The Lonely Way: Reflections from a Young Psychologist

Victor Morasse
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When I started university in 2007, I didn’t know it would turn out to be so lonely. For me, becoming a psychologist was mostly about the very serious business of understanding everything about the human mind, and having answers that nobody else had. Psychology was a science and I remember very well that I thought I could master it completely.

I spent seven years in school, studying every approach and reading about many theories. I have been taught about diagnosis, psychopathology, treatment, evidence-based practice, CBT (and its efficacy of course), research methods and so many other things that were supposed to help me in my professional life.

Now, professional life has arrived. I’m a certified psychologist. I have spent the last year or so speaking with people about their lives, their fears, their problems, their hopes and their solaces. It’s a great job, as fulfilling and full of bliss as I had expected. But every single day, when I try to understand and sometimes help people who enter my office, I have the same reflection.

This is not what I have learned in school.

Psychotherapy (I’m still searching for a better term, since the word ‘therapy’ involves thinking that there is sickness somewhere) is not about knowing everything. It’s about humanity, doubts and uncertainty. It’s about reaching out and reaching in, authenticity and honesty. It’s the most demanding thing I have ever done, because I’ve fully involved myself in this work; I use my own feelings, scratch away at my existential issues and try to care as deeply as I can for people who choose to enter my office. Sometimes, I know exactly what helps and what doesn’t. Sometimes, I have no idea. In a very odd way, it’s the most professional attitude I can think of.

But it is also the lonely way.

I feel lonely every time I read the newspaper, because most discussions about mental health revolve around diagnoses and illnesses. Nobody seems to realize how silly it is to use statistics and measurements for invalid concepts. Yet when I try to explain this, I always feel clumsy and obscure, as if someone had stolen the right words to speak clearly about those things.

I feel lonely every time I speak with colleagues. Over the years, the vocabulary of mental illness has become completely obsolete to me. I realize I don’t need to use it with my clients (luckily, in Québec, most insurance companies don’t demand an official DSM diagnosis for reimbursement). Part of this model’s weakness is its explanatory power, since it rarely takes personal history into account. The fact that emotions, thoughts and behaviors are transformed into “symptoms” makes no sense to me, a sad mockery of medicine based on the personal opinion of so-called experts.

I know that, if you’re reading this, chances are you know exactly what I’m talking about. Mad in America has been my ideological refuge for a long time, full of bright ideas about how things should and could be different. But most “clinical discussions” I am a part of use the words of the DSM as foundations for comprehension, diagnosis and treatment. I shouldn’t be surprised, after all this is what was taught to me in university. This is what is promoted in institutions all around North America. So, when I speak my mind, as I said, I feel very lonely.

I want to fight back and do something about this. I have turned down two job offers because of my ideas. I don’t want to stop being idealistic, and I hope I will forever be too young for that. At the same time, challenging the existing model is not easy. Powerful and respected people have built careers and lives out of these concepts. I’m searching for a way to tell them it has no scientific value and has caused more harm than good. I’m searching for a way to make a whole system realize it has been living in cognitive dissonance for a very long time. I want to do this without an open war, without a useless confrontation of egos.

So, I keep walking the lonely way. This text is an attempt to get a little company on my path.

I have started a book project. (It’s in French, by the way. Another obstacle on my route is the fact that many people in Québec don’t read or understand English very well.) I’m calling it “Porter Préjudice”, and I will offer you the pleasure of finding out what it means by yourselves. I have divided the book in ten chapters, each of them exposing a lie of the medical model. Here is a preliminary chapter list:

  1. We can establish valid diagnoses in mental health
  2. The progression of science is what allows us to better recognize, diagnose and treat mental illnesses
  3. A chemical imbalance in the brain is recognized as the origin of mental illness
  4. Psychiatry has always been a medical discipline using good science and proven techniques and treatments
  5. We understand the mechanism of action of pharmaceutical drugs mechanisms and we know they have a positive effect in the long-term
  6. Pharmaceutical companies and professional associations use objective science in the development and marketing of their products and treatments
  7. Depression is a discrete illness (a neurobiological or neurodevelopmental disorder) and antidepressants correct a chemical imbalance in the brain
  8. ADHD is also a discrete illness and stimulants work to correct a chemical imbalance in the brain
  9. There is no alternative model to the medical model
  10. People who critique the medical model have no empathy and deny the suffering associated with those conditions

 

I know, that looks like an all-you-can-eat menu. I tried to remain more specific, but there is so much to share on this subject that I couldn’t reduce the list any further. If you think you can help by pointing out useful information, sharing ideas or even writing something about any of those chapters, please feel free to contact me. I would be very happy to get any help you can offer.

