The Degrees on the Wall

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For years, I searched for the one who would save me.

As a combat veteran with PTSD, I’ve lived through decades of anxiety, panic attacks, and nightmares. I’ve cycled through therapists, psychiatrists, psychologists, EMDR specialists, CBT experts, trauma consultants. I’ve sat on dozens of couches—leather, fabric, minimalist Scandinavian design. Always chasing the same thing: relief. Hope. The tiniest crack of light.

Each time, I walked into the office filled with cautious optimism. The therapist came highly recommended. He worked at a top hospital. She had studied at Harvard. He had written books. She was the best in the field. I believed, over and over again, that this time it would work. That all the degrees, the polished diplomas, the framed certificates on the wall—they meant something. They had to.

But I learned, over and over again, that not every credential equals care.

I’m not here to bash mental health professionals. There are good ones. Compassionate ones. People who truly want to help. But in my experience, they are far fewer than we’d like to believe.

The problem isn’t always the training. It’s the tone. The distance. The cold professionalism that’s praised in clinical programs but feels, to someone in agony, like abandonment.

I remember one therapist whose credentials read like a dream: PhD in trauma studies, decades of experience, headed the PTSD clinic in a major hospital. His office was silent, sterile, intimidating. I sat five feet away from him as he nodded quietly while I poured my heart out. He never said much. He didn’t want to “interfere with the process.” When I asked if I could have a cup of tea before we started, he looked puzzled. “We usually don’t… do that here.”

The irony is, what I needed was so simple.

I needed warmth. A little humanness. A voice that said, “You’re not crazy.” A moment of shared humanity. A safe place to be not a diagnosis, but a person.

Eventually, I stopped looking for the best therapists. I started looking for the kind ones.

The ones who sit close. The ones who ask how your day was. The ones who don’t hide behind silence. The ones who, sometimes, if needed, will even give you a hug.

That’s taboo, I know. It goes against every boundary in the textbook. But trauma doesn’t read textbooks. It breaks them.

The therapists who helped me most weren’t the ones who dazzled with their knowledge. They were the ones who made me feel less alone.

They were the ones who spoke plainly, who didn’t pathologize every word, who didn’t shrink back when I cried or dissociated. They didn’t pretend to have all the answers. They just stayed with me, patiently, as I searched for mine.

I came to realize something that many trauma survivors will recognize: the more luxurious the clinic, the less likely I felt seen. The more prestigious the degree, the more clinical the interaction. The bigger the gap between chairs, the harder it was to connect.

I needed less expertise. I needed more presence.

I’m not dismissing training. Trauma work is delicate and dangerous, and it requires skill. But empathy is not a skill you can measure in exams. It’s not something you can frame on a wall. It’s something you feel—or you don’t.

Today, I’m still navigating the terrain of recovery. The symptoms haven’t vanished. But I’ve found a few safe harbors—people who sit with me like friends, not gatekeepers. And in those rooms, healing finally feels possible.

So here’s what I wish someone had told me years ago:

Don’t just look for the expert.

Look for the human.

The one who knows that healing doesn’t always happen through a theory.

Sometimes it begins with a warm voice, a listening heart, and a quiet cup of tea.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

35 COMMENTS

  4. Very interesting article to come across especially as just today, I was talking with my girlfriend and we discussed wether a therapist without a degree or many diplomas to his name, could actually be a good therapist – or if he should even be allowed to be treating people’s minds.

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    • Thank you for this thoughtful comment, Ilay.
      It’s such an important question, and one I’ve wrestled with myself. Sometimes, the presence and empathy of a person can matter far more than the number of degrees on their wall. I’m glad the piece found you on a day this conversation was already on your mind.

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  5. So Dr. Tana Dineen was right when she quoted the researcher Bickman:
    “The role of licensing in affecting client outcome and therapy effectiveness is to date mythical according to Bickman… Unfortunately, as mythical and meaningless as they may be, the average mental health consumer sees these licenses and certificates are totems of real professional power – as proof of the ability to understand, to help and to heal.”
    Quote taken from here: https://totalmentalhealth.info/how-well-does-psychotherapy-work-mental-health-workers-tell-the-truth/

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    • A very important quote! Having a degree conveys no magical power to understand or help others. I used to work a volunteer crisis line, and I found my engineers and computer programmers were often far better at helping than the degreed professionals who worked or volunteered there. And such success as HAS been shown in therapy appears to be directly related to the relationship to the practitioner, not the school of therapy practiced.

