Shortfalls of Therapy

It’s not easy to find the right therapist. A good therapist isn’t necessarily the right therapist.

My current therapist is a survivor. The difference in our discussions versus those I’ve had with non-survivor therapists is that she understands what I am experiencing directly rather than indirectly through observation. We have a camaraderie through doors ripped opened by #MeToo.

There are a lot of good therapists, but there are also a lot of highly educated, minimally informed individuals in the mental health fields who are not outright predators, but simply incompetent. Mental health is not plastic surgery, where incompetence is hard to hide. Mental health is vastly larger to comprehend and far, far more complex to treat.

A therapist should be sufficiently versed in neuroscience and trauma to be able to identify the difference between someone born with the wiring of depression, obsession, phobias, etc. and someone with acquired mental illness. I hesitate to even use the term “mental illness” here because our understanding of it is primitive. We are one generation away from Stephen Hawking being institutionalized.

Describing the spectrum of mental and emotional responses that come with childhood sexual abuse as an “illness” is incorrect. It is an injury. The sooner it is properly treated, the sooner it begins to heal. When someone breaks a leg, we put it in a cast so it will heal straight. We don’t just leave it to mend itself at a bent and twisted angle that will torment the injured person with lifelong pain and physical limitation. But we do this with our own mental health in large part because of our history of weaponizing shame.

We are just starting to discuss the human experience of depression in the proper, if elementary, clinical terms. My father was ashamed of his depression and tried to hide it and cope with it on his own and on his family for most of his life. Something broke his emotional well-being and was never encouraged to properly mend because depression means your mind is weak, he once told me. Though not a Scientologist, he was influenced by the dogma. It was only after precipitous weight loss and unrelenting darkness in his 70s was he finally persuaded to speak to a physician about depression.

He was prescribed Prozac and sent to speak with a therapist via satellite video—I suppose for lack of options, since my folks lived so remotely. But whomever thought a World War II veteran from farm country would describe his darkest secrets to a screen was woefully ignorant of human psychology. My father had more satellite TV options than accessible mental-health treatment options.

I first took myself to a psychiatrist when I was 16. I drove 50 miles one way to see him. I told him I was in a self-destructive spiral (that I hadn’t yet connected to childhood incest) trying to save myself. He told me to meditate. I paid him cash in waitress tips and drove the 50 miles back into the darkness. I was out of his league.

That was 41 years ago. I’ve watched the mental health community trying to sort itself for four decades. One thing we’ve learned, thanks in large part to military veterans, is that camaraderie can achieve what no therapist or drug can ever do. It can make us feel understood and not alone, and that’s imperative, because there are not enough therapists to treat the growing throngs of survivors—of sexual abuse, of human trafficking, school shootings and traumas to numerous to imagine.

We need each other. Trauma survivors are one.