The biomedical model is taking away humanity from us. By transforming our emotions into “symptoms” we have to numb, it takes resilience away. By transforming our thoughts into “symptoms” that need to be put back in the box of “normal”, it takes creativity away. By transforming our behaviors into “symptoms” that need to be fixed so that we can all be the same “normal” beings, it takes diversity away. We will need those things in the next few decades more than ever before in the history of humankind. I choose to fight this model with all my heart because I refuse the world it implies. I walk the lonely way every day, hoping it can make all the difference.

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Victor Morasse
Victor Morasse is a psychologist in Québec, Canada. So, yes, he speaks French! He just started a private practice and is trying to slowly get rid of words like "diagnosis", "psychopathology" and "treatment".  His plan over the next few years is to create a place for suffering people in which they feel cared about and safe.  He is also a writer of fantasy novels and a high school basketball coach.

59 COMMENTS

  1. I am glad there are still folks like you in the profession. Your description of a professional attitude toward counseling completely reflects my own. Your clients are very fortunate to have found you.

    Don’t be too lonely – there are others like you and me out there if you look hard enough!

    —- Steve

    • Hi Victor,
      Thank God there are so many dissenters-to-the-norm out there! I quit my therapist training because I felt so lonely in a profession that seems bent on conforming a person’s “symptoms” to a model of dysfunction, rather than focusing on the inherent strengths and resilience of the human spirit. Use of the word “empirical” in psychology really bugs me. The only empiricism we are likely to find is direct feedback from clients about whether or not their therapy is helping. Like you I found it very difficult to have a conversation that inspired me or supported this way of thinking. The therapy community is very fragmented, and the last thing a therapist should be is professionally isolated, but alas I don’t see that changing soon. I hope you find your professional tribe and continue to find joy in your work. I think you’re onto something very important and probably much more useful to your clients than the traditional approach.

  2. You are so right. Human emotional distress is not reducible to mental “illnesses”. I think you will be so much more helpful to your clients by understanding them as individuals with subjectivity and aliveness and problems in liing, not just illnesses.

    I have a story relevant to this. For a while I’ve been writing about how damaging the label “Borderline Personality Disorder” was for me and how I had to work against the existing DSM system of conceptualizing emotional distress to get better. I was recently approached by a well-known psychiatrist from a NAMI-funded group who read my story and wanted to include it in a book about recovery from BPD. So I wrote a summary of my recovery for his group, but it included the following points, summarized very briefly here:

    – BPD is an invalid fiction with no validity nor reliability.
    – There is no genetic or biological basis for this hypothetical non-illness.
    – Problems mislabeled BPD can be completely recovered from.
    – Rejecting the validity of BPD was a crucial part in my getting better.
    – BPD should be abolished.

    The psychiatrist was disturbed by my “radical” views and we clashed about whether or not to include them. I finally decided I could not participate with their book.

    Because I was upset by his authoritative attitude, I eventually told the psychiatrist that I imagined it must feel pretty shitty to wake up every day and know on some level that you are telling your patients lies about their emotional distress being “illnesses”, illnesses which have no validity/reliability as discrete phenomena, and prescribing them medications that are minimally effective and often harmful. I told him people like me are his reckoning and we are here to end the borrowed time these lies are based on. Not surprisingly, he had no comeback and I never heard from this sad man again.

    The moral is that it’s not that hard to confront people like the psychiatrists (and other therapists) who are promoting this crap. When their lack of evidence for discrete “mental illnesses” is exposed there’s nowhere for these people to run.

