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So You Want to be a Therapist…

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By the end of the day Monday, it will have been 32 days since I’ve had a full day off.  And I’m not sure if Tuesday should really count, because I have to go to the dentist, which is sort of like taking a day off to be tortured for an hour or so.  (I’m pretty sure hell involves some lesser demon grinding that fluoride goo into your teeth, and deliberately getting it all over your gums while only letting you rinse your mouth out roughly every 45 seconds). Then it’s back to work on Wednesday.  By next week, things should slow down some, although I fear I may have just jinxed that.

Now, in fairness, some of those work days involved only a few sessions, plus attendant phone calls and paperwork.  But some involved 14 or 15-plus hour shifts or a ten hour shift transitioning into a three-hour assessment, or…  At any rate, all of those hours were tallied up between my full-time job and assisting in the start-up of a new practice.

Another thing to consider is that my full time job is in crisis services/crisis intervention, which is sort of an ugly stepchild (with apologies to ugly stepchildren everywhere) of that highfalutin really real therapy.  Metaphorically speaking, we in crisis services slap on the splints, and close wounds with superglue, and let other people set the fractures proper, and heal up the deeper damage.  Unlike most jobs in the mental health field, crisis services involves round-the-clock shift work—Hollywood depictions of therapists who are accessible 24-hours-a-day notwithstanding.

Of course, movies and TV shows are probably where most people get their ideas of what being a therapist is about.  And if one accepts those portrayals, therapists are all a bunch of immaculately-dressed, well paid, eccentric/brilliant and/or unpleasant/neurotic people with amazing office space who can’t keep from having affairs with their most attractive but least stable clients.

And while that is pretty much my life in a nutshell—aside from all of those parts—getting to the stage of your career as a therapist where you make a high-six-/low-seven- figure income by sitting around dispensing wisdom to the worried well is a potentially treacherous path that is not for everybody.   So it’s probably much better to just embrace the idea of filling a role more like Mariah Carey’s Social Worker character in “Precious” than the jet-setting millionaire therapist she played in “Glitter.” (Admittedly, I haven’t seen “Glitter” for a while and may be misremembering some things).

The short version of how the process works is: first, get a bachelor’s degree.  It doesn’t necessarily have to be in psychology, although that might help.  Once you’ve realized your bachelor’s degree doesn’t really count for anything, and everybody you know who skipped college is making more money than you, go back for a master’s degree.  Don’t worry, there are plenty of private schools out there now that will gladly take insane amounts of your money (or the government’s money that you get to pay back) so that you can get a master’s degree.  Be forewarned that in order to get a master’s degree that will be good toward becoming a therapist, you actually get to borrow money to pay a school so that you can go work for an agency for free for a period of roughly nine months.  The length of your unpaid employment will depend on how quickly you can rack up hours meeting with clients and your supervisor.  In most instances, getting the hours shouldn’t be that problematic, because there’s a good chance you will be saddled with a far larger caseload than you can reasonably manage, especially since you won’t really know how to manage a caseload.  Your clients are likely to remind you on a regular basis that they are very aware that you don’t know what you’re doing and that they would prefer to have a real therapist.  Don’t let this bother you—most of them would say the same thing if Alfred Adler himself came back from the dead for the sole purpose of conducting sessions with them.

Once you have your master’s degree, try not to think about how much money you owe in student loans—you can’t possibly afford the therapy that it would take to manage your anxiety and your sense of hopelessness about ever paying it back.  One good thing, though, is that you are now probably able to get a job where you are making as much or slightly more than at least half of the people you know who skipped college altogether.  Of course, given the severe drubbing the public mental health system has taken in budget cuts over the last decade or so, jobs can be a bit tricky to come by.  Assuming you get a job in the field, be happy in this job—you will be stuck here for at least two more years as you attempt to rack up enough supervised hours to qualify for your license as a counselor.  In addition to the supervised hours you need to log, you also get to pay hundreds of dollars to take a test designed to prove that you have learned enough in grad school and your various forms of employment to be let loose on the public without supervision.

Now you can open a private practice and just let the cash roll in—assuming you can find and maintain a big enough client load in a space with a reasonable rent payment.  You might also want to go through the painstaking and tedious process of getting on various insurance panels, or establish your suitability to take on government contracts, or…whatever else you need to do to stay afloat.  There is no shame in moonlighting in the food services industry, although you have to remember not to acknowledge any of your clients should you, say, end up delivering a pizza to their homes—unless they acknowledge you first.  And depending on the specifics of your various licenses and endorsements, you will pay hundreds or thousands a year to keep up those endorsements, as well as paying to attend various seminars and conferences to keep up your ongoing education credits in all of the relevant fields.

Just remember that anywhere along this process, anybody who gets mad at you for whatever reason can file a complaint causing you no end of distress and the possibility that you will lose everything you worked for.  Keep up your liability insurance payments and remember that homicidal ideation can be grounds for a mental health detention.

