This was affirming. Though he was unknown to me, this was Dr. David Keirsey, Clinical Psychologist, and the head of the Counseling Psychology Department at Cal State Fullerton.
But it wasn't just that. I'm not so easily impressed by credentials or experience. Fools often have all the right credentials and experiences. I had met a lot of them already. No, it was that there were voices out there in the professional world that had long ago came to the same conclusion as I. This was just the first time I heard it. This meant my views had professional merit.
By 1983 I was immersed in my Master's program. I took work as an Admissions Director at a 120-bed agency. I was a vocal critic of medication for any kids at any time. I did many training seminars about strategies and techniques in child management, and I always folded this subject in, indicating that the practice was (1) unproven, (2) ineffective, (3) detrimental to children, and I would list the evidence for each. I was not persuasive, and I still had that damn degree in sociology.
It didn't matter. No one paid attention. The chemical wave had started.
The APA
Around this time, I was sitting in a barbershop on a Saturday morning, waiting my turn. I was thumbing through a psychology magazine. I ran across an article written by someone from the American Psychiatric Association. The APA is a member based lobby group.
Back then psychiatrists were still doing therapy while their client was on a couch, staring at the ceiling, and disclosing his or her most private thoughts and feelings. Troubled adults went to their psychiatrist to talk with them about their troubles, and the relationship they had with their doctor was very important.
More and more often, according to the author of the article, psychiatrists were giving their clients different doses of different chemicals to ease some of their symptoms. This was understood to be an addendum to the real therapy that took place in a quiet office for an hour. After all, a psychiatrist is first an MD, and if there are medicines available to ease symptoms, they could be used with certain clients. Once medicated, then the therapy in the office could continue with better results.
This article's author, also a psychiatrist, was concerned with a developing trend: there were a growing number of psychiatrists who were relying too much on medication. The author went on to warn that it seemed like many psychiatrists were abandoning more traditional forms of therapy, and were succumbing to the appeal of giving their clients chemicals to curtail symptoms, and in so doing minimizing, and sometimes eliminating, traditional "talk therapy" sessions.
Psychiatry, the author feared, was turning away from psychology and towards medicine when it came to helping their clients with persistent life problems. The tone of the article was cautious and meant to discourage their members from getting to far from the couch. It didn't take.
Now, quickly, roll the clock forward 15 years. By 1999, I was the new Executive Director for a new wraparound program. We had a contract with a County Mental Health Department in California. While we were an independent, private, nonprofit agency, the contract was clear that we would defer all medical decisions to the county psychiatrist. Any adult or child in the Mental Health system was required to be reviewed by a psychiatrist. Funding depended on it.
We attended a weekly meeting that included my staff, other non-profit agency staff, and the staff from the County. The psychiatrist sat at the head of the table while therapists reviewed the progress for the most troublsesome clients. Based on this information the psychiatrist would increase or decrease the amount of a current chemical, leave it the same, or change the chemical to something more effective.
On this day, one of the therapists from another program was exasperated. Her client was not improving, and in fact was getting worse. With the best of intentions, and a little desperate, she was looking for support and assistance, so she asked the psychiatrist:
"Would you mind talking to my client yourself, just to see what you think?"
I perked up, again, like I always do when something interests me. I wanted to hear his answer. I thought it put him on the spot and I didn't mind him squirming a bit.
Once again, I underestimated the implied ascendency that accompanies psychiatrists.
But it wasn't just that. I'm not so easily impressed by credentials or experience. Fools often have all the right credentials and experiences. I had met a lot of them already. No, it was that there were voices out there in the professional world that had long ago came to the same conclusion as I. This was just the first time I heard it. This meant my views had professional merit.
By 1983 I was immersed in my Master's program. I took work as an Admissions Director at a 120-bed agency. I was a vocal critic of medication for any kids at any time. I did many training seminars about strategies and techniques in child management, and I always folded this subject in, indicating that the practice was (1) unproven, (2) ineffective, (3) detrimental to children, and I would list the evidence for each. I was not persuasive, and I still had that damn degree in sociology.
It didn't matter. No one paid attention. The chemical wave had started.
Around this time, I was sitting in a barbershop on a Saturday morning, waiting my turn. I was thumbing through a psychology magazine. I ran across an article written by someone from the American Psychiatric Association. The APA is a member based lobby group.
Back then psychiatrists were still doing therapy while their client was on a couch, staring at the ceiling, and disclosing his or her most private thoughts and feelings. Troubled adults went to their psychiatrist to talk with them about their troubles, and the relationship they had with their doctor was very important.
More and more often, according to the author of the article, psychiatrists were giving their clients different doses of different chemicals to ease some of their symptoms. This was understood to be an addendum to the real therapy that took place in a quiet office for an hour. After all, a psychiatrist is first an MD, and if there are medicines available to ease symptoms, they could be used with certain clients. Once medicated, then the therapy in the office could continue with better results.
This article's author, also a psychiatrist, was concerned with a developing trend: there were a growing number of psychiatrists who were relying too much on medication. The author went on to warn that it seemed like many psychiatrists were abandoning more traditional forms of therapy, and were succumbing to the appeal of giving their clients chemicals to curtail symptoms, and in so doing minimizing, and sometimes eliminating, traditional "talk therapy" sessions.
Psychiatry, the author feared, was turning away from psychology and towards medicine when it came to helping their clients with persistent life problems. The tone of the article was cautious and meant to discourage their members from getting to far from the couch. It didn't take.
Now, quickly, roll the clock forward 15 years. By 1999, I was the new Executive Director for a new wraparound program. We had a contract with a County Mental Health Department in California. While we were an independent, private, nonprofit agency, the contract was clear that we would defer all medical decisions to the county psychiatrist. Any adult or child in the Mental Health system was required to be reviewed by a psychiatrist. Funding depended on it.
We attended a weekly meeting that included my staff, other non-profit agency staff, and the staff from the County. The psychiatrist sat at the head of the table while therapists reviewed the progress for the most troublsesome clients. Based on this information the psychiatrist would increase or decrease the amount of a current chemical, leave it the same, or change the chemical to something more effective.
On this day, one of the therapists from another program was exasperated. Her client was not improving, and in fact was getting worse. With the best of intentions, and a little desperate, she was looking for support and assistance, so she asked the psychiatrist:
"Would you mind talking to my client yourself, just to see what you think?"
I perked up, again, like I always do when something interests me. I wanted to hear his answer. I thought it put him on the spot and I didn't mind him squirming a bit.
Once again, I underestimated the implied ascendency that accompanies psychiatrists.
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