Therapeutic Credulity


Commenting on this article which is as hilarious as it is infuriating.


I don’t even know where to begin with this article, so I’m just going to dive right in.

This quote: Gallagher could benefit immensely from even a basic understanding of cold reading and mentalism (not part of psychiatry training).

While I’m no psychiatrist, these concepts actually are covered quite extensively in psychological/therapist training, and I’m pretty sure that psychiatrists tend to do undergrad work in psychology, but I could be wrong. I’m sure some med students decide later on to specialize in psychiatry, which I think is pretty ridiculous for very many reasons, most of which because I think psychiatrists should have a very good understanding of therapy before learning the “magic” of psychopharmacology.
The article also mentions: let’s not forget, these are mentally ill patients.
How insulting and misguided! There isn’t a line that divides crazy from not crazy, but there are many markers by which we can determine the level of a person’s functionality, and plenty of highly functional people could still benefit from therapy, including psychopharmacological therapy, and the days when general practitioners play psychiatrist and hand out psych meds just to ease the patient’s fear of being crazy SHOULD be far behind us. But comments such as “these are mentally ill patients” as if that just explains everything about them in a seriously negative fashion are exactly why people are still so concerned about seeing the proper specialist to treat their symptoms.

The author concludes by saying that if we play into a person’s delusion we’re doing them a disservice by reinforcing the delusion. Wrong!
Trust is extremely important in the client/therapist relationship, and a person who believes that they’re being watched by the gov’t, spied on by neighbors, abducted by aliens, possessed etc, are SO used to being placated and condescended to, but ultimately disbelieved. They do not trust mental health practitioners because they’re tired of being treated like a “crazy” person and to them their experiences are (most often) absolutely real. They desperately need someone to believe them. Additionally, I’m a huge proponent of the “whatever works” brand of therapy. If not, what’s to stop me from telling highly religious clients that prayer doesn’t work, and that going to church is just making things worse? I don’t believe in their god, so maybe I think these things are counterproductive, but I have to work within the framework that I’m given. What about 12 step? We know that shit does not statistically work. We have a huge body of studies to draw from, but unfortunately the medical and psych communities in many places still haven’t caught up and believe that some guy and his friend in the early 20th century were qualified to write a manual to treat addiction. Additionally, we all have had clients and people we know who did exceptionally well with 12 step, so it perpetuates the myth that it’s effective as treatment despite evidence to the contrary. So if my client has tried and failed at 12 step for years, but they love it and sometimes it works for a while, do I print out dozens of research studies to try to convince them that the shit isn’t helping and likely making them worse? Absolutely not! This falls under the Ways to Quickly Alienate Your Client and Forever Destroy Client/Therapist Relationships heading. It’s not a good idea to tell people that the things they believe to be true are not true, and that the things they hold dear are dreadfully unhealthy. There is an extremely apt, oft used but grammatically jarring phrase: Meet the client where they’re at. You start by building trust, then work within the framework presented and see where it can be taken. If a person believes that they’re possessed and that they need to have an exorcism, I’m certainly not going to refer them out to some nutjob religious fanatic, but I’ll help them to be sure that the method they choose is safe, and if they get their exorcism and it works, great! But more than likely it won’t work, or if it does it likely won’t last, and I can be there to help them through that, and to help them seek out other options to wellness. In addition, therapy is really all about helping a person to come to conclusions on their own. We’re there to guide them, to ask questions that help them to think critically about their situation and to examine their choices and beliefs in a healthy manner. If I could just tell people, Drugs aren’t healthy, or Your relationship is likely to literally kill you, or You’re just delusional those things aren’t real, and suddenly everything changes for them, well then I’d be out of a job (er, I already am, but not for this reason, heh) and there’d be little need for psychiatrists either. Most importantly with this issue, actual delusions are most likely biological, and irrational thinking, for lack of better or more succinct phrasing, is habit. If the meds work, delusion gone, but the irrational thinking is still there and even if the person doesn’t feel possessed anymore they may still believe that they were or are but that for whatever reason the demon is not active or biding its time or whatever, and they’ll still need assistance to deal with this. Plus, if a person believes they’re possessed they may refuse meds because they’ll say they aren’t crazy they’re friggin possessed, so how do we get them to give meds a try? Hint: Telling them that they aren’t actually possessed but just crazy doesn’t work.

