Climbing the Ladder / A Therapist’s Dilemma


Just like anywhere else in business, the phenomenon of climbing the ladder exists in the mental health industry. Yes, even mental health therapists (and those who work alongside us) routinely choose this route to power. 

Climbers are often quite easy to spot; after all, climbing the ladder is a game and most people can spot the often unskillful moves of the players.  If you are going to play, you can never forget this one simple fact: Never throw in your ante unless you’re willing to lose.

Are you playing?

What is your wager?

1. Your wager will usually involve giving up some degree of integrity, replacing it with any number of less flattering traits – traits you would not normally want to model for your parents, your children or your clients; but you do and you are not fooling anyone.

2. The moment you start on your journey up the ladder, it is unlikely that you will ever be able to stop climbing. Neither will you ever truly rest. You will always be afraid of taking your eye off the ball. There is always someone coming up behind you – someone just starting to play. Keep alert!

3. The prize for climbing is never clear; it is unique to each player. To know what your prize is, ask yourself what would it mean if you got to the top? What would be there waiting for you? What are you after? Ultimately, over time, some players realize that the prize has always available to them. It may have been in how they viewed themselves to begin with – before setting their sights on climbing to the top.

If you’re not enough without something; you will never be enough if you get it.

4. The object of the game is to just keep going up. In order to maintain the momentum, you have to grip the rungs that are most likely to propel you forward, faster. That is not as easy as it sounds. Over time, you forget the risks ahead and you become more and more vulnerable to others with the same level of enthusiasm or more ambition than you have.

5. Some climbers believe that luck plays a part in winning the game. This idea might prove harmful, if and when your luck runs  out or someone else gets luckier. There are a lot more snakes nearer the top, as you climb – and a lot further to fall if you do.

6. If you’re playing the game, people can always identify you; and they will describe you in terms of your game: an opportunist, a user, fake, untrustworthy, back-stabber – duplicitous. The impression most people make of those who climb, play and promote their own interests are:

• They forget about everyone except themselves and the key people they believe can help them move up. People notice that.

• They develop a single-mindedness and a whatever-it-takes frame of mind. People notice that.

• They have no limit to their ruthlessness in pursuit of their goal. People notice that.

• They try to take less risk than those above them and those below, leaving everyone motionless and ineffective. People notice that.

• They become more focused on looking active and fast-moving than actually being active and fast-moving. People notice that.

• They start to believe and behave as if they are active and fast-moving. People notice that.

• Their management of others is just another way of pursing their own ambitions. They eventually lose support, because people notice that.

• They make sure all of the successes of their team are attached to them and the failures are attached to others. People notice that.

• The closer they get to the top, the more visible their game playing becomes; because the game gets more demanding as the field of players begins to narrow and people notice that.

•If they play long enough, they will eventually meet someone on the way they never expected to see; and they will recognize you.

7. Working hard, setting more reasonable goals and determining your own list of priorities for success in your life may well prove, over time, to be a more peaceful, self-enhancing ambition. I like to use this guide for my life:

• Take into account the ethical and moral dimension in all of your decisions;

• Take a minority position if you believe it the right thing to do;

• Take responsibility for the mistakes you make;

• Try to forgive – everyone; even if it’s the same person, every day;

• Do a good job without focusing too much on getting attention and praise. Focus more on your own achievement, your own commitment and your own appraisal of your own work;

Try to be happy with what you are asked to do – or have determined to do;

Live a balanced life. Fill your life to the brim with work, fun, friends, hobbies and your private passions.  Top it all off with a never-ending quest for knowledge, empathy and understanding;

• Say ‘no’ when you have different priorities, a different position, a confident opinion – even when everyone else is saying yes; and,

• Commit to your family, your friends, your profession, your community and your colleagues. If you don’t, who will commit to you?

Whether you begin your climb or not is really is up to you. Before you start, however, ask yourself, What am I wagering? What prize am I pursuing? Is it worth dedicating my whole life to achieving it? When I get to the top (wherever that might be), will that be enough for me? When will I know I’ve gotten there? If I get what I want using trickery and self-promotion, will I ever feel secure in my achievements, no matter what I achieve?

