Replacing Psychiatrists and Psychotherapists

Eric Maisel, PhD
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During World War II 60,000,000 people died, 2.5% of the world’s population. The Soviet Union alone lost between 18,000,000 and 24,000,000 lives. Germany lost between 7,000,000 and 9,000,000, upwards of 10% of its population. Europe’s Jewish population was reduced by between 5,000,000 and 6,000,000, or 55% of European Jewry. A country like Portugal lost “only” 50,000 souls, but those 50,000 amounted to 10% of the Portuguese population.

Forget for a second about who was in the right and who was in the wrong. Rather, imagine a German youth of 18, A Russian youth of 18, a British youth of 18, an American Jewish youth of 18, a French youth of 18, a Japanese youth of 18. Think of the parents of each of these young men; parents, say, between forty and forty-five years old. Think of their grandparents. Think of their sisters, their younger brothers—think about everyone affected by that calamity.

To say that the “mental health” of all of these people was affected by the fact of a world conflagration is to make a bad joke. Affected, indeed! It may have been the defining, pressing, most important matter on their radar, completely altering their lives and producing year upon year of unbearable stress. The whole world’s population was “motivated” in drastically new ways—and unmotivated as well. How motivated would you have been to open up your grocery store each morning if you were now selling to your Nazis oppressors? How motivated would you have been to get out of bed if your city was under siege?

Psychology posits many “theories of motivation.” These include the instinct theory of motivation (think: birds migrating), the incentive theory of motivation (think: external rewards), the drive theory of motivation (think: drink water when thirsty), the arousal theory of motivation (think: cure boredom with an action movie), the humanistic theory of motivation (think: self-actualization), and so on. To vote for any of these is of course to make a fundamental mistake. The mistake is the way that these theories exclude the human experience. We aren’t machines, functioning or not functioning: we are human beings living.

The problem isn’t that all of these theories are wrong or that all of them are right some of the time. The problem is that this way of thinking prevents us from understanding human beings. Think of that mother of that young soldier. It doesn’t matter whether he is a German soldier, a Russian solider, a French soldier, a British soldier, or a Japanese soldier. Her son goes off to war, he has, say, a 20% or a 30% chance of dying, and for the years that he is away she is fundamentally not motivated at all, though of course she still drinks water when she is thirsty, plays the lottery in the hopes of a windfall, and so on.

She is “motivated” in all the textbook ways—she gets to work, she buys lottery tickets, she drinks water, she has sex—but her reality is that she is holding her breath. If you ask her why she is having headaches, stomachaches, sleep problems, an inability to orgasm, and sudden crying fits, she may well say, “I am waiting for my son to come home.” Will we really stand for a psychiatrist answering this with, “I have a pill for you!”? Will we really stand for a psychotherapist exclaiming, “Oedipal issues!”? Absolutely not! Our new helper of the future, one who does not exist yet—a new “human experience specialist”—would provide her with a genuinely human answer: “I know.”

Our new helper would say to her, “I understand. I want to make the following suggestions, none of which make any fundamental difference in your situation. Your fundamental situation is that you are waiting, that you are holding your breath, and that you are scared to death. Nevertheless, I have some suggestions to make, and each is very different from the next. Some even contradict one another. Shall we look at them?”

This isn’t psychiatry or psychotherapy, it isn’t mentoring, coaching, or counseling, and it isn’t friendship. It requires a new category of helper, a person not bound to set goals and cheerlead like a coach, not bound, like mental health counselors, psychologists, and psychotherapists, to buy our current “diagnosing and treating of mental disorders” model, not bound, like a psychiatrist, to dispense pills, not bound, like a cleric, to toss in gratuitous gods, not bound to ignore a human being’s real, pressing, and defining experiences and circumstances. There would be no “diagnosing” and no “treating.” Instead there would be a human interaction in the context of calamity.

And who isn’t in the middle of calamity? Forget about world wars. What is it like for the quarter million women diagnosed with breast cancer each year and the one in eight women threatened by it? What is it like for a gay youth in a fundamentalist town? What is it like for a workingman or workingwoman living in a tract home in Amarillo, Queens, or Dayton? What is it like for a writer with no publisher, a painter with no gallery, a musician with no gigs? What is it like for an obese man or an obese woman with no sex life? What is it like for the millions who hate their jobs, the millions with no job, the millions who cringe when their mate enters the room, or the millions who have aged into invisibility?

Against this backdrop of mental stress, distress, and misery, we are supposed to stand “mentally healthy,” as if life were a lark and as if sweet smiles were not only our birthright but also an obligation. Why should we be smiling? Why should we be “mentally healthy,” whatever that phrase is supposed to mean? For the whole history of our species, until very recently, your drinking water could kill you. In our age of good drinking water—which is only a reality for some percentage of our species—we have only had world wars and nuclear weapons to contend with. And what is life like for someone living under a dictator, where you can vanish for speaking? And how pleasant is your boring, taxing job? How pleasant, for that matter, is your own seething mind, packed with worries, regrets, resentments, and to-do lists?

But you are supposed to keep smiling. You are supposed to stay positive. No matter that every human right is a fight that must continually be fought for. No matter that in this modern age of plenty, which advertising tells us comes with beautiful homes, beautiful cars, and beautiful bodies, insomnia is an epidemic, obesity is epidemic, sadness is an epidemic, and meaninglessness is an epidemic. You must not notice the machinations of the powerful: none of that should affect your mental health. You must not notice your aging, your illnesses, or your mortality: none of that should affect your mental health. You may not even look in the mirror and announce that you might strive to be a better person: none of that!