    • I have had brushes with NAMI and there is nothing they do that isn’t promoting the medical model. If you look at their funding, the rate at which they abuse their volunteers and the way they actually create stigma using the medical model you understand how mainstream mental health they are.
      I too challenged them by posting contrary article that gave pause for people to consider something outside of the crap they post. I was banned. No shock there.
      Keep up the great work! We will make progress toward a more truthful humane approach to helping those who suffer from the undeniable need to be honest.

    • Hey, way to let him have it, you rebellious radical, you! I hope you thanked him for the compliment of calling you “radical.” He obviously finds any alternative viewpoint threatening, and doesn’t want to hear about “recovery” unless it fits his pre-established and accepted pathway.

      I bet he will remember you forever. I hope you were able to establish a few cracks in his defense system!

      —- Steve

      • “you rebellious radical, you!”

        That’s exactly how people get BPD labels – they have their own brains and are not afraid to use them or even do that loudly for everyone to hear. Psychiatry is scared to death of these people so it labels them with the label only insignificantly better than psychopath to make sure nobody listens.

  3. You are not alone!!! The great trick of the current regime is to create isolation it seems on top of creating an atmosphere of complete and utter lies.

    I am so happy for the people who will have the amazing experience of your non mainstream mental health approaches to resolving human distress. Too many people have suffered and been harmed by the medical model which has been a cash cow for pharmaceutical companies and professionals that prescribe and encourage their use. For those of us in distress, it’s a lie.

    You are very courageous to move forward in the face of great foes.

  4. Hi Victor,

    I admire what you’re doing and I also (with Steve) feel very happy for your patients :).

    It sounds like you are aiming your book at your colleagues and perhaps at those “Powerful and respected people have built careers and lives out of these concepts” that you know personally. Do you think that they would be convinced by your book? I’m just an outsider, but I have the impression that convincing currently powerful psychiatrists to change may be the hardest and least likely way to succeed at what you’re trying to do. I suspect that it’s easier to just kind of declare victory and assume that it is established that psychotropic drugs do more harm than good in the long run (since I think it really is established) and to go ahead and create coherent alternatives that really help people. I always think about an MD I once talked to about this who said, essentially, “Patients come to me crying and desperate. What do you want me to do, turn them away without doing anything?”. I suspect that if this MD had a better clinical plan than the ones provided by the APA (in the US), he would be happy to use that instead. He just wants to be able do to *something*.

    – Saul

  5. I am a Licensed Mental Health Counselor, a person with lived experience of my own recovery as a young adult and more recently the mother of a young adult who came through some difficult, existential experiences last year without the medical model. I share a similar lonely path and also find refuge here at Mad In America. I think we need to continue to come together and build humanistic supports that ask, “What is happening?” and “What has happened to you?” rather than “What’s wrong with you?” Thank you for your perspective and for taking the lonely path…you are not alone…

  6. I’m glad you’re doing the work you are doing and wanting to make a difference in how people understand the states of being associated with “mental illness”. I’m glad you are finding safe, humane, life-enhancing ways in which to help people who come to you for help.

    I don’t think things are going to change much until the general public understand what these states of being are and how psychotherapy can help people learn from the “symptoms” and learn how to use their thoughts, feelings, intentions, perceptions and behavior to live more the way they want to live.

    I agree that we need some other term besides psychotherapy although it is the one I use and am comfortable with. Although I’ve learned that, with some people, I have to say “non-drug psychotherapy”.

    Keep going.

  7. Instead of “psychotherapy”, how about “accompanied self-rehabilitation”? (from the South American accompanier of psychotic people, Alberto Fergusson)

    Or how about “partnership” or “ally in healing”?

    The word psychotherapy can have the feel of one party (therapist) doing something to the mind of the other (patient); but that is not its origin. It comes from the Latin and Greek words that mean “cure” and “heal”. If we consider it to mean healing of the mind then psychotherapy might be an appropriate term.

    • Wow, I never thought of that! A “midwifery” model would be the perfect counterpoint to the “medical model,” as the basic focus of midwifery is to help the mother realize that it’s her birth and that it’s normal and that she has the capacity to do it, and the midwife is only there to gently assist the way through any sticking points. I also like the idea of “giving birth” to a new spiritual awareness – definitely comports with a lot of what I hear those experiencing “spiritual crises” describing.

