Sunday, May 27, 2012

Whose me am I, anyway...?

As it happens, I've had some interactions with the psychiatric profession of late, and I find that I have many of the same doubts and reservations I had when talking about life coaches and the gurus of SHAMdom as a whole. [See in particular SHAM chapter 6, "Put Me in Coach," as well as the conclusion, "A SHAM Society."]

This psychiatric-interaction business is one of those admissions they say you're never supposed to make public in this era of corporate due diligence and background checks, but what the hell: I'm 62 years old and I've lived the life I've led. It is what it is at this point.

In any case, I come away with more questions than answers, many of them interrelated. Such as:

What is the goal of this process? Is it to optimize the me that I think I am (or should be)? Or to try to reshape me in certain respects so that I am suddenly a "new and improved" version of me, based on the shrink's expert assessment of things?

Is this undertaking supposed to make me happy or make me successful (bearing in mind that the two are not the same thing, and can even be dichotomous)? And is it legitimate for me to privilege my happiness over the happiness of those in my orbit who depend on me? (Yeah, I know, you can't make anyone else happy unless you're happy with yourself, blah, blah, blah...) Here are some further reflections on happiness from a 2007 Wall Street Journal piece of mine that elicited quite a bit of feedback.

And in the context of this endeavor, what constitutes a successful outcome? Is a successful outcome defined as my feeling more comfortable with the me that I am, even if the me that I am (or turn out to be) is not as good a fit with the external world as some other version of me might be? And who gets to make that call? Me, because I'm, well, me? Or others (like, say, psychiatric professionals, who supposedly know what's better/best for me?) Is this ultimately a solipsistic pursuit wherein I'm seeking to solidify my grasp of who I am and what makes me tick...even if what makes me tick is, in the shrink's judgment, counterproductive in the larger scheme of things?

All of this, of course, inevitably leads to, and depends upon, one's definition of Self. (I've blogged on this before, if you care to read, herehere and here.) I don't maintain many close relationships, but as I've said to the ultra-small handful of people who fall into that category, I think I've done the best I possibly could do with the raw material I had to work with. I am a man of many contradictions (as well as demons) and could've easily been a chaotic, potentially dangerous mess of a human being. (There are elements of my past that no one, and I mean no one, knows about.) Nonetheless, I've objectively achieved quite a bit in my lifeI've lived the kind of life that looks good compressed into the format of a resume, with its dry, chronological recitation of facts; I have been at or near the pinnacle of achievement in several realmsreally, in every sphere that was of some relevance to my personal notions of  "self-actualization"...so in that limited sense, I feel like a success. I made the best cake out of the ingredients I had to work with.

But it wasn't the best cake in the bakery. And it didn't fetch the price it should have from those who look to buy cakes. And it certainly wasn't a very tasty recipe for some of the folks who depended on me, like my long-suffering wife, among (too many) others.

Bottom line: What sort of therapist does one go in order to ascertain what the objectives of one's therapy ought to be?

17 comments:

RevRon's Rants said...

Steve, the function of psychiatry really boils down to three elements. The primary objective is purely sociological: to enable the individual to function within the accepted framework of society. The secondary goal is to enable the individual to come to some sense of peace with his/her idiosyncrasies, and if necessary, to either control or modify those idiosyncrasies to the extent that they do not represent significant obstacles to function or internal stressors. Finally, there is the most commonly-held objective - to help the individual achieve "happiness," in whatever way they define it, yet still within the bounds of social acceptability.

The stigma applied to psychiatry is borne of the illusion that other people have achieved a "wellmess" that always manages to elude us. Truth is, everybody has their demons, everybody feels like they've failed in one way or another, and everyone has regrets. Those who deny that fact feed into the mass delusion of normality that "everyone else but me" has achieved.

The most significant - and most liberating - lesson I learned from years working with psych patients is summed up in the title of an old Firesign Theater album: "We're All Bozos On This Bus."

a/good/lysstener said...

I can't say exactly why, but this post makes me very sad. :-(

Anonymous said...

People go to psychiatrists or psychologists because they know something is wrong in their life or they're in crisis. Psychiatry is not magic, it just helps patients clarify the problem in their own mind. If you're asking your "shrink" to make life miraculously perfect with no contradictions and trade offs, you're asking too much. Those extreme and unrealistic expectations alone can undermine your therapy.