No, I don’t believe everything a person tells me, but I’m not just humoring them either. I understand that what they’re experiencing is frightening and debilitating, and it’s all too real to them. Our perceptions are just as flawed as our memories. A person who is colorblind will see grey where I see pink. That doesn’t mean that they aren’t seeing grey. We perceive things in vastly different ways, sometimes in a very literal sense because of physiology, other times because our experiences, societal norms, family values and upbringing, have colored our perceptions. I can’t impose my values on someone no matter how much I may believe that theirs are wrong or unhealthy. But I can hope that trust, proper counseling, and application of effective therapies (which definitely does include pharmacological therapies) may help that person to recognize which values and beliefs are healthy, which are benign, and which are decidedly unhealthy.

All that said, I’m definitely never going to write a paper explaining that my clients are definitely being haunted and possessed. That’s taking therapeutic credulity a bit too far. :p


What Dylan Knew


I read the most brilliant article today, and would like to share it, as well as my thoughts concerning its topics, a shortened version of which I left in comment form after the article (with a quite embarrassing typo). Anyone with MS, a disability, or know anyone with such, please read:

The author, Marc discusses, among other things, personal identity conveyed through fashion, and how it relates to him. For me, it’s only been 4 years since my diagnosis, but to say “only” seems such an understatement. I refer to everything before as My Former Life, because that’s truly how it feels. As far as appearance goes, I was never one to primp or take any extra care in my appearance, but honestly I didn’t really need to. My hair was wash and go, face usually unadorned, and it was fine that way, I certainly was never accused of being plain. My clothing style was always relaxed, but it was a style. I dressed body shape and age appropriately with emphasis on ease and comfort, but also in a flattering manner, a fashion all my own, what my friends and peers believed to be both effortless and brave, as I never spent the money and time they did preparing for the day, and as far as I was concerned the reason I didn’t make much of an effort (or feel brave not doing so) was because I didn’t really care. When I think back now I realize that I did care, just not enough to inconvenience myself, only just enough that I did choose clothes specifically, but only with care at an almost subconscious level, because really it almost WAS effortless for me. It was an afterthought, get dressed and go. All of my clothes were suited to me because I chose them carefully when I shopped, and I did spend much time shopping. Clothes shopping=fun, right? Today, not so much. Not only can I not afford to buy clothes to fit my new frame, but I really wouldn’t have the energy for a shopping excursion. As many women can attest, weight gain and clothes shopping aren’t easy companions, and just the thought of such a trip makes me feel exhausted with nervous anticipation. As such, I own one pair of jeans that fits comfortably but now has a broken zipper, one pair that fits quite uncomfortably, maybe 2 properly fitting shirts, and an assortment of pajama pants that I’ve deemed appropriate for out of the house wear. I wear slippers almost everywhere, especially if it’s a wheelchair day. Why bother with shoes? I’d expend half the day’s energy trying to put the damn things on anyway.
I try not to think so hard about My Former Life. I certainly did not do so many exciting things with my life as Marc did, but it was full, productive, fun. In my professional life I worked hard to chisel out a career. Based on education and duration I say I was a counselor, but my work experience is all over the map and mostly revolves around two tethers that are human services and entertainment. An odd combination maybe, but they were two things I’ve always been drawn to, and recognized from a young enough age that entertainment would never be a lucrative career choice, not that human services ever made me a lot of money. Throughout my life in addition to doing counseling and working with developmentally disabled people, I owned a printing business, worked at a radio station, directed tv shows, did stage lighting, professional makeup for film and camera, and in my youth, was a model and a stage actress. For fun, I was a dancer and taught dance classes. I miss dancing, and I miss counseling, and I seriously miss driving fast with the top down. For me, my car represented my freedom and nothing was more relaxing to me than hauling ass down the freeway at night, wind in my hair, cranking the music and singing along like I was the only person in the world. Now I don’t even own a car, (it may be in both our names but it’s definitely my husband’s), and when I do drive, which is becoming increasingly rare, I do so slowly, carefully, hunched over the wheel tense with concentration.
I feel as if I’ve been demoted in life. Once vibrant, exciting, fun, now dull and drab. Once respected on a personal and professional level, now quietly humored or outright ignored. I worked with disabled people, in some manner or another, all my life. I heard their stories, shared their triumphs and sorrows, and was definitely no stranger to their struggles. Of course the view is certainly different from my own wheelchair, and the experience of becoming increasingly disabled is far more nuanced than I ever could’ve imagined, but at least in some fashion or another, it is familiar. What is most difficult is this feeling of becoming irrelevant, of losing status, of being pushed aside. My memory and cognition have suffered a great deal. I don’t speak as clearly or think as quickly. As such, I’m easily dismissed. In the time it takes me to complete a thought, that thought has become irrelevant. I believe, more than ever, that I can now empathize with the struggles of increased age more than ever before in my life. In such a short time I lost my career, my youth, my appearance, my self-sufficiency, my memory, and with all of those things, my self-confidence. I find myself telling the same stories over and over again, either because I don’t remember telling them or because I have nothing new to say, and being ignored. Or telling a story about my day that becomes long and meandering because I’m unable to properly organize my thoughts, and discovering that my audience is not so amused by the retelling as I was by the experience, and can’t you just remember a grandparent or great aunt who did exactly these things? I’ll be 37 in two weeks, but now understand my 80 year old grandmother, and believe I understand why she did the things that she did. I know now on more than just a sympathetic level, none of us wants to become obsolete with great dignity and grace, we want to fight and struggle and scream our way there, to rage against the dying of the light, as it were. The only question is, do we endure this struggle internally, or for everyone to see? I’ve often joked, even on this blog, that when I’m really old and living in a home in 5 years, will I be one of the ladies who quietly stares at the wall and is otherwise a pleasure to be around, or one of the old ladies who screams and throws her poo? I still don’t know. I could see it going both ways. I can understand being filled with rage at being talked down to as if I were a child, at the impatience of others while I take a very long time to do a simple task, at the confusion of knowing all I’ve lost, of knowing that I used to be able to do these things and used to remember so much more, and that there’s no way to get them back. I really don’t know if I’ll be able to face these things with outward calm, or if I’ll show my rage to everyone who cares enough to try to help me. I guess we’ll find out in 5 years. 😉

