Not normal enough for clinical

[arottenapple]

Hello all,

First time poster. I'm a junior at a small college with a 3.45 GPA currently majoring in psychology. Even before I went into my undergrad program, I expected to go to a graduate program after to further my psychology education. I'm going to be looking at Ph. D programs in the coming months, and I know I am interested in the Ph. D path.

When I came into my undergrad program, I thought I was headed for clinical practice. However now I am a little more hesitant. I've spent some time counseling autistics in my freshman year and also worked on a crisis hotline last summer that used a humanistic model and I'm starting to feel like the clinical path isn't for me. What I've been thinking recently, and I posed this question to my girlfriend too, is that I feel like I am not normal enough to be a clinician. I feel as though I cannot connect with people well enough, or I can though I don't display it well. Through my two clinical jobs so far, I felt mental illness was more of a maintence game rather than tying to find a cure. And I know Autism is extremely painful in this regard and hotline services aint great either, so my experience is biased. But I feel as though I am too direct of a person to beat around the bush with someone about their issues, if someone comes to me I want to fix their problem. Not help them cope with it. Has anybody else felt this way? And if so, how did you handle it?

Don't get me wrong, I still have a big desire to help people and am still fascinated with the clinical aspect of psychology. I just feel I'm having a personality conflict. The alternative I've been thinking of is going into academia and research, more specifically I've been intrigued by the revival of psychedelic research that's been going on to treat mental illness. If anything, I could see myself succeeding in that field, psychedelic therapy, since the idea is to bring about a life changing experience and helping the client to confront their problems. But I don't want to base my future education around giving people psilocybin and talking them through it since legality becomes a problem and sounds plain sketchy.

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[cara susanna]

Through my two clinical jobs so far, I felt mental illness was more of a maintence game rather than tying to find a cure. And I know Autism is extremely painful in this regard and hotline services aint great either, so my experience is biased. But I feel as though I am too direct of a person to beat around the bush with someone about their issues, if someone comes to me I want to fix their problem. Not help them cope with it. Has anybody else felt this way? And if so, how did you handle it?

Well, you have to think of it as helping people reach goals, which may include symptom alleviation. The idea of "curing" doesn't really work for me because, at least IMO, it's too black and white. For us, the illness exists because the behaviors are present. If you change enough of those behaviors, the person doesn't meet criteria for the diagnosis anymore. Does that constitute a cure? I don't know. But yes, the client has to be the one to want to change the behaviors and they're the ones who have to agree to the specific goals that are set. You and the client may not always see eye-to-eye on that. That is a frustrating issue and something that I also find difficult about clinical work.

Also, there are a lot of different clinical jobs and clinical settings and your disliking the humanistic model doesn't preclude you from being a clinician. If you don't connect well with people, that would be more of an issue I think.

 

[WisNeuro]

If you can't stand not "curing people" than the clinical realm really isn't for you. While I have seen people get relatively symptom free in some populations I've treated (panic disorder, some PTSD pts), as cara said, a lot of time it's about those goals and symptom amelioration. Take depression, most epidemiological studies would say that if someone meets criteria for a major depressive episode, there is a better chance than not they will have another at some point. Does that mean it's hopeless? Hell no. Maybe you can give them tools to better handle those future episodes. Maybe you help them go from a several month episode with severe symptoms, to a several week episode with mild to moderate severity. That's a huge deal for people.

Just remember that the medical model is the same thing. Giving someone an anti-depressant or anxiolytic does not cure their condition. It manages their symptoms, sometimes with significant side effects, and can sometimes even make the disorder worse (e.g., benzos and some anxiety disorders). Clinical work ain't like Hollywood, it's not filled with these light switch "A HA!" moments. A lot of times it's a slow slog, where progress is better seen at the weeks and months scales with some things.

That being said, there's always research, although that's even more of a delay in gratification.

 

[erg923]

People have to fix themselves. If that's what you crave, then be a surgeon.