      Great information – too bad the mainstream of the field appears to have forgotten their origins so completely.

      —- Steve

  8. Walking the path of truth and integrity can, indeed, be a lonely journey, especially in a corrupt world. That’s where we find our strength, trust, and the connection to our own voice and spirit, so you are good example to your clients. Keep up the courageous work!

  9. Dear Victor, Thank your for the work you are doing rethinking and challenging the Medical Model. I recently retired as a clinical social worker, having worked with people through a variety of mental health and social work systems for almost 40 years. I spent my entire career in constant conflict with all the Medical Model stands for. It truly made for some very “lonely” professional times, as you report. I hope in your project challenging the Medical Model that you will examine and utilize the ACE’s Study (Adverse Childhood Experiences Study), and the related research in neurobiology and epigenetics. I came across these related materials near the very end of my career, but they totally changed how I understood and worked with my client’s struggles in daily life. One understands at a visceral level that trauma impacts us in profound ways. The ACE study and the related research clearly identifies the “how” and “why” of trauma’s impacts, and thus bypasses the Medical Model “labeling” as “symptoms” the experiences that compose our own and our client’s lives. The question becomes not, “what’s wrong with you?” But rather, “what happened to you?” When we begin to explore the collective trauma of the Native Alaskan population I worked with, we see that traumatic experiences have been passed intergenerationaly and can be traced back to colonization, boarding school trauma, loss of land and spiritual traditions, etc. As a therapist how could I individually “diagnose” members of a group, who have been “collectively traumatized” by “my culture” while ignoring their shared intergenerational experience, and replacing it with the atomized world of the DSM? I could not. Ethically, morally, simply as a fellow human, I could not. By tracing trauma back even further, we see that we of European decent brought our own horrific history of intergenerational trauma related to hundreds of years of the Holy Inquisition, countless European wars, feudalism, the witch burnings, the Crusades, etc. which created the dehumanization of European culture necessary to let Columbus and all who followed transmit that trauma to the native populations in myriad and brutal forms and ways. As I continue to read, think and write about the world, I have come to see this powerful shared history of both past and current trauma as perhaps “the” key to understanding where we are as a species, and to imagining a different and brighter future in which we stop the seemingly endless cycles of trauma existing today in the forms of war, interpersonal violence, poverty, sexism, racism, homophobia, etc. etc. I will look forward to following your progress on this project. It is a very important undertaking you have embarked upon. It is one that will not endear you to powerful forces that profit from our current systems, but one that can do great good by challenging the true “madness” of our current Medical Model reductionism of world and humanity into meaningless diagnostic categories to be medicated into submission.
    Warmest regards and best of luck. – Gary Weglarz, LCSW

    • I largely agree with Gary, and many of the above commenters. And thank you, Victor, for working on speaking the truth. My son, much to my dismay, has chosen psychology as an undergraduate major. And I worry that his education will result in nothing but DSM propaganda and misinformation, which sounds like was your experience?

      Although my son is aware of how toxic the psychiatric drugs are, since he was unfortunately raised by a mother who suffered through iatrogenic “bipolar” / actually, primarily, the central symptoms of anticholinergic intoxication syndrome, then the long healing process thereafter. I hope that if he continues in that field that he will end up being a critical psychologist, although he is considering various fields for his post graduate work at this point.

      Those honestly speaking out against today’s “medical model” are traveling along a difficult and lonely journey, I too am grateful for MiA, and to find like minded people. And let’s hope we prevail sooner rather than later, since creating “mental illnesses” in people for profit is not actually “appropriate medical care.”

      Obviously, my personal expertise is in researching iatrogenic “bipolar” / “schizophrenia,” since the central symptoms of neuroleptic induced anticholinergic intoxication syndrome are very similar to the symptoms of “schizophrenia” today. And I know the psychiatrists in practice can’t tell the difference between neuroleptic induced deficit syndrome, the central symptoms of neuroleptic induced anticholinergic intoxication syndrome, and “schizophrenia” today.

