ACA Blog

Ken Oliver
Apr 21, 2010

The Legitimacy of Counseling

What is the etiology of the psychological distress we purport to treat? Some of you keen counseling philosophers have already become suspicious of my question, so I’ll ask it again in its most common form! What is the cause of mental “illness”? Now, if you’re feeling that sinking sensation in the pit of your stomach, don’t worry! I’m not going to ask you to examine your own philosophy regarding the nature versus nurture debate. I wouldn’t do that to you. Instead, my question intends to go beyond, at least professionally, the nature/nurture debate to explore how the counseling profession benefits from the controversy surrounding the cause of issues that bring people to our care. My task hereafter is to convince you that the counseling profession gains legitimacy as a result of the quest to find a biological etiology for mental illness.

Before I proceed with convincing you of this benefit to the profession, I find it necessary to disclose my existential/feminist/multicultural slant, just in case you aren’t a fan of satire. (Disclaimer: in other words, what follows is meant to be satirical in nature and does not represent the true beliefs of the blogger)
My argument is clearly delineated in five points as follows:
1.The concept of mental illness or disease (e.g., alcoholism) brings us comfort in knowing that we, ultimately, are not responsible for our condition
2.Consequently, mental illness or disease in others is more excusable
3.Positron emission tomography (PET) scans allow researchers to explore differences between individuals based on the responses of neurotransmitters in the brain, thus proving the cause of mental illness as being rooted in biological flaw. This also serves to disprove environmental etiology, not because we know which actually causes the other, but because we can see proof of the biological side. So, there you go!
4.The idea that illnesses like mood disorders and anxiety disorders can be caused by environmental stressors doesn’t explain why these disorders are effectively treated with medication.
5.Counseling, as a profession, doesn’t have a lot of support for efficacy in treatment. Also, research supports the notion that effectiveness has little to do with type of treatment (Seligman, 1995). Without a biological etiology for mental illness, what are we effectively saying about the society in which we live?
a.That people learn to cope with life stressors ineffectively?
b.That we are chronically stressed, which leads to a myriad of psychological distress?
c.That the medical model seeks to treat symptoms rather than causes?
C’mon…Really? Our profession is financially justified in treating things for which others have no control. Conversely, should my “third party provider” really be expected to help me cover the cost of “treatment” for relationship issues? Get serious! Furthermore, “counselor” isn’t even a protected term. The person who walks my dog is a “counselor.” So are my barber, my lawyer, and every bartender I’ve ever met.

Counselors want it both ways; they want to function as servants for the status quo in their promotion of normality and, with this new social justice thing, work to change the very social structure they strive to protect. One hand’s fighting the other! Maybe, just maybe, if there was a clear function or set of objectives for the counseling profession, they wouldn’t need to latch on to biological causes of mental illness. Right now, however, counselors are analogous to that kid from your neighborhood who never really knew he was “tagging along.” Remember him? That kid? Professionally, in many respects, that’s you!

Listen “third wheel,” the sooner you realize that you need a biological basis of mental illness to legitimate your profession, and that treatment of non-biological problems is an effort in mysticism, the better off you will be.



Kenneth Oliver is a counselor in Missouri and an assistant professor at Quincy University in Illinois.

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