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Insights about psychotherapy from an insider

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Winston
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Insights about psychotherapy from an insider

Post by Winston » November 30th, 2011, 8:56 am

This is a MUST READ. It's a long letter from my former mental health counselor friend now turned truth seeker. It's long, yes, but contains a lot of interesting insights from an insider about psychotherapy and many other topics, etc.


"Dear Winston,

I apologize for my sporadic writing. I am still pretty sick though the antibiotics are helping. I will try to make this a fairly long mail to address your previous mail with the comments about psychotherapy which in my reply I will conflate into this response. So, let me begin addressing it. I will then address your comments below. My energy level is usually very low but today I have more energy than I've had all week--so I must take advantage of it. I will answer the email you sent today at a later time as it is a very involved email which will require some thought on my part to answer intelligently.

I have browsed around your site quite a bit, actually, and had already run across your encounter with the Zen mental health professional (who looks like a real asshole). Let me say a few things about this man and his ilk, for there are therapists like him spread across the United States. As an interesting aside, Washington, D.C. has more therapists per capita than any other North American city and Buenos Aires, Argentina is reputed to have the most therapists per capita in the entire world.

Therapists, at least in America, have sort of become the modern day version of shaman, which almost every ancient society has had and they can still be found in more "primitive" societies around the world. Perhaps the difference between the average shaman and the average therapist is that the shaman probably had/have a MUCH higher success rate than the average mental health counselor.

As a former mental health counselor and someone who still possesses a license to practice, I am perhaps unique in your Happier Abroad community in that my critiques come from actual experience and knowledge about mental health issues, rather than just being the critiques offered by societal observers on your forum (some of whose critiques are quite apposite and ring true with me).

Just as you had some positive experiences with some therapists and some very negative experiences with people such as this Zen asshole, it is important to understand that when you use the term "mental health counselor" you are talking about a very broad spectrum of individuals, some with very different credentials, mind sets and training.

This variegation among mental health professionals was MUCH more pronounced in the 1960's, which was probably the heyday for mental health professionals in our society. When I say that therapy was in its heyday I mean that there were many methods of practice, many schools of therapy and a much freer environment for a person to practice in. Perhaps also reflecting the very changing and tumultuous times, much more emphasis was put on schools of therapy that were nonconformist in nature and also much emphasis was put on freedom of expression. Whether this "helped" anyone or not is debatable but arguably this freer environment of practice produced more empathic and creative mental health professionals than those you typically run across now.

Over the past 20 years or so there has been a radical change in the profession and concomitantly a great turning away from its "liberated" days so that these days a person entering the mental health profession is encouraged to practice mostly behavioral therapy such as cognitive behavioral therapy. The premise of this therapy is very similar to the philosophers of the Stoic philosophers such as Epictetus and basically assert that most mental health problems (excepting major ones like Schizophrenia, Bipolar Disorder (formerly "Manic-Depression) and a few others) can be treated by short-term treatment of 1-6 sessions in which the "irrational" beliefs of the person are challenged and the person gains insight, ostensibly, and thus change is brought about very quickly.

There are actually MANY schools of therapy and not everyone responds well to this short-term attempt to restructure and revamp one's thinking, just as not everyone that studies philosophy will like the philosophies of Epictetus or Marcus Aurelius or agree about their efficacy as philosophical systems.

The reason that such short-term therapies are used and preached as the modern-day gospel have little to do with what actually works and EVERYTHING to do with the fact they are cost-effective and this is important because the mental health system has been taken over by the major insurance companies and by Medicare and Medicaid and quick results (thus costing less) are naturally preferred over more protracted treatments--so what you have is the tail wagging the dog, in other words, so that a drone who has no experience in mental health working for some insurance giant like United Health Care can decide on the treatment to be given. Much emphasis has also been put into ALL therapists of whatever training being licensed and "credentialed" and this has further eroded the system in the sense that much more emphasis is placed on the novice therapist passing the license test than whether he/she actually knows what the f**k he is doing, to the extent anyone knows what the f**k they are doing.

As our society (and others) have become more industrialized and impersonal, the "shaman" of the society has become the modern-day psychotherapist or psychiatrist whereas even one-hundred years ago a person might have gone to a village elder in their community or to their preacher for solace or some form of treatment for psychological ills.

I might interject here a couple of things. One, mental illnesses such as Schizophrenia are seen in almost all societies but people in various cultures have had very different reactions to these "illnesses." Two, In some Native cultures in the Americas, for example, the "crazy" person was seen as someone with greater insight and greater communication with the gods and was often left alone or accepted to a far greater level of acceptance than in our culture.

