anybody else regrets going into clinical psych?

[ClinPsycMasters]

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I haven't done much clinical work myself but based on my little experience, I have come to regret my decision at having chosen this line of work--though there is nothing else that satisfies my desires. I have come to really dislike the dogmatic emphasis on empirical evidence, CBT, anything "insurance" related, paperwork, legal issues, etc etc.

I would love to rely on my intuition. I'd like to do some combination of psychodynamic/humanistic psychotherapy as opposed to the "mechanical" CBT--also not limited to x number of sessions.

I would love to see humanistic psychotherapy get the respect it deserves. I don't want to sit there pretending I have the answers. I want to understand the person sitting in front of me, to learn to love, value, and respect them. That is most helpful often enough.

I also wish that therapists had greater interest in politics and more political influence. As much "fun" it is to get people to stop using "magnification," "should statements" and "all or nothing thinking", it'd be even better if we could make some real changes in the macro system.

Psychologists are the ones who know with their heart and soul the effects of poverty, war/terror, the various -ism's, homelessness, lack of education, and the various ways people are constantly manipulated and abused by their workplace, businesses, political institutions, etc.

I respect people's culture, religion, upbringing, etc. But I like people to be educated in what means to be human and to have needs. I want them to see how varoius sociopolitical, religious, and traditional worldviews are not in sync with our nature and potential. Many of these systems were started with good intentions but soon power politics took over.

We are not "completely free" and can never be. So we might as well stop being selfish and focusing exclusively on our "rights" and our "legally defined" relation to others. We need many things including each other, not as means to materialistic ends, but to simply be together. If we could have richer and more meaningful relations--built on understanding and care--and spend time developing our spiritual potential, we'd have much less use for therapists, meds/drugs, materialistic substitutes.

I am an idealist (usually test INFP) and it saddens and angers me when I realize that there is so little I can do for people who need me most.

 

[robinsena]

Psychologists are the ones who know with their heart and soul the effects of poverty, war/terror, the various -ism's, homelessness, lack of education, and the various ways people are constantly manipulated and abused by their workplace, businesses, political institutions, etc.

No, not really. Once you meet enough psychologists, you'll see not everyone has the same sensitivity or passion as you may have for those less privileged.

I may not agree with all of your statements (I for one love EBTs), but I can totally relate to the feeling of being helpless, or not making much of an impact. Med students feel it too around their 2nd/3rd year, at least from what I hear. I have come to terms with it by recognizing that along with everyone else, I am a human and have limited capacity to change others. I've stopped trying to measure my success against an ideal, absolute measure of perfection and instead am judging my work based on my personal potential. If I am honest with myself, sometimes I -know- that I am not giving a client 100% of what I can healthily offer to them.

I guess another part of what helps for me to deal with the pessimism you describe is my spirituality and other components of my identity, and that there is more of me than just being a psychologist. By taking part in other activities and helping others through other means than just psychotherapy, it really helped me to balance out areas of my life so that when one area falls short (like being a psych in training), I won't be as negatively impacted as I could have been.

 

[KillerDiller]

I would love to see humanistic psychotherapy get the respect it deserves. I don't want to sit there pretending I have the answers. I want to understand the person sitting in front of me, to learn to love, value, and respect them. That is most helpful often enough.

Huh, from what I've seen, humanistic psychology garners a great deal of respect in the field. Those of us who consider ourselves to be a part of other orientations still make ample use of humanistic techniques. Research has shown us that building rapport and other "common factors" are extremely important in therapy outcome. In that way, humanistic psychology and ESTs go hand in hand.

I also think this addresses your point that CBT feels "mechanical". This is a common perception, but evidence-based therapists have the same ability to relate to clients as therapists from any other path.

 

[somedude14]

Sadly, the points mentioned as well as all the other cons involved in going into clinical psychology have swayed me away from it.

I still love psychology, I'm just more into research side of it. And the neuroscience side with fMRI's 🙂

 

[docma]

To the OP: Have you any familiarity with DBT? I was put off with the model initially because the text is hard to read at first--however, it is a EBP and integrates will with models you like while also meeting many of the demands the social system places on practice in this country. And it truly helps suffering individuals. If you can get to the place where you practice in community work and with interdisciplinary teams you may find more of what you hoped for in the work.

 

[Aura5]

OP: Ha, this'll sound weird, but when I read your post I swear I'd read it before, or heard the exact thing from someone before. Do I know you from somewhere?

anyway probably just a coincidence. But I had one of those 'deja vu' moments.

I haven't actually started grad school yet, but I like what robinsena said, about finding balance in your life outside of the psychology profession too, maybe doing other things to feel more fulfilled if you feel in a rut.

And from my minimal (compared to you all ) education on psychology, I was never a huge fan of CBT either...so I hope there'll be kind of a mix too. But of course I've never done 'hands on' with any theories so my opinion could change.