Against this backdrop of great difficulty, stresses to our system, dangers as real as wars, famines, and pestilences, and a mind that clearly recognizes injustices and indignities, has grown a mental health establishment that takes none of that into account. It acts as if our baseline is “mental health” and that deviations from that unreal, made-up baseline are “mental disorders” or “mental diseases.” It calls the warehousing of distressed and difficult people, people who are no picnic and who are having no picnic, the “institutionalization of the mentally insane.” Its psychiatrists spend fifteen minutes with patients, not exploring human matters but prescribing and regulating chemicals. That is where we are.

It creates countless labels for human distress, individual differences, natural reactions to painful stressors, and socially unacceptable behavior and it announces that this hungry, sad boy has a “clinical depression,” as if something blew in the window and into his brain, that this unhappy, bitterly unfulfilled woman has a “clinical depression,” as if her husband despising her wasn’t about as real as bricks, that this arthritic old man whom his children have long since stopped visiting has a “clinical depression,” as if it were really a lark to sit in a wheelchair in the corridor of a nursing home from morning till night.

It takes no account of the extent to which human beings fail and how failing hurts. For every PGA champion there are thousands of golf pros and would-be golf pros chastising themselves for not playing well enough, down on themselves for their lack of talent, their lack of discipline, and their lack of success. For every NBA star there are millions of young men completely thwarted in their dreams of rising out of the hell of tenements, drugs, gangs and violence and who at some very early age throw in the towel and live a life of menace. For every country western singer who wins multiple Grammys there are legions of waitresses in dives all across America singing along to the music they wish they were singing on The Voice as they wipe up coffee spills and scrape dried eggs off table tops. We fixate on that PGA champion, that NBA star, and that celebrity singer—each of whom, by the way, is having his or her own meltdowns, as any tabloid will tell you—and not on the “boring” ordinary people with failed dreams and bad lives who are supposed to keep smiling.

Against the backdrop of our species’ continuous history of difficulty and its ongoing difficulties, difficulties that can be increased any day of the week by a new war, a new plague, a new drought, a glacial winter, or just the continuous barking of your neighbor’s new dog, the mental health establishment, with your willing participation, has contrived to make all of these virtually ubiquitous outer and inner difficulties “abnormal” and, as a result, profitable to them. When you get very sad because life feels horrible or very anxious because everything from your bills to your mate feel threatening, they say you have a “mental disorder.” Then either you nod your head in agreement and partake of their pills and their “expert talk” or you announce your defiant disagreement and … what? If you do not accept the mental health establishment’s way of viewing your pain and if that pain remains, what will you do then?

In the future—a future that is not coming—you might speak with a new helping professional, a human experience specialist. Our new human experience specialists would replace psychiatrists and psychotherapists. Yes, this is fanciful; it would take another several thousand words to outline why this can never happen. But it also requires only a few words: follow the money. And follow the prestige, the power, the insider connections, the holding of hands and the washing of hands, the intense ties among pharmaceutical companies, academics, the hospitals, the magnates of mental institutions, the courts, the expert classes, the jailers, the advertising industry, the politicians, the bureaucracies, the talk show hosts, the establishment in all its colorful garb.

Nor, really, should psychiatry and psychotherapy actually vanish. It requires a full-length conversation to explain the profound difference between chemicals-with-powerful-effects, which is what psychiatrists prescribe, and psychiatric medication, which is what they claim to be prescribing and whose rationale for existence presumes the presence of diseases and disorders that not only have never been proven to exist but that on the face of them, by the way they are created around committee tables, ought to be disbelieved. However, some sufferers may want the effects of these chemicals-with-powerful-effects: and for that reason psychiatrists would still be needed.

Likewise, many psychotherapists, violating their licenses and their oath to diagnose and treat mental disorders for the sake of doing good and reasonable work, actually already function as human experience specialists—and could be converted over quite easily, so ready are so many of them to be untethered from the current false system of “diagnosing and treating mental disorders.” This is of course what psychotherapy should have been—a human experience specialty—rather than a pseudo-medical profession where even master’s level professionals claim to have “patients,” which must make them feel superior but which ought to make them feel ridiculous.

We need a helping class that cares about the human experience and that takes human difficulty as baseline. There are many therapists who could be retrained and released from the grip of the medical model—they are actually waiting for that and pining for that!—and there are many compassionate, psychologically-minded, willing helpers who would love to learn this new stance and become human experience specialists. But the stage is not currently set. Nor is it likely ever to be set, given the establishment’s power and our secret desire to explain away our difficulties as the result of illness. The time is not ripe—even as countless millions are suffering.

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41 COMMENTS

  1. I think the way the term “psychotherapy” is used in this article is imprecise. So, as a practicing therapist, when I read the perspective of others I always have to look around me and see if the author’s assumed definitions of how things are actually match my direct experience of doing the work. There are a lot of statements about what psychotherapy would say or do, or what its professional obligations are that simply don’t match my experience.

    So first things first, can we define psychotherapy? Because virtually no one conflates all human experiences to “Oedipal issues” and hasn’t in my lifetime. I don’t know of any fellow counselor or therapist who, in response to a woman’s deep trauma over the fate of her son, would say what you have written. Is there someone out there who might do that? Maybe. But I work in the field and don’t know of anyone around me who would respond like that. So how do I hold that experience and let it inform how we frame issues?

    “Psychotherapy” today is often a blanket term to mean any kind of “talk therapy.” It’s no longer synonymous with the stereotypical idea of a stuff old man in a lab coat talking to a “patient” on a couch about his mother. That’s a stereotype that hasn’t been close to accurate in a generation or more. These days, “talk therapy” is a catch-all term that really means, anything that isn’t rooted in the biomedical or behavior modification schools of thinking.

    Today, “psychotherapy” is often the term used to described compassionate interactions with people seeking support that start from the fundamental question “what happened to you” rather than the medical/behavioralistic question, “what’s wrong with you.” In response to the mother who is living every day holding her breath out of love and worry for her son, the question “what happened to you” is probably critically important. “What happened to you” doesn’t mean the answer lies in someone’s childhood or in their unconscious, though it can. And I certainly wouldn’t make those assumptions when I entered into dialog with another person.

