WillSpirit!


∞ Where Mental Skills Heal Mental Ills ∞

A former physician writes about mental health and recovery using insights from life, science, and spiritual practice.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.


Will of All Trades, Master of None

The essay I’d written for today will be delayed. It was another piece about the unreliability of belief, based on the work of the late physicist David Bohm. I wrote it two days ago but postponed publishing because I’ve decided that sending out entries more often than every three days imposes on readers’ inboxes. Apparently this policy risks what happened today: a topic that sounded interesting before now seems less vital.

So what is ‘live’ for me today? Self doubt.

Thankfully, I’ve gotten pretty adept at accepting the big hardships. Physical pain, failure, and grief feel quite acceptable to me. They even seem to instruct me in wisdom. I can embrace them. On the other hand, right now nothing momentous is bothering me, yet I’m feeling bad about myself.

My life strikes me as eminently comfortable. I live in a lovely area with many nearby trails. The wetlands restoration outside the neighborhood gate is nearing completion so there are more waterways, marshes, and birds in view. I have time to enjoy the natural beauty and also to exercise and meditate for long periods every day. My life right now is nearly without stress: no business to fret about, no medical problems in need of attention, no family issues.

So what’s to complain about? The same thing that has come up for me over and over since my surgical career ended twelve years ago: aimlessness.

What is the point of my life if I have no gainful occupation? Can I find satisfaction merely from blogging? Why have I proven myself capable of working in so many fields while also demonstrating my inability to stick with any of them? How am I going to justify my existence now that professional endeavors no longer seem feasible?

In high school my mediocre performance and chronic delinquency pointed to an unpromising future. But as my senior year approached I found a passion: biology. It grew out of a lifetime interest that dated back to time with my grandfather, who showed me the insides of fish and chickens he prepared for meals, taught me how to cultivate mushrooms, and enlisted me to work in his vegetable gardens. My father had encouraged the curiosity by buying me the Visible Woman and Visible Man models. I’d tried to incubate quail eggs and had loved the nature classes offered at the camp where I spent six weeks every summer. First in Boy Scouts and later with friends, I’d gone on many camping and scuba diving trips around the Los Angeles area, which is rich with natural beauty once you get beyond the freeways.

As high school drew to a close, I found biology so fascinating that buckling down and doing homework suddenly seemed like a great idea. Before long I was at UC Berkeley earning nearly straight A’s. Ecology was the subject that most fascinated me, and I planned to become a marine biologist or some other species of naturalist. But all subjects piqued my interest, and I took a tremendous variety of classes. Soon, I was singled out as possessing strong analytical skills and was shunted into an honors physics sequence tailored to a select few of the most promising students. My father only seemed impressed by this latter turn of events, since he considered biology a ‘soft’ science. Overly influenced by his opinion, I abandoned ecology and decided to pursue neuroscience through graduate studies in biophysics.

Thus began a long, meandering career search in which I seldom felt myself on the right path. Faced with a future spent poking microelectrodes into nervous systems, I became bored and discouraged. I’d also broken up with my high school sweetheart, and my grandfather had recently died. My first major depression hit. A therapist convinced me to go to medical school, largely by telling me how much he wished he’d had the grades for it himself.

Learning about the human body did, in fact, fascinate me, but the practice of medicine terrified me. I did not have the proper attention to detail, and I continually worried about forgetting important steps in clinical care. At the same time, I found the eye remarkably beautiful and decided to specialize in ophthalmology largely on aesthetic grounds. Little did I understand that my choice would place me in one of the most detail-oriented subspecialties. After learning to perform cataract surgery and many other procedures, I decided to pursue further training in ocular oncology and then in reconstructive surgery. These fields offered slightly larger margins for error, and so seemed better suited to my personality. Plus, I liked the artistry of facial surgery.

I got a great job after my training, working at Kaiser. There were no administrative duties and lots of autonomy in patient care. I thrived. But my neck was not up to the strain, and as the pain increased my old fears resurfaced. During a manic episode I made a hasty decision to simply abandon my hard-earned career, rather than doing something smarter like reducing to half-time.

