Clinician, heal thyself.

[gaudior]

So one might look at people who spend their entire lives listening to other people complain and wonder what exactly we're getting out of this. I mean, it can be a relatively good job financially (depending on circumstances), but it carries the risk of being attacked, harassed, insulted, annoyed, sued, and traumatized. It's a customer service job, except that your customers will also tell you stories about the most horrific things human beings are capable of doing to each other, fall in love with you, threaten your life, and not pay you. It's not unreasonable to wonder why people do it, and not unreasonable to conclude that you have to be a little crazy.

And based on all of the many sorts of shrinks and shrink-students I know, this is entirely correct. Oh, we're not most of us floridly psychotic or actively suicidal or any such, most of the time. But like everyone else in the world, shrinks have all been badly hurt or stifled somewhere along the line. And like everyone else, we've all partially healed, and built up new structures on the scars. Our past hurts shape our future selves, in no small part because in the process of healing from them, we create something new and worthwhile. And in the ideal situation, the hurt falls away, and the new creation can stand on its own. But you can still see the shape of the hurt underneath it, if you look carefully-- and it can take a very, very long time before the creation is more significant than the original pain.

So with that in mind, I went looking for patterns of what past hurts shrinks seem to have in common, and what unmet needs drive us to this particular profession. And I found a number of them-- many based on my own perceptions of myself, some just on other people I've known.

What do shrinks want?

Control. Not just the control over other people that goes with power, though that is often part of it. But I think what many shrinks crave is control over chaos and pain. You know how it's a lot easier to give advice than to take it, even your own? Sometimes shrinks are people who are hurting really badly, and cope by trying to conquer other people's pain.

Meaningful Relationships Oddly enough, I have known a lot of shrinks with just really bad social skills. I noticed this more in psychologists and psychiatrists on the inpatient unit, but... lots of shrinks just don't know what to say in a group, or how to make small talk, or how to do the basic day-to-day interactions. Some shrinks are rude, some shrinks are shy, many shrinks are awkward. Because if you aren't quite sure how to deal with other people, you may start studying psychology to see whether you can find out that way. And once you've done that, you may realize that you could go on to be a therapist, and have clients. And like a pregnant teenager who decides to have the baby because then she'll have someone who has to love her, you then get into a position where multiple people will enter a very intimate relationship with you, telling you their deep, dark secrets, asking your advice, maybe even falling in love with you. And you don't have to have social skills-- just a degree and an office.

To be Needed Like relationships, but one particular aspect. I think this was a major part of my own motivation, actually. On some level, I went through most of my life convinced that I wasn't real to other people-- that no-one really cared if I were there. Having someone else need me was a powerful proof to the contrary, and I craved that proof. I wanted people to depend on me, because then I would know they wouldn't leave me. I desperately wanted not to be so alone, and I desperately wanted not to be dependent on someone else's whim for that company.

To be an Authority This may be more tickling to the ego, but-- shrinks like to be wise. Or smart, or intellectually rigorous, or insightful, or having common sense-- we like to know what we're talking about, and to be seen to be know what we're talking about, and to be respected for it. It makes us feel good about ourselves (and needed, and in control).

To be a Good Person This is, I think, something that people come closest to when they try to answer the ever-difficult question "Why do you want to be a [psychologist]?" with "Because I want to help people." On a deeper level, this has to do with seeking self-respect, self-esteem, purpose in life, salvation and redemption. It's sometimes odd to realize that this is meeting one's own need, because in my culture, we tend to see good deeds as selfless-- but man, do they make you feel good about yourself. And man, do they help to fight the voice in your head telling you how worthless you are.

To Defeat Bad People To be fair, many people want to do this by "curing" the "bad" people, seeing that they are "sick," rather than evil. (Think people working with addicts, batterers, child-abusers-- oh, hell, most of the forensic field, and a fair amount of inpatient). There are not actually many people that I have run into who openly hate and want to hurt their clients. But there are any number in whom, if you scratch the surface, you see at least contempt and scorn, often paired with a strong sense of how people should behave. If you have doubts about your own behavior and self-worth, it certainly does help to work with people whom you can tell yourself are definitely worse than you are.

