“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.  

 

PS

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

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.

Pros

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.

Cons

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.

Why is therapy expensive? And why are you so cheap compared to others?

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 keeping costs down by working online. I don't have a fancy office with lots of rental, and I do my own paperwork which keeps everything nice and private and means I have no staff costs. 

 

I could probably double my prices, work less and earn the same. But I believe therapy should be at least a bit accessible if possible. So if I work a bit harder to survive, I'm okay with that.   

 

What Is It Like To Cut A Toxic Parent Out Of Your Life? A Personal Perspective

Note: the original piece did not identify the relative. Now, as he passed away some years ago, I have updated it. 23 November 2022

 

I’ve thought about writing about this topic more than once, and I’ve always chickened out. However, I was asked the other day for tips about coping with toxic people, including toxic family, and having had second, third and fourth thoughts, I’ve decided to go for it.

A few years ago I was making a phone call to my father. I intended to arrange a night out. A drink followed by dinner. I felt dreadful: churning stomach, sweaty hands, and headache alive and hammering.

I didn’t have the flu. It was pure nerves.

I was standing there and that’s when it hit me. I looked at myself and thought, “This is ridiculous. I’m not doing it anymore.”

I made a decision on the spot to end it. It wasn’t easy, and despite the apparent circumstances, it wasn’t a sudden one either. Our relationship had deteriorated over a period of years.

I’d tried to fix it several times but it was like talking to a brick wall. No matter how I tried, the barrage of lies, put downs, mind games and a whole load of other absolute poisonous crap that I won’t discuss here went on and on and on.

I’d kept going because I kept thinking that it would change, that it would get better.

But it didn’t and so I said, “Enough.”

Not making that call was huge for me. The moment I made that decision I felt absolutely awful. It’s hard to describe but it was a sense of failure, of utmost misery.

But you know what?  I also felt huge relief.

I cried buckets, pure guilt, and then I got sensible. I thought it through and planned for the fall-out.

First, I had to cut ties. I worked out what I wanted to say the next time we spoke, and I practiced and practiced so I’d get it all out in one go, without being drawn into long debates.

I don’t remember the exact words but I was very brief and impersonal. It went something like, “We’ve not connected for a long time. Our meetings upset me. It is best for me to step back.”

The conversation took place over the phone and it took less than a minute. Afterwards I went through more a barrage of those same conflicting emotions but at that point the relief loomed larger than the rest.

Then when the news spread, I tackled the issues one by one.

My close family and friends understood as they’d seen for themselves what led up to it.  Apart from, “We’re here if you want to talk” they were kind enough to leave me to it. 

 

And when I got myself together, I did do a bit of talking. Still do, sometimes. I don’t think I could have done it without them and I’m forever grateful.

It was the people I didn’t know well who were a pain in the bum. I learned to cut off the well meaning ones by saying, “This is a private family matter I prefer not to discuss.” 

The few who persisted got shorter shrift. “Mind your own business and I’ll mind mine” caused some red faces but I don’t regret it. Busybodies who want to second-guess and armchair moralise are best kept at arm’s length.

The most difficult thing was that some more distant family and friends complained. I had some very difficult conversations with them but I realised very quickly that they were mainly bitching out of fear.

I’m afraid this is very common in these situations: they knew I'd dealt with a lot of shit and if I stepped back, it might fall on them. Once you realise what’s behind the, “Why can’t we just go back to the way we used to be?” it’s easier to stick to your guns.

So, am I happier?  Was it the right decision? 

I do feel grief over What Might Have Been. And sometimes I play that, “What if I’d said this instead of that?” But on balance it was right to walk away. For me the answer is yes.

Is it right for you? I don’t know. What I would say is this: think it over. Wave a magic wand and ask, “What would life be like if...?” and think it through.

As this is my blog, and I’m a counsellor, I’d say that if you need to, it can help to talk it all through with someone like me. 

If you don’t want to hire me, my advice would be to  pick someone who has experience of abuse and domestic violence cases. People who’ve been up at the sharp end tend to be better at talking through all the possibilities of dealing with toxic relationships. 

Also, avoid therapists who are committed to ‘saving’ relationships. You want someone who wants the best for you, not someone who wants you to live according to a pattern they think is nice.  

And having said all that, Happy New Year. May 2018 bring you health, happiness and lots of laughter.

