Thursday, December 26, 2019

Another Casualty of Therapy

OK, the Daily Cal, the student newspaper of the University of California, Berkeley has a column about… get this… destigmatizing mental illness. Forgive them their innocence, but clearly they are young and naive about these things.

Anyway, the designated columnist, one Salwa Meghjee just got dumped by the psychiatrist she had been seeing for two years. Allow her to explain why this happened:

Last month, after two years of seeing each other, my psychiatrist dumped me. “I feel like we really have a connection, and it’s hard to let you go,” she told me. But she was transitioning to private practice and wouldn’t take my insurance after the end of the year, so even though she really wanted to, she just couldn’t see me anymore. I hadn’t foreseen our relationship ending anytime soon. The call was a shock.

Did you notice, the psychiatrist dumped her patient, a woman she has supposedly been caring for, via a telephone call. This redoubles our sense that she is deficient in moral character. 

Back in the day, psychiatrists and other therapists charged patients according to a sliding scale. They did everything in their power not to reject people on the grounds of reduced income. They felt a real responsibility toward their patients and clients. Therapists did not toss their patients aside because of circumstances that patients could not control. They understood that their patients often have a difficult time dealing with rejection, and thus, that it was bad practice to reject them.

Anyway, Meghjee’s psychiatrist did not understand any of this, so perhaps she is well to be rid of her.

But then, now that Meghjee is graduating from college and going out into the real world, how well have her sessions served her. She explains to us that she consulted with a professional because she was suffering from what I and Emile Durkheim call anomie. She felt socially disconnected and dislocated when she got to college. And the student counseling service naturally pronounced her to be mentally ill.

In her words:

The transition into college isn’t easy for anyone, but my mental health tanked when I first got to UC Berkeley. Trying to balance meeting new people, taking difficult classes and adjusting to life 3,000 miles away from home threw my brain into chaos. 

My therapist and I talk often about my relationship with change. She hopes that one day, I will be able to approach new life changes with acceptance and grace, instead of clinging to what has passed while kicking and screaming, which is my current preferred method of coping.

So as I prepare to transition out of college and formal education and into the real world in the spring, my relationship with change has been weighing on me. I don’t want to fall into deep depression when I leave school, as I have in the past when faced with huge life transitions. I want to enter this next phase of life ready to embrace whatever comes next, instead of mourning the end of my time at university and identifying only as an ex-student. 

Perhaps said psychiatrist should have been teaching her patient how to deal with complex social interactions, with situations where she did not know the rules of the game or the players. One understands that Meghjee liked the psychiatrist who dumped her, but clearly, she has not learned any real coping skills from her treatment. 

She has, however, learned to see herself as mentally ill. And she has doubled down on this appalling branding by writing a column for the Daily Cal in which she labels herself as mentally ill. Thus, she has good reason to maintain her dysfunctional behaviors. If she didn't have them what would she write about. If her psychiatrist did not recommend that she not write such a column, perhaps she should have been fired first. 

How does Mughjee feel about exiting college? Allow her:

The emotional stability and mental clarity needed to approach new phases of life with acceptance feel unreachable; I cannot imagine how not to be devastated by the loss of what has passed. 

Good soldier that she is, Mughjee does try to find a saving grace from therapy:

With three years of therapy, I feel armed and ready with tactics to combat the self-loathing, loneliness and uncertainty that comes with one’s early 20s. But all I have ever known is school; how will I know how to use those skills in the real world, where no one is guiding me, and I am all alone in building my own destiny?

Whatever tactics she has learned, and we wonder how many of them involve medication, she still feels alone and detached, as though she is still suffering from anomie.

She would do well to unlearn the notion that she is mentally ill. She would do well to learn to talk about other things, besides her mental illness. She would do really well to learn small talk or idle chatter.

If psychiatry has been grooming her to become a lifelong user of its services, it has largely disserved her.


Turbosquid said...

How do the armed forces do it? i.e., take 18yr olds and move them thousands of miles to a training area without "anomie?"

Stuart Schneiderman said...

Excellent point... I am sure they do not do it with multiculturalism and political correctness.

Freddo said...

Armed forces do it through boot camp. Put people in a very stressful situation while they cannot fall back on their existing social networks and presto: instant building of bonds and social cohesion. Note: some attrition to be expected (may serve as stress relief for the survivors?). Note: the hazing in fraternities also has this effect (hence banning fraternities an example of Chesterton's Fence?). Note: bonding - also with the organization at large - can be improved by telling recruits afterwards that they now belong to the elite-of-the-elite.

Take an immature person,
-move them far away from their social support network (as well as known, comforting physical infrastructure),
-destroy their self-image: "the smartest in the class surely destined for college" to "I'm lucky if I rank in the top 50% and suddenly I struggle to keep up with the education",
-in their struggle to re-establish a social network probably encounter challenges and ridicule to their personal and family values,
-add in a generous dose of (perceived?) sky-high expectations from the home front
and then pull a suprised-pickachu when this person feels a certain amount of anomie?

Probably nobody is surprised that in UC Berkeley the answer is "heaps of therapy paid for by anonymous insurance conglomerate". With the very unfortunate effect that she has established her new self-image as "mental patient". Her therapist may have been a comforting presence, but has failed her most disastrously. The rather rude phone call may be a blessing in disguise, as it has created a crack in her therapy bubble, perhaps setting her up for a better path (probably wishful thinking given her self-published behavior).

Side story: the Netherlands in the 1970-90s. University enrollment was booming; large class size means little to no personal engagement in the first two years. For historical reasons - colonization - Dutch universities accepted a lot of Indonesian students. The Dutch language was spoken by the Indonesian elites, but rapidly fading out, while English lectures were still as good as non-existant until the 1990s.
The Dutch engineering departments were of high quality and had been the source for Indonesian government engineers for a long time, so those degrees were a way to a solid future in Indonesia. Two types of students: kids from rich, powerful families, and kids from towns or villages where the entire village is saving and contributing to send their golden kid through university (with of course the agreement that when the kid returns salary and benefits will flow to the village).
Anomie wasn't really a concept in that environment, but a number of the latter students choose a very tragic end.

Anonymous said...

Back in the 90s "affirmations" were popular. They can work because of the power of suggestion. But they can't sound like, "I wish I could be happy;" it has to be, "I AM happy right now." The mind is influenced by that suggestion but not the one that takes place conditionally or in the future. Reminding oneself that one is weak, non-functional, and about to be miserable, only perpetuates the problem.

Sam L. said...

I recall Mr. T's response: "I pity da fool". Seems appropriate here.

UbuMaccabee said...

I’d feel socially disconnected if I went to UC Berkeley. It’s hard to make friends in the 8th circle of hell.

Anonymous said...

On your feet soldier! Fight for Skittles!

UbuMaccabee said...

Skittles? I knew a guy once, he swore by them.