And the thing is, any of these (even the last one, although that's the one I personally have the most bias against) can be a worthy motivation for getting one into the field. The problem is when, once they're in, people do not realize the problem and take action to meet these needs through some means other than their clients. Most psychology programs strongly suggest that students enter individual therapy, but I find myself wishing they'd suggest it more strongly. Some of these problems also deal with themselves as you apply what you're learning in your training to yourself and your other relationships, and grow more confident/certain/happy/etc.

The problem, I think, is when we don't manage to find another way to meet these needs, and rely entirely on our clients for them. That's harmful in a number of ways, primarily that when you need your clients, you're less able to help them get better, because then they'll leave you. You might see them as flat, simple characters, being nothing more than what you need them to be-- and if they try to act differently, you might try to influence them, consciously or not, to become more how you see them. That's almost certainly going to be bad for them. On a more practical level, this is the sort of thinking that lets shrinks slip into having sex with their clients, which is NOT OKAY, and also illegal.

Now, this is not to say that your shrink is a bad person or not trustworthy. But your shrink is probably also not working with you because s/he, boddhisattvalike, has achieved enlightenment and deigned to stay on earth to share it with mere mortals. In a best-case scenario (and this never happens completely, nor does it need to, as long as it's most of what's going on), your shrink is someone who started out with one of the above motivations... and then, over time, got over it. S/he found other ways to feel like a worthwhile human being, and if every one of his/her clients walked in tomorrow perfectly healthy, s/he would be happy for them. S/he doesn't need his/her clients in order to survive as a person. But on the other hand... there s/he is, with all these skills and experience, for which s/he can charge money and make a good living-- and, not coincidentally, do something s/he finds really interesting and worth doing. So s/he will probably go on, and continue to be a shrink-- but s/he will not need anything from you except to pay your bills. Which leaves you free to accept his/her positive regard as being all about you, not him/her and his/her needs. Which is quite healing, really.

I'm not yet in that place, of not needing my clients or my title in order to feel certain of my own worth. But I'm getting there.

And it's a cool journey.

--R

Comments

[sovay]

It's sometimes odd to realize that this is meeting one's own need, because in my culture, we tend to see good deeds as selfless-- but man, do they make you feel good about yourself.

Weirdly enough, I think this is one of the recurring themes in Fruits Basket: characters realizing how what they need from other people interlocks with what other people need—or what they think other people need—from them.

[queenlyzard.livejournal.com]

*laughs* On the way home from my therapy session today, I was thinking about FB, and how much I wish I could be more like Tohru... I was also wondering whether a lot of the attitudes I find in there are typical of RL Japanese culture or just of Japanese fiction, and whether it's possible to adopt some of the more positive traits (like the ability to see the positive side of awful situations) without some of the negative ones (like the obsessive apologizing for everything!)

[gaudior.livejournal.com]

(like the ability to see the positive side of awful situations) without some of the negative ones (like the obsessive apologizing for everything!)

Since I used to have both of those, to some degree, I don't think they're exclusively Japanese (though maybe more common?). I think, though, that they were the two sides of the same coin-- "Please, please, find me worthwhile and not hateful! Look, I'll like you very much, even if you're rude to me, and see good sides of you-- so please don't dislike me?" I think one can keep the ability to see the good in people once one has it, even after one loses the underlying insecurity-- but it definitely starts out a mix.

(I used to totally, totally, immensely identify with Tohru. Now... well, I want to see what she's like when she grows up.)

[queenlyzard.livejournal.com]

*laughs* I adore Tohru, but don't identify at all. If anything, I'm a cross between Kyo and Kisa (lol! The two cats!)... very much formed by negative experiences into an odd combination of shyness and anger, bitterness and yearning... yet still, of course, with the capacity to love and feel very deeply. Which is probably how I wound up getting so emotionally bruised in the first place!