Image by Arek Socha

Dear Ellen, “How to deal with people who keep bugging you on social media?”

This was written as a response to a Facebook post asking what you'd like me to blog about. 

 

The question was, “How to deal with people on Facebook who keep bugging you?”

Social media is great for keeping in touch, and making new friends, but unfortunately, it also opens the floodgates to unwanted contact. 

 

The two things that top the list include unsolicited advice and repeated PMs or requests for private chatting.  

 

Note: I'm not including PMs that ask for a contact, referral, or other very specific help or information. Those are always okay.

For me, the factors pushing both behaviours is similar. 

I see giving an unsolicited opinion once is okay, as it can be very hard to see if someone is just moaning about an issue because it happens to be on their mind or whether they are asking for help. 

 

Asking someone to chat when you've not met and you haven't had long public conversations on their timeline, well, I wouldn't do it myself but assuming it's polite and not a dick pic, I suppose there's no harm in it. 

However, it's only okay if the friend stops when you don't reply or fob them off with an "I'm busy" or equal non-response.

A person who is genuinely interested in your advice or who wants to chat in order to get to know you better will come back to you. If they don't, you should move on. This is why I think a second push is a no-no.

Still, suppose your friend goes for it again.  If you think they're basically okay but just not getting it, you have to be completely straightforward. The message has to be utterly plain, so they can't mistake it. After all, the subtle stuff has already passed them by.

For random unwelcome advice, you might say, “This is not something I wish to discuss further.”

If you have a health problem that's brought out the crazies, a friend who is expert at fielding these recommends, you preface it with a graceful, “Thank you for your kindness. I have a detailed treatment plan I am comfortable with.”

For persistent chat requests, I use this standard phrase, “If you have a specific question, or need a contact, do PM me, but I just don't have the time for random chitchat.”

It can be difficult to have to be this blunt but it means you can invite an “okay, I get it” in return, and it's all good again. With this option, you make it possible to keep your friend. I'm all in favour of this, because relationships are to be treasured.

 

However, if that person has a hissy fit, or keeps bugging you, that’s different.

I could beat around the bush here and be super sweet about it, but let’s talk turkey. There might be many underlying causes fueling this annoying persistence, and none are flattering.

·    They are self-centred/entitled and can't see their opinions/attentions are unwelcome.

·        They are selling something and hope to bully you into buying.

·        They are advocates/evangelists, meaning they are bullies intent on shoving their opinions onto you.

·        They are abusive and this is an attempt to control you by wearing you down.

In all these cases, I think it’s acceptable to cut them off. I do.

Clearly it will be more difficult if this person is close to you. However, there really is no reason why you should put up with bad behaviour.

Friends respect boundaries.

Oh, Oh! When We're Not As Clever As We Think

Long time, no see!  I’ve been busier than the proverbial bees and so haven’t had the time to blog.

However, apart from the private clients and the novel writing, I’m also back into research. I’ll tell you more about it in a few months. In the meantime, I thought you’d be interested in this nugget.

Do you ever find yourself super irritated by people who wax lyrical on complex topics they know absolutely nothing about? If yes, then read on....

The Man In The Pub is a classic. He’s the one who tells you how to fix the national budget, lower your blood pressure, dump your difficult boss, and he’ll have a sure fire fix your love life too - whether you ask him or not! The thing about him is that he's just ordinary but he thinks he's a genius.

Curiously, the Man In The Pub phenomenon is becoming more and more common. Just look around and you’ll hear people talking very confidently about statins, food additives, allergies - and they do it while admitting they barely passed their high school chemistry and biology exams, never mind taking a hard science course of any kind at college.

Question: why do these people think they understand complex topics when their ‘research’ consists of reading a couple of Facebook posts based on a magazine article that was shared by friends?

First, there’s the Dunning-Kruger effect. It says that when you lack skills, you come to the wrong conclusions. Then, because you don’t know what you’re doing, you can’t tell you’ve made a mistake. So you go about, thinking you’ve got it nailed, when actually you don’t. What you do have is a case of illusory superiority. Ouch, right? (Want to read the papers, check out the references below)

And here’s the bit I’m interested in... I think the reason we’re all becoming The Man In The Pub is because we have the illusion that we’re always connected and always learning. Our smartphones and our Google make us think that we’re soaking up smarts. 

