An Amends from a Therapist for the Mistakes of her Field
I love my work. I love getting to know my clients, and I love learning about research, theory and others' experience in therapy. There's so much that I have learned about the brain, human development and relationships that allows me to do really important work with really important people to support them in living their best life.
I'm so grateful to all the researchers, theorists, clinicians and clients who have provided me with my foundation to do my best work. And part of that is acknowledging where my field has gone awry.
It's true, back in the day, mental health experts were in the business of restraining people defined as "mentally ill" and parts of their brain were cut out.
Ah, Freud. He contributed oh so much to the field of psychotherapy, even under the influence of Cocaine. But he also took a big mis-step. Rather than "stir the pot" and accuse wealthy men of sexually abusing the women in their lives, he took the easier way out and concluded that women weren't being sexually abused, assaulted, or raped; instead they were having fantasies and repressed sexual wishes--and were treated for "Hysteria". #metoo
Yep, it was not that long ago an actual diagnosis listed in the "Bible" of Mental Health Disorders published by the American Psychiatric Association. Folks identifying as LGBTQ were thought of as "mentally ill" and in need of treatment. Unfortunately, there are many clinicians that continue to offer "Conversion therapy", attempting to "treat" those identifying as outside of heterosexuality, while adding to social stigma and direct harm to those "treated".
4. The Pathologizing of African American Boys and Men
Black boys are over-represented in the diagnosis of Oppositional Defiant Disorder and Conduct Disorder. Black men are over-represented in the diagnosis of Anti-Social Personality Disorder and Schizophrenia. In these ways and more, the mental health field has added to our racism-infused culture and contributed to the social stigma of Black males.
5. "Personality Disorders"
What a terrible label to be given! What kind of hope is there if one's entire personality is dis-ordered?!? While this is a diagnosis that is still frequently given in certain settings, many more therapists understand that labels like "Narcissistic Personality Disorder" or "Borderline Personality Disorder" are more like character solutions--creative and then-necessary ways of relating that children developed in response to a traumatic, mis-attuned, and/or emotionally dangerous relational environment. Many therapists now realize that these labels are often given with a spirit of frustration from therapists--but the real reason why therapists have felt so frustrated is because they haven't understood what has happened to the client--how certain ways of behaving in relationships have allowed them to survive through things that many couldn't imagine.
6. The Entire Mental Health System
It's true...I said I love my field and I do. But it's also true that the way that our society structures and funds mental health treatment causes good support to be in-accessible to many. People must have an identified pathology (diagnosis) to be funded for treatment--which adds to stigma and truly changes the way therapists work, treatment even with insurance is expensive, therapists who work in network are often over-booked, are not taking new patients, and/or can't offer consistent sessions, poorer children are more likely to take medication alone due to the inaccessibility of talk therapy, shorter-term therapies that have been shown to be less effective over time are prioritized over longer, less expensive therapies...the truth is that money determines what kind of therapies are available to you. While Howard Stern might work 4-5 times a week with a highly trained psychoanalyst, someone without such financial privilege may have to work within the constrains of their insurance--certain number of sessions per year, working on treatment goals related to the "problem" specifically. Others may have time finding consistent therapy at all.
Of course, I haven't covered every mis-step my field has made. But there is a pattern. From my perspective, we have consistently erred in confusing people with problems, giving a back seat to listening and empathy while prioritizing "labeling" and "fixing". In my mind, we are all human, all gifted and each flawed, and every one of us deserves to be seen as ourselves, not as our problems--to receive support when we need it.
I can't change the world--or its history--from my office. I wish my field could have been stronger, would have stood with people's needs instead of succumbing to outside pressures. But sometimes, it didn't. And I have learned from the mistakes of my therapist ancestors. At Creating Space Counseling and Wellness, you can count on being seen as a person and treated with dignity. We may not be able to change "the" world, but together, we can change ours.
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