It seems to me that in their roles as modern-day "shaman," most psychotherapists and psychiatrists have failed miserably. Part of this failure is what you have experienced and it involves seeking help and succor from someone who completely fails to apprehend or understand your particular situation, such as the crisis counselor who you called in a time of despair who treated you like a cretin for disturbing him and offered you no help at all. Unfortunately, I have known many such counselors and they are the norm rather than the exception. As I see it, there are multitudinous reasons for the failure of the mental health system, including its attempt to present itself as a science rather than a mixture of science and art. The field of psychology is probably most to blame for it because it worked very hard to establish quantifiable scientific methodologies to gain legitimacy alongside more "real" sciences. The end result of this in psychiatry has been an ever-increasing reliance on prescription medications and much less emphasis on treating the problems of a person at the human level. Some of the psychiatric medicines do work and the principles behind them are based on scientifically verifiable facts. In the case of Prozac and other drugs in its class (Lexapro, Zoloft, Celexa, e.g.), it is what is known as an SSRI, a Selective Serotonin Reuptake Inhibitor. The premise behind it working is that Serotonin is known as one of the "pleasure-causing" chemicals of the brain and so the more Serotonin being activated in the brain will lead to a happier state of mind.

Here I must add that one cannot separate a society's treatment of mental health or anything else from its prevailing belief systems. As you know, there is an expectation in our society that a person is SUPPOSED to be happy and something is wrong with him if he is not. One of the major problems with most therapists in America is that most are heavily enmeshed in the common cultural expectations of the society so that even though they have voluntarily chosen to work with many who are "different" either through a major mental illness or just in terms of thinking, their overarching goal is to get the individual to conform to the norms and mores of the society. In some cases this is not all bad. Men whose sexual enjoyment comes from f***ing four year old girls probably need both incarceration and treatment and very close scrutiny when they are "free" in society.

Another thing to keep in mind is that YOU were able to break free after many years of suffering--not everyone is capable of doing this! Not everyone has the intellectual ability to see a way out and get their needs met or the intellectual firepower to become a teacher of ESL like Ladislav and maneuver around the world. Many of these people are simply f***ed, though maybe ignorance is bliss.

Let me turn to your encounter with the "Zen" therapist. Types like this guy actually proliferate all over the country and most of them are hucksters of the first water and many of them are very successful hucksters because a great many people want to be told how to think and what the "truth" REALLY is. Andre Gide's famous quote comes to mind, "Believe those that seek the truth, doubt those that find it." It is clear from your description of this man that he had no understanding of you and little interest in attempting to understand you. Rather, he wanted you to "own" your feelings and I'm sure to his way of thinking that he felt your problem was your inability to "own" your problems. Resultantly, he spent more time chastising you for your phraseology than getting to understand what you were about. In other words, HE attempted to define your problem for you rather than to build a real relationship with you and determine how he could be of help.

A couple of points to make---

Since most of your readers are probably not well-read in the field of psychology they are probably unaware that the talking cures propounded by Jung and Freud and many of the other pioneers of what has become modern therapy were not focused on helping individuals lead happier lives except in so far as helping them ACCEPT the human condition, of the reality of human suffering which the Buddha and Schopenhauer declaimed as the basis of human existence. Maybe if Freud and Schopenhauer had visited the Philippines they would not have been so gloomy. But the idea that the human was supposed to be happy was not a notion held by the progenitors of psychoanalysis.

The famous Austrian iconoclast and journalist Karl Kraus once opined that "Psychiatry is the very mental illness which it purports to cure." lol. Part of its lack of respect comes from the fact that it has increasingly enfolded itself in a scientific, rational Western mind set yet lacks the reliability to uphold true scientific standards. This is why, for example, it is often exposed in the legal system as being a logical fallacy under the "appeal to authority" argument. You will often have one professional hired-gun psychiatrist saying that such and such serial murderer is a Paranoid Schizophrenic while the prosecution's psychiatrist will argue vehemently that the killer is totally sane. This happens so often that of all the appeals to authority, the field of psychiatry is considered the very weakest.

Lastly, on this topic, as I said previously, the mental health field is a vast one with many belief systems and in my area of training, i.e., social work, we do tend to view the person in his environment and place much emphasis on how that environment can be responsible for many of the person's ills. Not all therapists place such emphasis totally on the individual, as Mr. Peabody asserts, though he is correct in saying that most do.

lol, I have rambled and I apologize. I will need a long rest after this tome.

Let me address what you have written below:

---lol, Pneumonia IS curable unless you happen to die from it. It is known by many doctors as "The old man's friend" because dying from Pneumonia is considered an easy way to die. Most strains of the illness ARE curable through the use of Penicillin or other antibiotics and the usual regimen of bed rest and intake of lots of fluids, etc. I am on the way to recovery. People such as I, who suffer from heart disease, are much more susceptible to catching Pneumonia (I do not know all the medical reasons why). It often recurs because it weakens one's immune system making the person more likely to contract it again. It can also recur if one does not heed doctor's orders and get the proper rest and treatment one needs to make a full recovery.

--I always buy travel insurance whenever I take a trip anywhere, especially to Asia, and it covers 100% of all medical costs and will even pay for my medical evacuation if I am in some far-distant province and need to be air-lifted to Manila. If I got sick in the Philippines or Thailand, I would potentially get treatment comparable to what I would receive in the best US hospitals.

--The confrontation with the crone was unintentional and was initiated by her since she obviously was listening very closely to my conversation about her. Clearly she was a bitch and instead of just laughing my words off she felt the need to be a wise-ass with me and engage in putting me down. I think I acquitted myself with her fairly well, considering. lol, I may consider carrying copies of your tract and handing them out to men in need. Actually, I have been preaching the gospel of going to Asia for quite some time but most men simply do not understand and don't heed the call.