Life with equal parts of fun and responsibility, for me, is far more rewarding than a life of climbing the ladder.

If your mind is set on climbing the ladder, ante up! You might, however, want to live your life, instead, by your own standards, reaching your own goals, using established ethics and more person-focused and less self-focused principles. Never allow pretense or appearance to replace true achievement. You will never know when you have achieved your goals if you do.

Integrity and honest should never be what you sacrifice to reach any goal.

To truly succeed in your life, to get to where you want to go, you might stop feeding your demons and drink in inner peace, insight and honesty, instead. After all, you will ultimately leave this world resting in your own skin.

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A Boy From Honduras


Several years ago I worked with a seven-year-old boy who didn’t speak English.  He was from Honduras and he spoke about fifty or sixty words familiar to me – mostly nouns and verbs.

The rest of the time, he spoke fluent Spanish.

The boy from Honduras was quite timid, his dark, black bangs covered his eyebrows and flicked whenever he blinked. He rested his chin on his chest, the neck of his striped t-shirt pulled up over his mouth, muffling the English he could speak, making it even harder to understand.

At the time I met the boy from Honduras, I spoke English – and a good amount of French; I didn’t speak any other languages.

The boy had been adopted by an American, English-speaking couple who lived on Cape Cod.  Not long after moving to his new home, the boy’s new parents identified something unusual in their new son’s behavior.  The boy wouldn’t come out of his room.  He sat on the floor beside his bed all day.  The concerned parents sought help for what appeared to them to be depression.  “We thought it would be easier for him to adjust,” they said, almost in unison.  “He has his own room, a new bike, his own TV.  We just thought he would be happy and that we would all just eventually learn to communicate.”

“Does he speak English?”

“Not a lot,” the adoptive mother said.  “He can understand a lot, though.”

Upon our first visit, I found we were having trouble understanding one another, me and this boy from Honduras. I relied on my hands, facial contortions and the tone of my voice to make up for what I couldn’t communicate in words.  “Are you sad today,” I would say, lowering the vocal range of my voice to its lowest low, “Saaaaaaad?” I contorted my mouth into an exaggerated frown with the help of my fingers on either side of my mouth. He nodded in agreement that he understood and, realizing that even though he was sad, there was very little he could do to explain why; he looked at his shoes, swinging them back and forth under the little chair he was sitting in.

The following week, I found that I was quite adept at identifying the obvious.  Are you sad?  Are you happy?  Are you thirsty?  Are you cold? I couldn’t, however, ask him, When you think of leaving Honduras and coming to this strange place, what do you tell yourself?  This little brown boy from Tegus, sitting in an office in Boston, wearing a Red Sox baseball cap, was isolated by language.

The boy’s parents and I discussed the use of a Spanish-speaking therapist or an interpreter.  They said they had tried to find a Spanish-speaking therapist, but one was not available who accepted their insurance or at the price they could afford. The boy’s parents agreed that he may benefit from having an interpreter.

Over the course of the first two weeks of our twice-weekly meetings, while we waited for the interpreter to make room on her schedule for the boy from Honduras, his English vocabulary increased by a few words.  We were both thankful for that; but, alas, my Spanish vocabulary didn’t increase at all and we were soon stuck, again.

“Can you tell me about your trip to Boston?” I asked, “Do you remember that?”

“Trip?” he asked.

“When you came to live here?”

“Cametoleaveear?”

“Airplane,” I said, making wings with my arms and the sound of an airplane with my teeth and lips.

In our third week, I greeted the boy in much the same way I had when we met a few weeks prior, “How are you?”

“I-ng fy-ng.”

“How’s it going?”

“Fy-ng.”

You talk today?” I said, pointing my finger at his chest and then at my own mouth.

The boy sat looking around the room and then down at his shoes.

I waited.

Each time, just before speaking, the boy looked up, expressed some excitement, started to speak but gradually returned to thinking.  In fact, he tried several times to say something, but returned to thinking, his eyes roaming from left to right, as if trying to transform his Spanish thoughts in the right side of his brain into the English words on the left.  He did this several times until finally he said, “I not give good English.”

“I know,” I said, slumping my shoulders and frowning. “Just tell best you can.”  I emphasized the words, as if I were chatting with someone who was hard of hearing.  “I-try-good-understand.”