The Should Be Death of Chiropracty


I began watching a documentary today called Doctored. The description states “An investigation into the ‘monopoly’ of the medical industrial complex and how Americans are viewed as patients.” I think to myself, this sounds interesting. I’ve seen many studies regarding how patients are viewed with regards to invisible illnesses (particularly pain) and especially the discrimination toward patients with mental health diagnoses. I have experienced some of these issues firsthand, as I’ve mentioned here in my blog many times, and it’s definitely a big problem. Doctors believe that psychology and psychiatry are simple sciences at best and they have no issue diagnosing and treating psychological issues despite the fact that they have little to no training in the matter. They view counselors as nothing more than a sympathetic ear, a shoulder to cry on, and that they have no time or patience to be that person so they’ll send them off to a counselor or therapist and the patient will have their cry out, or as in the movies they’ll suddenly have this huge cathartic breakthrough and they’re all better. Before that happens, however, they’re treated as a crazy lunatic who can’t tell the difference between pain in their body and pain in their mind, so unless they go have that breakthrough moment and can get off the psych meds (that possibly the doctor has prescribed themselves) then the person is viewed as unreliable, the doctor can’t take any of their self reports at face value, because this is probably just the crazy talking.

So, I start watching this documentary thinking, I may have something to learn here. It begins with scenes from a taped interview in the 80’s of some doctors angrily arguing with some chiropractors about the veracity of their claims to treat illness using chiropractic theory and methods. Sadly, the documentary does not go on to denounce chiropracty for the sham it is, but vilifies all those terrible, haughty doctors who denounced chiropracty for some many years. The documentary tries to say that doctors and the AMA created a smear campaign against these poor chiropractors who were trying so hard to just help people.

I’ve heard time and again that there’s no scientific evidence to support the effectiveness of chiropracty, and I’ve had my own personal negative experiences with chiropractors and chiropractic treatments that I was ready to believe it. But I realized, I’ve never actually done any research into the topic, I’ve mostly used my personal experiences to bolster my belief in this theory. So, as I’m often wont to do, I began doing some research, and amongst the slew of interesting articles that I read, I found one that was particularly interesting. It is a discussion regarding an article that was posted in a journal of chiropractic medicine by a group of chiropractors and doctors stating in no uncertain terms that there is absolutely no proof, nor veracity to the claims, that chiropractic medicine is a viable treatment option.

