Sunday, December 16, 2007


Rambling about mental health and "counselors"

Almost everyone I know has had some experience with counseling. Some people are or have been counselors, some have been in counseling (and, yeah, some have done both, and others went through the sort of peer-counseling that happens in 12-step groups. I’ve never worked as a counselor—at least I’ve never been paid for it... Counseling is a good thing: it’s helped me through some rough places.

But it isn’t perfect. Some counselors are control freaks, of course: they have a carefully constructed picture of how people should act and do their their utmost to try to get people to live up to that picture. A lot of that type are in religious work, sure. Some counselors are counselors almost by accident, because they studied it to help themselves and ended up trying to help others. And it goes on. I’ve known all kinds, socially and professionally. I’ve got counseling through social-service agencies, mostly.

Social service agencies, like mental health departments, have an often unstated agenda that drives the system: to get people “better.” By that I mean to get them in and out and produce results that look good as statistics.

Statistics mattter to agencies. Patients or clients or whatever they’re called—”consumers of services” is one of my favorite labels, need to be diagnosed. The diagnosis required for billing/funding purposes.

I think the whole idea of therapy is to help us become comfortable with who we are—not to "improve" ourselves or become better adapted—it's just to say, hey am what I am and if you don't like it, fuck off. But the way the money works...the patient or client has to acquire a label, and "get better." A lot of counselors are agents of the status quo, especially those who have public funding. Results, results, results, otherwise no more money.

The big thing in our local mental health system is "DBT:" Dialectical Behavioral Therapy—sans Marx or Engels, of course. It's actually, I think, an improvement on a lot of behavioral stuff because it includes elements from outside the rat labs. There's no doubt that skewed thinking underlies a lot of our conflicts and misery. But skewed thinking is also a cornerstone of our economy and society ("You're nobody till somebody loves you..."), and where would we be if people didn't go out and shop (which means having money) to prove their patriotism... However, the purpose of DBT is still to turn out employable and employed people who are off the dole. This makes it hard for the counselors and it makes it hard for the people seeing those counselors. There are those of us, like I mentioned, who just believe we need to accept ourselves as we are—free up the energy it takes to struggle with internal conflicts between what is and what we think we should be. I mean, fuck getting better.

Who wants to move into a house in a neighborhood that's burning down?

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