      You can’t train someone to care and be emotionally available, no matter how many years they go to school. And some folks come by it completely naturally with zero training whatsoever. The results are all that matter, and the results, as quoted above, do not speak well for therapy as a profession!

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      • Thank you for this, Steve.
        Your words cut to the heart of it. I’ve met people with no formal training who could hold another person’s pain with grace and presence and others with all the credentials in the world who couldn’t tolerate a moment of raw emotion. The human connection is what truly matters, and sadly, no degree can guarantee it.

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    • Thank you for bringing this up and for sharing the quote.
      It’s a powerful and provocative perspective. The gap between what licenses represent and what actually heals is something we don’t talk about enough. I think many of us have come to realize that real understanding often comes from presence, humility, and shared humanity not just credentials on the wall.

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  6. General info about trauma (which you may know):

    Trauma is healed by self-compassion. If you don’t want trauma, become a kind of Budha of infinite compassion to (the wounded part of) yourself.

    Self-compassion can be blocked by guilt. Ask yourself it someone didn’t provide you false information (when you killed your friend, so that it’s not really your fault), if someone else wouldn’t have done that mistake too.

    Or in the realm of modified states of consciousness, lucid dreaming seems to be a useful tool to heal or alleviate PTSD, though I haven’t tried it myself :
    https://www.madinamerica.com/2023/09/embracing-the-shadow-charlie-morley-on-lucid-dreaming-as-therapy/
    for instance.

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    • Thank you, Jean-Philippe.
      You bring up some profound and thoughtful points. Self-compassion can indeed be both a path and a barrier, especially when guilt or shame stand in the way. I appreciate the mention of lucid dreaming as well; I’ll definitely take a look at the link you shared. Grateful for your presence in the conversation.

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  7. It’s harsh, the fight is never over and there are always more demons in the way. Im currently fighting a few myself.
    The story you tell sounds tough and heartbreaking, so many letdowns, the hope that goes away, the pain that lingers…
    Thank you for sharing this

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    • Thank you so much for your words, Hana.
      Yes the fight is relentless at times, and the demons keep reinventing themselves. I’m sorry you’re in the midst of your own battle right now. Please know you’re not alone. Your response means more than I can say.

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  9. Such a creative thinking analysts of diploma as power tool. Thanks.
    I think degrees of healers of any kind a complex web and hard to untangle.
    When did the use of diplomas start? Initially surgeons like the poet John Keats were called barbers and had an apprenticeship type program. Keats was medically knowledgeable t when he became a caregiver for his brother dying of TB he knew there was a good chance he would die young. Always admired him for that caring but bitter choice. So he probably had no diploma.
    There is the concept of Apescolplian Authority which is an unspoken social contract of power transfer between healer and patient. This goes back to the Greeks. Not sure how that was handled in indigenous peoples?
    The Roman Catholic sacrament of Penance was after the Gospels created renewed after in Ireland where folks would come to talk to the village priest who was usually the only literate person around. Same concept with a village Rabbi or Iman.
    Females once did this but more than not sideways and underground. Midwives. I am sure they heard much. And a new Russian Orthodox saint. St Olga in Alaska. And indengenious midwife who dealt with sex abuse issues.
    When my mother was a MSW she worked on liscencing as to give that profession more skin in the respectable profession game. It did not turn out as she hoped. It – the office/ board more of a game than not. Get your CEUs and some folks the trainers made good money from the need for CEUs and I bet in every healing type profession.
    Patch Adams fought this . Other folks too in different ways and always roller coaster paths. Anne Scraff Wilson was big then not. Family Therapy Jay Haley big than not. Group Therapy Irving Yalom big then not. Elizabeth Kubler Ross with death and dying big then not. And no institutional memory of this no archives so folks can reinvent the wheel abd say look what I discovered and a peek in history Nope it wasn’t you.
    We need healers and helpers. The one quality I have looked for and not found is the I don’t know sense and let’s work on this figure out as much as we can. Curiousity how did you figure that out? How did you come up with that tool? And no need to be big . Perhaps postage stamp little degrees from now on.

