Thursday, June 19, 2014

The Role of Diagnosis

     Why does diagnosis exist?  I think that a "diagnosis talk" should exist with clients who receive one from a clinical professional.  There is an obvious stigma in most cultures against people with such titles.  Perhaps as a clinical community, we can subtly change the message of diagnosis from one of hindrance and abnormality to one of medical jargon and record-keeping.
     I really think that a diagnosis would be better suited as a description/shorthand for some behaviors that help professionals understand the client.  Rather than saying, "You are a schizophrenic," or, "You have schizophrenia," why not say, "Schizophrenia is the best name one can give your behaviors?"  The former message gives a title and with it and with it an assumption of status.  The latter is more of an agreement between professionals as to what behaviors a client exhibits.  This should not be a label!

The Role of Therapist

     The role of therapist is a highly contested one.  At is inception, therapists were distant and interpretive, disallowing deep relationships (a la Freud).  The second movement was, in my opinion, less of a psychotherapeutic discipline as it was an experimental psychology doctrine.  But the behavioral method eventually rose to a direct client-based state.  Oddly, though the movement was in direct opposition to Freud's views on psychopathology, sex drives, and the unconscious, behaviorism shares the distance that Freud believed in.
     I think that Adlerian individual psychology was the bridge between the second and the third movements.  It seems to me that Adler was really trying to be a warm being in the client's life.  This could partially be due to the fact that he dealt quite often with children (as they were his main population).  Individual psychology may have even started the idea that the relationship between therapist and client is crucial.
     But, of course, Rogers's client-centered therapy is what it took for the therapist to be seen not as savior or expert (Freud) or caring doctor (Adler), but as a facilitator or helper.  It is this title that so interests me.  Other theorists have changed Rogers's view on the role of therapist slightly.
     Both Beck and Ellis of CBT fame espoused to be more structured and educator-based in their theories.  They acted in the role of expert.  They were teaching concepts for future use.  I think, to be honest, that this approach to therapist role has more to do with the type of theory that it is (teaching techniques for the future) rather than any specific plan they concocted.
     The more I practice, the more I find myself in the situation of psychoeducational technique use.  This could be due to the fact that most of my clients were in the drug and alcohol realm and that life skills teaching is a must in rehabilitation.  Due to this, I think that the role of therapist as educator and expert is important, but perhaps could be turned down so as not to discourage clients fro seeking further help.
     Changing the name of the role from teacher to tutor might reflect my views on the subject a little better.  A teacher can (and often does) talk down to a student from their high peak of knowledge.  A tutor, on the other hand, can teach and instruct, but also can have the ability to provide empathy.  A tutor works with a student, not in spite of him/her.  It is this collaboration that allows the real work to happen.  Just as a tutor can help a student with their research, a tutor approach can help a client conduct research into themselves and their behaviors.

Saturday, June 14, 2014

Intellectual Suicide

     Today, children, we are going to talk about suicide.  People commit suicide for a multitude of reasons, the major one possibly being the inability to cope with some stressor and the additional point of lack of support around them.  They figure that this inner-outer conflict is less preferable to death.  Then, depending on their belief system, they would have to cope with some after-life punishment.  This, if thought through, would imply that such never-ending punishment would be preferable to their current torment.  Some belief systems, if they can be called that, assume that there is a never-ending nothingness waiting to greet us on the other side.
     Suicide is the final action.  Nothing is more subjectively/personally last than this.  But for some people, suicide is scary.  The thought of "taking oneself out" is unpleasant, dissuading one from engaging in the action.  Honestly, the unpleasant thought could deal with the aforementioned afterlife consequences, the process, or the thought of possible failure.  Either way, such rash action is unpleasant.  This is why I think that people commit a more mundane, but no less effective, form of suicide.
     This form of suicide shares at least one aspect with "death suicide."  Both inhibit a future.  This other form of suicide is the tendency of an individual, when met with a fork in the road, to take the easiest path in order to prevent possible failure in the future: that is, to stagnate and make no decision.  But why would one engage in this type of suicide, this future or intellectual suicide?  Perhaps they are afraid of taking the harder road and failing.  Perhaps they are inundated with expectation or policy.  Maybe they are burnt out.  Either way, they are not engaging themselves on the path of highest self-betterment due to a fear of something.
     A lot more can be written on the subject as far as tools are concerned.  Last thought:  suicide, at any level, is about giving up.  There is no hope anymore.  Perhaps there is some learned helplessness here.  Either way, exploring hope with clients is probably one of the main tasks here.