Click on the link for this great interview with Daniel Mackler, for Mad in America (thanks Laura Delano for putting us onto this).
There is tons of good stuff here.
We too prefer the idea of ‘humans helping humans’ over ‘professionals treating clients’. The writer mostly avoids the word ‘client’ these days – sometimes dropping into it for slightly embarrassed shorthand. Mostly these days it’s ‘people I work with’ – more long-winded, but sits better…Where did this come from? A person the writer works with – who commented she did not like the word ‘client’, made her feel less like a human, more like an object.
We agree with Daniel’s comment about his days working as a therapist – we hear plenty of evidence of this from refugees from the psychiatric system who make it to our person-centred service. It bothers us too:-
‘The people who needed the most interpersonal connection were getting the least of it—and getting placed on the most drugs. I worked with a lot of people who had really been failed by psychiatry—and it really bothered me. And what bothered me—and them—the most, so often, was that if they’d just gotten better, simpler help at the beginning so much of the ugly stuff they had to face later could have totally been avoided.’
Monica Cassani (www.beyondmeds.com) has a wealth of information on her site about the extent to which the problems experienced by many, as a result of taking/seeking to come off psychiatric drugs, vastly out-weigh the issues that caused them to take those drugs in the first place.
We too think it is a bad idea ‘to put away the feelings that make us human’, and find deeply troubling the extent to which this has become the norm not only in the medical model, but in swathes of the talking therapy world too – therapists may not ‘pill’ people, but many have signed up to values around arm’s length, structure/norm-based, ‘professional’, risk averse (non-)relationship:-
‘So many don’t really want to hear what people are saying about their pain and their struggles and their history—or even more, simply can’t hear it. It’s too painful for them. So instead they prescribe drugs—or even ECT. I found it horrifying to see this in the mental health field, but even more so, I found it horrifying to see how common it was. It really made me question the whole field—like the whole field had bought this convenient lie and then rationalized it with a lot of simplistic junk science. How much easier to pill people to death than to really listen to them and try to feel what they were feeling in order to really be useful to them by helping them unravel their stories. Very disturbing.’
From where we are looking, one of the main issues is therapist training that emphasizes theory/technique, and skates lightly over the deeper reaches of the would-be therapist’s own emotional landscape, mind and spirit. We cannot accompany another to depths we have not plumbed ourselves, nor can we fully encounter another’s humanity, if we live in fear and denial of our own. The core conditions, especially empathy and loving warmth, require a therapist who is not themselves in a place of unprocessed fear – of feeling, of human relationship, of complexity, of shadow.
We also resonate with his comment:-
‘I see diagnosis as silly—at best—and at worst simply dangerous. A good therapist doesn’t need to follow these cooked-up diagnoses to help someone. A good therapist listens to real human problems, struggles to relate to them from his or her own personal life experience, and doesn’t put these human problems in an artificial box. These boxes are not really helpful at a deeper emotional level. I think our whole field would be much better off without them.’
And with this Question and Answer – there has, of course, been evidence for decades of the efficacy of therapy founded on human relationship for those with diagnoses of ‘psychosis’ or ‘schizophrenia’ – which the psychiatric model for the most part chooses to ignore:-
Q: ‘You say that most mental health clinicians in the US have never seen someone with psychosis get well, so much so that they doubt full recovery is even possible. Could you speak a bit more as to why you think this is?’
A ‘They haven’t seen anyone get well because they don’t do the things that help people go through psychosis. Instead they put people on pills and lock them up in hospitals and treat them like a bad science experiment. People in crisis don’t need that—at least in most cases that’s not at all what they need or really want. Instead, what I’ve seen is that most people in crisis, on a deeper level, want to be respected, listened to, honored, interacted with in a human way, and not medicalized. If the mental health system did more of that we’d see a lot more people go through psychosis and come out the other side. But that’s not how the system is set up. It’s set up wrong.’
We enjoyed (and agree with) his comment: “Seasoned” therapists often used to tell me that I shouldn’t “bring my work home with me” at night. My private answer was this: “Yuck!” I thought about my clients all the time—even dreamed about them at night. They were like my family in many ways—how could it be otherwise? I loved them. And I never referred people to the therapists who told me to leave my work at home at night. Those therapists were detached, emotionless—and, in my opinion, to be avoided.”
We also recognize (ruefully) how challenging many in the psychiatric model – and a surprising number in the talking therapy world – find these ideas. At our person-centred service, we meet both dismissal and hostility. Our recent conflict with a couple of ex-therapist/work-colleagues has been largely a battle of ideas – the kind set out in Daniel’s piece and held by us, versus the viewpoint that there is a right and ‘proper’/’professional’ way to do therapy, determined outside the therapeutic relationship, which requires regulation and rules, ‘accountability’ and enforcement, in the false belief that these things will create the illusory holy grail of ‘safety’. In our view, only loving relationship can create safety, and those ways of seeing/doing do not support loving relationship. The existence of the conflict has made it easy for those concerned to describe their differing viewpoint – without foundation in the facts – as being about ‘ethical concerns’ or ‘client safety’, dressing up what is in reality a political act: the coercive attempt to impose an ideology.
‘….from what I’ve seen, the mental health field, and so many psychological providers, are quite skillful at rationalizing their bad work.
But are the providers hostile? Often no—because mental health professionals, especially when they get up to the higher levels of power, seem to be pretty good at masking their hostility. Hostility to me is an action of last resort—for people who are feeling vulnerable or powerless. These folks are powerful, and so they don’t have to be hostile. Instead they practice a different psychological art: they’re more dismissive.’
It seems to us of critical importance to challenge this dismissal, and the abuse of power it represents. It is vital that at least some of us still doing this work continue to base what we do on – and to speak up for – the core conditions, real relationship, and an intention to offer: “…a way of meeting people where they are, not labeling them or diagnosing them but just meeting them where they are” . Carl Rogers knew this mattered. So do we. This is what the people we work with actually need, in order to heal and grow.
Thanks, Daniel. Keep doing what you do.
Palace Gate Counselling Service, Exeter