Thank you for your testimonial Sarah. As a Psychotherapist i hear often: "i don't need paychotherapy", including from mental health professionals I think part of this come from stigma. The studies show that stigma is the greates barrier for searching a treatment. I went for therapy for 6 years, as part of my therapy studies. Once in a while I go to my therapist office. Whwn my students ask me why, I tell them:" if we can be happier, why do anyone choose to be unhappy"?
Sarah - Thank you for writing this. It brings me back to my own time working in a psychiatric hospital years ago. I was struck by your observation that there was no real talk of healing in the program, and yet the focus remained on skills, symptoms, and management. That was exactly what I witnessed where I worked. It feels significant, because without space to consider what has contributed to our pain, it’s hard to imagine how healing could ever be possible.
Reading your reflections, rhetorically, of course, I found myself wondering what you’ve come to understand over time about the origins of your struggles. Not as a way of defining yourself by them, or me by my own struggles, but as part of what makes change more than just symptom control for any of us. It’s part of why I still see my own therapist, whose training is very different from mine. I sometimes want help opening new ways of seeing what lies beneath my own patterns and remind me that improvement, whether we call it recovery or simply life shifting in a better direction, comes from understanding that can lead to different actions or thoughts over time.
Your piece raises questions many of us wrestle with: what does it mean to move beyond management, and how do we find the conditions that allow us to truly heal, or at least live with a better quality of life, from a place that is, in many ways, unique to each of us? Thank you for putting words to these complexities with such honesty. I very much look forward to reading more of your work.
There is so much focus on diagnosis and treatment and “what’s wrong “ : with not much space for healing, what’s right, healing toolkits and hope…this is why I’m very passionate about healing informed rather than trauma informed approach…each patient deserves to feel whole, safe and hope. However how many therapists, clinicians are able to bring this into their practice? I’m not sure…
Good point! Thank you for sharing this perspective, Magdelana. I appreciate the emphasis you place on wholeness, hope, and helping people feel safe. That vision matters enormously. Without it, I shudder to think what treatment of any kind would become.
What I often find important, at least theoretically, is the distinction between approaches that focus mainly on the present and future, building skills, tools, and growth and those that also look to the past to understand what contributed to the struggles in the first place. Both seem essential, especially when trauma is part of the picture. Without a grounding in trauma awareness and root causes, even a healing-oriented approach can risk bypassing the forces that continue to shape a person’s life. But without an orientation toward hope and possibility, therapy can end up circling around symptoms without opening a new path forward.
From my perspective, deeper healing tends to happen when both are present: safety and understanding of what has been, and how it shapes the present, alongside space for imagining what might be different, possible, and taking steps toward positive change and growth.
As you indicate, the real challenge is how many practitioners, whether therapists, clinicians, and I would add coaches, are truly able to bring this full range into their work?
Thank you, Bronce! Actually, evolutionary psychiatry/psychology has made the most difference. I don't see a therapist (though I check in with my psychiatrist--still--once a year), but that school of understanding how the human brain works and how we aren't supposed to be living in the kind of environments we live in today made me say, 'Oh, my brain is doing the best it can and exactly what it's supposed to do. Nothing to fix.'
Thanks for sharing this. I think of therapy as a "workout" for that part of my brain that has caused me trouble in the past and could do so again. For me, it's similar to working on physical stability, strength, and agility to reduce the chances, or at least the severity, of physical injury, as I age.
Then there's the whole, people we assume go to therapy and people we assume don't. I never thought of you as a therapy person, which shows all the biases I wrote about in this post :)
Well crap, my friend. I don’t have the context for how long ago this was, so I will take a guess and assume it was years ago.
I’ve worked both inpatient and outpatient, led group therapy and done one to one therapy.
What your outpatient group was doing is more occupational therapy than psychotherapy. Teaching the members how to accomplish small tasks on their own can be helpful for some, but is not what you needed. And I want to practically shake the group leaders who allowed it to go on as it did.
In groups I led, I always based the focus on being witnesses to each other, since the majority of people in my groups lived alone and it helped them to gain the support of the group in regard to coping skills as well as self observation about when to reach out for help. Allowing anyone to rant on followed by nothing (which is what it sounds like happened) is not helpful. Yet real time coping skills and options for healthy self soothing would have been.
