Betty W. Phillips, Ph.D., Psychology
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Do Crazy People Need Shrinks?

Do Crazy People Need Shrinks?

I know this is a silly question, but it gives me the opportunity to write this month's column about therapy and therapists.

I used to treat adolescents before I "retired" from this demanding role. Teenagers often feel like self-determining adults, full of their own self-importance, certainly not needing advice from anyone. They rarely seek out therapy for themselves. In an attempt at humor I usually started my first session with teens by asserting that I'm not a shrink. I predicted that the teen would leave the room the same size as when he or she walked into the office. A dumb joke of course, but an ice-breaker nevertheless.

Negative stereotypes about therapists and therapy clients often serve to deter people -- even adults! -- from a profitable and life-affirming experience. The term "shrink" came from head- shrinker, based on a tribe in Amazonia which preserved the small mummified heads of their enemies. Not exactly an experience to look forward to!

Many people feel that the therapist-shrink somehow dismantles the person’s psyche, pokes around at the problems and finally entraps the patient into a navel-gazing experience. The patient leaves with a new label after a long and demoralizing series of costly sessions. Stories of inept therapists abound -- and I've heard them myself. "Will you talk with me? My last therapist just took notes." "Will you give me ideas and tell me what you think? My last therapist never did." Or even worse -- "I never knew what my doctor was thinking. Sometimes she had her eyes closed. I never knew whether she was asleep or not."

Rather than a shrinker, a good therapist is a life-expander. In my opinion a good therapist is an active participant in a professional process wherein the client seeks ideas and feedback about troubling life issues important for self improvement. A therapist is a professional to be utilized as any other professional such as a tax adviser, interior decorator, auto mechanic or financial consultant. Whatever your issues, the professional is an adviser, and the assistance is only as good as the knowledge and experience of the professional.

Are therapy clients crazy? Sick? Weak? Is it shameful to want or need therapy? I call my clients just that, "clients," to emphasize the element of choice and not sickness or weakness as might be suggested by the word patient. To me the word patient conjures up images of waiting in cold examination rooms, feeling exposed in a poorly fitting skimpy paper robe. Not for me unless I have no other choice! The therapy client arrives as an equal to the therapist, an expert about his or her own life and issues. Instead of receiving a hurried consultation and a prescription to drive away sickness, the therapy client instead interacts with a caring and expert professional to obtain individually-tailored advice about life strategies.

The therapy client may initially approach therapy sessions "feeling bad" as people often do when requesting professional advice. This is a sign of strength, an attempt to solve a life problem, not a sign of weakness. There is no more shame in experiencing life stress than having tax problems or mechanical problems with your car.

The concept of "crazy" is usually perjurative, conveying images of "lunatic," "insane," "mad", "flipped-out," "off your rocker," in other words, abnormal and subhuman. People who are actually seriously out of touch with reality will need more extensive assistance than one hour a week sessions. Conversely, most clients seeking therapy are quite in touch with distressing life issues and are seeking improvement in the quality of their life experiences. Sometimes therapists do provide crisis-intervention to help their clients deal with serious life issues, but most psychotherapy sessions also provide prevention and intervention in dealing with a myriad of life experiences.

Many therapists offer an initial consultation so that prospective clients have a chance to meet the therapist, find out if they feel comfortable in the office environment and decide if they are interested in continuing with this therapist. It is difficult to walk into a stranger's office and, as soon as the door closes, be asked to tell personal and private issues to this stranger. Website information provided by a therapist is helpful background information, and an initial in-person experience is also important. You want to know if the therapist is personable, empathetic, compassionate and mature. You want to know if the office space is designed for beauty, comfort and security. You want to know about the therapist's background and experience especially related to your issues of concern. My website noted above has a section "Choosing a Therapist" with a list of issues you may want to consider in making this important decision. I provide background information on my website including articles in the Reading Room and Advice Line sections so that my new clients can make informed choices.

Being rational and not crazy, you have the power and freedom of choice to select a professional therapist to facilitate your self-improvement and personal growth. If you see any shrunken heads in the waiting room or therapy office, you can beat a hasty retreat!