    I work for a small agency that serves a community of under ten thousand people as well as the surrounding area in the county. I work along side numerous therapists, all engaging in psychotherapy as the term is used to that. What is how the service is documented officially, and it has nothing to do with Oedipal complexes or all these other stereotypes from Freud and the 1920s. I may be blessed to work in a small community and not experience the same pressures that often corrupt institutions as they become ever-larger. But my experience is that there’s not a single therapist here who would read your descriptions of what “psychotherapists” do and think it was anything other than absurd.

    Now with that said, I definitely agree with the spirit of the article that says what is needed are people who are “human experience specialists” or, as I said, committed to the question of “what happens (or is happening) to you” rather than “what is wrong with you.” But when you suggest that its a violation of license or and oaths to do this, well, that’s not at all true for me, or any counselor or therapist I know under any licensing board I am aware of.

    LCSWs, MTFs, LPCs and others have all been practicing “talk therapy” identified as “psychotherapy” for decades along with clinical psychologists and a very small number of psychiatrists. What you are advocating in your article is not new or revolutionary to me, or anyone I work with here. We’ve been saying this for years. We’ve been practicing this as best we can within a system that does not prioritize or value experience-based support.

    I feel like talking about psychiatry and psychotherapy as though they are similar or equivalent is an error. Psychiatry is an institution. Psychotherapy is a very broad term that encompasses talk-therapy oriented processes, that are experience based, that grapple with the questions of meaning-making through questions like “what has happened to you, what is happening to you, how do these things influence who you are and how do you create meaning and identify values in your life?” Many people from different professional disciplines engage in such talk-therapy processes. And none of them that I know would ever walk up to a woman who’s son was in harms way and suggest she had some sort of “Oedipal” issues.

    • I understand your point but I’m afraid we’ll taking practice not theory here. I have had some (mostly negative) experience with both psych professions and from all the people I met there was just one person who had the right approach to her job. She is a psychologist but also my lifelong friend and I know that her ability to help people does not come from her education – it comes from her character and remarkable ability to connect to others and she did her job before she could even imagine that would be her profession. Psychotherapy in many ways is a better option in the current day and age as it does less harm and in some cases may even help. But the truth of it is it’s also based on a lot of false premises and it’s ability to help does not depend on any specific technique or special knowledge but on the relationship the therapist can have with you.

      • I agree that the character of the therapist and the quality of the relationship indeed matters the most. I think this is why there are a tremendous amount of new alternatives to therapists sprouting up….life coach, health coach, mentors, peers…

        How does two or three years of generally following a rote required curriculum prepare you for developing an authentic and caring relationship with someone else?

        The only difference between me and another compassionate person who is good at listening is my licensure and the many years I have worked with people. My licensure makes it easier for some people to pay because insurance covers some individual therapy. Is that a racket? Yeah. For the most part.

        I have gone to therapists and never come back a number of times who were licensed with a PHD. Their character, personal style and lack of authenticity could never be erased by education and a number of letters after their name. And I have seen therapists with no letters after their name who have astonished me with how they have helped me to develop insight and grow.

        Lets call it what is…a territorial game played out by insurance companies and certain licensed therapists to keep money flowing their way.

        • And sadly a bad therapist can also be harmful – this is what a lot of people don’t realise because it’s just a talk therapy but it very easy to, even without any ill will, implant someone with thoughts and memories that are destructive to this person’s life and relationships. People can be extremely open to suggestion, especially in this kind of relationship and that can be disastrous. I’ve read about a case some years ago of a psychologist who convinced her clients that they had repressed memories of child abuse. She wrecked a lot of families before she was finally punished by their association and stripped from the right to practice but the damage was done. It’s not always so extreme and does not always mean that someone means well but it happens.

          • These stories are told in Hysterical, oops, Historical Channel. I agree that bad therapy can harm but as I said before: therapy is done “WITH” the therapist. It is a process of the both.

            I heard many people complaining about psychologists who wanted to tell her the they should act. This is not therapy.

            Implanting memories can be done not only by therapists. It is outrageous that this charlatans keep with their licence.

          • To Ana:
            The first rule of any healing profession is not to do harm. People who go to doctors and psychologists expect help and, though it is advisable to remain skeptical, many just believe what they are being said. And psychologists can do real harm – I’ve seen this with my own eyes, don’t need TV for it.
            As to false memories: everyone has some. I know ma and a lot of my friends have memories like that, we once even did an experiment during my school lessons and since then I have to constantly remind myself that this is not a real memory (a harmless thing really but makes you realise how your own brain can easily be tricked). However, when this is done by a therapist and contains some pretty traumatic experiences it can really destroy your life. And it’s not always done with ill will, some people still believe in the bullshit about bringing out the repressed memories of abuse and such.

          • During the early days of PTSD from sexual abuse being the hottest topic in mainstream psychology/psychiatry, I sometimes ran across counselors who were visibly thrilled that I had been sexually abused and wanted to tell them about it.

            I also had a counselor so enamored with Jungian therapy that she couldn’t accept that I wasn’t angry because the orange dress in one of my paintings was red, in her opinion, and evidence that I was angry, though my life was golden at that point and I was not angry. After two sessions of her fruitlessly trying to figure out what I was angry about, I noticed all the angry tulips on campus on the way to our appointment, and then let her go.

            Take the best and leave the rest of any approach. If it works, it works, if it doesn’t it doesn’t.

        • I was lucky to have found the right person in the first attempt.
          I tried two after her because she was of town for a while and it was a disaster.
          One woman was extremely rude and the man I did manipulated him all the time.
          I visited him for six months and heard all I wanted him to say.
          I met one person who did therapy(?) with him for a period and he said that he slept during a session.
          I have numerous stories of people who told me how they psychologists worked.
          It is sad to have such people working in such an important field.
          One has to be very careful and search for the right person.