 

[erg923]

I would love to rely on my intuition. I'd like to do some combination of psychodynamic/humanistic psychotherapy as opposed to the "mechanical" CBT--also not limited to x number of sessions.

I would love to see humanistic psychotherapy get the respect it deserves. I don't want to sit there pretending I have the answers. I want to understand the person sitting in front of me, to learn to love, value, and respect them. That is most helpful often enough.

Well..... since you admittedly haven't done much clinical work, you obviously don't know the CBT model very well do you? If you did, you wouldn't feel it to be "mechanical" and you wouldn't attribute relationship importance only to Rogers. If its mechanical, you're doing it wrong. It;s not easy, and it not suppose to be. If it was, everyone would do it. Try again before you give up on science. IMHO, that is NOT the kind of attitude psychologist should have towards science.

 

[Therapist4Chnge]

There are some very real issues, though good clinicians (or mediocre clinicians who are good networkers) can do well. As a profession we are hurting, but you can still be successful.

 

[idealists]

There are some very real issues, though good clinicians (or mediocre clinicians who are good networkers) can do well. As a profession we are hurting, but you can still be successful.

I agree.

Most of what he/she says are true but you can still make a difference. Glass half empty or full?

 

[ClinicalTrainee]

I haven't done much clinical work myself but based on my little experience, I have come to regret my decision at having chosen this line of work--though there is nothing else that satisfies my desires. I have come to really dislike the dogmatic emphasis on empirical evidence, CBT, anything "insurance" related, paperwork, legal issues, etc etc.

I would love to rely on my intuition. I'd like to do some combination of psychodynamic/humanistic psychotherapy as opposed to the "mechanical" CBT--also not limited to x number of sessions.

I would love to see humanistic psychotherapy get the respect it deserves. I don't want to sit there pretending I have the answers. I want to understand the person sitting in front of me, to learn to love, value, and respect them. That is most helpful often enough.

I say "hear hear" to the paperwork dislike and insurance specifications, and until this year I would have agreed with the rest of what you wrote, too. I have, in fact, fought with supervisors who I felt were too bound to the the CBT model and did not incorporate the individual person.

But, after a few more years of doing therapy and some heart-to-hearts with myself about what kind of psychologist I want to be, I've shifted my viewpoint a little. Empirically supported treatments, CBT included, are pushed because they represent the best evidence available for how to most effectively treat certain problems. As helpful as the common factors are, there is a reason they are dubbed "necessary but not sufficient." Many clients are helped by someone understanding them, but often need skills to better navigate their lives.

I don't disagree that ESTs can seem formulaic, though I also echo what another poster said about how skilled therapists can follow a manual and still make the treatment individual. Nor do I disagree with the spirit of humanstic treatments, in that the indivdiual is valued as a human being and worthy of love and respect. In fact, I'm all over that, and have pushed myself to look beyond straight CBT to DBT, ACT, Emotion-Focused, and constructivist approaches. Rather than merely helping the client change his or her thoughts, these approaches promote flexibility in responding based on the needs of the person in situations, and thus feels more humanstic-y in nature.

Also, and very importantly, I think it's imperative to improve the science, not abandon it. Yes, CBT has good empirical support for a variety of issues, but so might other things. Our goal should be to advance treatments--if you're discontent with CBT (as were many who promoted the persectives noted above), that isn't reason to simply follow intuition. I think we need better treatments for psychological processes, not just disorders, and that address subthreshold issues as well as hard-core psychopathology. I'm also in favor of finding ways to include the role of the individual by developing idiographic approaches to treatment research. I think that a dose of skeptisim is a good thing, because it will push us to find new and improved ways of helping people. I guess my ultimate point is that there ARE things that can be done to help the people who need us most--and improving science is one way to do so. One necessary but not sufficient way (as dissemination, policy, etc. are also important avenues). 🙂

 

[PorkDumplings]

\
I am an idealist (usually test INFP) and it saddens and angers me when I realize that there is so little I can do for people who need me most.

Who needs you most?

 

[ClinPsycMasters]

Who needs you most?

I should have worded that better.

I meant to say that some people have few problems, are financially well-off, so if they come to see me or other therapists, they're looking for minor relationship/work-related type of help, and CBT is well-suited to that. I can help them. However, they could as easily read a book about it or talk to friends for emotional support/problem solving.

But some people come to see a therapist, wanting him/her to "save" them, to rescue them from a life of poverty, abuse, helplessness, biological/genetic illnesses, a sociopolitical system that ignores them, work-life that dehumanizes them, family that manipulates them, dogmatic traditions that have a hold on them, etc etc.

It is with them that I suddenly see a human being (myself too) as a point of contact between so many forces, only a few of them under the individual's control, and even fewer under therapist's. And that's not even talking about the conscious/subconscious distinction and free will. In fact, I am surprised when people actually get something out of the visit. Is it placebo? I don't know. If some people feel better after seeing "energy healers" then anything is possible.