So then I wonder, just as the author of the article wonders, where is the outrage? Where are the multiple exposés denouncing chiropracty for the fraud it’s always been?

This documentary is trying to say that medical professionals tried to suppress the miraculous healing that chiropracty had to offer because they wanted to monopolize the trade of healing and healthcare. In reality, doctors happily send people off the chiropractors who will do little more testing or analysis than xrays, if they’re lucky, and xrays are a terrible way to diagnose soft tissue issues such as disk swelling and annular tears. In fact, if a spinal issue were severe enough to be seen on an xray, a doctor would likely be very involved in the person’s treatment. Scoliosis can appear on an xray, and if it becomes severe enough it requires much medical intervention. But the reason that chiropractors are still so heavily used, the reason so many people are referred to them, is because compared to the cost of definitive medical testing, namely MRIs and the follow up treatment that may need to be required for such health conditions that may be diagnosed as the result, chiropractors are cheap. Insurance companies go to great lengths to insist that people attempt to cure what ails them through inexpensive (to the insurance company) chiropracty before ordering any further tests. This documentary’s opening complaint is that the doctors are trying to force out the chiropractors because they’re elitest and money hungry and can’t fathom the idea of a person being cured elsewhere before they extract their pound of flesh from them. (Well, not literally. Or maybe so, if they’re a surgeon. I dunno.) In any case, the reality is that chiropractors have a huge lobby, and have wormed their way into the healthcare community via the government and insurance companies. I won’t argue that doctors are often very elitest, with an attitude that, if you don’t have a medical degree then you shouldn’t have an opinion, and that definitely has to change, patients should, even MUST, drive their own healthcare, and doctors must let them, and help them. They could start by asking the patient to do their own research, and if patients made the effort they’d soon discover the sham that is chiropracty.

I will conclude by giving my own personal experiences with chiropractors. When my back pain first became so severe that I often found myself crawling on the floor, I finally had an angry discussion with my GP that something must be done. I was informed that I first must see a chiropractor. The chiropractor insisted that within 3 months I would be cured, that it may get worse before it gets better, but it will get better. I saw him twice a week, he applied much pressure in various ways to the area of my back that ached the most. It was excruciatingly painful, leaving me shaking and crying after each “treatment”. The chiropractor told me that I had a low pain tolerance, and that it was probably the biggest reason that I found myself unable to stand up when my back hurt. So in essence, he blamed my severe pain on my inability to tolerate severe pain. Three months went by and my back was worse, but he assured me that another 6 weeks should do the job, and he continued to quote the 6 week mark until I’d been seeing him for 9 months and my back was worse than ever before. Finally my GP was ready to refer me to a pain specialist, who immediately ordered MRIs. It turns out that my previous diagnosis of minor scoliosis (via xray) was actually much more debilitating than initially assumed. My spine had rubbed a bald spot on a disk in my lower back. Every time the chiropractor pressed that area the disk would rupture, and that’s why I was in such excruciating pain and that’s why I got worse with every visit. Still, for some reason I decided to see another chiropractor some years later. He came highly recommended by my brother, who was then a massage therapist in the chiropractor’s office. I met with the chiropractor who assured me that he could cure my scoliosis, if I met with him twice a week for 3 months. I had no intention of living through another nightmare of pain and empty promises. Both chiropractors were also involved in extremely shady practices. One of them did not accept my insurance, instead he told them that I paid exorbitant amounts of money out of pocket, then they decided how much they wanted to reimburse me for those costs and would send me a check, at which time I would sign over the checks to my chiropractor. I’m still not entirely certain whether this was legal. The second chiropractor employed massage therapists who were not yet out of school and therefore not licensed, which is 100% illegal. But it worked out great for him in that none of his therapists could rat him out for any of his shady practices because they’d never become licensed.