    • I was going to raise this issue but you did it very properly.
      I’m Brazilian an we still have psychoanalysis as in Argentina and France. There are great professionals and, of course, charlatans too.
      But it is easy to have a reference for a good psychoanalyst. I did it for 20 years. No, I’m not more crazy than someone who did 3, 4 or 10 years. This was the amount of time my experience needed. Time is different for each person in what psychoanalysis is concerned.

      We have psychologists and most people who try are let down and don’t want to search for another one which is very sad because sometimes the person found the wrong professional or a bad professional.

      It makes me very sad seeing a methodology which is different for each “patient” and has a very broad kind of approaches being described in generalizations such as Oedipus complex and the money – in same cases it is even therapeutic that the person doesn’t pay – and all these clichês.

      Psychoanalysis happens when the two are together and is done by the two. The psychoanalyst doesn’t “guide” like some people think.

      I’m studying to be a psychoanalyst since I have acquired some knowledge without planning. If I’m thrilled following this path?
      Nope, I’m scared, extremely scared. 🙂

      I can’t picture someone in this situation: !Yippee Yippee! I’m going to be a psychoanalyst.”

      I guess I have changed the subject.
      I rather say that that person is a “war neurotic” than “is diagnosed PTSD”.
      When I was a teenager we had a teacher that was a “war neurotic” and we all understoos what this man has been through.

      “The teacher is diagnosed PTSD.” I don’t know how children see it.

      All I know is that for ‘neurosis’ we went to the therapist. Neurosis disappeared.
      Everybody is either bipolar or has PTSD.
      A pill, or a cocktail of pills is the answer.

      In US it seems that CBT is indicated for everything. This is no good.

      • I just wanted to add that there is a group of psychoanalysts who are always questioning the methodology.
        Joel Birman is one of them and he started asking that if a period like the one we’re living, Freud would go crazy, he said, the psychoanalyst mus remains silent most of the time.

        There are numerous people in France, Argentina and Brazil questioning and rethinking.
        I’m glad that in US it is being done too as this article shows.

      • It’s just labels. I don’t really have a problem with PTSD so much because this name at least acknowledges the role of trauma. What I have a problem with is calling it a diagnosis or disease or mental illness. I suffer from trauma would be probably the best and most accurate one can say…

    • After 15 years working with psychiatrists, social workers and psychologists (Master level and PhD) in a community mental health agency, Dr. Maisel is spot on. Respectfully, I think the objections of Mr. Yoder and other therapists I have read demonstrate a fundamental weakness in the actual practice of the profession – too little honest self-examination and too much ‘buying into their own rap’. In the spirit of disclosure, I come to the field from another training background, as well (kind of grandfathered-in, as it were). As nice and kind-hearted as many of the people I have worked with are, I can honestly say that I would never see a therapist again after working closely with them. Why? The reasons are many. I agree much of what is going on is essentially guild-protection and a desire to feel oh-so-important as a “very serious profession”. What else? Well, sloppy thinking; an overgrowth of subjectivity so thick you can cut it with a knife; easy judgments; quick applications of theories; an all-too-obvious willingness to bring personal bias and class-based notions about behavior into case discussion, and yes, a remarkable willingness to accept diagnoses, plan so-called treatment accordingly and actually work to “diagnose more accurately” (as if it matters). I hear lovely professional people casually discuss other’s “characterological issues” or “social skill deficits” without batting an eye – or realizing how these norms are self-defined by the ruling class. By contrast, I hear absolutely no one asking “whose norms are these, anyway?” or “who ever said that one group of educated people had the perogative to define these important areas of human function for the rest of us?” I’ve heard it said that much of what goes on in this field is essentially Class CarpetBagging – in many cases, educated middle class women seeing the needs, hopes, wants and lives of people in distress through their own lenses-of-belief regarding what is right, proper and above all – normative. I agree. Let’s not waste time on Straw Men arguments, please. No one said there are no thoughtful, humble therapists out there! Simply there are far too many who are not.

  2. Wow! Thank you! Well said! I was about to print and leave a copy in the staff room of the behavioral health facility where I work as peer recovery support. However I am reminded by a quote from the Dahlia Lama that says our main purpose in life is to help others and if you can’t help them at least don’t hurt them. Some of these people are rooted deeply in their degrees and titles and cannot see the human being sitting in front of them.
    I’m also reminded that I must continue focusing on the change that need to happen and put the work and energy into that rather than fighting the old. We must continue being our best selves and hold our heads up and do this work of advocacy sharing recovery and even changing the word recovery to being human and having human experiences. I thank you Dr. Maisel for this very hopeful piece. We all must do our part. We are all in it together this human experience.

    • Corrine

      Please think again! You absolutely should leave a copy of this blog at the behavioral health facility.

      If some people are offended or even “hurt” by this blog’s analysis this can be a very good thing. First off don’t assume that someone might not learn from or be inspired by these words. Why would you want to deny someone the chance to know more truth about how the world really works and how to change it for the better?

      And Corrine, learning is not always painless, nor should it be. Think about some of the most important lessons you have learned in life, and I bet there was some pain involved. And I bet you are glad now that you went through such pain. Then think about all the great movements for social change and the necessary pain endured to achieve liberation.

      People are dying and suffering every day from the disease/ drug model of so-called treatment. Why should we be worried about hurting the feelings of a minority in power by challenging the harm they are doing? What about the majority being harmed and their feelings?

      “Revolution is not a dinner party” (although dinner parties can create fertile ground for the ferment of ideas and political organizing). Social change is not going to be smooth and painless; that is not how history works.

      Corrine, shake things up a bit; no business as usual!