I so want to save those kinds of patients because at times I feel that I have a real sense of what it is they are going through, and how painful it is, but I can't. And I can't make peace with my own powerlessness.

 

[docma]

These are issues you need to be diving into with a good supervisor. Part of professional development is learning to find your balance and see the work in perspective. In our desire to help, we can get pretty grandiosely sunk in the idea that we can "save" and that if we can't we are powerless. The perspective that DBT and ACT help us get on mindfulness, radical acceptance, distress tolerance, etc., are not only really useful for clients--but invaluable for clinicians. Intuition can be a useful but also risky gift; a value of well-informed social science is that it helps you use intuitive skills in a time-tested framework and the structure of many contemporary therapies helps us use the intuitive tool accurately and effectively.

 

[Therapist4Chnge]

I so want to save those kinds of patients because at times I feel that I have a real sense of what it is they are going through, and how painful it is, but I can't. And I can't make peace with my own powerlessness.

As docma mentioned, this is something to explore during your training. Our role as professionals isn't to save someone, but instead to provide a safe place for people to deal with their problems. Two of the biggest issues of "saving" someone is the imbalance of responsibility and over-reliance on external factors for internal validation.

he perspective that DBT and ACT help us get on mindfulness, radical acceptance, distress tolerance, etc., are not only really useful for clients--but invaluable for clinicians.

Very true. I teach DBT skills and I have found a lot of value in my own life, particularly in regard to mindfullness.....which I was pretty resistant to learning during my first go-around.

 

[deleted176373]

I should have worded that better.
I so want to save those kinds of patients because at times I feel that I have a real sense of what it is they are going through, and how painful it is, but I can't. And I can't make peace with my own powerlessness.

And this is why most people can't stand working with PD's, especially Borderlines, which I love working with. You have to come to peace with the fact that you can't save them, but maybe you can be happy with helping them just a little bit.

Mark

 

[livetosail]

I can't make peace with my own powerlessness.

First, I want to start out by saying that nothing you have said is wrong, and there is nothing wrong with you feeling this way. I am a strong believer in support within our profession. Compared with the medical side of the house, the Psychological community can be about as forgiving and helpful to one another as a pack of hyenas. So, please, feel free to share your thoughts, and feel free to ignore the quick "you shouldn't be feeling that way" or "if you are this then you are wrong" kind of comments. There are many methods by which we can define success in this kind of problem.

Second, in reference to your quote above: perhaps more now than at any other stage in your professional life, you have to have faith. Faith that what you are doing does in fact work (because we have the science to back it up), and is in fact important and beneficial. An attitude of apathy will only lessen your impact and effectiveness, and ultimately help you achieve your biggest fear- being nothing more than a placebo therapist.

Imagine yourself as a medical doctor. CBT is your medicine. It has been studied and successfully used thousands of times before in the treatment you are intending to use it for. You want to do more, say more, give more- and that is good. But use the tools for which you are being trained, and trust in their effectiveness. When you have crossed that bridge and emerge as the board certified Ph.D, then you can adapt, specialize, modernize, theorize, and generally trick out your practice (within the limits of the APA and code of ethics, of course) as you see fit. Right now, however, you are observing the machine in action, and learning the ropes.

I might suggest that you consider how such a valuable asset such as idealism can become a liability in this line of work if you do not learn to control it. There is a good reason why burnout is a highly measured phenomenon by the APA every year.

I have often said that I will never become my first Psychology professor, whose walls were literally covered from floor to ceiling in degrees and certificates from a nearly 40-year career, but who said to me on our first meeting, "Ultimately, it doesn't matter what I do. I cannot help anyone. The patient is the only person that can affect change."

At the time I was enraged at what appeared to be his severe sense of detachment and lack of empathy. I thought to myself, "Then why the heck do we have this profession to begin with? How in the world do we charge people money if we sit back thinking to ourselves that we cannot help anyone?"

As the years have progressed however, I have run the gamut of understanding to the point that I see the aged wisdom in his words. And I have learned that my desire to help, and my interest in affecting the ideal, must be tempered with reality and kept just close enough to keep me energized and motivated every day, but just far enough so as not to feel unhealthy guilt for a patient's outcome.

Have faith, friend.

Cheers.

 

[jonathansmith86]

I have to say that I've never gotten the impression that Humanistic approaches are looked down upon. CBT is increasingly the more common orientation, which I think is a good thing, but I also see Humanistic techniques as being well-respected, and in many cases very much in-line with CBT.

Also, I sympathize with the disillusionment you feel. The mental health system is even more broken than the medical health system, and it's incredibly frustrating. That being said, I'm not sure what you expected. I'm about to begin a PsyD program but I've worked in community mental health for a couple of years. If I set out to "save" anyone I would have burned out a long time ago.

Regarding your statement that you're surprised when people benefit from a session with you, or that they could have gotten as much out of reading a book as they do from working with a professional...that's troubling, because it makes me wonder how committed you are to the goals of mental health work and the science and techniques behind it, and without that commitment I don't know how effective a practitioner you can be.