This led to an immediate collapse of my psychiatric health. After a couple of years spent recuperating, I began graduate study of biomedical computing; that lasted about two years before blowing up when the professor I’d planned to train under moved to another state. Then I taught high school biology for a term. After deciding that the life of a high school teacher wasn’t for me, I found a job with the California Department of Public Health teaching physicians about childhood lead poisoning. The work was fun and took me all over the State, but when it started to stress me out a bit my psychiatrist persuaded me to quit (which I think did me a disservice). For a time I looked into studying entomology and took some college classes in preparation, but that direction seemed too far afield after so much training in medicine. I next spent a couple of years preparing for graduate school in psychology, working as a volunteer counselor, but when the few institutions I applied to rejected me, I gave up. Through an informal internship, I then learned to work as a patient rights advocate in mental hospitals, but the pay seemed far too low. Finally came the acupuncture venture, which longterm WillSpirit readers already know about.

Do you get the sense that I’ve pursued a lot of different disciplines but abandoned all of them? I do. Ecology, neuroscience, biophysics, ophthalmology, ocular oncology, reconstructive surgery, bioinformatics, high school teaching, public health, entomology, counseling, advocacy, acupuncture, etc., etc., etc.

My hobbies have been similarly sporadic. Just as I was getting some recognition from local sculpture teachers as a figurative sculptor, I gave it up due to neck problems. Poetry periodically grabs me, but I usually get tired of it before too long. I’ve written some memoir pieces that instructors really liked, but I never follow through to create a sustained text. For some reason I keep the blog going, but probably only because it’s so easy.

Whew. That’s my long catalogue of aborted vocations and avocations. In the last few days I’ve spent time with a number of friends, each of whom seems really committed to his or her career path. Why have I never found a road worthy of ongoing effort? Why do I always seem to find reasons to change directions?

I have no good answer. It appears my personality permits me to be a Jack of all trades, but a master of none. This is intellectually fascinating but professionally suicidal. Back in college the professors seemed unanimous in their belief that I was headed toward a stellar future. What went wrong?

Clearly, part of the problem is that I’ve been too easily swayed by the opinions of others. And I’ve often chosen directions that made logical sense but had little appeal to my heart. Other times, I’ve ignored obvious limitations and pushed myself to tackle fields that were too stressful. I’ve acted impulsively and in the face of challenges have quit projects entirely rather than effect more nuanced changes. So I suppose there are lots of reasons, but most of all, there’s been a lack of staying power.

Given that I’m blessed with reasonable financial security, fairly good health, and endless free time, you’d think I’d feel happy even without employment. Instead, I’m working hard to prevent my psyche from beating up on itself about my inability to sustain a career. The only remedy seems to be meditation, which allows me to stop thinking about what’s happened and imagining what might have been. So I’m practicing intense mindfulness as much as possible, including while driving, walking the dogs, and swimming.

Just a week or two ago I felt beyond all this; I was ready to commit myself to spiritual growth and abandon the pursuit of worldly success. Circumstances seem to be forcing me to look at my situation despite my resolve to turn my back on career obsessions. Perhaps I need to better understand what went wrong before I’ll be able to accept it. Or maybe this productivity-oriented culture simply makes it difficult to find relief from this angst. In the end, of course, I must simply embrace my life and myself. But apparently I’m not quite there yet.

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Will of All Trades, Master of None was published on April 30th, 2012 . 6 comments






A Burning Desire

Every journey starts somewhere. Although this blog was launched only three years ago, WillSpirit probably began way back in 2000, right after my brain exploded.

Well, my head did not literally blow up, but back then explosion seemed the only word sufficient to convey the eruptive onset of a visionary state of mind that far exceeded any previous meditative (or even psychedelic) experience. That psychiatrists pronounced it a manic psychosis did not in the least undermine my conviction about the profundity of what was happening.

Along with the visions came a burgeoning sense of being called to connect my education in physics, biology, and medicine with spiritual Truths that suddenly seemed self-evident. In a grandiose state of mind, I imagined myself one of God’s chosen prophets. The gravity of my new mission felt irresistible and overpowering.

But it weakened. Maybe the medications calmed me and helped me see my limitations and lack of realism; or maybe they derailed me from my proper path. All I know is that before long the idea of connecting my scientific training with my mystical experience seemed terribly impractical. I went to graduate school in bioinformatics instead.

That was the first of many aborted career plans that followed the end of my profession as a surgeon. Readers know my latest flop was the acupuncture business. Time and again I’ve compromised my true interests and passions while aiming for something more likely to lead to worldly success. I now recognize this as a doomed strategy.

During a recent dinner with good friends, I watched my inward sense of vitality and outward appearance of animation build as I spoke about connections between Science and Spirit. For the first time in quite awhile I recognized how powerfully these parallels attract me.