      Respectfully, Richard

      • Hi Richard,

        When I read your comment almost a month ago my response was, “I hear you.” I decided not to post but to respond at a later time when I had more time to write my thoughts behind those three words.

        Here is the thing, that table in the staff room at the behavioral health clinic where I use to work (I recently found a new job working for a recovery organization) was a place where people place articles, pictures, and such to share. I have read some interesting pieces and shared three articles myself, On the Urge to Take My Life, and My Decision to Take It Back From the “Mental Health” System Instead, by Laura Delano, Please Defend the Right to Bear Arms, by Deron Drumm, Response to “Power Needed To Make Potentially Dangerous People Take Their Meds” by Greg Benson and several pieces by Mary Ellen Copeland. Perhaps I shared these pieces after I heard negative comments related to the subjects, from coworkers about people diagnosed with mental illness but mostly because I sincerely wanted to share recovery and hoped I could encourage coworkers to see that people could live up to our full potential as human beings, it shouldn’t be all about drug pushing, and labeling people, but everyone is an individual worthy of love and connection.

        I was the only person with lived experience of accepting a diagnosis for too long at the staff meetings, I knew it was fifteen against one, so sharing the articles was my way of responding to them, without being seeing as aggressive or taking their comments too personally, or the last comment from the compliance officer, “you are sensitive…’

        Before I shared the articles on recovery, the articles shared by the staff (psychiatrist, psychologist, social workers) were insightful, sometimes humorous but overall informational. I noticed that the other staff member(s) started sharing negative articles towards people diagnosed with mental illness. The table became a place of “that’s what you think, this is what I think about…” So I stopped reading the articles that were placed there, I got the message, there would be a lot more negative articles coming. This is why I chose not to place this article by Dr. Eric Maisel there. I think someone said, “An eye for an eye make the whole world blind.” Forgive me I think it was Gandhi but not sure. Here is the thing, I am not blind, I have awakened to see what is going on in the mental health system and humanity, and peace and love is what will win. I read a quote by Mahatma Gandhi that says, “When I despair I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they can seem invincible, but in the end they always fall. Think of it always.”

        I have to accept the part I have played in the system, of accepting that titles and degrees meant that someone knew me more than I knew myself. I know I could say that is what I was taught about being inferior and superior, my lack of proper grammar is not of an inferior mind but inferior education. Still doesn’t stop me from being able to learn and grow and when we know better do better. Martin Luther King, Jr. said, “Everybody can be great…because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and verb agree to serve. You only need a heart full of grace. A soul generated by love. We have to stop judging each other; Mother Theresa said she saw Jesus even when she saw a homeless person. With my experience of people judging me, my race, my color, my weight, my sex, my geography etc… I now see that I am the homeless woman on the street and she is me. I have to accept responsibility for the times I refused to learn something new to help myself one example is when I was introduced to WRAP, it took months perhaps a few years more to engage, not sure how long I was still dying slowly. I had adapted to the helplessness not knowing about recovery, once I took the Pathways to Recovery and recognize that I was in recovery and had been for a long time, I kept on the track of learning and I took the WRAP course and now use it as part of my wellness tool.

        I know change can come we have seen it all through history. I choose to stay aware because even when I wasn’t, I was still involved, people making choices for my well being while I died slowly. Listen, we all have to do our parts, I heard a character playing Martin Luther King, Jr., say in the movie, Lee Daniels, The Butler that the domestic worker was a very important part of the Civil Rights movement, getting America to see all it’s people as human beings. He talked about maids, butlers, nannies, etc… doing this work with dignity, that we learn not to fear each other. As a recovery support specialist I carry this ideal with me, I share with coworkers, peers, about recovery, I see no man greater than the other. I know that some recovery support persons might want to say well, now I am on the other side of the table and also judge others, this attitude help keeps the mental health system where it has been, of course what happened to me at my work place for standing up is probably why one would choose to assimilate rather than stand up and say yes I am not a machine, I am a creative human being and I don’t think in a box.

        So I allowed these coworkers to get to know me, but fear of a person calling my self a well being and not an illness scared them, basically worrying about keeping their titles and degrees, the first chance they got I was written up as a diagnosis.

        There is fear in this country and globally towards mental illness. One fact is because it is being called mental illness and excluding a group of people who most of the time have been bullied and experienced trauma, and not looking at all humans as a whole who all have a mind and therefore, mental health is important.

        Did Hitler fear the Jews? Did European Americans fear African Americans that were enslaved? We see what happened there in history World War II and Civil War. Do you think with all the horrible murders, suicides, and mass murders happening in our country and around the world that this fear of people diagnosed with mental illness that the society we live in now would round people up and take away their human rights as we have seen in history? I like Deron Drumm do not like or ever want to touch a gun but, I learned that a law was being passed to put everyone who ever seek mental health services in a database. I also read in another article that NAMI had some approval or say in a community in California of people diagnosed with mental illness having to carry a White Card. This is what I have learned and see and make me ask the question, where will this awful road of blaming everything on mental illness go and taking away people who have suffered human rights.

        My life experiences have taken me to now accepting personal responsibility and I know it is cliché but if I could awaken in this world anyone could. So accepting personal responsibility means my time working at that behavioral health clinic ran its course. I know they are only doing what they know, but I know for sure that everyone could learn and grow. Perhaps some of them are in the dark ages right now on mental health, but we all could still learn. I just know that the people at that address do not get the last say on human rights. That I know for sure.