Another issue is that you seem to have a sort of "liberal guilt" that motivates a lot of your feelings. I say that as a far-left liberal myself, by the way, but I definitely recognize the potential trouble that can come from feeling like if you don't have it as bad as someone else then you can't possibly help them. That simply isn't true. If I had cancer I would not seek out a doctor who had cancer as well, I would seek out a cancer expert. The same holds true, in my view, with mental health professionals. You don't need to be poor to help a poor person, you have to understand and respect the the additional challenges they face.

 

[idealists]

And this is why most people can't stand working with PD's, especially Borderlines, which I love working with. You have to come to peace with the fact that you can't save them, but maybe you can be happy with helping them just a little bit.

Mark

DOn't I know it. My mom has borderline/covert narcissistic personality (father: overt narcissistic) and it's extremely difficult not to get sucked in. It brings out the parents in you, and then sometimes you turn into a child so it gets to be a really messy and complex relationship. So it's particularly hard for me to deal with anybody who has borderline because when you are raised by such a person you are not taught boundaries and the ones you have are violated so your sense of self is shakier than your average therapist. You have to deal with tremendous guilt, anger, and shame, everytime you deal with someone who has borderline.

Anybody who feels powerless in working with clients should spend time examining themselves first. Maybe you feel powerless no matter what you do. If it's not your background, it's your political views.

 

[futureapppsy2]

I meant to say that some people have few problems, are financially well-off, so if they come to see me or other therapists, they're looking for minor relationship/work-related type of help, and CBT is well-suited to that. I can help them. However, they could as easily read a book about it or talk to friends for emotional support/problem solving.

I think it's important not to minimize clients with "minor" concerns. I know that if I had to rank order the things in my life in the order of how difficult they felt to me, iit wouldn't necessarily be what you'd expect looking at the items themselves. Not everything affects all people the same way.

Granted, there are some people with more "severe" issues than others, but the almost-dismissal of clients with seemingly minor concerns rubs me the wrong way. Additionally, in my experience with clients, some clients seem to have very minor issues at first glance but actually have bigger issues than are readily apparent

 

[hereandnow]

First, let me empathize with you.

Much of the way clinical psychology is taught is far from ideal -- both on the CBT as well as the psychodynamic/humanistic end of things. When the clinical work is poorly taught it can appear "mechanical" (CBT), "esoteric" (psychodynamic), or "non-pragmatic" (humanistic).

However, good clinicians, across-the-board, do many of the same things, regardless of orientation, and I would encourage you to be open to the tenor of good clinical work, wherever it comes from. Hopefully, you'll be able to find a non-mechanical (dare I say "humanistic" 🙂 ) CBT clinician -- or for that matter a non-esoteric, pragmatic psychodynamic/humanistic clinician -- who can guide you in the direction that you sense is right.

Believe me, these people are out there, and they are looking for people like yourself who have a keen eye for meaning and a true desire to make a difference.

Be well and keep the faith. Truly, there are hundreds, if not thousands, of psychologists out there who share your sensibility, your heart, and your desire.

Peace.

 

[edieb]

CBT is not cookbook, and if you think so, you are not very good at it. CBT is not just about thought records and auto thoughts. there are other parts, such as changing schemas/core beliefs, and underlying assumptions with behavioral experiments, that are very rich and diverse

 

[ClinPsycMasters]

CBT is not cookbook, and if you think so, you are not very good at it. CBT is not just about thought records and auto thoughts. there are other parts, such as changing schemas/core beliefs, and underlying assumptions with behavioral experiments, that are very rich and diverse

Thank you all for all the compassion and empathy. I really appreciate it, and makes me feel good that I'm not delusional--though I'll check with my doctor .

As for the above comment--and I don't want to stray too far from the original topic--I do not believe CBT is a cookbook but I do think that for varous reasons is turning into one. Cookbook type CBT allows for quality control, and makes it easier to convince insurers to cover therapy costs. It's also "empirically validated", as opposed to psychodynamic therapy which is seen as antiquated and philosophical as opposed to scientific, and humanistic psychotherapy which is seen as too idealistic and impractical (unless people can "reach their potential" sufficiently in 10-15 sessions).

Yes, I'm a Kuhnian. I do believe that there was a paradigm shift in psychiatric approach last century, from psychoanalytical to biological view of conceptualizing mental illness, and that CBT is not superior to psychodynamic therapy but fits better in our current society in the West.

I see CBT as the answer to our fast-paced life. It's equivalent of fast food. You get quick results and significant symptomatic improvement but personally I prefer psychodynamic/humanistic approach for longterm improvement and prevention of symptom substitution. Once we become aware of the dynamics at work in our mind, and once we feel unconditional positive regard and compassion, we can work on improving symptoms through fixing cognitive errors and behavioral modification. Or we could do all therapies at the same time. After that, some also benefit from supportive therapy.