I never was a scientist in the truest sense of the word. Although a devoted student of scientific subjects, I always felt bored and limited when working in a lab or doing field study. My interest is in drawing analogies, making intuitive leaps, and painting a global picture of reality that is consistent with science but closer in tenor to poetry. My deepest heart wants others to open their eyes to the sweeping vista of reality as it appears to me.

In all honesty, allowing my passion free reign feels more important than writing this blog, though WillSpirit remains quite dear to my heart. I recognize that penning my uneven essays here helps me and helps others; it is a small but important project that must continue. But something grander is begging to be born from this cracked shell of a person. Most likely, the resulting neonate will appear lovable to me and me only. But it needs to burst forth into this world and cry out its Love of Life.

No longer will it suffice for me to harass my friends and family with my intricate ideas about the Cosmos. Nor is it enough for me to write boring philosophical posts about the Universe and Humanity’s place in it. I need to complete the vital task laid before me twelve years ago. And at last I understand the form my message needs to take.

It isn’t a question of proving that a realm exists beyond the Newtonian worldview accepted by conventional science. Any honest assessment of available studies will show that reality is richer than the desiccated landscape painted by technocrats. True, only a few anomalous phenomena have been convincingly demonstrated, and little is understood about the nature or limits of this strange arena in which people know about the world in ways that contradict customary reality. But scientific evidence is not what I feel drawn to provide.

Skeptics will never be persuaded, and most of us seeking deeper answers to life’s dilemma need no further proof of mystery. What I think is within my power to offer is a poetic distillation of the creation story as told by science, beginning with the moment of the universe’s first explosion into space, and ending with the present day. I can speak to those who feel lost and yet hopeful that Life makes sense. Many must yearn to square transcendent and intuitive experiences with a scientific worldview that has proven its utility but has yet to demonstrate its humanity.

So here at WillSpirit I’ll keep writing about my fluctuating moods, my changing fortunes, and my ongoing efforts to keep myself sane. But in the background, and probably linked to this site, I want to start a new project. A life’s work, if you will.

And by Life’s Work I mean to highlight my sense of calling but also to describe the project itself. I will work to bring my notion of the sacred to bear on my notion of Life. Not because physics and biology haven’t been written about from spiritual stances before; many quality tomes about such topics line bookstore shelves. Not because anything I say will be unique or especially inspiring. This drive to write something worthy of the countless hours I’ve spent thinking about these subjects is fueled by a deep-seated need. A yearning to describe biology and physics in spiritual and poetic terms has gripped my soul since the first shattering awakenings so many years ago. WillSpirit served well as an initial step, but the time has come to go further. And at last my goal isn’t success, it’s expression.

Only by doing something that feels momentous will I cease feeling pointless and defeated. Only by undertaking a truly impractical task can I free myself from the bonds of mediocrity and repeated failure. If I’m going to try once again to produce, then I want to at least be listening to my heart this time. Better to incinerate my dreams in one massive volcanic caldera than let them once again sputter out like wet fuses.

Only when I speak or write about Life in all its complex glory, and Spirit in all its confusing paradox, do I feel truly inspired. Perhaps this is yet another false start. Maybe I’m overestimating my reach or (heaven forbid) feeling grandiose. But I’m beginning to see that fulfillment can only be found by concentrating on what most fulfills me.

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A Burning Desire was published on April 8th, 2012 . 14 comments






High Emotional Reactivity and Self -Acceptance

http://www.flickr.com/photos/thatguyfromcchs08/2300190277

Just an hour or so ago I participated in a video taped conversation about mental health. When the show gets edited and completed I will post it here on my blog. Tom Wootton invited me to participate as a ‘client’ of his Bipolar Advantage program. Peter Forster, MD, the medical director of Bipolar Advantage, took a seat at the table. Our moderator was Barbara Meyers, who tapes a regular show on mental health, which I highly recommend.

Whew! I got all those links in place for those three!! I respect them all, by the way. They each do unique, good work for the mental health community.

The taping went by fast. Having thought through my answers (I knew the questions in advance), I was shocked when the show came to a close before the end of my question list. I took too long to answer the first three questions, so the last one or two got dropped. Predictably, I ended up feeling bad. Fact is, I’ve never liked cameras. I love to write; I feel OK on a stage; but I get quite uncomfortable when filmed. Even though that has always been true, I did not expect to feel nervous this time, since my general stage fright has reduced so much since my eighteen months of working as a public speaker. No such luck. I ended up feeling just as self-conscious as the first time a stranger shoved a video camera in my face after a movie premier in New York and asked for my reaction to the film.

