FWD: More on "Therapism"

> Certain people within the mental health profession
> want to pathologize just
> about every part of what used to be considered just
> normal parts of the
> human condition.
>
> sounds to me like the equivalent of running to the
> doctor every time one
> gets a hangnail. The idea that people are acquiring
> mental health problems
> from politics looks to me like yet another absurdity
> from the culture of
> therapism. What will they think of next? --M P

I very much agree with you about the culture of
therapism absurdities and they exist on several
levels. A big part of it is socioeconomic. Inner city
schools are full of children who face threats that are
unique in history in both degree and type. Some of
them sorely need help and have no chance for it for
both cultural reasons and terrible failures of mental
health coverage parity.

At the same time, some therapists offices are full of
kids for which therapy is just another status activity
or indulgence. For every Virginia tech shooter who
slipped through the cracks, there's a line of kids at
the therapist's door because they don't like to do
homework or don't care for the teacher who nags them
about it or they are depressed because they don't have
a big enough computer monitor or their parents won't
let them pierce their tongue. If you're upset because
you didn't make the wrestling team, therapy. If you're
skinny or fat and someone called you a beanpole or a
tub, therapy. If peers don't like you because you
don't share or you're a poor sport, therapy.

For adults, the privilege element is not much
different. The same ones who keep the tummy tuck and
eye job surgeons hopping and have standing
appointments with chiropractors and personal trainers
just add psychotherapy to their list of entitlements.
Almost everybody can benefit a bit from talking about
themselves with someone wise and rational. In the old
days it used to be a grandmother or a big brother or
else you just did without until you got over it.
Nowadays people buy the service the way they buy a
massage.

As a result we have a generation of children with
little experience in working out problems, controlling
impulses of anger against forces they dislike, and
working through fears and anxiety about conditions
they can't control. Paradoxically, this may create an
adult population that really does have coping problems
that expand into real psychological dysfunction.

Ethical psychotherapists don't get involved in these
situations but it can be hard to read them initially.
Every time a Virginia Tech or Columbine occurs, it
reinforces the fear of missing a sleeper. Nobody wants
to be the one to tell a kid to go home and work it out
and later realize they're the one who dismissed a
shooter. So it's a bit of a vicious cycle.

There are also some real differences today that make
it hard to pretend it's the good old days where people
could learn to work things out without any
intervention. The disappearance of the extended
family, the high percentage of broken and single
parent homes, the malignant adult-izing of children by
competitive parents, the overwhelming influence of
uncontrolled media and the poor reality testing it
precipitates in young people, and a more threatening
world than ever in modern history all combine to
create a situation that isn't like earlier times.

In the same way, advances in medicine haven't made
people sicker but have made it more likely to consider
and diagnose illnesses that would previously have gone
unrealized. Some of those people would never have had
a problem and and some would have died with the reason
unknown. Psychotherapists have at their disposal
diagnostic instruments that can help to identify those
most at risk so they can deliver services to those who
need them most. These tools are underused and the
profession has a fair share of ethically challenged
practitioners who are happy to just fill the
appointment book with whoever comes along and asks to
be treated, the more benign the complaint the better
and easier to deal with. It would be nice if those
therapists would drop a couple of those patients and
dedicate those hours to pro bono service where it is
badly needed and not affordable or available. ---CT