I also think that a spiritual take on life can be helpful, since it can make us feel valued and loved, and give us purpose. Though simple reflections on the complexity and beauty of life itself sometimes gives us the courage to ask tough questions, to go on an adventure to the depths of the mysteries of life, and be able to extricate ourselves from day to day hassles.

I also love to have the freedom and knowledge to use fiction, poetry, art, myth, and spirituality/religion in helping people improve their lives. Given the importance of "common factors" in psychotherapy, I think that the most important part for me is to learn to love others exactly as they are. And that's the hardest part because I don't love myself as I am. Once I can do that, then even while using CBT, I can be flexible enough and open enough to connect with people at a deeper level.

Yes, I know, I'm all over the place, but that's psychology for you. If you look at the last hundred years, you'll note that psychology/psychiatry are still in their infancy. I really think standardization and quality control are important as there are so many people out there looking to take advantage of people's vulnerability and sell them their worldview or products. At the same time, I worry about standardization of treatment that may be happening too soon before the field has progressed significantly. There must be other ways to stop manipulators from abusing people and yet allow enough freedom in therapy to figure out what works best for people.

 

[deleted176373]

I think you touched on something important that doesn't get enough attention, and that's the common factors. The common factors like therapeutic alliance and other "curative factors" despite being labeled differently by different schools of thought are more powerful in my mind than any one theoretical orientation. Theoretical orientations are powerful, but in a way that allows us to look at the case from a broader perspective, they guide us in our approach to therapy, but they are not the therapy by themselves nor is any one theoretical perspective the only way to reach a successful outcome.

I know I will be excoriated for this, but in some ways we are scientists, and in others we are artists. I will use the analogy of auto mechanic, mechanics live in a world ruled by science (as do we), but not all mechanics are equally skilled, some things are best done by "feel". I know that sounds decidedly non-scientific, but it's true... sometimes it's more efficient to hand fit a part than it is to use a mass produced part that has a given error tolerance. Imagine a part, 1.00" +/- 0.050", versus a part that has been hand lapped to match far more perfectly. Therapy can be the same, we can "hand fit" therapy to fit our clients, but only through our clinical experience and an integrative approach. Modern psychological thought is that we are an empirically based science with no room for treatments that have not been empirically validated, but we are not so advanced where we can claim that the artistry is no longer a factor... It's a lofty goal to be sure, but we have a bit farther down the road to travel before we can claim that.

Mark

 

[Buzzwordsoldier]

I haven't done much clinical work myself but based on my little experience, I have come to regret my decision at having chosen this line of work--though there is nothing else that satisfies my desires. I have come to really dislike the dogmatic emphasis on empirical evidence, CBT, anything "insurance" related, paperwork, legal issues, etc etc.

I would love to rely on my intuition. I'd like to do some combination of psychodynamic/humanistic psychotherapy as opposed to the "mechanical" CBT--also not limited to x number of sessions.

I would love to see humanistic psychotherapy get the respect it deserves. I don't want to sit there pretending I have the answers. I want to understand the person sitting in front of me, to learn to love, value, and respect them. That is most helpful often enough.

I also wish that therapists had greater interest in politics and more political influence. As much "fun" it is to get people to stop using "magnification," "should statements" and "all or nothing thinking", it'd be even better if we could make some real changes in the macro system.

Psychologists are the ones who know with their heart and soul the effects of poverty, war/terror, the various -ism's, homelessness, lack of education, and the various ways people are constantly manipulated and abused by their workplace, businesses, political institutions, etc.

I respect people's culture, religion, upbringing, etc. But I like people to be educated in what means to be human and to have needs. I want them to see how varoius sociopolitical, religious, and traditional worldviews are not in sync with our nature and potential. Many of these systems were started with good intentions but soon power politics took over.

We are not "completely free" and can never be. So we might as well stop being selfish and focusing exclusively on our "rights" and our "legally defined" relation to others. We need many things including each other, not as means to materialistic ends, but to simply be together. If we could have richer and more meaningful relations--built on understanding and care--and spend time developing our spiritual potential, we'd have much less use for therapists, meds/drugs, materialistic substitutes.

I am an idealist (usually test INFP) and it saddens and angers me when I realize that there is so little I can do for people who need me most.

Hey. I really felt you on this post, even though I have not worked in the capacity of psychologist, and I simply had to respond before reading any of the other replies. Your lament (inasmuch as it seems a lament to me) almost perfectly captured some of the central challenges that define the way I think about mental health work. Almost, that is, except for this little nugget...

"I want to understand the person sitting in front of me, to learn to love, value, and respect them."

I get the wanting to understand part. But the "learning to" (love, value and respect) part seems to hold the key to your lament (if I may call it that). For me, the love, value and respect are guaranteed. And not in some ga ga unconditional sense, but in the toughest of senses. True, I may have to figure out any given patient's expectations regarding love, value and respect, and in that sense the guarantee comes due as we work out a learning curve. But the commitment to follow that process has to be based on love, value and respect.