On the other hand, if you want to be a life coach, all you really have to do is watch a minimum of four episodes of “Scott Baio is 45…and Single,” (which, admittedly, is getting much harder to track down) and find a web site that allows you to print off a life coach certificate—I think Crayola’s site has some good ones.

We-ness and the Fog of Buts

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Therapists often get caught up in trying to find unique ways of expressing fairly common ideas.  On the one hand, this can be a great way to get clients to recognize a simple truth by, for example, visualizing it in a new way.  On the other hand, expressing an idea with some catchy, novel phrasing can have unintended consequences, frequently making the idea or its expression off-putting or even comical.

A short while back, I was watching a video feed of a seminar where the speaker, discussing elements of couples and family therapy used the phrase “we-ness.”  The first time he said it, I was jarred out of my passive viewing of the seminar.  Did he just say what I thought he did?  I scanned the image of the PowerPoint slide projected on the wall behind the speaker.  There was nothing there that could sound like what I was relatively certain I had heard.

Now, for those of you who don’t immediately recognize the hilarity of the phrase, say it out loud.  If that doesn’t work, take a moment to have any eight-year-old read the word, and check his/her reaction.  If need be, ask them to follow up with an explanation of what is so funny. 

For the non-eight-year-olds (and those completely out of touch with their inner-eight-year-olds) who might be reading this, “Weenis” or “wenis” is one of those ultimate insult-sounding non-insults.  It combines “weiner” with “penis” yet doesn’t actually mean anything ‘dirty’ at all.  Depending on the source, some claim the word refers to one’s elbow, or the skin of the elbow.  At any rate, it’s one of those words you (or your eight-year-old self) could say again and again, even with adults around, as you protested that you didn’t say anything wrong.  “All I said was ‘weenis.’ That’s not a dirty word.  I don’t know why he’s so mad that I called him an elbow.”

The seminar speaker used the phrase “we-ness” again, but clarified by contrasting it with “me-ness,” which I suppose could be confused with “meanness” to those of us using actual words.  The we-ness/me-ness (weenis/meanness?) divide essentially means that members of couples or families have to recognize their connection to one another, and make decisions that are mutually beneficial, not get caught up in their own individual  and frequently selfish needs.  A quick “Google” search led to the knowledge that “we-ness” is really a ‘thing’ (pun intended?) in certain therapy circles.  Or perhaps it’s some sort of maturity test for couples.  If a therapist uses the phrase and gets no giggling reactions, the members of the couple are mature—or perhaps not paying attention.  If the couple has a sudden, jarred reaction, they weren’t paying attention, but now they are, if for no other reason than to wonder what the hell the therapist just said.

But the phrase immediately got me to thinking of other botched ways people could present concepts.  The following night, I was discussing with a client how she was closing herself off from each possibility of how to resolve a particular issue by saying, “yeah, but…” or “I could do that, but…”  For each route she could run, she was predicting a negative outcome, so refusing to even try.  There are plenty of clinical and non-clinical ways to explain this kind of thought pattern, and I used one of those go-to explanations involving cognitive distortions and how to get past those, but it occurred to me that I could have engaged the following explanation, perhaps to much more memorable effect…

We are always and forever at the intersection of many roads, like at the hub of a wagon wheel, forever faced with the option to go down one road or another.  Even when you have nothing pressing to do, there are all kinds of roads…read a book, take a bath, watch a TV show, clean out the closet…  It is only when we become aware of a decision we have to make that we really begin thinking about the roads.  The more important the decision, the more deliberately we need to consider the roads.  But also, with the increasing importance of a decision, the more likely it is that we are going to cloud that decision with doubts, fears, or paralysis of some sort, the more likely we are to mentally block some of the options. 

Now, each time we look down a road, we have the option to take that road, or to consider that road as one among many choices.  As long as we have not closed that road off, the path is clear.  But as soon as we shut ourselves off from a possibility, as soon as we say, “I could take that road, but…”, we have decided that that road is no longer a possibility.  It becomes obscured, cut off.  A fog settles on that path, blocking your view, a fog you have place there with a “but.”

Each road that you look down and say, “I could do that, but…” becomes yet another road, obscured with the fog of a but.  This road gets a but so it becomes fogged.  That road gets a similar fog of but.  That road gets blocked by but fog as well.  Pretty soon, we find ourselves standing at a hub that was once a center of possibility, but is now just a point from which we cannot see anything.  We are at a point of loss and confusion, surrounded by the fog of buts.

Now that we are all fogged in by buts, though, we need to remember that fog is not permanent, fog is not solid, fog can be lifted.  We don’t even have to commit to a particular path to lift the but fog from that path.  We just have to shut down the but.  Shut down the but, and the fog will lift.  The path will become a possibility again.

