As I embark on the middle leg of my second year of graduate school in clinical mental health counseling a course looms on the horizon that I’m simultaneously excited about and simply wish I didn’t have to take at all. That class is Intro to Psychopathology with an emphasis on psychopharmacology. Both words are packed with oomph and leave me with an array of mixed feelings.
As I blog I look to the left of my computer and on my desk is “Abnormal Psychology, An Integrated Approach” by David H. Barlow and V. Mark Durant. At $125 used, this behemoth will serve as my text for the aforementioned course. I am training for this class by taking extra vitamin supplements and running three miles a day. Okay, maybe that’s an exaggeration. I am getting my exercise solely through worry and an occasion jump on an elliptical machine. I’ve never subscribed to New Year’s resolutions.
All right, I am using humor to avoid the actual issue here which is: Where will psychopharmacology and it’s the parent “the medical model” fit into how I function as a counselor? I am fully aware that although we as counselors cannot prescribe it is of the utmost importance that as counselors-in-training we learn about psychotropic drugs and understand what mental illnesses they can be used to help.
Intellectually, I know this is true, but the coach and the bright eyed idealist in me believes that we are all basically healthy and the majority of mental disorders are created through normal reactions to abnormal circumstances. These circumstances may be physical and verbal abuse, war combat, poverty, sexual assault – the list is endless. If this is the case, than nobody is really emotionally “sick” in the true sense of the word. Within this construct what part does biology play?
And, of course, this line of thinking inevitably leads to considering the work of William Glasser – which my classmates and I did in a class this past semester in what was a heated, and I mean HEATED discussion (which is often the best kind!). Dr. Glasser developed Choice Therapy and Reality Therapy which emphasizes personal choice, personal responsibility and personal transformation. As a renegade psychiatrist he rejects the medical model of diagnosis and prescribing medications to treat a particular illness when, in fact, the patient may simply be acting out of unhappiness, not a brain disorder. He has written many bestselling books explaining his position, which is utterly unmovable. No meds under any circumstances - which led to said discussion in my class.
In graduate school these debates have been endless – often intriguing and sometimes tiresome. In the behavioral wings of hospitals there are many patients who hallucinate, hurt others and/or self harm – there are also outpatients with severe symptoms. How are they to function without medication? Medication often aids in therapy for clients with certain conditions – how is this bad? Where would we be without the medical model? Without psych meds? What role does positive psychology play?
It seems that this blog is devolving into a series of questions, but maybe that’s a good thing. Perhaps that’s the best aspect of being a graduate student. You are not yet confined by agency quotas or managed care restrictions. You can freely ponder these questions and get many valuable points of view from a variety of sources while you formulate your own opinion which will inform how you navigate your career.
Licensed counselors working out in the field reevaluate their positions on these issues continuously. It seems to me at this juncture that flexibility is key and knowledge is power…and one thing is for sure - we must never stop asking questions.
Susan Jennifer Polese is a counselor in training, a personal coach and a freelance writer. Her areas of interest are mindfulness, divergent thinking, and creativity in counseling.