Your withdrawal from the medicines is also horrible. I hope that Dr R was either able to find you medication which allows you mental balance without side effects or set up a vitamin regimen and dietary routine that helps. Reactions to medicines are bad when they happen. So is uncontrolled anxiety due to being a highly sensitive person.
The stigma of “therapy being for those who are sick” and “medicine being for those who are out of control mentally” is an old one, and I will continue to hope society shifts away from this mindset. It wasn’t that long ago that people were sent to horrid institutions where they dealt with electro shock therapy and unneeded lobotomies. So I do understand the fears.
The fact that you weren’t getting anything out of group therapy is enough reason to leave. For those who are still afraid of you losing your balance, they need to know that you have coping skills and know when to call a friend or a loving sister.
It is important to give tools to the people we work with so they can observe themselves and not simply react to symptoms and not know what to do. Some people (like myself) must have real time techniques to calm the body when there are runaway reactions happening chemically to us. I went to therapy for years and worked with an amazing woman who helped me to know what was an out of control bodily cascade of chemicals versus actual dangers and how to interrupt autonomic dysfunction and regain my balance. None of this was “easy”. I didn’t want a pill that would stop symptoms in 20 minutes by making me a zombie. I worked with my tools (and still do when stress is high). I no longer have enormous panic attacks out of no where.
I have loved sharing techniques and clear tools for folks to understand their bodies and their environment.
I apologize this is so long, yet clearly I have some rather big responses to the poor quality interactions you had with “therapists” a nd psychiatrists (prior to Dr R)
You're so amazing, Teyani. The work you've done! It was many years ago, and I hope these places have changed. So fascinating that many of the people in group lived alone. And yes, I have many, many tools now and understand my brain and body from an evolutionary perspective, which has been immensely helpful. Coming soon...
Thank you for your perspective on this. As a person that has been on SSRI’s for over thirty years, had a frontal lobe brain tumor and suffered chronic depression and anxiety all my life I can attest that the choices to remain on or of medicine is not an easy one. For me I had been poly drugged and it ended me up in the hospital because of the abuse and lack of consideration with these medicines that doctors took when prescribing them. I am tapering off my last med at 1.20 ml of 20 mg/ml Sertraline. I chose to do this because the medicines just stopped working . Does this mean I am better without the therapeutic dose? Not great but better in a different way. I was never right on these meds and for me they just covered up the emotional state. I lost my sex drive and have severe anhedonia. While I feel meds have there place I was fed the diabetics need insulin line to justify the use of long term and life long meds. I think they can be mind altering and damaging for a life time and withdrawal is hell. I have a long standing distrust now of the psychiatric field and the use of any intervention. It is sad really that I feel this way . I feel damaged and mislead.
“Can you be ‘healed’ and still on meds” is a demon that has been plaguing me for the last several years. The mantra “healing is not my purpose” has been an ongoing lifeline.
Thank you for your testimonial Sarah. As a Psychotherapist i hear often: "i don't need paychotherapy", including from mental health professionals I think part of this come from stigma. The studies show that stigma is the greates barrier for searching a treatment. I went for therapy for 6 years, as part of my therapy studies. Once in a while I go to my therapist office. Whwn my students ask me why, I tell them:" if we can be happier, why do anyone choose to be unhappy"?
Sarah - Thank you for writing this. It brings me back to my own time working in a psychiatric hospital years ago. I was struck by your observation that there was no real talk of healing in the program, and yet the focus remained on skills, symptoms, and management. That was exactly what I witnessed where I worked. It feels significant, because without space to consider what has contributed to our pain, it’s hard to imagine how healing could ever be possible.
Reading your reflections, rhetorically, of course, I found myself wondering what you’ve come to understand over time about the origins of your struggles. Not as a way of defining yourself by them, or me by my own struggles, but as part of what makes change more than just symptom control for any of us. It’s part of why I still see my own therapist, whose training is very different from mine. I sometimes want help opening new ways of seeing what lies beneath my own patterns and remind me that improvement, whether we call it recovery or simply life shifting in a better direction, comes from understanding that can lead to different actions or thoughts over time.