 

[horse.renoir]

There's a big difference between this:

I am too direct of a person to beat around the bush with someone about their issues

and this,

autistics

this,

I cannot connect with people well enough

and this

Through my two clinical jobs so far, I felt mental illness was more of a maintence game rather than tying to find a cure. And I know Autism is extremely painful in this regard and hotline services aint great either, so my experience is biased. But I feel as though I am too direct of a person to beat around the bush with someone about their issues, if someone comes to me I want to fix their problem. Not help them cope with it.

Based upon your description, the issue is not that you're (supposedly) direct, the issue is that you believe that coping is mutually exclusive to fixing problems. It appears you don't see people as separate from their illnesses and lack (or are not tapping into) the ability to empathize, and yes--that's crucially important to clinical work.

That being said, clinical acumen is very much something that's learned and gained. Yes, some people are naturally better at it than others, but that doesn't mean great clinicians didn't have to learn how to be great. Your starting point would likely mean needing to change your mindset about psychological illnesses, their etiologies, and treatments according to evidence as opposed to your own intuition(s).

 

[synesthetics]

I don't think it's an issue of normalcy. I would venture to say that many of us don't consider ourselves to be "normal." It sounds like you do not enjoy clinical work... and that it is a little more about you than it is about whom you are helping. If you cannot keep aspects of your personality/opinions in check enough to help your patients, maybe clinical work isn't for you. That's not abnormal, that's why a lot of people aren't interested in clinical work. It sounds like you had a different idea of what this meant going into it, and now that you have some experience, you are realizing that what you were imagining and the day-to-day reality of working with patients were two different things.

Helping people learn to cope is extremely important, because it puts power to handle mental disorders back into their hands. Even if you work toward a "cure" rather than coping and there is full remission of symptoms, what good does it do a patient when relapse (which is highly likely in the course of many-- or most-- disorders) occurs? Then they have to hope for someone else to cure then again? That doesn't sound like an ideal model either.

You didn't mention research, only clinical work. That alone makes me wonder if pursuing the clinical PhD route makes any sense for you. The clinical PhD (as you will read in 90% of the threads with the phrase "clinical PhD") is a research-heavy degree.

Maybe there is a certain population of people which would fit better for your ideals/approach. But in general it seems like a good idea and time to evaluate your goals and skills and to determine if maybe there is a path for you which you haven't yet considered because you got used to the idea that you wanted to be a clinical psychologist. Maybe make a list of the top three or five things you want in your career (i.e. helping others, working with kids, working in an institutional setting, NOT working in an institutional setting, instructing more than collaborating, etc.) and your best three to five traits or skills and see where all that leads you.

Good luck! It's great that you are thinking about all this now rather than starting grad school and realizing it isn't leading to a career which fits well for you.

 

[smalltownpsych]

Many problems can't be fixed and part of life is suffering. Part of being a psychologist is coming to terms with that fact. First we have to come to terms with it for ourselves and then we can begin helping others.

Some of the problems we deal with are a bit clearer though. For example, if you are addicted to substances and continue to use, your life will suck really bad and if you stop using them, then your life will get better. It might not be all peaches and cream, but it will be better than the life you have now. Might do better working with this type of issue than people with autism.

 

[T Brown]

I wouldn't consider being direct as negative trait to posses. It depends on the population and depends on rapport you have with the client. Nothing is "normal" about clinical and everyone has their own style. Take some time off school before jumping into another program. Work a few years and figure out what you really like.

 

[sockit]

Hello all,

First time poster. I'm a junior at a small college with a 3.45 GPA currently majoring in psychology. Even before I went into my undergrad program, I expected to go to a graduate program after to further my psychology education. I'm going to be looking at Ph. D programs in the coming months, and I know I am interested in the Ph. D path.

When I came into my undergrad program, I thought I was headed for clinical practice. However now I am a little more hesitant. I've spent some time counseling autistics in my freshman year and also worked on a crisis hotline last summer that used a humanistic model and I'm starting to feel like the clinical path isn't for me. What I've been thinking recently, and I posed this question to my girlfriend too, is that I feel like I am not normal enough to be a clinician. I feel as though I cannot connect with people well enough, or I can though I don't display it well. Through my two clinical jobs so far, I felt mental illness was more of a maintence game rather than tying to find a cure. And I know Autism is extremely painful in this regard and hotline services aint great either, so my experience is biased. But I feel as though I am too direct of a person to beat around the bush with someone about their issues, if someone comes to me I want to fix their problem. Not help them cope with it. Has anybody else felt this way? And if so, how did you handle it?

