Shrink

I saw an interesting article in the NYT written by a psychiatrist called in after a suicide attempt, .

Even after he had four years of therapy, he had never reached any goals, which his therapist simply wrote off to “underlying anxiety and low self esteem.”

The doctor called in didn’t see that at all.  What he saw was that therapist “apparently believed that no one could genuinely prefer solitude and that there must be a psychological block preventing this patient from seeking intimacy.”   Four years of failure didn’t cause her to question her assumptions at all.

The author notes “Granted, psychiatric illnesses are generally more difficult to treat than simple bacterial infections, but why should psychotherapy be any less self-critical and self-correcting than the rest of medicine?”

I sent this to a local therapist.   Her comments:

However, there is also social anxiety where people want friends, and there is Aspergers, which this person sounds more like than schizoid….schizoid behavior is often “odd”….not just unsocial, but bizarre, and they rarely have good job or function well in society….The fact that the client was not in emotional pain, high functioning, and very smart, leads me to a Asperger’s type of diagnosis more than a personality disturbance.

In other words, she didn’t engage the point of the article, the failure of therapy, but rather just made her own diagnosis based on nothing but a bit of hearsay.  Her MSW and experience lets her challenge people who have actually seen a patient.  Oy.

The whole idea that, somehow, these people are trained, skilled, healthy and open enough to move beyond their internal assumptions and understand others in a way that helps them heal has always seemed crackpot to me.

This story, where one therapist’s assumptions lead a patient to suicide, and my local therapist rediagnoses off of a few paragraphs illustrates the limits of giving our own mental health to a profession whose “self-criticism and self-correction” are very often limited by their own biases and sicknesses.

Often that means that they like abjection, and believe that we just aren’t working hard enough to meet their expectations, that our sickness is really the lack of being like them.  The assumption seems to be that if we could just enter their world more, be more like them, we would be healthy, rather the expectation that they have the obligation to enter and understand our world.   They know, we are less.

I been to my share of therapists, and while some have been useful, that experience has taught me that I need to be the primary contractor for my own wellness, bringing in subs to do what I cannot do.  Talk or books or workshops or whatever, others can be valuable mirrors, but like any mirror they have their own point-of-view, their own human limits.

Therapy is great, but too often therapists don’t at all enjoy the process where they see their own humanity reflected, so they stop healing.  So why should these be the people who get to make pronouncements about our own mental health, the gatekeepers about what is healthy?

I mean, if they really think all they have to do is blow it out their ass on a patient they never met, how can they ever be open to what they don’t yet understand, or worse, how can they ever see their own fear blocks, their own blindspots?

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