Trajectory of Psychotherapy - Psychological Suffering: Final Reflection

** The following was submitted as the last reflection paper for my Psychology of Suffering and Disorders course **

          For this reflection paper we were asked for our thoughts on the “trajectory of the field.” The first thing that comes to mind is part of a conversation I had with some of our colleagues after class on Thursday. I mentioned that a friend of mine, who is in her Podiatry Residency posted something on her Facebook titled “Dear Lawmakers: This is what it's like to be a doctor today.” As I read through the article (link here) I couldn't help but think of the parallels I was seeing with my own career projection. To summarize, the physician laments his soaring student debt and modest salary as a young doctor while purchasing a home and raising a family. He presents a question about why doctors still bother; and answers that it is not about the money any more, it is because they care. I thought this bore a striking resemblance to my thoughts on entering a career as a psychotherapist or even as a psychologist. As ***** pointed out below, if money is your game, you're in the wrong field. So, why do therapists still bother with 2-3 years of graduate school (5-7 if you're chasing a doctorate) and another 3 years of supervised training? I suspect it is not too different from the reasons stated in the article.

          More to the point, I think that there are two predominant directions that “the field” is headed in simultaneously. Firstly, I think the divisions between professions (Psychiatrists, Psychologists, and Therapists) is only going to deepen. As technology, science, and medicine relentlessly accelerate and are pushed by various influences (consumer demand, payment policies, research and education politics, etc...) the idolatry of a “human science” seems to be waning even from its current crippled state. Secondly, I suspect that further integration between these fields will develop regardless of who holds the “majority share.” While technology can do incredible things, the screaming voice of the last half-century or so is pleading that capital and industry can not solve all our problems.

          I mentioned Human Science in quotations and with the pejorative of “idolatry” with specific intent. I feel that emphasis is needed there and not doing so discredits what science and medicine have done to improve our (every helping profession's) quality of care. If nothing else, options are available now that would have been beyond comprehension 100 years ago. I also think it would be dishonest of us to deny that there is any “theoretical seclusion” or “mental masturbation” going on in our field. Personally, I plead no exception to this. I suppose that I am more hopeful than making a probable projection that integration will occur. I also mentioned a waning presence of “talk therapy.” I mean this in a public/political stock-holding sense. I don't think that this necessarily means a weakening of strength within our own context and scope of practice; rather, a concentration of skills and emphasis... a refining richness in quality over quantity if you will.

          On the specific subjects of this course, I think that suffering is inevitable, perhaps even integral. Sooner or later something or someone will come along and hurt us, scar us, disease, or dis-ease us; probably more than just one or once also. As part of our growth and developmental processes, I think that a radical “foundation-shaking” occurs at some point in life (a breaking of the dam) whose reaction fosters growth in one area or another, be it “orderly” or disorderly. While this can be taken into several personal contexts, I think it is also fitting to the “trajectory of our field.” As I read ****'s post, I don't think “willingness to” or “state of” suffering has ever been the question; although, certainly we are living in an age in which our career path seems dis-ordered, the foundation of the field questioned, and no where to go but onward. In one direction or another, it will grow. Decades of medicine and technology have not abolished the need for therapists, counselors, and social workers; nor has the prevalence of CACREP-accreddited programs erased the existence of non-CACREP programs. I highly doubt either of those things will ever occur. There's no replacement for human-to-human customer service; and “it takes a hell of a drug to beat a placebo.”