In fact, my point in writing tonight is the jumpiness of my response, my incredibly high reactivity. In one of my answers on the show I said (I think) something to the effect that sensitive moods can be an advantage (an idea that is a pillar of the Bipolar Advantage concept), giving us a wide range of experience of the human condition. Yet it is hard to believe anything very advantageous comes out of having a gas pedal that gets shoved to the floor at the slightest challenge. Much as I tried to remember breathing, staying relaxed, and visualizing calm scenery, the instant I started talking my mind went into the stratosphere, and I was on autopilot. My emotions have always had hair-triggers, but my moods have gotten even more touchy since my breakdown, followed by nine years of powerful drugs, punctuated by a series of failed enterprises. So tonight became a reminder that I still have the same old issues, waiting to lift their irritating little heads when I reach beyond my comfort zone.

Much of my jumpiness, I am sure, comes from the trauma of my upbringing. One major source of over-reactivity was my stepmother’s habit of sneaking up on me in my bed at night, and shaking me awake with her hands clenched around my neck. Yes, she really did that. Fairly often, actually. As a variation she would clamp her palm over my mouth. After a while, I learned not to make a noise when she came to get me, and she gradually quit the histrionics of mock suffocation. (After she woke me, the next step was for us to go out back where she could hit me or abuse me however she wanted without my dad awakening–kind of like going to the second location with a serial killer.) Even though I learned silence then, now that I am an adult it is impossible, apparently, for me to keep from shouting if someone wakes me up at night. Even at age fifty, I still awake in full screaming terror if my wife just taps on the door to the guest room. (Sometimes I go to sleep in that room while she reads in bed, and then she comes to get me when she turns out the light.) Thanks, Della (that was the name of my late stepmother), for leaving me with nerves of glass.

So now I contend with this high-voltage response to the equivalent of turning on a AAA penlight. Back in my days as a surgeon (pretty hard to imagine doing that kind of thing now), I had very measured responses to acute situations in the operating room. I think it was because my attention was on high-alert already when I was operating, so there was none of that pounding acceleration from zero to one-hundred-and-ninety that leaves me so disoriented. In the O.R., everything moved at a speed that made sense, and I was able to remain focused and calm come what may (except for one dreadful day that I will no doubt write about eventually, when I ended up quite agitated after a big mistake on a small procedure). The night after a tough case I might lay awake replaying whatever happened. Or the night before I might be sleepless in anticipation of a challenging case. But during the time of the actual work, I stayed in a centered zone.

There is no situation like that now, and I would never dream of trying anything as stressful as surgery again. But despite that caution, I still find ways to demonstrate my limitations to myself and then feel bad about them. I share this because it may be that someone else out there beats himself or herself up like that. Maybe someone else gets embarrassed about nervousness. Maybe someone else can understand.

Sometimes, I am fine with where I am in life. Happy with what sometimes seems like a lot of wisdom (purchased at great price, but mine nevertheless). Lately, I have felt less accepting. Maybe now that I am writing more, I can find my way back to that place of spiritual openness that works so well, that soulful space that is the only worthwhile destination.

That is my goal. Not performance; not looking good on TV; not making a living, even. Just finding connection with whatever it is that embraces me when I let all the expectations go.

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High Emotional Reactivity and Self -Acceptance was published on July 15th, 2009 . 1 comment






Engaging vs. Escaping the Mental Health System

psychhypnosisMarian (Different Thoughts) pointed me to her interesting commentary on the practice of clients (aka users or consumers or patients) becoming practitioners in the mental health field. I was aware of figures like Dan Fisher, MD, PhD. I believed myself in a position to follow a similar path, though I did not count on becoming much of a public persona. Marian’s blog set me thinking more about the implications of my failure to get accepted by psychiatry residencies, and helped reaffirm my current path. At first, getting rejected felt just like that terrible word I used in the last sentence: failure. As someone who used to be a high achiever but then suffered a string of nasty losses over the first ten years of this third millenium, that perceived failure and humiliation hurt. And of course, it’s a short journey from hurt to anger.

Since I already carried a burden of hostility toward the system for how medications damaged my life and my body, the rejection propelled me into a belief that I should be an activist from without, rather than a clinician on the inside trying to do a better job. Problem is, I’ve never been an activist before, having mostly done safe (though long and tedious things) like go to medical school and become a surgeon. But at least I like to write, and apparently one can accomplish a lot just by putting ideas on paper. ‘Activism’ doesn’t only mean I have to get out and hit the streets.