That said, I have to admit I don't know what you thought you were saying or what you hoped to convey. And FWIW I've tested as an INTJ.

 

[docma]

In response to MarkP's response (I haven'tfigured out how to do the quote box thing)...

Among the things I have come to admire about Marsha Linehan is her integration of science and recognition that the art is also essential. She talks about the "jazz" and "dance" involved in doing DBT. But the effectiveness is about both mindfully being "in the moment" and fully engaged with the client AND having intimate knowledge of principles and structures that have been verified over time. So science informs the art and vice versa: it is a dialectic.

 

[Buzzwordsoldier]

Who needs you most?

Good catch, PD. The OP needs the OP most. Then family. Perhaps friends. If patients enter the equation, something is seriously amiss.

 

[Thirdxthecharm]

This thread has been very interesting thus far. Because of the feelings being experienced by the OP I am very thankful that I did not get accepted straight out of undergrad into a grad program (not saying that the OP did). I have been employed as a case manager for the last two years, and have definitely felt some of the same things mentioned above. I came out believing that I could change people, and "save" them from their "horrible" lives. I do not know about every case managers experience, but I am given SMD clients, with problems in the community. Basically, those who are really suffering with a mental illness and really suffering with living daily. When I first started I wanted to get everyone social security, everyone a house, everyone to manage their meds, to stay out of the hospital, to not commit suicide, but that didn't last for long. I couldn't do all of that and while part of me was outraged at the way our society is set up, I realized that bitterness didn't help my clients.

So after much soul searching and contemplating other career paths (all of this happening while being rejected from grad schools two times), I came to the same conclusion as Markp. I can rarely "save" someone, but I can provide some difference in their lives. I may be able to help find stable housing, or work with them to get their social security and medical card, but my main focus is to leave them feeling slightly different, and to not just focus on their "problems," but focus on their "strengths" and build upon them.

Anyway, I think that this field causes us to constantly examine ourselves and the believes we hold about society and humanity. I am thankful for the supervision I have received thus far, and am hopeful that I can bring this attitude into my graduate work next year.

 

[docma]

As
thirdxthe charge notes, the "strengths model" is key. Social work students learn it in year one, many psych programs fail to teach it and you hopefully gain it in the internship setting.

 

[futureapppsy2]

As
thirdxthe charge notes, the "strengths model" is key. Social work students learn it in year one, many psych programs fail to teach it and you hopefully gain it in the internship setting.

+1

I got a undergrad degree in social work as well one in psych, and the strengths model was probably the most valuable thing I learned from the former.

 

[ClinPsycMasters]

This thread has been very interesting thus far. Because of the feelings being experienced by the OP I am very thankful that I did not get accepted straight out of undergrad into a grad program (not saying that the OP did). I have been employed as a case manager for the last two years, and have definitely felt some of the same things mentioned above. I came out believing that I could change people, and "save" them from their "horrible" lives. I do not know about every case managers experience, but I am given SMD clients, with problems in the community. Basically, those who are really suffering with a mental illness and really suffering with living daily. When I first started I wanted to get everyone social security, everyone a house, everyone to manage their meds, to stay out of the hospital, to not commit suicide, but that didn't last for long. I couldn't do all of that and while part of me was outraged at the way our society is set up, I realized that bitterness didn't help my clients.

So after much soul searching and contemplating other career paths (all of this happening while being rejected from grad schools two times), I came to the same conclusion as Markp. I can rarely "save" someone, but I can provide some difference in their lives. I may be able to help find stable housing, or work with them to get their social security and medical card, but my main focus is to leave them feeling slightly different, and to not just focus on their "problems," but focus on their "strengths" and build upon them.

Anyway, I think that this field causes us to constantly examine ourselves and the believes we hold about society and humanity. I am thankful for the supervision I have received thus far, and am hopeful that I can bring this attitude into my graduate work next year.

Thank you for your post. To think that someone started out being as "idealistic" as I am, but has been able to adapt to reality of the situation by focusing on people's strengths, and still remain interested in this field, gives me hope.

I come from a very research-oriented program. They don't teach us stuff like that.

 

[PorkDumplings]

I can provide some difference in their lives.

I like this. What I was taught is that it's probably better that the person is seeing you than seeing no one, so there's no need to feel bad; figure you do the best with what you have right then, and hopefully they get something out of it. The rest of it is just honing your skills so that you can be a better therapist.

I think that we as therapists have a responsibility TO our clients, but we are not responsible for their problems. I come from a program that is very person-centered, and I think that it is a discredit to the client/patient to say that the therapist is responsible for 'fixing' the client or 'solving' their problems. This whole idea paints the client as some sort of helpless victim and the therapist as a savior, and I really feel that this sort of mentality is counter-productive and self-serving for the therapist. Working WITH people - a collaborative effort between client and therapist.