“O.K.,” he said, “I-yam . . . estoy nostálgico,” and gripped his fists together, “Nostálgico?”

“No,” I said, sadly, “again . . . try again.”

The boy looked at me, transforming the space between us into a brick wall with his expression.  He returned his chin to his chest.

“I have an idea! Tell me in Spanish,” I heard myself suddenly say.  “Just talk to me in Spanish.  Use your own language to explain to me. You understand?”

“Non,” he said, but obviously interested, energized by my facial expression. He leaned forward.

“You-talk-Spanish,” I said.  “You-say-Spanish.”

He appeared uncomfortable, embarrassed by the idea of speaking Spanish to me, knowing full well I wouldn’t understand a word of it.  “Non,” he said, covering his mouth, smiling broadly.

“You try!” I said.  “We try! You, me.”

He waited. Cautious not to speak outside the conventions of discourse he had learned over the course of his lifetime.  He appeared outwardly self-conscious of the sound of his own voice; as if talking to himself was wrong – outside the boundaries we allow ourselves to express our thoughts. He leaned forward and began whispering in a somewhat animated, articulated fashion.  He said something that only he and other Spanish-speaking people could understand.  He waited for my response.  Was he testing me?  He smiled broadly, giggled and said the same thing again. I raised my shoulders and put my hands in the air, expressing my inability to understand.

He laughed and seemed content.

“How you to-day?” I asked. “Talk Español.” I moved my hands, expressing some universally understood sign language I imagined would help translate each word.   “How (raise and lower shoulders and show palm of hands) you (point finger at his chest) today (move hands in a circular motion; finish by showing the palms of my hands)?” “Talk (point at mouth with finger and point at his mouth) Español (put finger in front of my own mouth and turn it in circles).

The boy sat back in his chair, placed his hands between his thighs and looked down at his chest.  He spoke softly at first, but then gradually, as he grew accustomed to the sound of his own voice, raised his eyes and spoke with more volume, determination and intention.

The boy from Honduras spent the next thirty minutes telling me a story that occasionally brought a smile to his face but, just as quickly, filled his eyes with tears.  He wiped his eyes with his t-shirt.

Of course I couldn’t understand his words, but his eyes, his face, the color of his ears, the way he moved told me something about his story that could be clearly understand – something not really available to language.  After a few minutes, however, I was in pace with him. I allowed my own face to mirror his face, and, checking for understanding now and then, he clearly recognized something in the way I was responding, something deeper than words; something that fueled his story by promoting a sense that I was truly hearing him.

Mental health experts believe that facial expressions are primarily communicative in nature.  They can serve as a prelude to our intentions, an indication of our internal state. In fact, facial expressions are often recognizable across cultures.  Facial expressions, even among some animals, could possibly be a primitive way of expressing thought – thought that this is not readily available in spoken language.  (Even those who share a common language have been known to use facial expressions to communicate an internal state, quite accurately.) Facial expressions may even predate spoken language and may have been, at one time, long ago, our primary source for communicating with others. Anger, suspicion, happiness, sadness, disgust and surprise are regularly expressed using universally accepted facial expressions. Now, in instances where language is a barrier between people, facial expressions seem to be Nature’s enduring gift, bridging the median that often exists between understanding and indifference.

A great deal of emphasis is often placed on the use of spoken language in the provision of mental health services.

What do I say to my client?

What if my patient says this?

What do I say then?

Even therapist who have been in practice for many, many years sometimes focus their encounters with others on language, banter, crafty psychological philosophy and theory, magical talking cures that, when practiced just right will result in a miraculous cure for their patient.

It is our responsibility as therapists to help each of the people we encounter to be what s/he can be.  This goal is better achieved by ensuring that our talking cures are focused not on our own language but on the language our clients use to articulate their ideas, interests, hopes and dreams.  We cannot limit understanding to the words and meanings we understand. We must also strive to truly see and hear the people with whom we come in contact.

Nothing could have trained me better to appreciate any eventuality in language, every nuance of sound and movement, than the boy from Honduras.  I never did learn what he said to me that day.  His parents took him by the hand and they went home.  The interpreter never called back, and everyone blended back into the world.