Certainly some paths will be better suited to our goals and needs.  However, it is much better to consider the pros and cons of each decision, leaving all of our options open so that we can make an informed choice, rather than fogging ourselves in with a bunch of buts.  

America’s Hate/Love Relationship with Sex Offenders

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If you use social media enough, it’s not that uncommon to come across ‘memes’ about how sex offenders should be maimed or killed in some horrible fashion, memes involving ideas like “Why use animals for laboratory research when there are so many sex offenders available?” or ugly, violent images tagged with bombastic proclamations of homicidal ideation toward anyone who would “hurt my children.”  Now, I understand the desire for a simple solution to a complex problem, but is there really some ‘debate’ about whether any of us want somebody to sexually abuse our children?

Arguably, the source of such black-and-white statements is a lack of knowledge, even a commitment to ignore any real information that might lead to a greater understanding of how to address the problem of sexual abuse, or even what is encompassed in the term “sex offender.”  “Sex offender,” to the oversized segment of the population desiring to eradicate problems through violence, is synonymous with “rapist/murderer of children.” 

But the reality of the term “sex offender” is that it applies to plenty of people who have never had any sexual contact with a child, let alone murdered anybody.  I don’t say this to minimize the seriousness of sex offenses, but to point out that, unlike the term “serial killer, “ “sex offender” does not have a single, well-defined meaning.  What’s legal in one state based on, for instance, the age of the participants, can be illegal in another.  What is normal, adult sexual behavior may be criminalized in a state, while much worse forms of sexual abuse are not defined as crimes, or are given much lighter penalties.

For example, if your 16-year-old son’s 16-year-old girlfriend sends him a nude or semi-nude photo of herself via phone, even if it may be legal for them to be having sex in your home state, your son may now be in possession of a depiction of a minor engaged in sexually explicit conduct, aka child pornography, which can lead to being charged with a crime and labeled a sex offender.  The label “sex offender” is also applied to exposers, who in the not-too-distant past were characterized as oh-so-comical ‘flashers’ and given a slap on the wrist. 

The sex offender label includes those convicted of statutory rape, which can include people who, if they had waited a few months, or lived in a different state, would have been having perfectly legal sex.  A 35-year-old software engineer engaging in a sexually-charged chat with a 38-year-old insurance salesman pretending to be a 13-year-old girl is disturbing and isn’t going to lead anywhere positive.  A 35-year-old software engineer engaging in a sexually-charged chat with a law enforcement official posing as a 13-year-old girl could lead to being labeled a sex offender under charges of communicating with a minor for immoral purposes, or attempted rape of a child–if the police can get the engineer to take the admittedly-twisted fantasy a bit further. 

To be sure, those convicted of sex offenses have almost certainly done things that range from the unsettling to the unthinkable, things that provoke reactions from disgust to outrage, things that require some form of restitution to the victims and to society at large—forms of restitution that are provided for in law.  But to lump ‘sex offenders’ into a uniform group whose members are all deserving of murder is to take the Carl Spackler approach to problem-solving: blowing up the golf course to get at the gopher, ultimately making the problem worse.  And, no, I’m not suggesting that the gopher was a pedophile.  I am saying that outright hostility toward “sex offenders” ensures that we will never get to a point of dealing with the problem in a way that might eventually reduce instances of sex offenses—but that’s an argument for another day.

For now, what most baffles me is how the self-righteous anger of those who would annihilate all sex offenders can so quickly reverse itself from being focused on the offender to being aimed at the victim.  While there are numerous recent and not-so-recent examples of this, Steubenville immediately comes to mind as a town that is now synonymous with rape and rape cover-ups.  It is also synonymous with blaming the victim.   And blaming the victim is just a different way of saying “siding with the sex offender.”   Let’s be clear about that: to whatever degree one blames the victim, one is, to that same degree, siding with the sex offender.

So how does the threat to smoke out and crush every evil, lurking sex offender get transformed into threats of violence against sexual abuse victims?  Well, when the offender is no longer some random, unshaven, greasy-haired creep in an arrest photo shown on the local news, but instead a high-school football star who is well-known in the community; and when the victim is no longer an unquestionably-innocent seven-year-old, but a 16-year-old girl who got drunk at a party; large swaths of the public suddenly decide to love the sex offender and hate the victim. 

In such situations, all of the Internet-clogging-bravado that fuels adolescent fantasies of being the slayer of sex offenders suddenly gets channeled into death threats and, astonishingly enough, rape threats aimed at high school girls.   Justifications are created to excuse the ‘dumb mistakes’ made by the teen sex offenders who apparently no longer deserve any consequences for their behavior.  And the Internet equivalent of pitchforks and torches are taken up in service of ridiculous arguments about how teen girls need to recognize that if they are going to behave like drunken sluts, they have to accept the responsibility for being sexually assaulted.