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    • Dear Mary,

      Thank you so much for your deeply thoughtful and beautifully woven response. Your words stayed with me.
      I was especially moved by your invocation of John Keats, how knowledge and tenderness can coexist outside formal recognition, and by your reflections on Asclepian authority and the lineage of village healers, priests, midwives, and mothers who have long carried the burden of care with little institutional validation.
      You articulated something I’ve struggled to put into words: that behind every credential there should be, not always is, a humble “I don’t know,” a willingness to wonder aloud with another person.
      I also loved your “postage stamp little degrees” what a perfect image. Quiet authority. Earned not by walls of certificates, but by listening, witnessing, staying.

      Thank you for sharing your voice. I’m grateful for it.

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  13. Omgoodness, Yishay, I don’t know how I missed your essay- it is beautiful, poetic prose.

    I’m glad you found some people who could help you find relief. It is astonishing how very few there are in a vast industry full of so many practitioners. Wishing you well.

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    • Thank you so much, Annie. Your words truly mean a lot. You’re absolutely right, it’s heartbreaking how rare true healing relationships are in a system that’s supposed to help. I’m grateful I found a few. And even more grateful for thoughtful readers like you.

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  14. This is all so true and very well expressed Yishay. I experienced a traumatic ordeal after briefly seeing a cold, deceitful psychiatrist for “help with sleep meds” after chemo and steroids had caused sleep issues. When I searched for a psychologist who could support my healing I didn’t have much luck. One was a older man who was trained in working with cancer patients and held many degrees. I attended a number of appts but didn’t find them very helpful and he seemed very bored. One day my appt was 1 pm. I was feeling weak that day and got a friend to drive me. It was a 35 minute drive so I got back home at 2:40 pm. The psychologist phoned me at 3 pm. and stated it was very important that I come back for another appt at 5 pm. that same day. I got excited thinking it must be something very important so called my friend and arranged to go back for 5 pm. (his last appt for the day) It turns out he had a cancellation he wanted to fill and as I talked during that appt he actually nodded off a couple of times. Sigh. That was a very costly day and I didn’t go back again.

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    • Dear Rosalee,
      Thank you so much for sharing your story. I’m so sorry you had to go through that especially after such a physically and emotionally exhausting time. It’s heartbreaking how often people in pain are met with boredom or indifference, when what they need most is presence and care.
      I truly believe healing begins with being seen not as a diagnosis or a time slot, but as a full human being. I’m grateful you’re here, and I hope you’ve since found better support.
      Wishing you continued strength and gentler days ahead,
      Yishay

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      • Dear Yishay, Thank you so very much for your kind reply. I highly commend you on your brave military service and also wish you the best on your healing journey.
        To be honest finding the the Mad in America website and reading various articles and essays, such as yours, has been the most helpful and validating to my healing. I am very grateful to Robert Whitaker and his website, and how he has bravely stood up for those who were being harmed but were also oppressed and silenced.
        Congrats on writing your book! I will be on the look out for it in October 2025.

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  15. Another superb piece, causing a small lump in my throat. Thank you. Have you read “Achilles in Vietnam” by Jonathan Shay? I would guess so, but if not, I highly recommend it. He sculpts the concept of “moral injury” out of pure marble. Quite an achievement for a noncombatant. Another gem is a 1987 short story by Robert Stone in the New Yorker, “Helping”, which resonates with what you describe above from the veteran’s point of view. Both of these works surged unbidden into my mind while reading your essay.

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    • Dear MJ,
      Thank you so much for your kind words they truly mean a lot to me.
      I actually hadn’t heard of Achilles in Vietnam or Robert Stone’s Helping, but I’ve just looked them up and they sound incredibly relevant and powerful. I’ll make sure to read both.
      Grateful for your thoughtful recommendations and for taking the time to write.

      Warmly,
      Yishay

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  18. Dear MJ,
    Thank you so much for your kind words they truly mean a lot to me.
    I actually hadn’t heard of Achilles in Vietnam or Robert Stone’s Helping, but I’ve just looked them up and they sound incredibly relevant and powerful. I’ll make sure to read both.
    Grateful for your thoughtful recommendations and for taking the time to write.

    Warmly,
    Yishay

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