The boy from Honduras, however, is ever-present in how I have encountered everyone – everyone I have ever met since hearing him.

Children with Character


When I was a child, in the early days of the growing phenomenon that eventually became known as attention deficit hyperactivity disorder (ADHD) – before the harsh, punitive medications we now use to control children with character, my caregivers accommodated, as best they could, my curious nature.  In response to what I believe to be the disastrous burden placed on unsuspecting children by their misinformed caregivers, and drawing from my own experiences as an energetic, intelligent and misunderstood child, I will offer an intervention strategy for helping to improve the futures of children who, instead of having a disease called ADHD, have, instead, a misread and underappreciated gift.

For eating chalk, I sat behind the piano.  For pulling a worm from my nose, I sat in a chair outside the classroom; For general misbehavior, I was sentenced to sit in Murderers’ Row – a special line of seats and desks set aside especially for inquisitive, energetic and distractible children like me – mostly boys.  I was often the sole inhabitant of Murderers’ Row, so, sitting at the first desk in the row, I imagined I was at the head of a series of empty rail cars, chugging across the Pacific Northwest, The Little Engine That Could.

Learning to read, identify colors and do simple mathematics was often achieved from hearing, alone.  I traced my finger on the shiny, painted cinder block wall, making letters, numbers and symbols that I imagined accompanied the lessons that were being taught. A leaf was green.  A fire truck was red.  The sky was . . . blue – and so was the wall in front of me.

I didn’t need to actually see to learn.

I was Helen Keller! Only I could hear.

I adapted.

As punishment for living in my imaginary world, where so much more was possible than in the world in which my classroom merely existed, I would have to write lines –

I will not yell out. 

I will raise my hand and give others a chance to answer. 

I will not aim for the face when playing dodge ball. 

I will take my own bus. 

I will eat my own lunch.

After a while, I simply expected to break the rules and, as a condition of parole, write lines.  I was so confident that I would be found deficient in nearly anything I tried each day in school, I wrote out part of the sentence in advance – the part of the sentence I knew would be there no matter what I had to write – I will not.

I filled my desk to the bursting point with reams of paper; hundreds, thousands, millions, trillions of partial sentences that would only take a few more words to complete – freeing me to do as I pleased.

I will not – turn my eyelids inside out.

I will not – cut in line.

I will not – take powdered soap from the boys’ room.

The crinkled paper with the partially completed sentences written hurriedly across each page spilled out on the floor beside my desk and was the first thing to greet me every morning when I came back to school.

The number of school-age children (ages 3-17 years) who have been diagnosed and treated for ADHD is estimated at 5.2 million.  Following diagnosis, and when placed under psychiatric management, the treatment of ADHD is expected to involve some combination of medications, behavior modifications, lifestyle changes and counseling.  Often, however, the treatment of ADHD is limited to psychotropic medications, alone; leaving children drugged and with less potential than they had previous to the diagnosis.

The symptoms of ADHD can be difficult to differentiate from normal childhood development, increasing the likelihood that the ADHD label will be misapplied.  Impulsivity, emotional fluidity, lack of concentration and variability in mood and behavior are all observations suggestive of ADHD.  In addition, due to the constraints of time and opportunity, the diagnostician will often rely on caregivers, teachers and other adult historians for the longitudinal (biased) data necessary to formulate the diagnosis.  Rather than estimating the potential contribution to the child’s conduct made by the caregiver’s own level frustration tolerance, environmental conditions or early and current parenting style, the child’s behavior becomes, instead, a treatable disease, cured, ostensibly, with drugs.  A kind of no-fault provision in the implied contract between caregiver and child – a provision where the caregivers is absolved of responsibility for the child’s behavior and the child is found blameless for h/er poor choices.

After all, it’s a disease.

As early as the 1970s, when the ADHD diagnosis was first starting to gain momentum, it was, even then, considered a controversial, exploited and mismanaged psychiatric disease of childhood.  (Only recently has the disease become diagnosable in adulthood.)

At a time when the developing brain is highly susceptible to damage by intruding chemicals and other caustic substances, the use of stimulant medications for management and treatment of ADHD in children has become standard, rudimentary practice among healthcare providers.