So, if you’re going to be all black-and-white about how much sex offenders deserve to be burned at the stake, then don’t pull them from the fire so that you can toss their victims in.  If you so enjoy black-and-white thinking, the only absolutes involved are that nobody deserves to be sexually assaulted, and that nobody has the right to sexually assault anyone.

If things are so black and white, then ask yourself why you would ever choose to side with sex offenders against their victims. 

Dr. Keith Ablow’s Political Hero, the Unabomber

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On June 25, 2013, Dr. Keith Ablow, rogue psychiatrist and resident Fox News psychobabbler, desperate for attention, published an article on the Fox News website entitled “Was the Unabomber Correct about the Horrors of Technology Combined with Government?”

Apparently, the main basis for Dr. Ablow giving an Internet-based high-five to Ted Kaczynski, aka the Unabomber, is that Kaczynski’s Manifesto, “Industrial Society and Its Future” is critical of “leftists” and the “politically correct.”  Dr. Ablow’s support would appear to come under the concept of ‘the enemy of my enemy is my friend, even if the enemy of my enemy is a murderous psychopath with rambling, incoherent ideas that only partially coincide with my own ridiculous beliefs.’  Or perhaps Dr. Ablow just recognized Kaczynski as a fellow traveler on the road of ill-defined political positions using shallowly-explained psychology in an attempt to justify paranoid delusions.

Dr.  Ablow acknowledges at the outset of his article that we may not have had access to Kaczynski’s delightful little thesis if Mr. Kaczynski hadn’t demanded its publication under threat of blowing up more people if he didn’t get his way.  Yet, while Dr. Ablow’s article states repeatedly and in bold that blowing people up is not good, and Kaczynski really shouldn’t have blowed those people up, and No!! I really, really mean it!!  Blowing people up is really, really bad!! he still insists that Kaczynski’s ideas “are increasingly important” and “cannot be dismissed.”  I assume the bolded statements exist so that there is a legal wall shielding Dr. Ablow and Fox News if anybody takes Mr. Kaczynski or Dr. Ablow all that seriously and decides that blowing things up is actually a useful solution to whatever-the-hell it is that either of them are talking about.

Of course, taking Dr. Ablow seriously in this (and most other) case(s) is rather difficult for any rational person—which includes a whole lot of people who don’t need bolded statements telling them not to blow people up.   But perhaps Dr. Ablow just plain doesn’t realize that what generally happens with the manifestos of psychopaths is that they are dismissed, except by other psychopaths.  Instead, Dr. Ablow elevates Kaczynski’s explosives-backed malarkey to the heights of time-honored literature, saying it “deserves a place alongside” Orwell’s 1984 and Huxley’s Brave New World.

What is truly adorable in Dr. Ablow’s column is how he imagines Ted, sitting in his cell, recognizing just how correct (not politically correct) he is (as opposed to the type of psychopath who would acknowledge that maybe he had gone a bit too far) all because people use Twitter, Facebook, and GPS too much.  Dr. Ablow even imagines engaging in a mind-meld with Ted where they jointly recognize the evil caused by the Internet (President Obama used it to get elected) and engage in paranoid delusions about President Obama “making a play to disarm” American citizens.  Yes, there’s nothing that shores up your argument quite so much as being in (pretend) agreement with somebody who hid out in a shack in the woods and planted bombs in alleyways so that he could defend, as Dr. Ablow says, “individuality and autonomy” or what “constitutes the core of a human life.”

Never mind that Kaczynski’s work, among other things, indicates his support for radical environmentalists, as he tries with much confusion to explain why they aren’t really leftists.  Never mind that Kaczynski advocates the destruction of technology and the collapse of the economy, stating, “conservatives are fools: They whine about the decay of traditional values, yet they enthusiastically support technological progress and economic growth,” which “inevitably break down traditional values.”  Never mind that Kaczynski ridicules Constitutional rights as bourgeois tools for enforcing control.  What’s really important is that either Dr. Ablow hasn’t actually bothered to read Kaczynski’s work, that Dr. Ablow is counting on anyone agreeing with his ridiculous column to not actually read Kaczynski’s work, or that Dr. Ablow actually suffers from a reading comprehension disorder and didn’t understand Kaczynski’s (largely incomprehensible) work.

Relaxation for Nerds Part One: A Carbon-Thawing-Based Stress Reducer

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Ideally, therapy will involve a component of providing clients with new tactics for addressing everyday difficulties. For example, one way to get clients to develop skills in the area of anxiety management is to walk them through a relaxation exercise, maybe even aiding them in creating or recording one that works well for them. While doing my practicum, my supervisor had me create a stress-reduction ‘scenario’ of my own and present it to a very high-anxiety client.