I'd also like to speak to this a little:

I respect people's culture, religion, upbringing, etc. But I like people to be educated in what means to be human and to have needs. I want them to see how varoius sociopolitical, religious, and traditional worldviews are not in sync with our nature and potential. Many of these systems were started with good intentions but soon power politics took over.

I'm a little confused on this one, because what you are saying to me does not sound very respectful of different cultures, but I also don't really understand the specifics of what you are saying to say much more. Could you tell me more?

 

[ClinPsycMasters]

PorkDumplings:

I am not quite clear on what system works best or how people should live their lives.

I do have some ideas though which are open to debate:

If people learn critical thinking and basic psychological theories of human needs/motivation at an early age, they are less likely to be manipulated and taken advantage of by the media or politicians or other scheming unkind people. Businesses, politicians, and various special interest and well-funded groups have access to psychological literature (and conduct their own) so they can learn how to sell their worldview or product to people. It is only "fair" that people have access to knowledge and methods that would help them take control of their life instead of being overly vulnerable to "fear-based" tactics of the media/religious/political organizations or those of businesses that try to link consumption with happiness with their ads.

Let me talk some international politics for a second because that's another area that angers me. As someone who is in helping profession I want to be able to do something about war, terror, homelessness, poverty, military occupation, etc.

Here's an example: Western imperialism in the Middle East has led to some reactions, from mild to severe. Western sexualized media and materialistic messages clash with traditional and religious views there. Dictators in those countries (many supported by US at least initially) use much of their financial sources to maintain power and suppress dissent--instead of dealing with widespread poverty and various social issues--usually in name (and using authority) of religion. The attacks of 9/11 which led to 3,000 deaths were also justified by referring to religious principles. A number of people in Middle East seemed to support the attacks, which some saw as evidence of religious brainwashing. US retaliated by invading and occupying two countries--which led to over a million deaths--by referring to cherished American values such as patriotism, justice, freedom, democracy, etc.

Whose needs were being met there? Think about Bin Laden, Bush, defense contractors, neocon/religious fundamentalists, etc. People who joined Bin Laden or later supported him, did they feel powerless about economy or political freedom or Western influence in their country? Could they have empowered themselves to bring about change in their countries in a way that did not involve killing people? Were Americans starting to feel angry about the economy (WTO protests etc) and did they feel very insecure about future threats after 9/11? Was there any other way to meet those needs without resorting to war? Were people from both sides so caught up in the situation that they did not think about that? Were they not compassionate enough? Were they vulnerable to fear-based tactics of the media or were they blinded by anger and fear?

Now, think about the NY kid who saw the plane crash into the tower where his dad worked, taking his life, or the kid in Afghanistan who saw a bomb destroy him home and kill his family? Are these kids going to grow up to forgive or seek vengeance?

This frightens me deeply. Sometimes I adopt a nihilistic view and think that human condition is tragic and that is that. Throughout history empires have used various tactics and strategies (from brute force to more subtle ones recently) that have created gross inequalities and so much hostility and suffering.

Sometimes I think I'm just one person, I can't do anything about that. I can help people with anxiety/depression and that's the best I can do. I stay away from the news.

Other times I start to think that I may be able to make a postive change in the world, one that might go beyond my immediate circle of influence. The urge may be greater if you deal with PTSD patients from war-torn countries or deal with poverty, AIDS, torture victims, etc, almost exclusively. But what to do and how?

I wonder if teaching people about needs and desires, about human motivation, about our psychological makeup can help. Religious organizations or political parties or business may need to consider their own needs of survival in the society. That may not be what is in the best interest of a particular individual.

Maybe if we really learned about our universal needs and motivations, if we were self-aware, we could avoid such horrors. That doesn't mean that people can't have their traditions or worldviews. However, people can act more rationally and compassionately if they can stop in their tracks and think about the situation. We can all vote by our actions. So if someone tells me that a certain authority (of science, religion, politics) says we should do this, I take a moment to think about my own frustrations and unmet needs in life. I realize that doing X can make me feel valued or powerful or loved or whatever. Then I think about the consequences to other people. How would they feel in the short-term or long-term? Assuming I have the presence of mind to act compassionately and assuming that I have learned about needs and motivations, I may decide that there are other ways to meet my needs and refrain from action.

I respect religion and I'm a spiritual person myself. I respect people's political views. Businesses are not evil, either. 🙂 A friend of mine is a business owner and I see how hard he works everyday and how unstable his job is. He needs to make a living and he does what he can to provide for him family and I respect that.

However, I believe that human life and life in general is so precious that no matter what we believe or how we live our lives, we can stop and think how to obey the law, or follow religious teaching, or make a living, and do it in a way that is most compassionate and considerate of our own and others' well-being.

 

[jnine]

Well said my friend. Good, interesting ideas. If you haven't been reading Chomsky, definitely pick him up.

It sounds like you're walking around with the weight of the world on your shoulders. I think you know that you shouldn't but you still do. Take it easy! 🙂

PorkDumplings:

I am not quite clear on what system works best or how people should live their lives.

