with an ability to heal when possible, and to adapt if necessary. That doesn't mean its easy or quick, just that we have the capacity. It also doesn't mean it has to be done alone. Sometimes our greatest strength lies in the supportive people we have around us.
What I like about positive psychology is that it helps individuals understand their own resources and to take charge of their own change. Clients are strengthened in the belief that they can be successful at overcoming because of themselves, not because of a pill or any other expert. My clients who make improvements own that change, and get all the credit for it. I'm humbled to be able to assist in some way, but they are using their own mental muscles to get better. They are then strengthened not just for the current trial but for whatever else might come their way. By virtue of our humanity we will all go through difficult things. It is essential to know we have the ability, the strength, to overcome.
I have also noticed, and am a part of, a rise in the use of "alternative" treatments. They are called "alternative" because they do not fit the medical model. Some examples follow. Eye Movement Desensitization and Reprocessing or EMDR taps into the human systems' ability to process through trauma. Emotional Freedom Techniques or EFT which looks at helping individuals realign their own internal energy. Biofeedback which makes individuals aware of their own physiological processes and than clients learn skills to change their current processes into more healthy patterns. All these modalities have shown a shift in the approach to mental well being, more client focused and client driven. They all help to make a client aware of their own power for wellness. I don't wish to make an endorsement of these modalities as much as to make note of that pattern, the individual is the expert for their own systems and they have the power to heal themselves. I'm encouraged by this shifting, especially when I consider the effects of the medical model and government involvement in the mental health professions.
I love good parents, they are quite simply one of my favorite things. By 'good parent' I don't mean perfect parents. In fact one of the things I tell parents is that it is absolutely essential that they be imperfect, because their kids are, and they have to know you can be imperfect and still be good. Good parents do their utmost to help their children with whatever needs come up.
When parents are struggling with helping their children's emotional state or in their ability to focus often look to experts to help them. We have in society right now an absolute flood of children being medicated for ADHD and Bipolar disorder among other things. I'm troubled by this. I want to make it absolutely clear that I do not hold negative judgments of the parents who are seeking whatever help they can find. To be sure there are some kids who truly do have some positive changes when on medication. Parents who look for ways to help their children are good parents hands down. But, the mental health professionals have not done an adequate job of informing parents of all the statistics of efficacy (or lack thereof) of medication nor of informing parents of the negative realities that can result, such as stunted growth, disregulation of physiological systems and possibly dependence (even life-long) upon medication. Parents have been made to believe that someone else is the expert on raising their children. That is simply not the case.
Parenting is one of the hardest things in the world, but every parent is up to the job. I would encourage parents to look at alternatives to medication if able and to use those God given parenting skills. Absolutely seek support but recognize that you are the expert, the final say on raising your child belongs to you. You've got all the muscles, continue to strengthen and use them.
Now in speaking about government intervention I will be speaking specifically of what I've seen with clients who use Medicare Medicaid and SSI/SSDI for their mental health needs. I have no negative judgment on those individuals who use these programs. They are making use of what is available to them. Most people who use these programs feel they have few or no other options available to them. This is of course by design. The results of using government assistance in the mental health arena are detrimental. As there is a reliance on government for mental health there is a decrease in personal responsibility. That goes not just for clients but for professionals. I cannot stand having insurance dictate to me what treatment should be, and Medicare/Medicaid is the absolute worst at this. The practitioner is made to behave as if the government is the expert, which of course than separates the client even further from the reality that they are in fact themselves the expert and master of their own healing.
From my experience in working with individuals on government assistance for mental health services, I'll offer a few observations. These individuals have a much higher rate of missing scheduled appointments. I'm not sure I know the full extent of what that means, but I think when individuals feel less invested than they also feel less responsible. I've also noticed that efforts are made to maintain disability or financial status. In order to do so clients would tell me they could not seek better employment or make other significant improvements in their lives. If the point of government assistance is to truly assist, why than are individuals feeling and staying so stuck?
Another disturbing aspect I've noticed is government dictation of medication. Medicare, for instance, recently expanded their roles making more people eligible. This increase was not accompanied by a sufficient increase in available funds. At that time the medications that the government program would cover were altered, because of expense. So, I had clients who had become dependent upon a certain medication that suddenly they could not obtain, or afford. Can I say it was more than a little scary, in fact for some the reality was a life or death situation. I was quite frustrated with that development and can see it getting worse as we continue to march towards socialized medicine in the United States. Yuck!!
Now given all that I'll let you in on my ultimate and quite frankly unrealistic goal as a mental health professional: To work myself out of a job. I love my work. I love being able to be a support for others. My guiding principles as a therapist are 1) to have unconditional positive regard for every individual I work with 2) that the very best answers for an individuals problems come from the individuals themselves, my job is to guide them there and 3) that my absolute most basic relationship with my clients is that I'm their sister. The best thing I can do for my brothers and sisters is to be a support and to help them discover their own power and responsibility, their own muscles again.
I ponder again that original question that brought me into writing this three part post. Why would Communists want to take over the field of psychiatry? I think in the end it comes down to making people feel and believe that someone/something else is and/or should be in control and is the expert in keeping them safe. As a mental health professional I say phooey! Parents have the best answers for their kids, individuals have the best answers within themselves. The power really is inherent in the people.
I of course also believe strongly in God and that He has blessed us with the abilities to heal and grow and change. He has provided ways for all of that to occur. Healing may include social support, therapy, it may even include medication (just be educated on its use). I would never presume to know all of the right answers for each individual, but I do believe each individual can know them for themselves. I start out each work day on my knees, I know I need His inspiration. He will guide us all to the best practices and solutions. He gave us the muscles, He also gave us the tools to build them up.
Thanks so much for taking the time to read all of this. I know it was considerably longer than any thing else I've written. I just felt it was important to find out for myself and than to share with others what my own profession has been up to. Truth rocks, and so does sharing it.
Sarah Emily Jordan, MA, MA, LMHC