        • My comment above, “…of course what happened to me at my work place for standing up is probably why one would choose to assimilate rather than stand up…’ I’ve learned that words are important and if you don’t explain your thought behind the word if you are not a grammarian or well versed on vocabulary it could be misconstrued. My thought behind the word “assimilate” is when I sat at the staff meetings with the license clinicians and they made jokes about a client’s circumstance, I did not laugh, even when it was uncomfortable being the only one at the table not laughing.
          When diagnoses were thrown out I asked questions and think, what has been happening in that person’s life? Fox example one psychiatrist really liked using the word “grandiose” I became aware of this and paid attention to what he was referring to. The last time he was talking about a person who was having marital difficulties, employment, financial and shelter issues. The doctor said he/she has grandiose delusions talking about going back to school and going back to his/her homeland to help the people. Why would this doctor call this person grandiose? This person does know that they are having difficulties why they are at a behavioral health clinic seeking help. The doctor mentioned that relationship, food clothes and shelter are unstable. Perhaps after the person get these things stabilize they could work on the dream. But isn’t helping others we know for sure is the best thing human beings do for each other. Is it not better to give than receive? Perhaps if the focus was to help this person stabilize the basic needs of food clothes and shelter instead of labeling and drugging, this person could then help themselves then move on to help others. Ask the question, why do you want to go back to your homeland and help people? Why do you feel education is important to do that? What kind of trauma’s has the person lived through or saw happened to others? Is it grandiose to want to help others even when you are at low point in your life, or is it just showing that you are still trying to awakening to being your best self in this life?

  3. Eric,
    Thank you for writing this insightful piece. I totally agree, “we need a helping class that cares about human experience and that takes human difficulty as baseline.” I wish I could go back to school and get a degree, or be certified, as a human experience specialist. I’m already fairly well qualified for that job. “But the stage is not currently set.”

    The current system of “care,” however, is upside down and backward. Psychiatric practitioners harm infinitely more than they help. Their belief in “lacking in validity” disorders is insane. We need change. Personally, I had adverse withdrawal effects of a “safe smoking cessation med” (antidepressant), which complicated real life issues I was trying to mentally come to grips with (cover ups of a “bad fix” on a broken bone and the sexual abuse of my child, and disgust at 9.11.2001, including a child-abuse-covering-up-pastor denying my daughter a baptism at the exact moment the second plane hit the second World Trade Center building) misdiagnosed as “bipolar.”

    My real life and concerns were literally declared in my medical records to be a “credible fictional story” by a lunatic psychiatrist, after (on my second to last appointment) he finally listened to me. All that he apparently could mentally comprehend while “treating” me was that he believed it was his right to force toxic drug cocktails onto an innocent woman who had been misdiagnosed with one of his DSM biblical “mental disorders,” to cover up his and other doctors’ malpractice.

    The mere existence of scientifically “lacking in validity” disorders is the problem. And the DSM disorders are no more valid, or beneficial to society, than was claiming being Jewish is a mental illness during WWII. Change is mandatory, and it needs to happen now, since “countless millions are suffering” from the psychiatric industry’s most recent crimes against humanity. Psychiatry, and the corporations, industries, and governments advocating it’s validity, are the Beast, IMO. I pray for quick change.

  4. This article is my favorite thing I have read here in a long time. Almost everything in it resonates with what I have been learning and discussing with others.

    I am not sure I agree that being a human experience specialist is different than friendship. I acknowledge that surely being in that role professionally would be different than an informal friendship.

    However, I like to think that a great deal of suffering could be, and already is, abated by the presence of friends who have shared similar human experiences, those who can resonate with what we are going through. Many people who live in the oppressive circumstances you describe do so with some joy thanks in large part to the quality of relationships in their lives.

    If this is true, then in addition to developing a professional class of human experience specialists, we ought to have a class (or perhaps classes, as in school) that teaches lay people about their own inherent human experience specialty. Society would benefit greatly from our existing communities of mutual aid (i.e. churches, markets, households, families, and community groups) learning to listen more closely, and draw on the many possible ways of making meaning that helps us through hard times.

    Additionally, I suspect that increasing our communities skills in empathy, trauma-awareness, and the multi-faceted gem of human meaning-making would go a long way toward shifting the systems that cause war and oppression.

    • The best friend I’ve ever had is who keeps me feeling strong and grounded. He has never been “disappointed” when I’m less than my best self, and even when he doesn’t understand things I do, he trusts me and my processes. He knows me better than anyone ever has, and vice versa. We’ve earned each others’ trust and we both honor it.

      In the U.S., most of don’t have community. Philosophers argue over what is community, but it’s certain that we live in a fragmented, atomized, and hyper-individualized culture. We, as social animals, should be disturbed by the insensitivity and abuse that is broadly accepted as normal.

      • I’m reading The Spirit Level by Wilkinson and Picket, it uses epidemiological and economic evidence to point out that the greater inequality in a society the less people trust strangers and the more mental health problems there are, as well as a host of other social and medical problems.

        So there is evidence that in the USA there is less, “Community,” as people are too busy protecting their social status, which people have to do in societies where there are great differences between the poor and the rich

    • Honestly, I doubt that you can help someone in this kind of way and become a friend. What makes people happy, what helps them through difficult times and gives meaning are relationships. The only way you can really help someone with emotional distress is by connecting with them. Doing so for enough time will always result in real relationship.

      I’ve always felt that psychotherapy is wrong in trying to offer a fake relationship for money. For me it’s no different from prostitution, it’s only emotional contact you’re selling rather than physical. And as prostitution it can help to relive the pain for a short while but it can’t substitute for anything real. This whole talk about having your boundaries and so on feels just plain wrong to me. How can you expect a human being to listen for hours and days to someone’s innermost thoughts and experiences and not connect with them and not form some kind of a friendship? It’s a sick premise. It’s only normal that people break these boundaries but then they’re somehow not good professionals. I call bs on that.

  5. Interesting article. Actually religions have pretty much addressed the human condition and accurately proposed a number of ‘remedies’ for suffering. In some instances these religions have had hundreds of generations to work things out for the practitioner or devotee. A religious age is religious not because someone has found a proof for the existence of God. Likewise, an irreligious age is not irreligious because it has found a proof for the non-existence of God. Neither proof exists and neither is possible.

