The Truth About Therapy

*****WARNING: Some NSFW language in this upcoming post*****

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I am one crazy motherfucker. To say some screws are loose is an understatement. I put the “normal” in “abnormal.” I openly admit I am nuts. It is likely due to a combination of trauma and a chemical imbalance fucking with my head. My mental instability dates back seventeen years to the age of twelve. It was this same internal chaos that fueled a realization that I did not want others to experience something similar. As a result, at the age of seventeen, I started my ten-year-long journey to becoming a mental health counselor. Having been on both sides of the client-counselor relationship, it is safe to say I can offer a rather unique perspective on it.

Myth: If I go to therapy, everyone will know I am crazy. I truly despise the stigma surrounding mental illness. It prevents so many people from reaching out for help out of fear of embarrassment. They see mental illness as a sign of weakness that may contradict their positive reputation. For others, it is a matter of pride. Irrationally, they cannot acknowledge that there is something wrong. I hear this more often from my younger clients in middle school through young adulthood where we tend to take others’ perceptions of us more into account and want to feel included among social circles.

Mental illness is more common than we think. About 1 in 5 American adults will experience a mental illness this year. 1 in 5 teenagers and about 13 in 100 children 12 and under will experience a mental illness during their respective time frame (NAMI).

Reality: You have the right to privacy and confidentiality. The truth of the matter is nobody needs to know that you receive treatment. All medical personnel including mental health must uphold the legal standards put forth by the Health Insurance Portability and Accountability Act (HIPAA) in 1996. This law protects your health information and allows you to dictate who receives this information. A HIPAA violation could result in the medical professional losing their license, endangering their career, and potential legal action.

Myth: I know most of you guys are in it for the money. Ha. Ha! HA! HAHAHAHAHA! *Wipes tears away from face and slaps knee* This one always make me laugh. A college graduate with a bachelor’s degree in psychology is lucky to make between $25,000 and $35,000 a year. Also, the types of jobs are limited to case management, residential settings, and hospitals at that level. If you want to become “successful” in the mental health field, that means a master’s or doctorate. Bend me over and fuck me sideways. The debt accumulated from graduate school makes having a sugar daddy look like a viable option.

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Reality: Mental health professionals do not make that much money. At least starting off, mental health professionals will not make much. When I was looking for a job out of graduate school and with my counseling license, I was looking at $40,000-$48,000. My salary has gradually climbed with more experience, and I can say that I am making a comfortable salary. However, I work fifty hours a week to do so. This does not include the six figures in student loan debt. Even with a doctorate in psychology, an individual could make $90,000-$100,000 a year usually in higher education or research. Psychiatrists know what they are doing by going to medical school. That is the one exception to our field (roughly $200,000 a year full-time according to the U.S. Labor or Statistics in 2016). As a whole, I know few colleagues who do not work at least two jobs in the mental health field. I know some who worked as many as four or five part-time gigs.

Myth: Once I start going to therapy and/or taking medications, I am going to be stuck going forever. I have been in and out of therapy since my teen years, and I took several medications starting in high school. I will likely receive some level of mental health treatment for the rest of my life, and I honestly would not have it any other way. Although it took some time, my doctors worked with me to find medications that treated my depression and anxiety with least amount of side effects. I am only on one medication as of now. As for therapy, my routine feels off when I go more than two weeks without an appointment. I use that time to reflect on my life, thoughts, and situations. I do not go every week like I used to, and I am the maintenance part of my treatment. I can go two or three weeks without a therapy appointment, and three months without seeing my prescriber. Usually, if you are looking long-term, the face-to-face time significantly decreases as your symptoms improve.

Reality: Many individuals receive short-term interventions and do not need services for long. For part-time work, I provide short-term in-home counseling for children and adolescents. My state has a crisis intervention system in place for children where parents, teachers, guidance counselors, etc. can call a 24/7 hotline to have a case manager come out and evaluate the children. Depending on the situation, the children are authorized typically for eight to twelve weeks to receive services. It is a short-term intervention.

The vast majority of the world’s population will experience a significant trauma and major life transition. Usually, mental and emotional well-being takes a hit when this happens. An individual may need counseling to make it through these changes, or may need treatment to be stabilized in more severe cases. Changes can occur in as little as six individual sessions or four to six weeks if in a partial hospitalization program.