I do have some ideas though which are open to debate:

If people learn critical thinking and basic psychological theories of human needs/motivation at an early age, they are less likely to be manipulated and taken advantage of by the media or politicians or other scheming unkind people. Businesses, politicians, and various special interest and well-funded groups have access to psychological literature (and conduct their own) so they can learn how to sell their worldview or product to people. It is only "fair" that people have access to knowledge and methods that would help them take control of their life instead of being overly vulnerable to "fear-based" tactics of the media/religious/political organizations or those of businesses that try to link consumption with happiness with their ads.

Let me talk some international politics for a second because that's another area that angers me. As someone who is in helping profession I want to be able to do something about war, terror, homelessness, poverty, military occupation, etc.

Here's an example: Western imperialism in the Middle East has led to some reactions, from mild to severe. Western sexualized media and materialistic messages clash with traditional and religious views there. Dictators in those countries (many supported by US at least initially) use much of their financial sources to maintain power and suppress dissent--instead of dealing with widespread poverty and various social issues--usually in name (and using authority) of religion. The attacks of 9/11 which led to 3,000 deaths were also justified by referring to religious principles. A number of people in Middle East seemed to support the attacks, which some saw as evidence of religious brainwashing. US retaliated by invading and occupying two countries--which led to over a million deaths--by referring to cherished American values such as patriotism, justice, freedom, democracy, etc.

Whose needs were being met there? Think about Bin Laden, Bush, defense contractors, neocon/religious fundamentalists, etc. People who joined Bin Laden or later supported him, did they feel powerless about economy or political freedom or Western influence in their country? Could they have empowered themselves to bring about change in their countries in a way that did not involve killing people? Were Americans starting to feel angry about the economy (WTO protests etc) and did they feel very insecure about future threats after 9/11? Was there any other way to meet those needs without resorting to war? Were people from both sides so caught up in the situation that they did not think about that? Were they not compassionate enough? Were they vulnerable to fear-based tactics of the media or were they blinded by anger and fear?

Now, think about the NY kid who saw the plane crash into the tower where his dad worked, taking his life, or the kid in Afghanistan who saw a bomb destroy him home and kill his family? Are these kids going to grow up to forgive or seek vengeance?

This frightens me deeply. Sometimes I adopt a nihilistic view and think that human condition is tragic and that is that. Throughout history empires have used various tactics and strategies (from brute force to more subtle ones recently) that have created gross inequalities and so much hostility and suffering.

Sometimes I think I'm just one person, I can't do anything about that. I can help people with anxiety/depression and that's the best I can do. I stay away from the news.

Other times I start to think that I may be able to make a postive change in the world, one that might go beyond my immediate circle of influence. The urge may be greater if you deal with PTSD patients from war-torn countries or deal with poverty, AIDS, torture victims, etc, almost exclusively. But what to do and how?

I wonder if teaching people about needs and desires, about human motivation, about our psychological makeup can help. Religious organizations or political parties or business may need to consider their own needs of survival in the society. That may not be what is in the best interest of a particular individual.

Maybe if we really learned about our universal needs and motivations, if we were self-aware, we could avoid such horrors. That doesn't mean that people can't have their traditions or worldviews. However, people can act more rationally and compassionately if they can stop in their tracks and think about the situation. We can all vote by our actions. So if someone tells me that a certain authority (of science, religion, politics) says we should do this, I take a moment to think about my own frustrations and unmet needs in life. I realize that doing X can make me feel valued or powerful or loved or whatever. Then I think about the consequences to other people. How would they feel in the short-term or long-term? Assuming I have the presence of mind to act compassionately and assuming that I have learned about needs and motivations, I may decide that there are other ways to meet my needs and refrain from action.

I respect religion and I'm a spiritual person myself. I respect people's political views. Businesses are not evil, either. 🙂 A friend of mine is a business owner and I see how hard he works everyday and how unstable his job is. He needs to make a living and he does what he can to provide for him family and I respect that.

However, I believe that human life and life in general is so precious that no matter what we believe or how we live our lives, we can stop and think how to obey the law, or follow religious teaching, or make a living, and do it in a way that is most compassionate and considerate of our own and others' well-being.

 

[PorkDumplings]

lots of stuff

Thank you for clarifying, I think I understand better now where you're coming from. I think that you raise a lot of interesting points - there are certainly lots of places to help and many different ways to do it. In my humble opinion, if you can do something that makes some sort of positive change in the world and be happy doing it, well, that just about takes the cake.

I think that whatever you do will have a ripple effect though - those people you see in a therapy session also have their own influence on the world, and if they get something out of therapy, they take that with them. There's also lots of opportunities for community outreach and social advocacy in this profession as well (my professors say that it is part of the job).

 

[Thirdxthecharm]

basically, it is an insurance commercial. You do something good for someone, and someone else sees this and is inspired to do something good for someone else a "pay it forward" if you will. I know no one needed that clarification but sometimes i just like to see myself type.