    Our age claims to be scientific though it isn’t. In fact currently scientists can not even determine satisfactorily whether the planet is cooling or warming, whether ionizing radiation is harmful or whether GMO’s make good food. It has no real idea what mental illness is or whether psychiatric medications do any real good. Our science is sloppy. Soon we may expect an anti-science age. But at present it functions rather like religions did. But it has only a few generations of development. So it is rather shoddy in many respects. Amateur.

    George Orwell would certainly like your “human experience specialist”. Instead of thinking of humans as hyper-animated lumps of matter we might consider them micro-corporations and mental illness as the micro-corporation in potential bankruptcy due to inefficient use of energy. Special MBA programs could be designed.

    • If you can find a pdf download of “The Myths We Live By” by Mary Midgley, I think you won’t be disappointed. So much scientism is being hailed as the ultimate in scientific knowledge and wisdom that it would be laughable if it weren’t so pervasive and out of control. Psychiatry and evolutionary psychology seem to have so much bum “evidence” qua wishful thinking and implicit bias, that it’s a gobsmacking, head-desking, face-palming world of elite and well-funded idiocy.

  6. Eric, you have struck at the core of what is wrong with the current model. It is not merely the minimization of dangers and the overstatement of benefits of drugs; it is not merely the promotion of drugs and suppression of alternatives; it is not merely insurance companies trying to increase profits by decreasing services. It is a fundamental misapprehension of the human condition, predicated on the idea that we all should be OK with the status quo, whatever that is. If the status quo is perfect, then it follows that any distress is not caused by current social conditions, but by an inability of the distressed person to appreciate the wonderful world s/he lives in. It is a philosophy that is designed to protect the powerful from scrutiny and to punish the little child in all of us that’s willing to say, “Hey, why is the emporer riding through the town buck naked?” Naturally, those in power want to stay in power and the psychiatric worldview is perfect for suppressing dissent. But it is also necessary for those in power to deny their own personal vulnerability and distress, and this system is the perfect way for them to transfer their own discomfort with the current state of affairs onto their clients, and then “wipe out” those projected feelings with drugs.

    I like your vision, and agree with Andrew that there are many who are already doing this kind of work, even if they are not supported in doing so. I wish there was a simple way to get this idea across, but the medical model is so embedded in our social fabric that it will take many years of hard work to change, even if we were not opposed by a multi-billion dollar industry filled with sociopaths.

    — Steve

      • Three reasons I can think of from my experience:
        – you’re not wearing a lab coat or Milgram experiment (but you’re not a psychiatrist so how can you know)
        – but my sister got better on drugs (even intelligent people have sometimes problems to understand that this is not an evidence for anything)
        – there are a lot of people around who deny all kinds of science: climate science, vaccines etc. – you just get grouped as a conspiracy theorist

  7. Interesting piece Eric. On many levels I agree but I side more with Andrew on this issue. If a therapist is acting within the confines of the medical system and promoting a DSM V label and treatment using medication as an “answer” to the inherent suffering that is normal to most of humanity, then I would agree that this type of therapy should be abandoned completely. On the other hand, I agree with Andrew that most of the therapists that I know do not act within that conventional framework., or indeed an old school Freudian model.

    Most spend most of the time listening, finding out “what happened”, serving as witness to human experience, with all its frailties, confusions, failures, happiness and underlying tragedy. It can be deeply challenging for a friend or family member to be a witness in that way as their own confusions, projections, worries and self-protection can easily fog the relationship.

    I easily see the issues inherent in the role of therapists. Time periods are allotted. Payment is made. A power structure is created that can feel unnatural. But the notion of free peer based service is fraught with difficulty as well as people can feel drained by helping too much.

    My essential issue with the therapeutic role is the philosophy of care. Is the job of a therapist to be simply a witness? Should there be an active role of nudging people towards a search for meaning within the pain? Should there be a goal of greater happiness? Or should there be a goal of greater acceptance? Stoicism? Buddhist mindfulness of what is? Should therapy be about teaching “skills” for managing anxiety and depression? Should it involve discussing diet, exercise, sleep patterns? Should it involve encouraging social justice? Promoting meditation? Prayer? And on and on.

    Many therapists have their own take and own philosophy of “helping” people in distress. But you hit the nail on the head when you suggest that diagnosing “depression” and trying to help people feel happier when their son is away at war, or has been killed, or their life is simply miserable does a disservice to the person who is looking for support. The goal of happiness is not really a great answer for many people in this world and aiming for an unobtainable goal can make many people feel worse for falling short.

    • Jonathan and Andrew

      Eric’s blog posting was overall very very good!

      Yes , of course not all therapists/counselors have bought into the disease/psych drug model; many do great work helping people go through difficult periods in their life. However, it must be said that a large percentage of those people working in this field have accommodated themselves to the medical model. They are either ignorant about it or try to pretend it is not there, and go about their work oblivious to the damage this model does on a daily basis.

      I have worked 21 years in the community mental health system with several hundred therapists, and been involved in hundreds of meetings and discussions about clinical work. I can honestly say that there is a great deal of ignorance in the field with many people traveling on the dangerous “path of least resistance” in this helping profession.

      How many therapists/counselors have a discussion with their clients about what is wrong with diagnosing and labeling?

      How many continue their critical thinking skills on a periodic basis by carefully examining the true nature of the medical model that has completely taken over the mental health system?

      How many simply defer to the power and authority of the psychiatrists they work with and back away from challenging psychiatry’s dominance in community mental health?

      How many try to learn about psychopharmacology and take the time and the risks involved with discussing the dangers of psychiatric drugs with their clients, and discuss how the drug model disempowers and derails the therapeutic process?