Jenny said...

When you talk to yourself, which me do you address? There's your answer. I'll read that chapter again and comment further. That is one bizarre photo, by the way. :)

Anonymous said...

No answers from me on the function and purpose of the shrink profession but you might like this book from a shrink with a less than idealistic view of the results of shrink practice, its almost a 'SHAM' for the therapy/psychiatric industry:

http://www.amazon.com/Manufacturing-Victims-Psychology-Industry-People/dp/1552070123

Thomas Szasz and David Smail(both long time practitioners) have made similar critiques of the shrink business.

Dimension Skipper said...

On the subject of achieving happiness and the dear-to-your-heart associated SHAMminess of "experts" dispensing such advice over the years...

7 Tips for Good Behavior… From the 16th Century

There are some other links therein to related items in the same vein, but I noticed the "Lord Chesterfield" one was mislinked, so here's the correct link...

Seven Tips for “Pleasing in Company” — from 1774

Just thought you might enjoy them, Steve.

And btw I enjoyed this post. I think you raise very interesting and quite valid questions. I also think it's important to ask such questions and not rely solely on blind trust just because someone has certain credentials.

I have no personal experience of the psych profession, but that's not to say I've never had reason to consider getting some or perhaps SHOULD have gotten some for various reasons at different times in my life. I think my view of the profession is similar to my view of God... I have many doubts, but I also can't rule out their effectiveness as a "tool" to be used/consulted. (Hey, wait!... Did I just call God a tool?!?!?! Sorry 'bout that Big Guy.)

I do read many various PsychCentral blog items (the ones that catch my eye and interest) as they pop up in my subscribed "feeds". My guess (and that's all it is) is that if you interviewed many psychiatrists/psychologists you would probably get many variations in answers since there seem to be so many different schools of thought in the continually evolving fields. Those answers may possibly be "boilable down" to a few generally applicable bullet points, but how they propose to get to the specific "answers" for each client would probably be all over the (brain?) map.

Anonymous said...

No answers on 'happiness' either, but I came across this yesterday on the common perception of us Brits as miserable moaners ('whingeing poms' etc, although, being an internationalist, I suspect its a common trait of human nature):

"We don't moan because we're miserable, we moan because it makes us happy"


There's some truth in that I think, somewhere, to be excavated--though preferably not while flat on your back, paying through the nose for endless years(a la Woody Allen) on the therapeutic couch.

Jenny said...

I've been giving this a lot of thought, and yes I did go back and read chaper 6 of SHAM again. A number of people within the "mental health community" have been critical of that world we inhabit.

The two people who come to my mind at the moment are James Hillman and William Glasser, but they are only speaking of what so many of us know instinctively, that psychology and related fields like social work and psychiatry are based on ideas people have come up with to help us cope with people problems. The only way I've ever been able to make sense of it all is to accept the paradoxical nature of life.

In We've Had a Hundred Years of Psychotherapy -- And the World's Getting Worse, James Hillman talks about "archetypal fantasies" and how the "myths that seize us are comforting, because any single one you get into is comforting."

Think about how we cling to our ideas as if they somehow are what keeps us anchored to the planet. In reality, a thing we call gravity is what keeps us from drifting away into the great beyond of space we know is out there.

In my own personal quest or quixotic journey or whatever it is, I came to realize how arrogant it was for me to play the role of therapist; so I stopped participating in the expensive, never-ending credentialing scheme. Nipped it right in the bud, before it got too far.

What I came to understand is that in order to be a successful therapist, one needs to continually promote the self, that "me" who treats people as patients and clients. I'm glad to be done with that phase of life and on to the next, whatever it might be. Find another archetypal fantasy to inhabit. :)

Steve Salerno said...

Thank you, Jenny. That is pointed and beautifully put, for what it's worth coming from me.

RevRon's Rants said...

Ironically, having an insightful, honest, and trusted friend precludes the need for a "therapist." Those individuals who suffer from some organically-based pathology can benefit from pharmacological treatment, but to a great degree, the role of "therapist" is more satisfying to the therapist than to the patient.