I find the whole process repugnant.

IMPROVED WILLPOWER AND FRUSTRATION TOLERANCE

As a boy with more energy than I had support for my ambitions, I spent a great deal of time, instead, trying to be like other children.  I remember watching the best-behaved students in my class – mimicking their movements, believing that if I shadowed them, talked like they did, I would be good too.  If one student moved her hand a certain way, I would move my hand just like she did.  If another student sat quietly, his hands folded on his desktop, so did I.  But my plan didn’t work. Nothing could save me from my teachers’ suspicious gazes. They simply didn’t trust me.  They were skeptical of me, even when I was behaving like one of the good kids.

One day, toward the beginning of summer and the opening of spring – a miserable time for a child with character who is stuck inside all day, separated from frogs and swamps and tree limbs, my teacher, the originator of Murderers’ Row, said, “Michael, let’s try something NEW!”

“Sure!” I said, taking my shoes out of my desk and slipping them on.

While the rest of the class was reading silently, my teacher took me to a small foyer in the back of the classroom.  He carried a chair in one hand and a TV tray in the other.  He clung to a bag of marshmallows under his left elbow.  He set the chair down, “Sit,” he said, pointing his chubby finger at the wooden seat, and unfolded the TV tray, clipping the legs into the plastic slots.  He broke open the bag of marshmallows and placed one on the table in front of me.  “I want you to sit there for twenty minutes and, if you can control yourself and not eat the marshmallow, I will give you two.  You can eat it any time you want; but if you can control yourself for twenty minutes and not eat it, I will give you two.”

“Really?”

“Really.”

I remember sitting in the chair for what seemed like hours, waiting for twenty minutes to elapse and I could eat the marshmallow in one bite AND have another one to boot.  Every now and then a student would turn around and give me a knowing glance – to which I stuck out my tongue and returned my gaze to the lone marshmallow sitting on the tray in front of me.

I ate it.

Nineteen minutes later, my teacher returned.  “Hmmmmm,” he said, hands on his hips.  “You couldn’t resist?”

I smiled, looking up at him, my red hair hanging just above my eyebrows.  “Nope,” I said.  “I almost did, though.”

“We can try it again tomorrow.”

Over the course of that spring, my teacher did the same experiment with me every day (sometimes two or three – maybe four times), until I was capable of not only making it through twenty minutes to achieve my second marshmallow, but I had strengthened my resolve and built my frustration tolerance to a point where I could sit for over an hour with little or no reward at all.

My willpower, my self-discipline, had increased dramatically. I had trained myself and built the neurological connections necessary to not only improve my frustration tolerance, but to make it a habit!

I still recall this memory of my teacher’s systematic instruction – his dedicated effort to teach me to focus my attention on a goal – to commit the proper amount of devotion to the task ahead of me.  Toward the summer, when school was letting out and I was free to roam the woods, quarries and sand pits in my neighborhood, that lesson helped strengthen me by creating an atmosphere of achievement and success that I could use to grow and improve.  Over time, my willpower, self-discipline and loyalty to my goals improved – leaving that place in my brain, the one that defined who I was as an individual, intact – where I could be myself and something more.

I am still the child I have always been, unimpeded, spontaneous and impulsive – instinctive and unrehearsed.  I am myself, unadulterated and un-medicated.  I enjoy myself and my unique perspective, and I have learned to live with all of my strengths and weaknesses, even when these traits are not as well received as I would like them to be by others.

Instead of thinking we will all be better off after taking pills, conceding to others and how they think we should be, deadening our intuitive nature to explore and challenge our understanding of the world, we may remember that our brains have immense possibilities that pills will never improve, but only creativity, inventiveness and ingenuity can achieve.

This is not a talk show


Therapists, rather than helping their clients tackle the more critical, covert sources of their emotional distress, often treat them for the signs and symptoms they expressStress, for example, has a very loud voice and will not likely be easily concealed by contradictory behavior, i.e., unhappiness, depression, anger, rage and discontent are all common and quite obvious indicators of some form of personal hardship.  We have to be careful as therapists, however, not to treat these emotional and somatic gestures as if they were our client’s primary illness.  The emotional signals our clients send are more often symptomatic of something much larger.