Don't get me wrong, I still have a big desire to help people and am still fascinated with the clinical aspect of psychology. I just feel I'm having a personality conflict. The alternative I've been thinking of is going into academia and research, more specifically I've been intrigued by the revival of psychedelic research that's been going on to treat mental illness. If anything, I could see myself succeeding in that field, psychedelic therapy, since the idea is to bring about a life changing experience and helping the client to confront their problems. But I don't want to base my future education around giving people psilocybin and talking them through it since legality becomes a problem and sounds plain sketchy.

In my experience, not as a psych student but as a person with some years on earth behind me who's been trying to pay attention, this is a fantasy. I blame Oprah. It almost never happens, outside of extreme (naturalistic, unpredictable) life situations (like someone almost dying or surviving war or divorcing or losing their job or immigrating under adverse conditions). Life itself builds in the incentives and reinforcers in a much more compelling way than any person can.

I also think the desire to direct that kind of change (which I've also felt in the past, I understand it) is a lot ambitious and a little suspicious. No one person has or should have that kind of influence over another. People come to terms with things on their own (or don't). Ime, a psychologist can reasonably hope to offer their patients/clients an education in particular cognitive-emotional skills, and facilitate small insights, which may or may not (likely not) translate into change.

 

[smalltownpsych]

In my experience, not as a psych student but as a person with some years on earth behind me who's been trying to pay attention, this is a fantasy. I blame Oprah. It almost never happens, outside of extreme (naturalistic, unpredictable) life situations (like someone almost dying or surviving war or divorcing or losing their job or immigrating under adverse conditions). Life itself builds in the incentives and reinforcers in a much more compelling way than any person can.

I also think the desire to direct that kind of change (which I've also felt in the past, I understand it) is a lot ambitious and a little suspicious. No one person has or should have that kind of influence over another. People come to terms with things on their own (or don't). Ime, a psychologist can reasonably hope to offer their patients/clients an education in particular cognitive-emotional skills, and facilitate small insights, which may or may not (likely not) translate into change.

I agree with what you are saying to an extent, but it is also an oversimplification of what we do. Many of our patients come to us in a particular crisis and quite a few are in so much emotional distress that thoughts of suicide are present. Good empathic skills and some cognitive or behavioral coping strategies might seem small, but at times like those, my patients are glad they have someone who has the skills to help.

 

[sockit]

I agree with what you are saying to an extent, but it is also an oversimplification of what we do. Many of our patients come to us in a particular crisis and quite a few are in so much emotional distress that thoughts of suicide are present. Good empathic skills and some cognitive or behavioral coping strategies might seem small, but at times like those, my patients are glad they have someone who has the skills to help.

Of course, people can be assisted by psychologists! Those small insights and skills are hugely important. But it's the patients who really do the work, if they're going to do it, imo - you are facilitating it but it's down to them - and it's not exactly a one-and-done thing, or a wholesale personality change, is it?

I don't see it as a good field for someone for whom immediate results or gratification are necessary. Maybe other health professions with clearer outcomes (a bone's mended, certain functional milestones evidently achieved) would be more suitable.

 

[smalltownpsych]

Of course, people can be assisted by psychologists! Those small insights and skills are hugely important. But it's the patients who really do the work, if they're going to do it, imo - you are facilitating it but it's down to them - and it's not exactly a one-and-done thing, or a wholesale personality change, is it?

I don't see it as a good field for someone for whom immediate results or gratification are necessary. Maybe other health professions with clearer outcomes (a bone's mended, certain functional milestones evidently achieved) would be more suitable.

Yep. I think another problem is the common misconception that we give people advice. I am usually the only one in the patient's life who doesn't tell them what to do. Many wannabe therapists dispense their wisdom freely and get very frustrated when people don't take it. Usually ties into some countertransference issues.