Thanks for the advice re: the Clarkton. I may book there once I have finalized my trip. I tend to prefer very comfortable accommodations at as low a price as I can come by them. I am considering going to Singapore first, to hook up with a Pinay nurse I met on Blossoms, and then fly on Tiger Air to Clark if such a flight exists, or at least to Manila and obtain transportation to Clark. I do not wish to arrive in either city in the middle of the night. I have met a lot of women and it has been very hard keeping up with them or corresponding given my illness. I am relying a lot on phone text messaging to continue showing interests--most of the Pinays seem impressed that I text them to maintain contact, even if it is only once a week. As I improve I will return to writing and will try to narrow down my travel plans and not bite off more than I can chew.

--Asperger's Disorder is sort of a form of autism with the difference being that the person who has Asperger's is able to function at a higher level in terms of social interaction and many with the disorder attend college and hold down jobs and have some level of social skills. I should note that there is some controversy about whether this disorder actually exists (as with many mental illnesses) and some lump this syndrome into just another higher form of autistic functioning. After talking to you and listening to you interact with your Pinay friend, I think I can safely say that I don't think you suffer from Asperger's at all. You are a very sociable person, I believe, while at the same time you are an inquisitive and intellectual person and probably value your solitude. I am much the same way and sometimes getting involved too closely with a Pinay worries me because I have read accounts of Pinoys who have never spent time alone their entire lives. I spend about 90% of my time alone (probably far too much) and know I would not do well being part of a Pinoy clan in some distant province.

---I suspect you feel like a misfit because of your background and personality, not due to some disorder like Asperger's. The difference is that the Autistic or Asperger's person does not care what others think of them socially. They are highly self-involved. You care a great deal, I think, and appear to have a very playful side. But I think your feelings of alienation stem from your past experiences here in America and they are based on real experiences. I, too, have a lot of these feelings for different reasons and the words of Dostoyevsky from "Notes from Underground" come to mind, "Though I have said that I envy the 'normal' man, even to point of bitterest gall, yet in the condition in which I find him, I DO NOT WANT TO BE ONE."

--Actually, less than 1% of the population has Schizophrenia and it is one of the easier mental health diagnoses to make though it is true it is often abused and misunderstood. Prozac is an antidepressant which came out in the mid-1980's and was the first Selective Serotonin Reuptake Inhibitor to be put on the market. It is probably the best of all of them though it does not work for all people and it does have the potential in some people to cause the person to get worse and commit suicide. This is the sort of thing you will read, anyhow, and as with many other things involving the human mind it is a complex issue. For example, many depressed people do not commit suicide not because they don't want to but because they lack the drive and motivation it involves to take action to kill themselves. Ironically, many depressed people will attempt suicide as they are feeling better because it is only then that they have the energy to carry out their suicide plans. Some might argue that drugs like Prozac gradually induce this "improvement" which then allows the person to suicide. As with most things, this is a highly debatable topic and I have probably treated five-thousand people on Prozac and never seen anyone taking it commit suicide.

---You are very right about the notion that a person lacking empathy should not be allowed into the counseling profession. I have some very strong feelings about this and have had them since graduate school when I noticed that many people who were definitely unsuited for the profession were not screened out. This is a definite problem with the profession and it results in all sorts of assholes and nutcases being allowed to ply their trades. I have known far too many of them. Since it doesn't require a great deal of intellectual rigor to become a mental health therapist, other than to get a Ph.D. in psychology (which is harder to gain acceptance to a program than even medical school), the standards for admission to many programs are quite low and no personality screenings are done. By contrast, in my city (Greensboro), to become a police officer one must have a college degree, undergo a rigorous background check including psychological testing and interviews and only one of a hundred candidates are hired. Almost anyone of moderate intelligence, on the other hand, can get a counseling degree and some sort of licensure and I know of NO programs that screen out applicants based on the lack of natural ability to do the work.

--I enjoy Russian fiction a great deal, or used to, but am not sure I would journey to Russia. I am more attracted to Asian women in general though I do like the native wisdom and fatalism that seems to be prevalent in the Eastern European women I have had contact with. Do you have any regrets about hooking up with a Pinay instead of a Russian?

btw, a tidbit of juicy gossip. I was watching the Showtime series "The Green Room" which is hosted by comic Paul Provenza and is basically a different group of comics meeting every week to shoot the shit and crack jokes and play off one another. Many of these guys go back very far and have some interesting dialogues. On one of the shows Doug Stanhope (I think that's his name) was on the show with Janeane Garafalo and Richard Belzer and a few others and Stanhope, who's kind of an obnoxious ass, was berating Janeane for hanging out with Tom Leykis. He mentioned Leykis by name and stated that he was a "big phony." Stanhope has a reputation as a truth teller and non-bullshitter and was implying that Leykis's act is total schtick and that he doesn't believe a word he says and is sort of a low-budget Bill O'Reilly--(more about making money than actually believing in his conservative message).

Ingat always and I will answer your other mails as I recover,"
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