  • Lethargy, lack of interest and inertia may be symptoms of thinking that one’s life is wholly irredeemable and that there is no hope left. 
  • Anger may be a symptom of fear
  • Attention deficit (ADHD) and behavior disorder (BDD) may be symptoms of weaknesses in a child’s physical and social environment – or a parent’s inability to undertake the responsibilities of raising a rambunctious and demanding child.   (The way I look at it, if Helen Keller’s parents were able to raise Helen through childhood into meaningful adulthood, and we elect to give children chemical lobotomies because they won’t sit in their chairs at school, we’ve lost an essential component  in our present-day system of parenting and education. We are also addressing, in this example, the symptoms of the real problem.)

Like most things in our fast food culture, people who seek help resolving an emotional hardship want immediate relief of their symptoms – step up, get your product, swipe your card and leave. (And there are many therapists who are happy to do it that way.) Rather than working to modify the source of the symptoms, people often want the kind of help that will, instead, make them sleep, stop crying, stop obsessing, stop caring, stop feeling – to be NUMB!  If we treat our client’s from this perspective, however, it is unlikely that we will ever help them achieve emotional stability over the course of their lives.  

Ah, I see you’re back.  How can I help you?”

“I’m really depressed, again!”

“Heavens, you’ve only been gone an hour.  I really thought the last year of therapy had helped. That can be expected. People get depressed when they lose their job. What happened?”

 “I got fired!”

Relieving the overt symptoms of distress is often a therapist’s first goal.  It isn’t nearly as tough, however, as resolving the covert problem.

“Oh, that’s horrible! What are your plans?”

“I don’t have any.  I can’t get out of bed in the morning.  My life has gone to hell in a hand wagon.”

“I am SO sorry to hear all this.  This is all normal, though. You can’t let this get you down.  This will all turn out good.  You watch!  You’ll get another job – you and those pearly whites!”

If we persist in addressing only the symptoms of emotional distress, and attribute their cause to some external source, we will be forever chasing after temporary, short-term relief. For example, if a child persistently gets second degree sunburns in the summer, and h/er physician treats the burn with a topical medicated cream – and does nothing else, we would not be recognizing and addressing the prevailing issue, which is that the child’s parents can learn to take steps to avoid the damage in the first place.  The child may need to learn about the suns potential to cause serious injury.  If we can take steps to impact the true problem, rather than the symptoms of the problem, we will likely be more successful at negotiating an intervention.

This example might be used to develop and improve our approach to mental health mediation.  If we teach our clients that depression is just an expected result of misfortune, the client will likely always express depression whenever s/he experiences misfortune.  The client will be forever, as well, left to seek outside help to resolve nearly all of h/er emotional problems.

Contrary to the conversation, above, we might, instead, practice differently:

“Ah, I see you’re back.  How can I help you?”

“I’m really depressed, again!”

“You’ve only been gone an hour. How do you know you’re depressed?”

 “I got fired!”

“What I mean is . . . how do you know you’re depressed?”

“I can’t eat.  I sleep all day.  I sit and stare at the wall. You know . . . that sort of thing.”

“How is that a problem for you?”

“Oh, here we go again!”

“Yes, this is not a talk show.  This is therapy.”

“Well, I shouldn’t have been fired in the first place.  My boss is an asshole.  He was out to get me.”

“So is your problem that you were fired or that you shouldn’t have been fired in the first place?  Or maybe your problem is that you think your boss is a rectum?”

“Both!  All three!”

“Which event do you think is contributing to you staying in bed and not eating?”

“Probably thinking that my boss shouldn’t have fired me in the first place.  It’s his fault I’m in this shit mess.”

“What do you suppose you’re telling yourself about your boss these days?  What are you saying to yourself about him and these events?”

“I tell myself that my boss shouldn’t have fired me.  I didn’t do anything and people shouldn’t have to suffer if they didn’t do anything. People who follow the rules shouldnt have to put up with shit! My boss should be fair with me.  I ought to be treated better.  I deserve it.  I think your boss should always show you respect!  I need things to go smoothly in my life in order to be happy. If things don’t go smoothly, then I just can’t stand it!”

“Is that it?”

