I Can Tell You Exactly Why We Don’t Trust Our Therapists

I have the unique experience of not only being a mental health patient (as a person diagnosed with Bipolar Disorder and Adult ADHD), but also a mental health professional for some years. During this time, I was employed first as a patient advocate, then as a case manager at a dual diagnosis treatment facility that catered to mental health patients and substance abuse patients alike. It was one of my obligations to sit in on the treatment team meetings with each of my assigned client’s personal therapist, nurse practitioner, and psychiatrist. I found these meetings to be incredibly helpful for my own sake for a handful of reasons, but they also served as a driving force behind my decision to abandon my ambition to seek a formal education in clinical therapy.

With the recent increase in attention that my own brand of mental health advocacy has received (thanks guys), I’ve been asked more than once why I wasn’t trying to become a “real” therapist. There is actually an array of answers I could give (depending on how I’m feeling when the question is asked), but ultimately it’s because I knew I would be able to make a larger impact by not distancing myself from my fellow mentally ill. As someone that has “dated” and “broken up with” a pretty hefty number of therapists and psychiatrists, I’ve come to realize that we may be a little predisposed to paranoia surrounding our treatment. After working with these people professionally, it’s pretty clear to me that we aren’t entirely misguided in our initial assumptions.

Let’s start here: If mental health services weren’t a business first and foremost, they would be free. You and I know that living with severe mental illness is a total nightmare sometimes. Really sit and think for a moment about the fact that there is an entire branch of capitalism dedicated to our sickness. At some point, it has to be recognized that in order for them to get paid, we need to be sick. Before you can navigate the good and bad moral practices that both truly exist within the mental health world, you need to come to terms with the fact that we are, to some degree, suffering for their dinner. Are you mad yet? Good.

For the sake of keeping this fairly short, we’ll take a look at therapists, mental health organizations, and psychiatrists (in that order, as we’ll work our way up to the true offenders). I won’t be mentioning any practices or organizations by name.

In my experiences as a mental health provider, I would say that most of the therapists I’ve worked with have been, at least in the beginning, genuinely good people. When you graduate with your masters and license to practice, you’re only really given two types of opportunity– either you work for a facility and get paid pennies, or you work for yourself in a closet sized shared space… also for pennies. I’m not trying to radicalize anyone here (or maybe I am), but I think it’s safe to judge the potential for social harm based on how much money the perpetrator stands to lose. In a world where money talks, it’s acceptable to assume that most of the people that pursue a career in therapy typically do so because they want to make a difference in the world.

Now, what isn’t obvious on the surface is that your paying another human being money to tell you what’s going wrong in your life, while their lives are just as susceptible (if not more so) to strangery, stress, and the development of problematic behavior. There are laws and principles put in place and beaten into any potential therapist’s head from the very beginning to try and counteract some of the malpractice that occurs… however, that malpractice still occurs (and is swept under the rug) all the time. I’ve worked with psychiatric nurses that slept with their patients, therapists that were engaging in rampant drug use, abusive facility technicians that would pull pranks on their patients… the list goes on, and it isn’t happening in small, rare occurrences either. There are studies out there that promote the idea that when a person is given too much power (in any capacity), they are more likely to exhibit abusive behaviors towards their “subordinates.” This can manifest (especially in treatment facilities) in truly horrific ways. Because the mentally ill aren’t being recognized on a global front as marginalized, when these terrible situations arise, it’s typically easier to sweep under the rug.

Some therapists will be terrible because they’re not great people, and they’re easily triggered by the problematic behaviors they’re being PAID to address and treat.Some therapists will be terrible because they are human and can only take so much pressure from their superiors (and our behaviors) before they make some bad moves. I have yet to meet more than a very small handful of therapists that actually practice what they preach, including self care. I’ve seen this manifest in some truly catastrophic ways. As mentally ill people, we are held to the flame when we try to balance the symptoms of our disorders with managing a normal life. There is little to no authority above our treatment providers that hold them to the flame, when their lives become unmanageable. I am, by no means, demonizing therapists for having real life problems. I’m just posing the question on when and where do we draw the line, and more importantly, where does the one with the license to practice therapy know to draw the line?