      I’ve come to the disheartening conclusion from my past ten years of research that the likely most common etiology of schizophrenia today is doctors misdiagnosing ADRs or withdrawal symptoms of drugs, or ACEs, or symptoms or concerns of child abuse as “psychosis.” Then creating the positive and negative symptoms of “schizophrenia” (or “bipolar”) with the antipsychotics / neuroleptics themselves. And it appears that 2/3 of “schizophrenia” patients had ACEs or child abuse misdiagnosed and mistreated with the antipsychotics, and my guess is it’s likely the other third of “schizophrenics” we’re dealing with doctors wanting to cover up easily recognized iatrogenesis. An ethical pastor of mine confessed this to be the “dirty little secret of the two original educated professions,” after reading my medical research and tale.

  10. It’s true Victor: you are not alone. MIA is introducing us to each other, for which I am so grateful. I read your piece after Corrina West’s and thought they go well together. Her advice to all of us to stop referring to the disease mongering pharma-psychocracy we’re in as part of the “medical model” and to start referring to it as what it is, a “disease model”, may be a helpful way to be clear about your relationship with your professional colleagues and clients.

  11. You are definitely not alone. The loneliness you speak of is all too familiar, as is the solace found here and in similar other places. Perhaps you will check out ISEPP (as recommended by Al Galves) and make it to Boston in October…if so, make sure to say “HI!” As for your comment about “schizophrenia” being the so-called condition you are least familiar with, that happens to be the area that I focus on the most (you can see some of my posts here). I am happy to share any resources you might be interested in, just send me a message. In any case, I wish you luck on this difficult journey. It is one that is worth travelling.

  12. Mr. Morasse, Mad people are standing beside you. When your bio-psychiatric peers are forced to close their practices because all of their clients have “voted with their feet” and ran away from their sanism and pseudoscience, they’ll find all of their “dropouts” with clinicians like you. If I had had access to a psychologist like you when I was a teen, I would have cut my quacks loose faster than you could banter “brain disease”.

  13. You’re definitely not alone in how you see things, even if it often feels that way in certain settings. I also am a psychologist, and back in the 1980’s discovered the “consumer movement” and then the “consumer-provider” movement (now the peer support profession). I found that my views were similar to only a few psychologists, mostly in APA’s Division 27–Society for Community Research and Action, and in the International Society for Ethical Psychology and Psychiatry (ISEPP), which Al Galves mentioned in another comment.

    I also came to realize that that the field of “psych rehab” had more folks in it with similar world views to mine and yours about people and mental health/mental illness. I suggest looking into its main professional association–the Psychiatric Rehabilitation Association (www.uspra.org). Our next conference is in Boston next year and is always an uplifting experience. Also the International Association of Peer Supporters (www.inaops.org); our next conference is in August in San Antonio.

    Hang in there–I’ve been doing this work for a long time, and agree with so much of what you said about it and the comments your post has engendered. It’s hard to maintain your philosophical compass at some times, but absolutely worth it, whether working with folks who are only mildly distressed in their lives (neurotic is the term often used to describe them, or the “worried well”), or those who’ve been pretty badly beaten up by the system and sometimes their own neuropsychology, and have acquired the unwelcome label of “seriously mentally ill.”

    As a psychologist, you’ll be well served by joining ISEPP, and Al’s post reminds me to renew my own membership there.

    Andy Bernstein ([email protected])

  14. Hi Victor,
    Sorry, I put this reply in the wrong section previously.
    Thank God there are so many dissenters-to-the-norm out there! I quit my therapist training because I felt so lonely in a profession that seems bent on conforming a person’s “symptoms” to a model of dysfunction, rather than focusing on the inherent strengths and resilience of the human spirit. Use of the word “empirical” in psychology really bugs me. The only empiricism we are likely to find is direct feedback from clients about whether or not their therapy is helping. Like you I found it very difficult to have a conversation that inspired me or supported this way of thinking, and I began to feel incredibly isolated. The therapy community is very fragmented, and the last thing a therapist should be is professionally isolated, and alas I don’t see that changing soon. I hope you find your professional tribe and continue to find joy in your work. I think you’re onto something very important and probably much more useful to your clients than the more traditional approach.