I have no doubt that there are honest chiropractors out there, who aren’t shady, who believe they’re helping people, who would report their client’s lack of progress immediately to their GP and insist on further testing, but in my experience, they are just as happy to continue doing what they’re doing in order to continue receiving the paycheck of twice weekly visits from someone who is never going to get better.

For further reading on discrimination perpetuated by the medical community:


Socially Acceptable Discrimination


I hate the term “privilege”. I’ve seen this term pop up so frequently recently, and I fully understand what it’s supposed to convey, but to me it seems to carry a very negative connotation, and apparently I’m not the only one. An article was written recently on Everyday Feminism to help people not guilt themselves about their own privilege. Apparently people are wandering the country with privilege guilt, feeling bad for being born into a real or perceived higher status in life. Within this article is a particularly sickening quote: “When spaces are open to those striving to be allies (keep in mind that not all spaces will or should welcome people of privilege), show up.” So basically, people of “privilege” are expected to be discriminated against, and somehow that’s okay. From the same website, another article tells us that while it’s okay to want to remain in touch with our European heritage, and that not all white people are bad, whiteness itself, in fact, inherently is. I find these statements amusing and unsettling. Much of my “European heritage” is Jewish. Does that absolve me of this privilege guilt that’s supposed to weigh heavy on my heart? Or am I supposed to do as these articles state and get in touch with my roots in a positive manner, understand my privileged place in society and use that to enact change? I have quite a diverse mix of ancestry, it’d take quite a lot of time to research all of that, keeping it all positive of course, reminding myself at every turn that whiteness is bad! Whiteness is bad! Then use my new found knowledge to help others who are less privileged than I? It just amazes me that a site that prides itself on being so open, inclusive, and anti-discriminatory would so blatantly socket so many people into a category of which they have no control, and is so broad stroked that you couldn’t possibly know for a fact who fits this category without an intimate look into their personal upbringing and experiences.
The idea of privilege is just too subjective, and it seems like it would be easy for some to make assumptions about another’s privilege without knowing enough about their background that I don’t feel comfortable applying the term to any person, creed, group, what have you, as we’re all individuals with vastly different backgrounds and coming from different places in life. When everyone is screaming that equality is so essential, why single out whole groups of people based on their gender, religion, sexual orientation and race and tell them that they must ADMIT to, even SUBMIT to, the fact that they’re perceived by other groups to have been dealt a better hand in life? It is discrimination come full circle, and I’ve never been willing or able to abide discrimination in any form.
As one with “privilege”, (being white apparently gives me privilege…but being a woman does not, and I suppose neither does being disabled, so do those two things cancel out my one privilege point?), I grew up dirt poor in an equally poor neighborhood being one of the few white children at a primarily Hispanic school, and had the misfortune of being painfully shy, nerdy and always at the top of my class. I got beat up by other kids on a regular basis and they expressed so much rage at my very existence. They accused me of incurring favor with the teachers, not receiving my high marks for actually doing well in class, but solely because I was white. As they stood around taunting me and kicking me with their high dollar, stylish LA Gear shoes, and I lay curled in a ball crying, wearing my sister’s too large hand-me-downs filled with holes that I’d poorly patched myself, I just didn’t understand. I was so completely colorblind as a child, in so many ways, and their rage at something about me that seemed so without grounds or merit was puzzling to say the least. I obviously knew that there was historical racial tension, but to my childhood mind that was a thing of the past. I didn’t have any comprehension of racial tensions, stereotypes, or the anger that these children presented to me. As far as I was concerned, we were all just kids. I wondered where these kids got the idea that my skin color gave me an advantage. As far as I knew, it was more likely my huge forehead, or rather the giant frontal lobe encased within, that gave me what was basically my only advantage at school. I certainly wasn’t any good at sports or fitting in and making friends. It’s tough to make friends with people who hate you simply because your skin color doesn’t match theirs.
When I was 13 I was outed by one of my closest friends at the time, because I confided in her that I felt more attraction to women sometimes than men, and even though at that point, as I told her, I wasn’t even sure what I was or who I was or what I liked, she took it upon herself to tell our entire circle of friends that I was gay. I didn’t realize the waves this would make with my classmates. I expected they’d be more understanding, and had no idea that being gay or bi would cause such a scandal. I was outright crucified for something that I didn’t even know for sure yet might grow to be a permanent part of my life. I was taught by my mother that being gay wasn’t a bad thing, that people are born that way, just as people are born hetero, and in my mind at that time I honestly thought that confiding in my friend was not a big deal. After all, being gay is normal, why would it be a bit of juicy gossip?