Now, while the relaxation exercise I actually used in session had to do with the client feeling warmth spread through his body, thawing ice/tension in his veins, it actually came to me first as a relaxation exercise that I didn’t dare do. For the original relaxation exercise involved a certain space pirate emerging from a block of carbonite, inside a desert palace (carefully avoiding overly-specific references that might result in cease-and-desist letters from the lawyers of a certain film director who is still apparently cheesed off about those pirated copies of a certain 1978 ‘Life Day’ Holiday Special that frequently pop up on eBay). And, hey, for any of you overly-ambitious types who want to turn this into a full-blown relaxation video production suitable for YouTube, I’ve been told I have a voice that’s made for radio…or was that a face for radio? Both?

Anyway, it goes a little bit like this…

Close your eyes.

(We start with deep breathing, so sit comfortably in an upright position feet flat on the floor, arms resting on your lap or the arms of the chair. Now breathe in slowly through your nose. Take in a deep breath, all the way into the trunk of your body. You want your trunk to expand. You want to breathe from your diaphragm. You want to do some belly breathing. When your diaphragm has expanded with the air to its maximum stretching point, pause for a few seconds, then breathe out through your mouth, slowly and deliberately. Try to make the count of your breath out match the count of your breath in. Do a slow count as you take in air through your nose, expanding your belly…four, five, six, seven. Your breathing is at capacity. Pause, two, three four. Now breathe out…four, five, six, seven. Continue your breathing in this fashion, aware of the feeling of calm it brings.)

Everything is darkness, and silence, and immobility. In fact, you cannot remember the last time you saw daylight, the last time you heard anything other than the faintest, muffled sounds. You cannot remember the last time you were able to move, to stretch. You realize that this lifelessness, along with the negative feelings it brings, the fear and anxiety, are all the result of your inability to move, to experience the world around you. But you still feel your calm, measured breathing. You still feel a sense of hope…a new hope?

You have a vague sensation that you are in an awkward, standing position, as with your hands up in front of your chest. But you cannot move. Still, this realization of frozenness brings awareness, and this awareness brings with it the possibility of movement.

You have the briefest sensation that you are falling, and feel a slight, jarring in the solid material around you. And then all is silence and darkness again, but you feel a change.

As you continue your deliberate, measured breathing, a slow warmth starts to expand near your forehead. The warmth spreads slowly down your face. You feel as though your head is no longer pinned in one place, that you can move it ever-so-slightly. You feel the stiffness begin to fade from your head and neck. Along with the warmth, you begin to take in other sensations. Your eyes are registering light, even if only a little. There is a reddish light to the transformation that is freeing you. The confined space begins to give way to open air.

Another wave of warmth begins in your fingertips and spreads over your hands, up your arms, to your elbows, your biceps. The warmth moving down from your forehead meets the warmth climbing up your arms at your shoulders. You feel the tension melting out of your facial muscles, out of your neck, out of your shoulders, arms, and hands.

The warmth spreads down your chest and your breathing becomes easier, deeper. The warmth envelops your torso, trunk, your hips, your buttocks, your groin, your thighs.

Your senses are still overwhelmed by the chemical changes, and mechanical whirring around you. But soon, smells other than the faint chemical burning start to reach your nose, smells of desert air, of stale but fragrant smoke, exotic fruits, odd beasts.

As the warmth reaches down past your knees, releasing the tension in your calves, your ankles, your feet, you feel a sense of being freed. And you recognize in amongst the smells reaching you, something familiar, intimately familiar. As the tension, and the binding solidness melts away, you feel no fear, even as you realize you begin to fall. For that familiar smell that reaches you is the smell of security, the smell of one who will not let you fall, of one who will catch you, the smell, the words, the touch all grip you at the same time…the smell, and clutch, and declaration of “someone who loves you.”

About the New Letters

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So, last week I was able to officially add to that string of letters that follows my name when I’m feeling professionally pretentious enough to attach it (like on the main pages of this blog).  The new letters: ASOTP.  I am loath to spell out what exactly it means, as that revelation is usually followed by one of a small number of responses, most of which can be boiled down to either a prurient curiosity or an “Ewww!” reaction—if those are really different things.  Different sides of a two-headed coin, I suppose.

Deep breath, throw it out there, let it sink in.

The letters stand for Affiliate Srrm Orrherrm Treatment Provider.

Ahem.  Let me try that again.

The new letters stand for “Affiliate Sex Offender Treatment Provider.”  In other words, I’m now officially allowed to provide therapy specific to the, uh, needs of convicted sex offenders, generally those who are involved in particular sentencing programs that I won’t detail here, apart from saying that they involve community supervision.  And, more accurately, the “Affiliate” portion of that title means that I am allowed to provide such treatment so long as I have a supervisor who is a Certified SOTP (having a contract with such a supervisor being one of the elements necessary to be granted said letters).

While this particular status is new, my involvement in the treatment of sex offenders is not. I’ve been working in one capacity or another with both juvenile and adult sex offenders for a little over six years now—which sounds like both an insanely long and an unimaginably short period of time to me.