What is happening, however, is that I am being pushed into a more extreme position than that from which I started. I’d like to think medications are not all bad. I do believe they have a role in acute situations. It’s just that as chronic treatments, they suck. Side effects and destruction to health build up, and efficacy diminishes. In the end one gets stuck in my position, having a really hard time getting off the drugs because my brain has gotten habituated (read: addicted) to them. Yet, the more I read, the more I wonder how much the benefits outweigh the hazards. While some small number of acutely psychotic people will perhaps always need some medication, most likely the majority of  ’patients’ could be treated better with kindness, cognitive techniques, and comprehensive attention to their spiritual and physical health. This is the kind of approach I believe Tom Wootton’s Bipolar Advantage is advocating. Maybe we have enough medications for now. Maybe the whole endeavor (and highly profitable industry) of looking for and marketing new drugs needs to be shelved. These are questions that I can’t answer right now. Not for myself and certainly not for others. But I do see my attitudes becoming more and more opposed to the medical model and psychiatric drugs. This wouldn’t be occurring if I was on my way to becoming a psychiatrist.

My biggest question is: would I have been able to make more difference as a clinician? Would helping dozens, or hundreds, of patients get (what I consider) appropriate treatment be more valuable than writing? The point is mostly moot, of course, since I don’t have a door into the field. On the other hand, I could reapply (to programs that don’t already know me) without being so revealing about my psychiatric history. Yet, all I’ve read since I entered the (badly named) blogosphere convinces me I’m better off not going into the field. Marian makes a persuasive argument about the compromises that one inevitably makes in the course of entering any kind of organization. Plus, if I could bring myself to get my whole story out (I’m still hesitant to reveal the worst of it), it might attract some attention and really increase awareness. It would require a lot of work, and that much effort might be beyond me (not to mention the requisite compelling writing style). It is an idea for the future. For now I am just exploring options, writing my blog, and commenting on the blogs of others.

I never wanted any of this. Although I once had dreams of glory, more recently my ambition has just been to settle down as a happy worker bee, productive and comfortable. Unfortunately for those modest dreams, however, my past has caught up with me. My only choice seems to be to tell my stories and comment on the messed-up systems of psychiatric care. That puts me out in public view, where the way to be successful is to try to be as visible as possible. So now the question becomes, once again, how successful do I want to be? Especially knowing that the price of success is exiting my comfort zone and losing my anonymity?

Which brings up the whole question of obligation. Having learned medicine formally, a lot of psychiatry informally, and possessing a pretty good understanding of cellular neurophysiology, I certainly can speak with an authoritative voice about the medical implications of modern mental health care. Add to that how I’ve suffered really horrible side effects and lost a decade of my life  to mental illness-related disability (which might not have happened if I’d not been given so many medications), can I justifiably stand by and not speak out? Can I actually, in good conscience, let this go on without trying to make a difference? Painful questions for someone who just wanted life to get easy.

Forgive me for using this website as a chalkboard for sketching out a future strategy and a guiding philosophy. I am learning a lot from your blogs and your comments, and look forward to a lively and productive conversation.

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Engaging vs. Escaping the Mental Health System was published on July 10th, 2009 . 4 comments






My First Blog Visitors

Yeah! People have actually visited my site. Thank you! I welcome suggestions, by the way. In particular, I don’t want to turn people off with my tagline, and my naive concept of mental harmony as the key to mental health. Works for me, but maybe not for others. Let me know if it’s too much.

I suppose it’s predictable that as people visit, I begin to feel self-conscious. As much as I believe that my history might help others, it also seems presumptuous to say so. Just to fill in a little, my background as a physician both gives me perspective on psychiatry as a field, and makes me feel bad about myself for making the mistake of trusting it too much. It seems like I should have known better than to get so caught up in the medication/therapy cycle, knowing how much it has been to my detriment over the long run. My clinical work was surgical, and I got used to the idea that you could effect improvement with medical care. With psychiatry, however, the results are much less positive and harder to pin down. I know that now, but at first my expectation was that I would take the right drug(s) and all would be well. I should have understood that drugs can help a little but are not enough by themselves. I made more progress once I expanded my sights and began other approaches, including CBT and meditation. Now I suspect the medication step could have been skipped altogether. But I’ll never know for sure.