      Given the pervasiveness of the disease/drug model, and the overall numbers of people on these drugs, how can anyone do good therapeutic work with people without addressing some of the above questions?

      The answer is, you can’t. And there is not nearly enough people in the field grappling with these questions at this time to make a significant difference. We all have much work to do in order to change this reality. Eric’s blog is a positive contribution in this effort. If some people are offended by it, then perhaps this will start them thinking about what they are, or are not doing to make the world a better place.

      Richard

      • Richard I entirely agree. I would guess most therapists either avoid the issue of medication or encourage it as a way of “treating” an “illness.” Many of them avoid it because it is bordering on practicing medicine and may be seen as unethical or at least out of their purview. Or perhaps they avoid it out of ignorance. Many dont understand the intricacies of poly drug prescriptions, let alone the complex issues of tapering off of these meds.

        But I believe that therapists must have a much broader understanding of this subject and act as a bulwark against the immense dominance of psychiatry in this field. Since doctors aren’t doing it, therapists should become trained in how to support people through a drug taper. They should encourage a full examination of their medication regime if the person wants to do that. As for some, they could encourage social justice as part of processing the effect of these meds on their emotional and physical health.

        There should not only be a movement by therapists to thoroughly discount the medical model but to also support alternatives to this system of “care.”

        The tight spot is that insurance companies pay for treatment of diagnoses based on the DSM V. It’s a bullshit game to make therapists adhere to a corrupt model. To truly avoid that, you would have to make everyone a private pay client. But most people can’t afford that, so some therapists play a cat and mouse of billing for a diagnosis and then completely ignoring it and going on with the real work of helping a person through their process of healing.

  8. Dr. Maisel or Eric (…as you prefer), I very much appreciate your inclusion of Freudian conceptions in the analysis of the historical character of the problem facing us with institutions like the current ones in the allied mental health professions, locking people up and refusing to learn firsthand from them once a label has gotten prescribed, and cooperating with one another for their special place and privilege all over the country as we speak.

    Having just read Glover’s terrific book Freud or Jung? after the worthy recommendation of it by Marcuse in his Eros and Civlization, I realize how important such dynamic conceptions of consciousness are for respecting the present madness and willingness to gloss over the tremendously arrogant positions of professionals and academics in all categories of relationship to persons in desperate psychological conditions.

    Likewise, and still up there on the high shelf, I am still trying to get around to a complete reading of Being and Nothingness, wherein Sartre not only dismisses Freud’s and Jung’s mistaken conception of the unconscious, but also insists that “something Oedipal is going on” for us each.

    Over and over I have had psychologists do nothing for me pertinent to my needs, and psychiatrists, of course, existing with the authority that they possess, can pretend to care without pausing to defer to psychiatry itself, as psychologists invariably have and will–everyone that I have met.

    Thank you

  9. Please take into account in my message above that I mean in saying “respecting the present madness” of the situation as you diagnose it, I mean respecting the nature of the beast and should have said something like that…. I say beast because of the interdisciplinary collusions and destructive power of its arrangements.

  10. Hi Eric, well said. There is a certain amount in the community as well. In my own case it wasnt really the external suffering. I went everywhere looking for a solution as my head was breaking (withdrawal syndrome) when I stopped the psychiatric drugs. I went to the Buddhists, to the Hari Krishna’s and also to MIND UK and they organised ‘counselling’ . The counsellors were trainees, but they were really good, they gave me friendship in my hour of need. I stopped with the 12 step though, and I’m happy to remain with them, they have what I want.

    I also tried a CBT group and this was very good as well, maybe because of the leader, as he had his own life experience to draw on. But my anxiety is not too bad now.

  11. Very soulful refrain. Can we not admit that life is very hard sometimes, and that much of the time it’s much harder than it has to be?

    I read an article once by philosopher in Israel who was among many philosophers in that country who wanted their profession to be paid for counseling the way psychiatrists are. He and many of his colleagues were already volunteering on suicide hotlines and helping people sort out their thinking and feelings and helping them try to get a grip on what was important to them. He said that first, they must be a “friend”— by that he meant that they must in that moment care for that person and want very much for them to see their way out of crisis so that they listened as if listening to a friend they respected, admired, and felt equal to.

    I would love to talk with an epistemologist about my trauma, but most of all, I would love to talk with other people about our trauma, and at this time, I don’t know how to go about that. But being able to put a traumatic event or a response to one into the context of what it means to be human and what to do about evil, does seems to elude psychiatry.

    • wileywitch, I don’t want to give useless advice since I know everyone usually finds their own best way to heal but have you tried to write it down? It sometimes comes easier than to talk to people, especially people who have never been through the same. At least I know that helped me (I talked to a friend as well during that time but there were things that I just could not say for various reasons).
      Back to the article, it reminded me of a song:
      “In My Time Of Need

      I can’t see the meaning of this life I’m leading
      I try to forget you as you forgot me
      This time there is nothing left for you to take, this is goodbye
      Summer is miles and miles away
      And no one would ask me to stay
      And I should contemplate this change
      To ease the pain
      And I should step out of the rain
      Turn away
      Close to ending it all, I am drifting through the stages
      Of the rapture born within this loss
      Thoughts of death inside, tear me apart from the core of my soul
      Summer is miles and miles away
      And no one would ask me to stay
      And I should contemplate this change
      To ease the pain
      And I should step out of the rain
      Turn away
      At times the dark’s fading slowly
      But it never sustains
      Would someone watch over me
      In my time of need”
      by Opeth:
      https://www.youtube.com/watch?v=9x6YclsLHN0&feature=kp

        • I find it easier to talk about it on-line where I don’t really know the people personally but who have similar stories. For my issue I found a forum which looks secure and is policed by the person who set it up. I spent a lot of time there, now I don’t do it anymore, I think I got over that. It’s actually the psych abuse that did much more damage to me than whatever was my problem initially.