Myth: I bet they can tell what I am thinking. Jesus fucking Christ. I hate this one. I am a therapist, not a fucking psychic. I can read body language, not your mind.

Reality: Counselors, psychologists, and psychiatrists are not mind readers. The client-counselor relationship models a real world relationship. Therefore, communication is key. As a counselor, I do not expect my clients to open up right away about everything, but you have to give me something to work with. It could be small talk in the beginning until you feel comfortable and can build rapport. As a client, I remember the exact session where I realized that I needed to be forthcoming. If I did not open up a little, I knew my psychologist at the time would not be able to appropriately guide me on how to resolve my issues.

Myth: They are psychoanalyzing me. I can feel them judging me through the stare.  I loathe when people ask me to “analyze” them moments after finding out my profession. I like to fuck with them and use my “John Edwards” psychic routine. Google him if you don’t remember his show back in the 2000’s. However, he was debunked as a medium and claiming to have the ability to talk to the dead. He would start off with general clues among an audience of 50 people. The odds were someone would latch onto his clue. By keeping general, the individual would jump up and apply it to themselves. This happens a lot with zodiac horoscopes as well. Our minds take general concepts and apply it specifically to our lives. However, if you find a mental health professional truly judging you, then they should not be working in this field.

Reality: Most mental health professionals offer a judgment-free zone and are open-minded to their clients’ experiences. Each of us is unique. Every human is different. In order to help our clients, our biases must be put to the side. Every person comes in with unique experiences, values, cultural backgrounds, etc. It is not the mental health professionals job to determine what is right or wrong. Our job is to provide unconditional positive regard. This way our clients can explore their situations openly and in a safe space.

Myth: Once I start talking, they are going to look for every reason to throw me in the looney bin. No, we do not. It means more paperwork for us. The last place anyone wants to go or wants to send someone is to the psych ward. Trust me, I’ve been there. I have to say though that the food was off the hook.

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Reality: Mental health professionals are mandatory reporters and only report as a last resort. As someone who has been hospitalized following a nervous breakdown, I know what goes on behind the scenes. Your rights are stripped away from you, and time passes you by while staring at the walls. It is nowhere anyone wants to be. Most mental health professionals are well aware of this having worked in these environments or seeing it happen with their family and friends. Professionals will often make every effort to contract for safety with a client and develop a plan. We will send someone to crisis if they are truly a harm to themselves or others.

Myth: I saw a therapist once, and they were horrible. I am never seeing a therapist again. Following my first and a severe panic attack, my parents took me to a psychologist. He was an older gentleman with glasses. His personality was flat and unwelcoming. Barely ten minutes into the session, he pulled out this thick packet. It was some fucking type of questionnaire. This was my first time in therapy, and this motherfucker who barely knew my name threw homework my way. My parents looked at him in confusion, took me out of his office, and did not even bother scheduling my next appointment at the front desk. I left there feeling disheartened.

Reality: Having a bad experience in therapy does not reflect the field as a whole. When shit truly hit the fan a few years later, I relied heavily on therapeutic services through my high school’s psychologist and an outside adolescent psychiatrist. I had few friends, and my family was in shambles. These individuals were the complete opposite of the jackass I met five years earlier. My school’s psychologist always set time aside for me if I went to his office. My psychiatrist let me sit and talk with her for my entire hour appointment. Even as an adolescent, she heard me out about side effects and concerns.

Just like with any profession, there are shitty mental health providers, and there are great ones. However, I could be the greatest counselor ever, and there will still be individuals who just do not match up well with my style or treatment delivery. Your job as the client is to shop around and find the right fit for you. It is like buying a car. One person could get away with buying a sports car, whereas the next person has a large family and needs a minivan to transport them all. Everyone has different needs and preferences. Some clients do better with a comforting, nurturing style, and others work better with a blunt, crass approach. As a counselor, I attempt to be well-rounded and accommodating with my style, but I do not stray far from my overall approach. Otherwise, I would not be myself and might even make the client feel uncomfortable.

Myth: I could vent to my friend, and it would be the same thing as paying a therapist. Listen, friends and family members provide fantastic support, especially in times of need. They likely act as a fabulous sounding board for your issues. However, your friend did not go to school for six fucking years, took a national exam, and then 3,000 hours of supervised experience.