By the way, I don’t practice medicine anymore. My neck won’t allow me to operate, and besides my mental health is a little too fragile to tolerate the stress. I wouldn’t be blogging and opening up so much if I had any plans to practice again. It would expose me to accusations of ‘physician impairment’, among other things. I imagine that is why psychiatry programs passed on bringing me on board, back when I thought a good plan was to enter the field. I don’t know if they saw the advantage that I did in being both a consumer/client/user/patient and a psychiatrist; but they surely saw the risk.

Maybe I’ll be more useful from the sidelines. It is encouraging to get a few people stopping by. I really do have some strongly held and possibly well-informed ideas about medications and psychiatry. Not only did I go to medical school, by the way, but I also spent time in graduate school studying neurophysiology. So I’ve had ‘fun’ reading about the drugs and their interactions with neurons. Among other things, they are far less ‘selective’ than we are often led to believe.

Well, this is just a rambling post in response to the comments here, and those I read on Beyond Meds, courtesy of Gianna. I’ll reiterate my desire for advice on how to make this blog useful to others. Thank you for stopping by.

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My First Blog Visitors was published on July 10th, 2009 . 4 comments






Computers Instead of Therapists?

computer eyes

Insomnia? Depression? Anxiety? Soon, you will be able to turn on your computer and learn how to work with these problems.

Widely recognized as effective, Cognitive Behavioral Therapy (CBT) has been demonstrated experimentally to improve emotional health. The theory behind CBT, as most people involved in mental health care (whether clients or providers) understand, is that you can change how you feel by changing how you think. Leaving aside the question of whether you should change how you feel (I’ll deal with that in a later post), if you learn the techniques, they seem to work. At least they did for me. I learned to cut my depression and anxiety in half, easily. I also started sleeping better, just by not driving myself nuts with worry. Good stuff!

It’s called ‘therapy’, but is it? In truth, it is a set of methods for working with thought to keep it from wrecking your life. Person-to-person ‘therapy’ is not absolutely necessary. I got most of what I needed from a book or two, and you can search Amazon to find any number of texts on the subject. (They all look about the same to me.)

So how about learning the techniques from a computer?

I was not surprised to find out this is already possible. I came across one article about an internet-based protocol for teaching CBT techniques to manage insomnia.

I am not a big fan of therapy, even though (or because) I have undergone more than 20 years of weekly sessions. In truth, I have found it almost as often harmful as helpful. Maybe someone with a good, strong sense of identity and purpose could visit a well-skilled and careful therapist and do really well. At my best, and with the best therapists, that has been my experience. The problem has been that usually by the time I’ve stumbled into therapy I’ve been pretty well crushed emotionally. Desperate for guidance and support, I have given my counselors far too much control over my decisions. Later on, when I’ve felt better, too often the choices made under a therapist’s influence look like his or her choices, not mine. His or her values shine through, and mine get obscured.

Maybe a computer therapist would have been safer. I would not have leaned on a computer for support in the same way. I could have just learned the techniques, and relied on my own personality for courage and strategy. Given the never-ending effort by insurance companies to reduce mental health expenses, it is safe to assume that this method of delivery will become widespread. As much as I think psychiatry services should be covered by health plans, perhaps it would not be a terrible thing if some of the care came from silicon circuitry rather than the neuronal networks of a (fallible and corruptible) human brain.

I like people. There is no substitute for the warmth and support of another human being. But paying a therapist to guide me through life has not always worked well. I would not have become a doctor and a surgeon had it not been for a therapist who vehemently encouraged me to look for the highest paying job within my reach. Without those choices, I might not have damaged my neck by leaning over an operating table four days a week. I might not have lost my career at age 42, and might not have had a nervous breakdown. Who knows how my life would have gone? There’s little benefit to thinking about ‘what if..,’ but obviously therapists with poor boundaries can push vulnerable clients in directions that may prove disastrous.

The crucial decision about my career direction should have been made by me under the influence of family and friends. A person paid to help me (especially one who later admitted he was a cocaine addict and alcoholic) should not have been the one to choose. I was too young and emotionally weakened to understand how vital it was to make my own choices, and I allowed myself to be swayed away from my heart’s native desire (to study nature and ecology).

So I applaud the development of computer systems to teach mental health techniques. Psychotherapy can be helpful, but sometimes it is better to let people find strength and solutions on their own. Therapy should be a tool, not a crutch.

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Computers Instead of Therapists? was published on July 8th, 2009 . 9 comments






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