I got married very young, while still in college, because I thought that’s what people do, but maintained an open relationship because being bi and monogamous with a man was never going to work for me. Because of my experiences, I applied to volunteer at the LGBT center near my college to work with teens, remembering how painful and scary my surprise outing was, and how confused I had been with regards to my sexuality. I was none too politely declined because they stated that, being a married woman, I’d have little experience with “alternative lifestyles”. I was beyond hurt by their remarks. I explained my history to them, but apparently I was still too mainstream to be of any use to needy teens who may benefit from someone who might understand them. So it seems that I do both have privilege and don’t, and those people who should be most open minded about the state of my privilege or lack thereof are the first people willing to judge me based more on what they perceive that I have, rather than on the struggles I’ve dealt with that make me such an oddball and so likely to be cast out by “privileged” society members.
It’s just too easy for someone to make assumptions about another person’s place in society. We’re such complicated creatures. Some things may seem inarguable, that yes men get paid more in the workforce overall, and that yes in general western culture is heteronormative and cisgendered, but that doesn’t necessarily mean that each and every person from that pool of people does, or is able, to reap the benefits of these skewed standards, and it doesn’t mean that people outside of those circles cannot find their own niches in which they’re able to flourish and compete on an even footing, and it certainly doesn’t mean that the “privileged” members of society are so high up on their ivory towers that they can’t possibly grasp or engage in the struggles of others. Pain is universal, and empathy is a natural reaction for most people.
The social services industry is dominated by female workers, even to the highest levels of management. Payscales at many of the organizations where I worked were preset, if you got the job you got paid for that job, same starting salaries for each position across the board, and if any of us were ever lucky enough to get a raise, which would occurred if the budget allowed and we weren’t on a corrective action plan at the time of our annual assessment, those were all scheduled in advance and given to each of us in the exact same increments, regardless of race, religion, sexual orientation, facial piercings and etc. If I was still able to work, I could still be climbing that career ladder if I so desired. One thing I absolutely loved about working there is that no one was ever discriminated against for their tattoos or piercings, and I worked alongside many members of the LGBT community at all levels, from entry level to upper management. I was treated with just as much respect as the next person, regardless of my mods or sexual identity. So despite people’s insistence that one may be given a better footing as a white male, I’ve worked in at least one industry where this rule of thumb doesn’t apply.
I’m certainly not saying the world is a perfect place, I’m just saying that when we stress that we should make efforts to be mindful of our language and our approach to how we treat people of different backgrounds and affiliations, it’s important to be mindful of ALL of it, and the idea of being a person of privilege implies across the board that that person has something more or better than the rest of us, and from my standpoint, I find that hurtful both as one who would be deemed with privilege, and without.
By accusing someone of having privilege they’re being set aside as different, as unable to understand another’s struggle, as being above any possible personal struggle or status that may make their lives more difficult simply by being who they are. Isn’t that exactly what making them “privileged” society members does to them? It sets them aside as a group to be hated, despised, avoided, and on whom we can place all manner of blame. Isn’t that the exact kind of discrimination we’re trying to avoid?
Despite all my hard work in school I had very few opportunities for scholarships or grants, those being reserved for, not just underprivileged kids, but underprivileged MINORITY kids. I’ve had difficulty finding jobs due to being monolingual. I even had to fight tooth and nail to get promotions in some workplaces for which I was more than qualified simply because I was deemed too young at the time. Within each group, and each subgroup, there will always be barriers, there will always be those who incur favor, there will always be, in one manner or another, inequality, because humans are, after all, only human. Flawed creatures. Prone to creating and staying within niches and protecting their own. Do we really have to create another group to be angry with? Do we really have to build more barriers?
Perhaps those people who are so keen on breaking down preexisting barriers should make more efforts to not build more, to include those who are different as they would like to be included, rather than make as much effort as possible to make them feel guilt, or at least feel keenly aware, of things beyond their control, particularly who they are and where they came from. They would never stand for being made to feel guilt about such things in themselves, why go to such lengths to put that burden on others?