So, why, may you ask, would I want to work with sex offenders?  Everybody asks.  And my answer is usually rather vague and abbreviated, dodging the real heft of the answer.  Let me attempt to present the most straight line formulation of this reason that I can, and please follow closely or you may get a lot of incorrect impressions…

My father was a pastor in the Lutheran Church, Missouri Synod, “stationed” in the Midwest for that part of my life when we were both alive.  My father was killed by a reckless driver exactly one week before my third birthday (which is where a lot of that attachment and blankie business comes in).  My mother, my siblings, and I then moved out to the West Coast, where we soon joined a(n) LCMS church with two pastors.

One of those pastors turned out to be a sex offender, of the hands-on, child molesting type, including incestuous molestation.  For the record, I had always been very wary of this pastor and kept my distance, despite his apparent popularity with other kids/teens in the church.  (Someone call Oprah—or whoever has usurped her throne—to see if we can suss out whether this has to do with repressed memories, supernaturalish intuition, or guardian angels).

The information about the SO pastor became public knowledge during my first year of college, when I was already pretty deep into a crisis of faith.

Bye-bye, faith.

Now if you want something to piss out the flame of your faith, there’s nothing quite like having one of the pastors most responsible for your religious education turn out to be a child molester.  This is particularly dousing when it follows that whole bit about God letting your dad, one of His faithful servants, get killed in a totally senseless accident—all while driving a Pacer, nonetheless (my dad was the one driving the Pacer, not God).

I don’t know how common it is for PKs (preacher’s kids, not Penalty Kicks or Player Kills or Purple Kush{es?} you sporty stoner nerds) to feel some sort of obligation to follow in their father’s (or mother’s in some churches that don’t include the LCMS) footsteps.  But for this kid, who never really even had a conversation with his dad, yet was enthralled by the idea of someone devoting his/her life to faith, there was a perceived pressure to aim, or perhaps a desire to feel at least the smallest inclination to lean, in that direction.  There was a weird, but unfulfilled, sense that there should be a calling—that God should be reaching out a hand, or tugging a leash, or kicking a butt.  I mean, if God could go to the trouble of getting that Jonah guy swallowed up and barfed out at exactly the right times and places, why not at least lay out something more profound than watery eyes during the candlelit singing of “Silent Night” at the Christmas Eve service?

So much for that straight-line formulation.

Anyway, while it took the overcoming of numerous mental blocks and bad habits (okay, the habits are still there) to get to the point where the idea of a ‘life of service’ was even a possibility, the calling wasn’t really perceived until it was time to sign up for final projects in the ‘Abnormal Psych’ course of my Master’s Program.  The list went around.  And while I immediately knew to sign up for a presentation on Pedophilia, I found myself choosing Conversion Disorder (‘hysterical blindness’ and the like) instead.  A sense of guilt immediately began eating away at me, until, a short time later, bothered by what I felt was cowardice at steering clear of the topic I really wanted to study, I tracked down the clipboard with the list, erased my name from the line next to Conversion Disorder, and instead, wrote it next to Pedophilia.

An explosion of anxiety and purpose, roughly on the order of the destruction of the first Death Star, or perhaps equal to the magnitude of the reaction of a normal human digestive system to a Jack-in-the-Box meal, tipped my world forever in the direction I had been looking for…or kind of looking for…or at least in some damn direction for the time being while I decided if this was really what I wanted to involve myself in.

At any rate, it was momentous enough to stick in my brain as some kind of pivotal event that all that previous junk had led up to…or to which all that previous junk had led.

More on that later.

Therapists’ Therapists

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It’s a well known fact that a majority of people who go into the field of psychology do so because we—I mean they—are self-absorbed and trying to figure out why they are such human train-wrecks.  They self-diagnose, bolster their negative behaviors with justifications born from that self-diagnosis and then set about diagnosing everyone else and recommending therapy, all while avoiding engaging in therapy for themselves.

To help compound the failure of future mental health professionals to seek much-needed help, grad school programs for such people often fail to require that students engage in even a minimal amount of therapy.  There are roughly 12 billion reasons why this should be a requirement, and essentially only one reason why would-be-therapists reject the idea that they should get therapy: “I don’t need it.”

But therapists and would-be-therapists arguing that they don’t need therapy, is like meth-heads arguing that they don’t need dental care.   It’s the voice of fear, not confidence.  Or if it is confidence, it’s confidence born of meth—at least for most of the meth-heads, and a few of the therapists.  It’s saying ‘I’ve messed around in my stuff enough, and don’t need anybody else poking around in there, because Lord knows it could all come crumbling apart like that bust of Martha Plimpton I made out of things I picked off my scalp, after I forgot to mist it for four days running.’