[foleyartist1.livejournal.com]

I don't think Tohru's attitudes are very typical of Japanese culture. In fact, the other characters in the Furuba universe (while all pretty outside the mold themselves) are often shocked by them. I read it in Japanese so I'm pretty far ahead of where I'm guessing you are and I don't remember the beginning very clearly, but I feel like it came up a couple of times how excessively polite her language is, and I think everything about her is like this. It's almost like she's an old-school ideal of Japanese femininity taken out so far to the nth degree that she out-cultures her own culture and winds up confusing them. For a while I had trouble getting into Furuba (which is now one of my favorite manga) for this reason, but eventually I realized that (as I think gaudior has said), for every creepy extension of Perfect Nonexistent Japanese Womanhood that Tohru exhibits, she also has a subversive and under-the-radar atypical trait (like her devotion to protecting her lifestyle with three young men, the fact that she hangs out with gangsters, her tendency to involve herself in other people's problems, etc.). And she does have her own issues, and some of her responses spring from more complex places inside her than the typical manga heroine. So yeah, those things made me like her and the manga itself a lot more. But the sort of base set of patterns and behaviors that is Tohru seems much more to me like a commentary on Japanese culture than like a typical representation of Japanese culture.

(Sorry, we don't know each other--I'm a Japanese-English translator, so these are issues I think about rather a lot.)

[queenlyzard.livejournal.com]

I'm a Japanese-English translator, so these are issues I think about rather a lot.

Cool! Thanks for the info. I used to be a linguistics major, but have switched to psych. It's all I can do to try and understand people in my own culture, let alone any other!

[gaudior.livejournal.com]

Squee, yeah. I swear, I love Fruits Basket (or "furuba," as it is sometimes abbrieviated, which I find entertaining) because it has some of the most accurate portrayals of how people heal and help each other that I've ever seen in fiction. And that it's not just "Tohru is so wonderful that she fixes everyone,"-- Tohru has her own issues, definitely, and it's really clear how she relies on the people she's helping. And, in fact, since they are her family (not her clients) how important it is that she lets herself do so, and how hard that is for her.

[breadandroses.livejournal.com]

s/he will not need anything from you except to pay your bills.

this is pretty much the only reason I can handle talking to a therapist at all. because I know that, fundamentally, she doesn't care. She's going to walk out of there and go back to her life and won't stress over what I've just told her the way that a close friend would. (I mean, I know that's not entirely true, but near enough for me). It is very nice to be able to talk without the burden of how my words will affect the listener.

[gaudior.livejournal.com]

Yeah-- and that's a way important point that I'm not sure gets stressed enough to shrink students.

Also, good you're back!

[queenlyzard.livejournal.com]

Oh, ouch. I admit I sort-of skimmed this entry, but I don't quite have the nerve to go over it in depth at the moment. Because I think all the stuff you listed about shrinks is true about me... does that mean I'm making the wrong decision to go into this field? Or the right one? Or just choosing it for the wrong reasons? *gulp* "Heal thyself" indeed... believe me, I'm trying!

[gaudior.livejournal.com]

No, no, read it more carefully-- everyone is like that. That's why we do this in the first place, instead of being accountants or truck drivers or whatever. (People who do those things have their own kind of damage that they heal by crunching numbers or driving trucks-- it's just a different sort.) It's fine. The thing is that you must also work hard with your therapist and move through these things, so that in a few years, when you're out there working, they won't be as true any more.

But no. This is, I think, normal. Very, very, very normal. Standard, even. I'm pretty sure that every single shrink out there started with one or more of these motivations (at least, all of them that I've ever seen). Don't worry-- just don't stop trying.

[queenlyzard.livejournal.com]

Oh good. *starts breathing again*

[alaria-lyon.livejournal.com]

Hi. Totally unrelated, but can you explain to me the difference between content validity, construct validity, and concurrent or predictive validity? In social research worker of course!