Thursday, January 20, 2022

Comments by MichaelKohut

Showing 2 of 2 comments.

  • Michael, What a refreshing article. I worked in the field for 20 years as an LCSW including some time in the VA system. I experienced the attitudes among the psychiatric establishment as brick walls. I certainly knew of my own vulnerability to psychosis prior to going into the field and talked about it in depth for 5 years twice/week with my Psychiatrist at MGH. She chose to never suggest medications for me and felt that I had the ‘ego strength’ to work through and manage states of very high anxiety. I know now in retrospect that that anxiety did in fact break through. It was a struggle for me to maintain my own stability but I did…just barely for years. I did finally disintegrate under a highly unusual set of circumstances that I wouldn’t wish on anyone. Suffice it to say: “I know what a breakdown looks like and feels like from the inside…” It’s terrifying. I’m not out of the woods yet for sure. Life is a daily struggle and total abstinence from alcohol, drugs, cigarettes among other things is fundemental. It takes all of my skill and experience to cope day to day. So I appreciate your position and your emphasis on empathy in treatment and among professional peers. I would love to have worked with you in the field. It’s very difficult to find support among your peers when you’re working in the field. No one wants to touch the stigma of mental illness with a ten foot pole for fear of damaging their own professional facade. I knew the folly of that approach from day one and had to be careful with my boundaries along these lines. I was absolutely won over by Heinz Kohut’s view in ‘Self Psychology’ basically that all or most psychopathology stems from failures in empathy. I know this to be true from my own struggles combined with 20 years professional experience providing care at the in-patient and out-patient levels. I think the real reason most providers are steered away from empathic treatment of clients is becasue the system lacks the continuum of care that is necessary to properly assist someone from the crisis stage all the way through to the point where they can gain the skills and confidence to manage their own affaris and inner states. Our culture is not designed that way. Lack or Housing, education, medical, dental…etc, etc…people are stressed to a degree that cannot be helped in a clinical setting. And nothing is more frustrating for a provider trying to help a person when that provider can see so clearly how ovewhelming are the issues facing their clients. At the very least we should be able to treat them with the dignity and respect that owns up empathically to the reality that anyone immersed in misery long enough is going to break down somehow. Wishing you all the best. Thanks for your enlightened article. Peace