Reality: Mental health services seldom take on the role of a venting session. There are times where a client needs to just “go off” and let off some steam. Time with a mental health professional is so much more than that though. Time with a mental health professional is meant to be constructive. It will come in the form feedback, suggestions, resources, education, and developing insight.

Myth: This person is just going to make me lay on the couch while they take notes and go “mhm” for an hour. This mental image dates back to the days of Freudian psychoanalysis. Patients would come into a psychoanalyst’s office and lay down on a couch. The psychoanalyst would sit in a chair behind the couch in order to prevent eye contact (Types of Therapy-Psychoanalysis). Psychology and mental health have come a long way in the last century.

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Reality: Mental health services, counseling in particular, are meant to be interactive and conversational. It rarely is a one-sided conversation. Sessions often engage both sides in dialogue. There have been plenty of instances where I find myself as the counselor doing most of the talking, especially if I am providing education on a topic or telling them a story that relates to the conversation.

Myth: Mental health professionals have a magic wand or pill that will fix all of my problems. I like to think I am a crafty son a bitch (Sorry, mama! I didn’t meant it!). I am always looking for ways to work smarter, not harder. Problem solving comes easy to me. Couple this with my desire to help others, and I am usually showing others my ways. This was the case at work with both clients and colleagues. I got a bit extreme however. It reached its boiling point one morning when I literally walked into my office and had not even taken my coat off. Four people in my office stopped me to ask me a question. I huffed at them to give me a moment to settle in before I come help any of them. They expected me to fix their problems.

That weekend I took a stroll to the local outlet stores and saw a Toys R’Us outlet store (RIP). Near the cash register, I saw a toy magic wand hanging, and it was only five dollars. I immediately ripped it from the shelf and bought it. The next day I took it to work. The minute my coworkers came in to ask me a question, I spun around in my seat with the magic wand in my lap. I tapped the button and waved it in the air as a small blue LED light flashed across the air. Problem solved, right?

Treating mental health is more along the lines of treating a torn ACL versus treating a cold. If you went to the doctor for a cold, they give you medications and remedies that get rid of the cold in a few days. A torn ACL requires more in-depth treatment. More importantly, it requires time and patience.

Reality: As a client, I will have to put in effort in and outside of sessions. Just like the torn ACL, in order for your well-being to improve, it requires effort on the client’s end. If your physical therapist gives you exercises to do at home, following through on them and going to all of your appointments feeds right into a successful prognosis. The same can be said for mental health. If a client comes in expecting an hour a week to fix their problems, progress will happen but at a much more limited rate. Concepts and skills learned in session must carry over into real-world application. You are going to have to put in some….

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Myth: They won’t get it. They just won’t understand. They have never been in this situation, so they can’t relate. The God’s honest truth is that we try not to let on that we can relate. More often than not, we get it. Sympathy and empathy run rampant in our profession. Also, the relationship is also one-sided in this sense. Rarely will professionals share personal details with a client unless they worked with them for a long time or if they feel that it is relevant to the situation. Clients will likely never know the full story behind the professionals they work with. This does not mean that they cannot relate. Our job is to try and understand what you experienced to the best of our ability.

Reality: Even though they might not have gone through the same exact situation, that does not make them immune to trauma and mental illness. When I was a counseling intern, I had a supervisor tell me, “Everyone that comes into this field comes in with their own shit.” What she meant was that most mental health professionals entered this field for the same reason. Professionals are human too. Life was not kind to them. They likely experienced trauma somewhere along the way and wanted to help prevent others from feeling the way they did.

Many of my colleagues are clients in their own right. They see a therapist or take psych meds. I have seen them battling addiction, anxiety, depression, mania, family conflict, significant loss, and the list goes on. Some could argue that this makes them a better professional by adding an inside look at what helped them in their recovery.

 

-The Caring Counselor

Resources

HHS Office of the Secretary, Office for Civil Rights, & Ocr. (2017, February 01). Your Rights Under HIPAA. Retrieved July 15, 2019, from https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

NAMI. (n.d.). Retrieved from https://www.nami.org/learn-more/mental-health-by-the-numbers

Type of Therapy – Psychoanalysis. (n.d.). Retrieved July 16, 2019, from https://careersinpsychology.org/psychoanalysis/

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