Monday, January 22, 2018

“If it’s quackery, why is it working for me?”

One of the things I find fascinating about psychology is that it’s a field riddled with controversy.
“If it’s quackery, why is it working for me?”

The definition of psychology is that it is the scientific study of the human mind and its functions, especially those affecting behaviour in a given context. 
However, when you don’t have universal agreement on the definition of basic terms like normal and healthy, then you’re going to have a lot of fights over what’s proper.

As psychology is constantly evolving, there are a lot of discredited theories. That’s okay because we’re all learning. (Go the end of the article for a list - Freud is on it!)

To make it more complicated, there are con artists working in the mental health field.

Mental health attracts con artists for many reasons, including:
Scared=Easy Target: Desperate people don’t think clearly so they are easy to fool
$$$ Fast Money: Desperate people will part with money quickly, hoping that paying over hard earned cash will magically help them find a ‘fix’
Power Opportunity: It’s easy to influence frightened people. Cons and nuts find that being The Guru is an easy way to power.
From what I’m hearing, many of the ones here in Malaysia call themselves ‘Dr’, talk a lot about the unconscious, and the really cheeky ones run urine and blood tests - all at extortionate prices.

I’ve blogged before about how to avoid mental health con artists. Today I’m focusing on a sensible question I’ve been asked,  “If it’s quackery, why is it working for me?”

The answer isn’t a simple one but here are some points to consider.

#1 How much time do you spend on your mental health?
If the answer is, “Erm.... dunno. Minutes a month.” then you have to consider that spending a whole hour every week on identifying your issues is helpful all by itself.

Sometimes, all you need is to focus on what’s up and you can find the solution for yourself.

#2 Being upset means you don’t think straight
For most of us, thinking about a problem goes like, “Why am I feeling so bad? This sucks. I hate this.” And on and on and on for hours.

This is not helpful.

Sometimes just sitting down with a person who can help you focus on unraveling your thoughts is enough to clear the fog.

#3 Empathy goes a long way
When I said earlier that psychology is full of controversy, Freud springs to mind. Some of his theories were absolutely insane, yet he did some excellent work.

If you read his books and papers, it’s very easy to see why he was effective: he was genuinely interested in people and he was a kind, thoughtful man.

Sometimes, just having an understanding ear is enough to help.

This of course begs another question: “So if I see a quack who has good intentions, an empathetic attitude, and I’m willing to spend the time, what’s the problem?

A wacko quack can cause real damage
Just this: a wacko quack can cause real damage.

Think about it in terms of fixing a car. If you see blue smoke coming out of the engine, you can take it to a cowboy mechanic and one of two things happens: you strike lucky and it’s fixed, or you pay your money and you end up with a vehicle that blows up.

It’s the same with mental health. 

So, please look after yourself and avoid cons and quacks. Your mental health is too important to be in their hands.  
If you’re curious why rubbish is increasingly popular, check out Prof Patrick Grim who's one my favourites, or throw the terms pseudoscience into Amazon to see a list of current publications. It’s an awesome field, and worth taking a look at.

Curious what psychological theories are considered nonsense by insiders? Here’s a paper you’ll love. (Skip straight to page 518 for the list.) Pseudosciences included:
o       Jungian sand tray therapy for treatment of adolescent and adult disorders
o       Neuro-Linguistic Programming (NLP) for treatment of mental/behavioral disorders
o       Rage reduction therapy for depression
o       Freudian dream analysis for treatment of mental/behavioral disorders

Sunday, January 14, 2018

I Can't Pay For Therapy; How About Working With A Student Therapist?

If you can’t afford therapy, one option is to work with a student therapist. There are pros and cons, so here’s a short list of things to take into account when you make your choices.


Students tend to be open to exploring options. That can be good if standard therapy approaches haven’t worked for you.

Students need hours, so they tend to favour long sessions. That’s good if you have issues that need lots of time to address.

It’s free. As students aren’t qualified, they can’t charge. At least, that’s the rule of thumb in Malaysia. I am hearing of other countries where students charge money; I find that very difficult in terms of ethics. See my next points.

Your student therapist is still learning, and that has implications. It’s just like asking a student doctor to give you an injection or medical exam; sometimes they’re terrific and sometimes they’re a bit clumsy.

As you’re not dealing with a fully qualified person, your sessions are not private. Your student therapist will be talking about your case with her supervisor, her tutor back at school, and then the examiner will see the notes as well.  In my school, we were also asked to present cases we were working on in class. In addition, your case may be evaluated by a licensing board.

All this checking and double checking is to make sure everything is being done right.

Should you be worried? Some student therapists are pretty good about anonymising information and destroying notes after. Others are not. To be certain, ask for details. 

When students do their practice hours, everything needs to be documented and checked. This is to prevent fraud. This means contact hours are face-to-face sessions held in the supervisor’s place of work. This has implications for you because when the student therapist has completed her hours, she leaves. To prevent your sessions from halting abruptly, ask your student therapist how she will plan for this.

If you want online therapy, this may be difficult: students typically don’t work online or across borders because of the way hours need to be supervised and documented.

I knew when I was studying that I wanted to work online so I planned specially for it. I took an extra course in online therapy. On top of that, I also did an extra project, working online with overseas clients. 
Throughout, I leveraged my Masters Degree supervisors to make sure I was on the right track and I had an overseas teacher as well.  If you want to work online with a student, just ask how she’s getting her supervisors to work with her.

Note: I’m in Malaysia and I write from a local perspective. As countries have their own laws governing licensing and practice, you may have different or additional issues to deal with.

My advice: if you’re in doubt about a mental health provider or service, ask your family doctor to direct you to the proper organisations in your country. Mental health practitioners know it’s a minefield for the general public to find good quality help, and they tend to be generous about helping you find someone proper.

Thursday, January 11, 2018

"Why is therapy expensive?" - And Why I Charge Just US$35

Sign of hope
One question pops up fairly often, "Why is therapy expensive?" So here are some thoughts.

#1 We’re slow to start. It takes about seven years of school, Bachelors plus Masters, and apart from the classes, you need to spend roughly 1000 hours on unpaid internships that include some 300 therapy hours. Getting that done takes a year, sometimes more. So getting to the point where we can work costs a bomb.

#2 We do a lot of stuff you don’t see. You talk for an hour, but the second you leave, we’re writing up session notes. Then, before we talk next time, we read through the notes to prepare. While it varies, for every hour we talk, I tend to spend an hour on notes and prep.

#3 We're always studying. Every job involves constant learning but psychology is particularly intensive. I do constant journal sweeps as well as reading new publications, attending lectures and taking short courses. It costs money to stay current.

So there you go. I'm keeping costs down by working online, and I have other revenue streams. Also, living in Malaysia means my cost of living isn't as high as in some other countries. Even so, it's not good ROI on my education investment. Frankly, the second the economy comes up again, so are my prices.  
PS, an update in case you're curious why there's a local rate, here is my reasoning