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Archive for April, 2011

I’ve been mulling over the my ex-grifter’s therapist’s notes about me and all the factual errors, omissions and skewed comments in them.  They are worthy of many posts in themselves.  (These posts are on their way, once I scan the documents, etc.  Promise!)

In an effort to understand the psychotherapist’s perspective, I googled “psychotherapy notes” and found this:

http://www.askdrrobert.dr-robert.com/therapynotes.html

The whole post drips with condescension, but the excerpt below struck me as VERY authoritarian.

If your therapist is any good, you should let her manage the therapy as she sees fit. If you have questions, ask them, but don’t expect the therapist to be an open book. The therapist should be authentic and honest, but not ingenuously. If you feel a bit infantilized by such an approach to your treatment, that may be one of the costs of psychotherapy, just as losing control of certain personal choices and freedoms might be one of the costs of a surgical operation and subsequent hospitalization.

What. the. fuck.  Feeling infantilized is just one of the costs of therapy?  The therapist should manage therapy “as she sees fit”?  Um, yeah.  What about how therapy is supposed to help you figure out your own ways of coping?  What about the client being an equal partner in setting the therapy agenda?  What about the client being treated and feeling like a fucking ADULT, which is what the client is?

I have no doubt that many therapists would come up with some bullshit rationalization about how infantilization is just a temporary phase in therapy in which you re-parent yourself so you can unlearn all the dysfunctional patterns you got from your family, and then you re-enter adulthood equipped with healthier coping strategies.  Or some horseshit.  (As I keep saying on this blog, there is no proof of this.)

It’s a premise that can work to the therapist’s advantage.  Once that parent-child dynamic kicks in, the therapist is a heavy-duty authority figure who gets to decide what you should work on and how much progress you have made and when is the right time for you to leave therapy (hint: it won’t be anytime soon, ca-ching!).

And don’t you dare question the therapist’s authority by asking to see your file.  You’re not ready for what’s in there anyway.  Just trust the process, grasshopper.

Shifting topics slightly, Dr. Robert is speaking WAY out of turn by saying notes are the therapist’s property.  There are variations by jurisdiction and by professional standards of practice (e.g. psychologist v. social worker), but in general, therapists are required to provide copies of their notes to the client at the client’s request.

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I wasn’t even thinking of doing a post today, but then I came across this:

www.inthewater.ca

Actually what I came across was this therapist’s flyer posted on a grocery store bulletin board.  The content on the flyer is much the same as that on the website, but with more info on the therapist’s background.

The content of the flyer and website typify much of what I believe is wrong with therapy.

1. The idea that by delving into your unconscious will be of some benefit to you.  For one thing, the “unconscious” is just an idea.  There is no proof that it exists, and if it doesn’t exist, it cannot hold any truths or secrets.  For another thing, let’s say the unconscious does exist – its functions and purpose have not been thoroughly researched and understood, so no one knows if it is a good idea to go spelunking in there.   Maybe things hide out in your unconscious for a very good reason.  Maybe you are better off staying out of it.

2. “Befriend the sea monsters”.  Well OK, this is the metaphor she’s working with in her advertising and that’s her call.  But what does it mean?  My interpretation: facing your hidden issues, problems, dysfunctions, etc rather than running away from them.  My issue with this sort of thinking is that it builds into therapy a couple of dangerous notions: a) that you have sea monsters, and b) it’s good to befriend them.  I.e. that therapy might get very intense and painful but good will come of it (all those pearls you will bring to the surface).  I.e. that “it will get worse before it gets better.”  Again, there is no proof of the value of this exercise.  It’s dangerous because it provides a ready-made explanation for harmful (iatrogenic) therapy.  If feeling worse and worse as a result of discussing painful issues means therapy is working, how can you tell if therapy is not working?  When you start contemplating suicide?  Maybe sea monsters make bad friends and you should stay away from them.  And if you don’t have sea monsters in the first place – if you are basically healthy and self-aware – does it make good sense to go looking for them?  Will your therapist believe that you don’t have sea monsters?  Do you have the option to say “No thanks, I’ll let sleeping sea monsters lie?”

3. There’s a kind of power-of-suggestion Neuro-Linguistic Programming vibe with some of the language.  “You and I will identify”, “we will bring”, “I will be your guide” (emphasis added).  Well, not necessarily, Donna, that’s up to me.

4. The word “potential” appears three times on the flyer, maybe more on the website.  This suggests that therapy might result in your having a better life, or being better at life, than you are right now.  Again, there is no proof of this.  It sounds great though – everyone can think of ways their life could be better, so it’s hard to walk away from something that seems to promise that it will.