When I was pretty well consumed by my own demons, I was working with psych patients, but got the help that I needed from an old Buddhist monk who offered only common sense and brutal honesty, albeit from a very compassionate perspective. I ultimately came to view "therapy" as little more than a tool for confinement and the perpetuation of dependency.

Jenny said...

P.S. The William Glasser book relevant to this conversation is Warning: Psychiatry Can Be Hazardous to Your Mental Health. He talks about the evolution of psychiatry as it has moved away from mental health to psychopharmacology. He also talks about his own pet theory, which includes the idea that "unhappy choices" are why people are unhappy. This book was published in 2003. His "choice" theory has evolved into "reality therapy."

Elizabeth said...

Jenny, I concur with Steve: beautifully put, and, what's more, deeply resonant with me as I too have arrived at the point of seeing the arrogance and more or less utter uselessness of the enterprise. After spending years in it, I must say, with just a little bit of regret, that I don't have much respect for it. Some of its people, yes, but the enterprise as a whole, not much. (I like and respect Hillman.)

Steve, as always you turn out a personal issue into a universally provocative one. I would very much recommend that you acquaint yourself with the Theory of Positive Disintegration (we may have talked about it way back when), which posits that our emotional difficulties are, by and large, creative and necessary for shaping our unique, unrepeatable personalities. IOW, there is no growth without inner conflicts, anxieties, doubts, and even more severe emotional problems.

TPD's approach focuses on understanding such difficulties in the developmental context, without pathologizing them or medicating them away. It is rooted in a very different from the American views, existential -- and tragic, I'd say -- conception of human life, which, perhaps unsurprisingly, brings with it solace and relief (for many).

Most psychological and psychiatric approaches to mental health stress successful adjustment to "what is" as a marker of a healthy person. TPD, contrarian (and correct) as it is, posits that such an adjustment is in fact unhealthy and that a true sign of mental health is positive maladjustment to the unacceptable status quo in the world and usually within ourselves. (You have that in spades, if I'm not mistaken).

Not many mental health professionals in the US are familiar with the theory, BTW, nor would understand and accept it, I believe, as it is fundamentally incompatible with the culture of positive thinking and does not yield to quick fixes.

Elizabeth said...

DimSkip, those tips are quite useful (and somehow I have an impression that you naturally follow all of them).

Elizabeth said...

"We're All Bozos On This Bus."

I agree, Rev. :)

Anonymous said...

By training, I'm a family/marriage therapist, not a psychiatrist (thought I'm married to one). Here's my take: Skepticism, in general, is good. Projection i.e. it's all their (insert: self help authors, psychiatrists, clergy, my husband, my parents) fault is (in general) not so good. I see a lot of projection on this blog, not much introspection. Therapy works much better with a bit of both.

RevRon's Rants said...

Anon, I suggest you read through some of the previous discussions here before pronouncing that there's a paucity of introspection (or, for that matter, an abundance of projection). Such observations remind me of the frequently defensive Freudian therapists' reaction to Berne's work, by which many therapists felt their roles threatened.

Anonymous said...

Have visited a few therapists, psychiatrists or psychologists back in the day, and in most cases they asked what I wanted from them, what I wanted to accomplish out of being together, the ones I saw more than once did anyway.

the therapist wanted to hear what I said I wanted, what I was said I was concerned about and dealing with and what I said my expectations were, and mostly they listen to me for an hour. These get-togethers had a certain precious value to me, I perceived the secret normally unspoken parts of my life known during that hour, a sense of relief. BUT it had a short shelf life, and did not seem to address the concerns I said I had outside of the get togethers.

The ones who prescribed meds as if it were some happy candy or gave me lists of things to do, did not attract me for a second visit. I felt like a pre-existing cookie cutter agenda was being put onto my life.

About 2 years after I had dabbled in that, I did a self-help course called "the est training" and all the neurosis and worry and stuff I would label "junk" was put in a place where it left me alone and where I had the say in the matter of what I obsessed on, and I started obsessing on and practicing on being an awesome human being and being involved with the awesome human race that was around me, and I initiated that not some person outside me. It has had a 40 year shelf life and is still vibrant and alive for me.