Thoughts on Mental Health

So many thoughts come flooding into my temporal lobes for this post…

 I try to present myself as a clinician who is genuinely concerned with providing assistance to clients, even if I have never met them before. What strikes me as odd is the statement “I’ve never met you, so I really don’t have anything to say to you,” followed by 20 minutes of history, complaining, griping, whining, bickering, solution-seeking, etc. Call it what you will, I have more instances where a client states they will not share anything with me (either due to a lack of rapport or my age) and then they offer a dissertation of their needs, wants, fears, and desires. Needless to say, I am fairly puzzled by the behavior.

I know that establishing a therapeutic relationships takes time with a client; what differs is who the client and who the therapist is, and how they feel there is (or isn’t) a connection there. Moving forward may take the shape of a variety of ways, either in progressing through therapy for a number of years with little movement toward a model of rehabilitation, or may take as little as 6 visits to gain insight into a particular issue. However it pans out, there is almost always initial reticence to discuss things pertaining to the client’s situation.

Even more so is there an unwillingness to speak about these things with a person who you don’t know after you have established a  relationship with another therapist. It’s like a child who has grown accustomed to a specific baby-sitter: when mom and dad leave, even though it was a challenge in the beginning, they eventually grew used to that new person who would take care of them. There were a lot of trust issues, uncertainty about what would happen when their only source of tangible security walked out the door. After time, they learned to trust the baby-sitter. They felt that they could relax and at ease.

With the client-therapist situation, it’s very similar to that. In many ways, the client has just gotten over dealing with trust issues with the baby-sitter. All of a sudden, the original baby-sitter is gone, out sick, on vacation, or quitting, and the new baby-sitter comes in and tries to offer some kind of solution to any problems that may be coming up for the client. This is not really something that is easy for the client to do, and understandably: think back to when you were at that age of basic trust versus basic mistrust, and you had serious difficulty accepting people who you didn’t know. Would you have wanted those strangers to hold you? to coddle you? to try and provide comfort? Probably not.

What strikes me as odd in all of this, then, has to do with the sudden openness that is revealed regarding things. In what seems to be a complete 180 from their self-preserving standard, the client shares things with you; they let you in on secrets, things they know. My question in all of this is a resounding why. If there is willingness to come to that conclusion after five minutes of telling you off and letting you know they have little to share, where does the change come from?

I realize that my rambling can probably be absolved by a couple of sessions spent in a Treatment methods class, gaining an understanding of the client’s feelings about these things and how the therapist can help (or not). But what I find most perplexing is the argument that if a client is able to share things with a new person that they didn’t think they would be able to do, why then are we making the statement that it shows true progression, self-actualization, and insight, especially after 20-some years of “treatment”? Just because a client is able to open up about things and reveal some insider information does not mean that he or she has come to a point in treatment where they are “getting better.” I’m sure that it may allude to that, and with the proper treatment that may be the case. Let us therefore assess what “proper treatment” means.

Can we not say that the therapist is a big part of the client’s rehabilitation? Certainly, without their intervention, there would be little progression. I’m not arguing that only therapists can help people; I’m not even arguing that clients can’t come to know healing unless guided by a mental health professional. What I am saying is that clients who recognize the need for help will allow themselves to fall into the arms of a therapist and have them help begin the healing process. While this does not always automatically happen, it is certainly doable. And while it cannot be perfectly scripted, that is why we follow certain treatment models and modalities to give the best care to clients.

I am unfamiliar with many clients and their problems, due to one reason or another. Either they have a different therapist, or they are reclusive, or reticent to share things with anyone. But what I believe is that with the right attitude from the right person and given the right amount of time, a client will slowly open up and realize that any person can be a helper. Going back to the baby-sitter analogy, if a child has good relationships with their parents or other immediate caretakers, then they will only be anxious for a brief period of time when that new baby-sitter enters the room. Rather than stick tot he same baby-sitter, it may behoove parents to have a number of them on a list. In that way, the child will start to grow at ease with many people when their parents are gone.

In case you haven’t gotten it, the therapist (or the mental health realm) is like the babysitter. The clients are not always guaranteed a good life growing up; in fact, many people in the metal health system have had severely dysfunctional lives. And not to state that if we be the best therapists we can possibly imagine, all clients will become better and lead lives of production within the society. That may be a stretch. Rather, it would be more appropriate to state that the therapist has the power to lead the client into a direction of health and wellness.

I recognize that this post leaves so many doors open that there’s a strong gust through each of them, to the point where you almost can’t hear a person talk. I just wanted to get some ideas on the table…