Mental health organizations are popping up like weeds in this day and age. There are some (unnamed) heavy hitters out there, as well as a splattering of local grassroots movements. I believe that mental health organizations are slightly more threatening than therapists because there is a lot more money being shifted around.
Dealing in nonprofit is a touchy subject, and the potential harm they cause really comes down to this: are they willing to show you where your money is going? At any scale, most non profit organizations provide financial benefit for the people at the top. This isn’t a bad thing inherently. I believe full heartedly that people doing good things should be paid for what they’re doing. But with an explosion of stories regarding massive nonprofits (once again, I won’t name any names) paying their presidents millions of dollars while doing virtually nothing to positively impact their community, it’s a good idea to start looking at who exactly is benefiting from our suffering. Following my last massive episode of psychosis, I lost virtually everything. I looked for any viable resources or help I could find. Not surprisingly, I came up empty handed.

If a mental health organization claims to help the mentally ill, but are unable to provide anything past some lazily organized group meetings, it’s time to give our money to someone else. Mind you, I know I’m coming off as miffed because I couldn’t find the help I was looking for in my particular situation, but I’m mostly disappointed that I’ve yet to find an organization that helps people at all ends of the spectrum. During my time as a patient advocate for a facility, I came across some truly remarkable resources for mentally ill people that needed very high levels of support. As a matter of fact, every organization I’ve looked into claimed to provide assistance to any one extreme end of the spectrum. If they’re recognizing severe schizophrenia as mental illness and not general anxiety (or the other way around), they’re not really doing anything to assist in the dismantling of stigma.

Okay, so let’s tackle the psychiatrists (not literally- actually, you know what? Yeah. Let’s tackle them). Once again, I’m going to dig through my own experiences here, but I don’t think that’s terribly off point considering I’ve sat in many rooms with many psychiatrists, as both a patient and a fellow professional.
I have yet to have a psychiatrist look me in the eyes. I have yet to have a psychiatrist validate my experiences as a mentally ill person. I’ve yet to have a conversation with a psychiatrist where I felt that my personal preference against or for specific medication wasn’t being undermined in an incredibly rude fashion.
Having worked with psychiatrists, I can think of maybe 2 or 3 that could have possibly gotten into the profession because they wanted to actually help people. Most of them did so for the $250 (minimum) bill they’re cashing in on for five minutes of face to face time with patients.

I still believe that everything I said about therapists (the stress of the job and our own complicated behaviors, accidental lack of self care) applies to psychiatrists, and I’m not stating that I think their job is easy. Being responsible for someone’s well being is a huge order to fill; I’m just saying it would be nice if they treated us like people while they did it.

Now, I’m not saying you should break up with your therapist. This entire article should simply serve as an eye opener. As we continue to establish our own culture (and the conversation that surrounds it), these major flaws in the system will be addressed. It’s just that it should absolutely be done while considering our terms as well.

If you feel that things aren’t working out with your therapists, evaluate why you feel that way. If they’re simply making you uncomfortable by encouraging you to look inward on your journey to self awareness, then they’re probably a very good therapist. If they’re making you uncomfortable by belittling you (and your problems) or overstepping boundaries, they should be thrown in the trash.

If you’re seeking resources from a mental health organization, fact check their history, mission statement, and previous accomplishments. There are already too many neurotypical people out there capitalizing on our conditions and disorders. If you can give your time, energy, and money to an organization that is orchestrated by people with mental illness, that’s even better. If the organization your either seeking assistance from or looking to volunteer with can’t in good faith explain where the money is going, or if they serve only as a vehicle of profit for neurotypical people, throw it in the trash.

If you like your psychiatrist and feel that your experience with mental illness has been validated, good. You’re one of the lucky few. If you feel like you’re being infantilized or manipulated into forms of treatment that you clearly stated you weren’t comfortable with, throw them in the trash.

Ultimately, the purpose of Girl Precarious and this particular article is to encourage you, as a mentally ill person, to maintain a grasp on the way you’re being treated by society. That ABSOLUTELY includes the people that are paid to help us, first and foremost. Of all the stigma that surrounds mental health, one of the lies I hate the most, is that we are too sick to know what’s good for us. The cold hard truth is that yes, sometimes we are unmanageable and we will absolutely need outside assistance– but it’s never a good idea to go into a new treatment arrangement without questioning the who, what, where, when, and why. Consider this as a final thought: we live in a society that now encourages middle class folks to question where their bottled water comes from, but we aren’t pushing the narrative that the mentally ill have the right to question the ways they’re being treated by professionals.

Also, if you’re a mental health professional and this article has rustled your feathers, good. Either get better, or find a new job.