And, really, if a student is going through a Master’s program to become a therapist, and doesn’t have at least one or two experiences that frighten/disturb that student into recognizing her/his need for therapy, that student is either the most together person ever, or has built up such impenetrable defenses around his/her frail psyche that she/he is probably in danger of eventually dismembering, freezing, and eating his/her clients bit by bit—either metaphorically or for reals.  (Or else the student is just in a really shitty program where he/she never actually gets challenged to explore much of anything about her/himself beyond early childhood experiences that contributed to his/her preference for natural fibers over synthetics or vice versa).

A large number of mental health professionals, and people in what are dubbed the ‘helping professions’ have a sense that they need to exude confidence, avoid negativity and doubt, and just generally have, or appear to have, their crap together across the full range of life activities.  Any admission that such is not the case can be looked on as an admission that one is not fit to help others.  The big twist, of course, is that if one can’t admit when one needs help, and stop trying to fix everything for everyone else, one really does start to lose the ability to be effective at providing help for anyone, oneself included.

As a confession of sorts, I am not currently seeing a therapist—not because I feel I wouldn’t benefit from it, but because I like to pretend I’m together enough to recognize when I need to seek help, and also because I kind of like the idea of seeing what would happen if I let everything just completely go to hell.  On top of that, I am what I would call ‘therapy-resistant.’  I approach therapy like a jealous magician watching another magician’s show—noting the ‘re-directions,’ and countering with an extra helping of defense mechanisms—‘Just try and abracadabra your way out of that underwater straitjacket, before my Buick hits your milk can, buddy.’  Okay, I don’t really own a Buick.

But, what the hell—I was trying to say something about the problem with therapists not actually getting therapy, and then presented myself as an exhibit to bolster that argument.  But don’t worry about me. I’m completely together.   And I like cotton more than rayon.

Why Respect the Blankie?

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Among an infinite–okay, infinite minus the already-taken selection of names, why “Respect the Blankie?”

The idea for the “Blankie” title came more-or-less spontaneously, when I uttered the phrase while mock-chastising the dogs for having messed up my side of the bed (the other side belonging to my wife, not the dogs–although I don’t bother to disabuse the dogs of the notion that the bed is theirs, too.).  The blankie, after all, is very important to my tactile health–or is that the tactile component of my mental health?  Let’s just say I’m rather attached to that little satin strip along the edge of the blanket (and, no, I don’t mean that in a pervy way).  It helps me think–I think.

A quick Google search revealed that the only other reference to the specific phrase “Respect the Blankie” involved a photo on Tumblr or Imgur, or one of those other vowel-challenged sites (I would add a link here, but don’t want to imply that my site is in anyway endorsed by the photographer or the photographee–look it up if you want–like I said, it’s quick).  The Google search also turned up numerous parenting articles about when is the appropriate time to make children give up their security blankets and/or strategies for making one’s child give up his/her security blanket.  “Ah-ha!” I thought, “I’ve definitely found the name I want!”

‘But why would that be the deciding factor?’ you may ask.  And the answer is, because ‘you wouldn’t hit an instant shepherd,would you?’  (Dammit!!  Another Peanuts reference.  I’ll move on from these, I swear.  Or maybe I won’t anytime soon–I’ve got a lot of Peanuts-related stuff to work out).  At any rate, the notion that a search on that particular phrase would land on articles about making children stop being children was entirely too appealing.  Parents get caught up in the idea that they need to stop other people from thinking their kids are weirdos.  I had plenty of struggles around parenting my own weird, but wonderful, kid that centered on that same notion.  It’s incredibly difficult to get your kids aimed in the direction they really want to travel in–the one they choose for themselves–too easy to try to steer them (subtly or not) where you want them to go, or to give them too little direction so that they don’t feel they have any sense of where they’re going.  Letting them hold on to their blankie may give them the direction they need, or the option to hoist it like a sail, or tie it on like a cape, so they can change course mid-expedition, or mid-flight.

In the world of Peanuts, Linus carted his blanket around everywhere, and, for the most part, it never hindered his development.  On the contrary, it allowed him to be himself at all times and in all places.  He was a boy of conviction, but also a boy who could admit to his lapses in faith.  He could own up to his own fears while also helping alleviate the fears of others.  In short, while his older sister set up shop demanding nickels to dole out abuse, Linus just walked the earth, blanket in hand, distributing sage advice, able to call people on their negative qualities, while also demonstrating the power of love and consideration, embodying the desire to create a better world, and defending the weak (even when that included himself).

I don’t recall ever actually dragging my security blanket around all over the place (although I can’t claim definitively that I didn’t), but it did stay on my bed, and for a time ‘back at home,’ then back on the bed until it essentially crumbled to dust (perhaps more later on why it was there in the first place).  I’ll admit that in my daily life, I tilt toward Lucy-like scolding, and Charlie-Brown-like dread far too easily.  But the goal is to to be more Linus-like, and to allow others the same.  The real trick of security blankets is for those who have them to  recognize why they have them, how they are using them, if they need to throw them out, get a new one, or…whatever other solutions work out best.