“No! My wife things I am a fuck up!  My boss might as well have cut my balls off. Maybe he and my wife are right about me.  Maybe I am a fuck up! My kids are mad because we can’t do much anymore, because I don’t have any money. I’m sure people are laughing behind my back.  I can’t even go out and mow my grass.  If people see me out during the day, they are whispering that I am a failure.  Which I am. Oh, hell, it goes on and on.”

“Sounds to me like maybe losing your job and getting fired are not your problems at all.”

“How so?”

“All that stuff you’re saying to yourself about your boss and your neighbors, your kids and your wife, that might be a bigger problem than losing your job.  Maybe if we can change some of that self-talk, some of that insane, nutty shit you say to yourself, you might make yourself feel better.”

“How will we do that?”

“That’s the hard part. That’s why I’m a therapist and not Dr. Phil.”

It is NOT the therapist’s role to treat the obvious symptoms h/er client presents in therapy.  It is our role, however, to uncover and treat our clients’ problem thinking – something they don’t often know they have.  By doing so, we will improve the likelihood that our clients’ symptoms will experience some measure of relief through more logical and rational thought.

The very thing that separates a client from a therapist is in the therapist’s understanding of the human mind and the human body – not only its structure, but its plastic, ever-changing environment for emotional evolution.  Your client depends on your ability to show h/er around inside their own heads (a place where you would think everyone would be more intimately familiar) and help them uncover the true nature of their emotional distress.  If you can have an impact on your client in this way, you will have helped h/er build h/er skills at self-help and self-sufficiency.  If you continue to treat your client’s symptoms, you will be establishing a foundation for a lifelong commitment to dependency.

Professional Equivalent


The foremost weakness in our present-day mental health industry, besides our overdependence on drugs as the primary source of mental health mediation, is the numbers of paraprofessionals who are treating not only the walking worried, but people who are far more gravely ill. 

People have an expectation and a right to excellence from those who claim the role of social worker, clinical counselor, psychologist, psychiatrist and the like.  People in need of mental health mediation, however, are not even coming close to meeting that expectation.

In the field of mental health, unlike other professions whose members are expected to meet a training standard before services can be reliably provided, there is a creature known as a professional equivalent

Normally the professional equivalent to the social worker and clinical counselor is a person who majored, as an undergraduate, in some topic that, shortly after graduating, lead straight back into a career field that was similar to the one they had prior to spending thousands of dollars on their undergraduate degree, i.e., sociology, psychology, anthropology or religion.  Mind you, there are no professional equivalents in law, dentistry, chiropractic or medicine.  Yet the professional equivalent to the clinical mental health counselor and social worker runs rampant within the field of mental health.

Often these stragglers, these poor misinformed and misguided students, will pursue a graduate degree in an area that may prove more useful later on.  Many, however, will be absorbed into the profession of child protection (and call themselves social workers) or community mental health services (and call themselves counselors); thereby creating the impression in the minds of their clients and others that they are trained social workers or clinical counselors, and not the paraprofessionals and nonprofessionals they truly are. 

Simply because someone says they are a social worker or a counselor does not mean they are trained in that field.  In fact, it has been my experience that a person who identifies h/erself as a social worker or a counselor is, in fact, neither. 

This well-tuned process of hoodwinking the unsuspecting public not only debases my profession, but provides fodder for the numbers of stereotypes we encounter in the world of human service. 

Social workers steal children from well-meaning, misunderstood parents. 

Therapist listen and their clients talk. 

Counselors give advice and are responsible for changing lives.

This whole process, of course, is nothing more than a money-saving device.  Most often used by mental health organizations, it is a way of increasing reimbursement for services that are provided by minimally trained or not-trained-at-all therapists.  For, if anyone can be a therapist, a social worker or a clinical counselor (and no one is likely to ask questions), why not hire a desperate recent college graduate and pay them minimum wage, rather than a licensed and trained practitioner and pay them something more competitive?

I would suggest that my reader ask questions and expect answers from those who would claim to be trained to help you resolve your problems and achieve your goals – especially where your children are concerned.  Often you will be surprised to find that the person with whom you plan to share the intimate details of your life is no more likely to help you with that than your next-door neighbor is likely to help remove your tonsils.