Why I love psychology, but will probably never be a therapist

My mother has suffered from a variety of emotional issues throughout her entire life. Among her problems were depression and severe mood swings. Though she has never been diagnosed (at least not that I know of), she has many of the characteristics of someone with dysthymia and some of those of someone with borderline personality disorder. She has extremely weak distress tolerance, lies frequently and transparently (often in the service of attempting to convince others that she is correct or to support the validity of another lie), and expects others to be responsible for her moods. She also once accidentally overdosed on painkillers at one point and nearly died.

Despite having all of these issues, my mother has received very little in the way of therapy in her life. It's not that she hasn't had opportunities. There was a brief time when she saw a counselor about her profound unhappiness in her life, but she discontinued seeing him/her because "it wasn't helping."

I don't know what my mother said to her therapist. I do know what people tend to want from both therapists and advice columnists. In fact, one of those things is so pervasive that it has been incorporated into the training that therapists receive. That is validation of their feelings. No matter what you feel, a therapist is supposed to validate it in some way. If you are angry because your husband forgot to pick up milk at the store for the 100th time, then the counselor is trained to say, "I can see where that is frustrating".

The therapist says this even if your husband forgets things because he's a medical intern doing back-to-back shifts and is exhausted all of the time. He says this even though you're selfish and demanding and utterly lacking in empathy for the circumstances around the forgetful behavior because your feelings need to be validated. He says this because you can't help people unless they feel you empathize with them because they won't come back unless you validate whatever they feel. I should hasten to add that validation of feelings is not the same as validation of actions or logic. The counselor says he can see why you feel the way you feel, but he may not think a reasonable person would feel that way. Unfortunately, clients don't necessarily understand that a validation of their feelings is not the same as a validation of their logic or actions. In fact, they often think they are one and the same.

The second thing that everyone wants from a therapist is to be told what they want to hear. If they go there to get help with a specific problem, they often want a concrete answer. They don't want just any old answer, or even a good one. They want the one which conforms to their worldview and meets them in their comfort zone. When my mother said that my father's alcoholism made her unhappy, she likely wanted the therapist to tell her how to get him to stop drinking. Chances are that he/she told her that she could not control anyone else, but would have to learn how to change her responses to his behavior instead. My mother has never wanted to control or change her reactions. She has always,  always, wanted others to change to conform to her preferred way of doing things. I don't know why she stopped going to therapy, but I'd wager a large sum of money (and I'm not a gambling type) on the likelihood that she complained and was told that she needed to change rather than trying to convince others to do so.

People often want change, but they don't want to do the things which lead to change. They want to lose weight, but they don't want to change how they eat. They want to be fit, but they don't want to exercise. They want to be rich, but they don't want to work harder. They want better jobs, but they don't want to acquire the types of skills or education that will get them that type of work. They want to be happy, but they don't want to think deeply about what that really means and requires. They want achieving all they desire to be somehow within the boundaries of what is comfortable for them and it is their expectation that the counselor has some sort of magic wand to make that happen.

The bottom line is that people are often not saying, but are indicating, a particular question. That question is, 'How can I get what I want without doing things I don't want to do?' This is, by and large, what therapists are dealing with and the biggest reason why I don't want to be one. I don't have any easy answers. I don't want to sit with people who are looking for them and see the looks on their faces when I tell them in a nice and validating way that their fantasies aren't coming true, there isn't a place over the rainbow, there is no glass slipper or princess or prince charming, and they can't live forever. There isn't some magic handshake that will stop the world from being a place full of self-centered and selfish jerks who think only about themselves so that you can be a more satisfied selfish and self-centered jerk who only thinks about herself without any interference from the needs and issues of others.

I should make one thing clear. In general, I don't think people have to change or improve their lives. I don't care if someone drinks, smokes, or is overweight. I don't care if they don't want to have sex with their partner or work at a dead-end job. None of that is my business, but if you're a therapist and people with issues come to you for answers to such problems because they're unhappy, then it becomes your business (quite literally). I also have nothing but sympathy and empathy for those who can't change for whatever reason. I've been in that boat for much of my life. My issue is with people who go to counselors looking for a type of answer that doesn't exist and then believe that the therapist has failed him or her because of that grim reality, not that people have issues and lack the energy or psychological wellspring from which to combat their problems.

Quite often, I feel that there are answers to every person's problem. Often, those are answers they can't pursue. For example, a person who suffers from chronic back pain may benefit from more exercise, but the benefits are in the long run and the pain they have to endure to reap any benefits may be too overbearing to tolerate. The answer is there, but unreachable. However, there are also answers that people refuse to pursue because they don't like the price tag that comes along with them. Recently, I read a blog that I've followed casually for quite some time which brought this home to me and was the motivation for this post.

This particular blog, which I will not link to here as I don't want to embarrass anyone or start any ridiculous blog wars, is written by a woman who has been trying to lose weight for many years. She has serious issues with her relationship with food and, based on her copious blog entries, it's clear she has emotional, compulsive, and binge-eating issues. She went to an eating disorder therapist who recommended that she take steps to normalize her relationship with food by learning to embrace all types of food and exercise moderation and portion control. This is actually an integral part of stopping the cycle of food obsession and abusing food for comfort that many people with her particular problems possess. Placing food out of bounds, seeing it as an adversary rather than a source of sensory pleasure and sustenance, and restricting your intake are part of what creates the disordered relationship. The first step is repairing perceptions by stopping the actions that created the distortions.

This woman wrote that the therapist told her something she really did not want to hear and then went on to refute the value of this approach. She didn't do this because she doesn't want to solve her problem. She did it because this behavior is outside of her comfort zone and the perimeter of that zone was put in place by another priority - losing weight. She doesn't want to repair her relationship with food if she can't lose weight in the process. The price of fixing her eating disorder is too high, particularly in the short term and she refuses to seriously entertain the notion that the short-term risk may carry long-term benefits (i.e., that curing the disorder will ultimately give her better control over her intake and result in the desired weight loss).

This woman did what I think many people in therapy do. They have an issue, seek an answer, and then dismiss the answer when it's not the one they wanted to hear. She says that she wants to fix her disorder, but she doesn't want to risk gaining weight in the process or failing to lose more. What she needs is a doctor who forces her to stay on a strict diet and berates her until she's thin as that is actually her priority - a priority which is incompatible with her desire to deal with her relationship with food. You don't go to an eating disorder specialist to lose weight. You do it to fix your mental health problem.

Some people choose to see therapists and work on their issues. These are the people who often populate the re-enacted case studies that people who are studying psychology are shown in order for them to believe it is an orderly process in which clients are cooperative in their own healing process. The reality is far from that. Clients resist. They drop out of therapy. They refuse to discuss the roots of issues or to see themselves or others for who they are. They waste time in sessions talking about things which are not on point.  I know some people can and are helped, but most are just looking for magic, and I don't have any to give. Despite everything I know and all I'm capable of in regards to being a therapist, I know that I don't have what people really want because it doesn't exist in many cases.