Ideally, people will internalize the sense of security that a security blanket represents. But to think that we can actually be self-contained, that there will be no elements of security that we have to draw from outside ourselves is a mistake.  Respect the strength that comes from within, but also the strength that comes from the people and things around us.  Respect the blankie.

A Personal Promise

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Although this is a blog by a Licensed Mental Health Counselor (LMHC), mostly concerning mental health issues, the author promises never to use the word “journey,” unless it’s, like, capital J Journey–as in the Steve Perry/Neal Schon juggernaut whose “Don’t Stop Believin'” closed out the final episode of The Sopranos, and was later usurped by the cast of Glee, forever linking the FM radio hit, in the minds of American TV viewers, with the potential assassination of lovable sociopaths and their family members, as well as with the failure of high-school singers to achieve their dreams of attaining notoriety via a largely-ignored-but-allegedly-national competition.  In short, “Journey” will henceforth be used only in a limited musical context related to happy times with murderous thugs and sad times with singing losers…and with whatever personal associations you connect to that band and their work–but not with your personal growth path through life–except, perhaps, as it intersects with capital J Journey.  The Wheel in the Sky Keeps on Turnin’, and sh*t.

A Largely Uninformed Screed in Support(ish) of DSM-5

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“That book would be like my heart and me / Dedicated to you”

                                                 –Zaret/Chaplin/Cahn, Johnny Hartman, Ella Fitzgerald, etc.

“It’s a poor craftsman who blames his tools”

–My eighth-grade shop teacher (although he probably stole it from somebody)

Depending on what source you consult, it’s either already out or will be out later this week, but the controversy over DSM 5 (and, yes, it’s Arabic number 5, not Roman numeral V, lest people get confused and think the APA is trying to cash in on publishing trends with the Diagnostic and Statistical Manual – Vampire Edition, soon to be followed by Werewolf, Xenomorph, Yeti, and Zombie editions) is already in full swing.  And regardless of its release date, the window wherein (wherethrough?) I can lob opinions and then claim ignorance of the source material as a means of justifying my eventually-recanted opinions is rapidly closing.

One of the main criticisms of DSM-5 is that it is entirely too influenced by pharmaceutical companies, leading it to be nothing more than a prescriber’s guide to rapid labeling of potentially non-existent mental illnesses, thereby justifying the distribution of medications to people who don’t really need them.  Something that people who make this argument often forget to address, though, is that the DSM-5 (and previous editions) also serves the purpose of providing a coding system so insurance companies have confusing numbers rather than actual explanations to use on the forms they mail out when they deny coverage for those medications.  The real test of your mental health care, then, becomes how good your doctor’s office is at submitting the right codes to ensure that you won’t have to pay too much for the medications you probably don’t need, and whether or not your doctor will give you whatever medications you try to convince her/him to give you based on something you saw in a commercial.

My cynical rejoinder to the above claim is: “No shit–the same basic process happened with medical health care. Why did you think it wouldn’t happen with mental health care?  And, really, why didn’t you realize that the pharmaceutical companies already largely instituted that process even without DSM-5?”

My completely naïve and hope-filled response to the above argument is:  “Well, actually, the DSM-5 (as with previous editions) is a tool intended to be used by professionals who are trained in mental health care, and who realize that, except in a relatively small number of very serious mental illnesses, pills are not going to function as the primary means of addressing those issues.  In the hands of these professionals, a diagnosis is more a means of trying to identify what is at the core of a person’s mental health needs, so there can be a common language to use when trying to figure out what kind of strategies might help the clients—only one of said strategies being the use of medications.”

But let’s be clear about a few things.  First, the majority of people working in the mental health field are NOT trained, qualified, or legally allowed to prescribe medications.  They fall into various categories of counselors, therapists, treatment providers, and social workers.  They are the ones who try to address mental health issues not with a pill, but through a complicated process of human interaction (ridiculous, I know, but I read somewhere that it can actually work).  Secondly, and perhaps more important to the current criticism of pharmaceuticals/pharmaceutical companies, the vast majority of people prescribing medications for mental health reasons are NOT adequately trained in mental health.  Arguably, most uses of medications to deal with mental health issues already involve a kind of crapshoot as to whether the medications will be effective, in what doses, and for how long.  And yet we compound this uncertainty by having primary care physicians, who, for example, see patients for eight minutes every three months, try to keep up with changes in patients’ mental health status by ‘tweaking’ said patients’ medications.

To be sure, DSM-5 is flawed, just as DSM-IV (that’s 4, not intravenous) is flawed, although perhaps in different directions.  I am not suggesting everyone in the mental health field fall in lockstep and adhere blindly to whatever is laid out in DSM-5.  But like every professional in every field knows (or should know), you use the tools you have, but with a critical eye, and a knowledge of the tools’ limitations.