5. Qualifications.  A BA in.. what?  An MA in … what?  A Doctor of Ministry degree from an independent US school that specializes in one religion.  What does any of that have to do with psychotherapy?  Religious guidance for members of that faith – OK, I can see that.  But beyond that – no, I do not think these are adequate qualifications.   Then there is the “in training” with the Ontario Association of Jungian Analysts.  Hm.  This is the just the sort of unregulated, unaccredited, snake oil type of training I discussed in an earlier post.  To say the least, Jung remains a very controversial figure and Jungian analysis has not been empirically validated as a treatment modality for anything.

6. Regulation.  Notice that this therapist is not connected to any regulatory body.  As of this writing, this is technically permissible in Ontario because psychotherapy is not regulated.  It will be within a few years; the legislation had passed but has not been formally enacted (or promulgated, or whatever the correct term is) yet because the details of regulation are still being developed.  When regulation comes into effect, this therapist may not meet the necessary requirements.  (Although regulation is such a joke that I predict she and other similar therapists will be grandfathered in.  Hey – maybe I should get in on this action!)

OK, that’s enough harshing on a therapist I have never even met.  She isn’t doing anything that thousands of other therapists aren’t doing, so she is not especially deserving of criticism.

But you see what I mean.  With a bit of surfing you could find hundreds of therapist websites with similar language and ideas and conduct the same analysis, and get – I predict – much the same result.  Ask yourself – at a moment when you are calm and reasonably content – is that good enough?  Is it wise to entrust your emotional and psychological health to a stranger with this background?  Oh yeah, and maybe don’t look for a therapist on a grocery store bulletin board.

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Feck the poor!

So I was updating my links here on TIAC, and stumbled onto this post and accompanying comments:

http://www.socialworkersspeak.org/hollywood-connection/money-guru-suze-orman-offers-social-workers-financial-advice.html

In particular, I was struck by the comment below.

Alternative Perspective

April 6, 2011 • 6:04 pm

I am thrilled to see this article by one of my heros–I love Suzie Orman!

I’ve made this point in other threads, but it is important to reiterate it: MANY SOCIAL WORKERS ARE MAKING LUCRATIVE SALARIES! After a few years of work experience, you can start making more money; you DON’T have to take a vow of poverty to do social work–just think outside of the box a little. We are only limited by our thinking!

Besides having decent paying day jobs, I have MSW colleagues who have started small businesses (some do it full-time while others only one day a week) and are making money as:

1) Life Coaches & Executive Coaches
2) Independent therapists
3) Adjunct Professors
4) Mediators
5) Focus group Facilitators (there’s a lot of $$ in market research)
6) Grant Writers

Respectfully, the people who claim poverty, after years in the field, are the individuals who either lack entrepreneurial ability or have internalized a victim mentality. Personally, I reject the idea that I have to be poor to do good work in the world!

Here is to living comfortably AND being a social worker!!

In case you doubted the mercenariness (yes that’s a word) of therapists, well, there it is.  That’s how social workers talk to each other when they don’t think anyone else is listening or reading.  The flight of social workers from their original purpose – helping the poor and marginalized – has been noted before, in this book: http://www.amazon.com/Unfaithful-Angels-Social-Abandoned-Mission/dp/0028740866

Not all therapists are social workers and not all social workers are therapists, but I’m inclined to doubt that the sentiments regarding money vary much among therapists, whatever their training.

Notice that the first two alternate careers on the list are ones with very low or non-existent entry requirements.  In many jurisdictions, “life coach”, “executive coach” and “therapist” etc are totally unregulated titles.  Literally anyone can use the titles and charge clients for the services, and the money can be quite good, as I discussed in an earlier post.

The other positions are MUCH harder to get.  There are only so many adjunct professor jobs to go around (and they are precarious positions).  People from a variety of backgrounds work in grant writing and mediation; a social work degree confers no particular advantage.  As it happens, I know quite a bit about the market research industry.  In a given city or town, there is only so much demand for focus group facilitators, the pay is good but not outstanding (unless you own the company!), and social work would generally not be considered relevant experience.  (And how is helping some corporation figure out how to sell more crap that people don’t need doing “good work in the world”?)  The bottom four items on the list, therefore, are not quick paths to easy money.

But at $100+ per hour, working as a therapist at least allows you to make a crap wage at less than full-time hours.  You can probably sleep in most days.

But if what you really want is to earn a great salary, why bother going into social work at all?  Why take the detour of earning a social work degree and spending years making less than you think you deserve, and then cast about for an alternative later?

And if you are a therapy client, don’t you want a therapist who is genuinely interested in the work, not just doing it as a fallback?

(BTW, “feck” is a stand-in for another word that I’m sure you’ve heard.  Turns out I have standards for this blog – no profanity in the headlines.  Everywhere else is OK.

Also, I’m not endorsing Suze Orman’s comments re: social work salaries.  I believe everyone deserves a decent wage for any honest work, and investment advice isn’t much good if you don’t have enough money to invest in the first place.)

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