We feel empowered, which is lovely, but we’re not actually learning that much. While we might be a bit better about finding out quickly where Bangui is, or who was fighting at Flodden back in 1513, no amount of Googling is a substitute for serious study. That's common sense, right? If all you had to do was Smartphone away, we’d all have a couple of dozen PhDs by now.

Given we're living in the Internet age, we’re all suffering from the Dunning-Kruger effect at least a little bit. And the problem is that it can make life awfully difficult. (I’ll write more about that later, as this is getting a bit long.)

It got me thinking, what’s a quick self-check to see if you might be falling into this?

I suggest this: the next time you talk about a complex topic, like medicine or space exploration, ask yourself what kind of knowledge you would need to be a world renowned expert. Could you be a surgeon on the basis of your marketing degree?  Would NASA ask you to take charge of the Space Station because you have a masters in psychology? If the answer is probably not, watch yourself.

Crushing, right? And I was so certain I could do Robert M. Lightfoot Jr's job! But hey, better than being The Man In The Pub. 

Check it out these papers:

Dunning, D. (2011). 5 The Dunning-Kruger Effect: On Being Ignorant of One's Own Ignorance. Advances in experimental social psychology, 44, 247.

Kruger, J., & Dunning, D. (1999). Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. Journal of personality and social psychology, 77(6), 1121.

 

Image by Barbara A Lane from Pixabay

Are You For Real? A Tip For Avoiding Con Artists Posing As Psychologists

Most of the information we see online about  psychologists comes from the EU, North America, Australia and New Zealand. That's a problem if you don't live there because it gives a very false impression of the field.

Psychologists deal with vulnerable people but in most of the world, the profession is totally unregulated.

Shocking, right? If you're in Malaysia, Cambodia, Indonesia and goodness knows how many other countries, you can simply announce, "I'm a psychologist!" and nobody will do a blessed thing to stop you messing about with people who are suicidal, struggling with learning issues and other serious problems.

There are con artists with no training whatsoever, not even a basic diploma in psychology, running companies that advertise in newspapers, setting up their own endorsement agencies, and even their own training centres.  They  'diagnose' you and often charge the earth, too.

There is plenty of discussion about it in the field, but in my opinion, this will be an ongoing issue for some years to come. Even if you fix the problem with a quick bit of legislation, enforcement is difficult - especially as these people will simply rebrand themselves as "lifestyle gurus" or whatever other title sounds cool.

So when you need a psychologist, how do you avoid the cons? I had the look yesterday at the social media (Facebook and LinkedIn) of several leading lights in the community and then I compared it to some known crooks.

The legitimate people were posting cartoons of owls, photos of their lunch, moaning about their kids, giggling about silly things that happened to them, sharing jokes - and very occasionally commenting on a psychological issue.

The cons had a steady stream consisting of shares of journal articles, press articles, motivational quotes and their own evil advertising.

Also, you should know that cons make up fake associations.Yes, it doesn't take much to register an association, and as anyone can be a psychologist, nobody cares who's proper and who isn't.

Depressing, right?  The cons looked so damn good that if I didn't know better, I'd consult them!

So what can you do?

Sourcing specialists, say those who work with eating disorders or autism, is best done through your national hospital network and your public universities.

If you're looking for a regular therapist to talk about relationships, divorce, abuse and so on, a safe bet is to work with someone who has a basic Bachelor’s degree in psychology as well as a Masters in a mental health field that includes several hundred hours of supervised practical clinical work. That way you have someone who's done all the academic work with a healthy dollop of practical work. (My Masters involved about 400 hours of practical work.)

When you see a therapist you think you want to work with, ask where they went to college and what their qualifications are. As a first step, make sure that the school exists and that they have the programme your contact says they have completed. (You can call the school but in my experience, they rarely know who's in class this week, never mind who's graduated.)

Then, do a little spying on their social media. One thing that stood out from my looking around is that professionals have connections to universities. They don't necessarily work in them but they'll have friends there.

So, see who their friends are. If you see their pals are from recognisable unis, you're probably okay.

You can also ask me. I may not know the people you want to consult myself, but I have a South East Asia network that I'm happy to draw on. Oh, and if you want to check me out on social media, have a look at my Facebook page.

Did you like this? Then you may enjoy this, “If it’s quackery, why is it working for me?”