Your piece raises questions many of us wrestle with: what does it mean to move beyond management, and how do we find the conditions that allow us to truly heal, or at least live with a better quality of life, from a place that is, in many ways, unique to each of us? Thank you for putting words to these complexities with such honesty. I very much look forward to reading more of your work.
Warmly,
Bronce
There is so much focus on diagnosis and treatment and “what’s wrong “ : with not much space for healing, what’s right, healing toolkits and hope…this is why I’m very passionate about healing informed rather than trauma informed approach…each patient deserves to feel whole, safe and hope. However how many therapists, clinicians are able to bring this into their practice? I’m not sure…
Good point! Thank you for sharing this perspective, Magdelana. I appreciate the emphasis you place on wholeness, hope, and helping people feel safe. That vision matters enormously. Without it, I shudder to think what treatment of any kind would become.
What I often find important, at least theoretically, is the distinction between approaches that focus mainly on the present and future, building skills, tools, and growth and those that also look to the past to understand what contributed to the struggles in the first place. Both seem essential, especially when trauma is part of the picture. Without a grounding in trauma awareness and root causes, even a healing-oriented approach can risk bypassing the forces that continue to shape a person’s life. But without an orientation toward hope and possibility, therapy can end up circling around symptoms without opening a new path forward.
From my perspective, deeper healing tends to happen when both are present: safety and understanding of what has been, and how it shapes the present, alongside space for imagining what might be different, possible, and taking steps toward positive change and growth.
As you indicate, the real challenge is how many practitioners, whether therapists, clinicians, and I would add coaches, are truly able to bring this full range into their work?
Thank you, Bronce! Actually, evolutionary psychiatry/psychology has made the most difference. I don't see a therapist (though I check in with my psychiatrist--still--once a year), but that school of understanding how the human brain works and how we aren't supposed to be living in the kind of environments we live in today made me say, 'Oh, my brain is doing the best it can and exactly what it's supposed to do. Nothing to fix.'
Thanks for sharing this. I think of therapy as a "workout" for that part of my brain that has caused me trouble in the past and could do so again. For me, it's similar to working on physical stability, strength, and agility to reduce the chances, or at least the severity, of physical injury, as I age.
Then there's the whole, people we assume go to therapy and people we assume don't. I never thought of you as a therapy person, which shows all the biases I wrote about in this post :)
Well crap, my friend. I don’t have the context for how long ago this was, so I will take a guess and assume it was years ago.
I’ve worked both inpatient and outpatient, led group therapy and done one to one therapy.
What your outpatient group was doing is more occupational therapy than psychotherapy. Teaching the members how to accomplish small tasks on their own can be helpful for some, but is not what you needed. And I want to practically shake the group leaders who allowed it to go on as it did.
In groups I led, I always based the focus on being witnesses to each other, since the majority of people in my groups lived alone and it helped them to gain the support of the group in regard to coping skills as well as self observation about when to reach out for help. Allowing anyone to rant on followed by nothing (which is what it sounds like happened) is not helpful. Yet real time coping skills and options for healthy self soothing would have been.
Your withdrawal from the medicines is also horrible. I hope that Dr R was either able to find you medication which allows you mental balance without side effects or set up a vitamin regimen and dietary routine that helps. Reactions to medicines are bad when they happen. So is uncontrolled anxiety due to being a highly sensitive person.
The stigma of “therapy being for those who are sick” and “medicine being for those who are out of control mentally” is an old one, and I will continue to hope society shifts away from this mindset. It wasn’t that long ago that people were sent to horrid institutions where they dealt with electro shock therapy and unneeded lobotomies. So I do understand the fears.
The fact that you weren’t getting anything out of group therapy is enough reason to leave. For those who are still afraid of you losing your balance, they need to know that you have coping skills and know when to call a friend or a loving sister.
It is important to give tools to the people we work with so they can observe themselves and not simply react to symptoms and not know what to do. Some people (like myself) must have real time techniques to calm the body when there are runaway reactions happening chemically to us. I went to therapy for years and worked with an amazing woman who helped me to know what was an out of control bodily cascade of chemicals versus actual dangers and how to interrupt autonomic dysfunction and regain my balance. None of this was “easy”. I didn’t want a pill that would stop symptoms in 20 minutes by making me a zombie. I worked with my tools (and still do when stress is high). I no longer have enormous panic attacks out of no where.
I have loved sharing techniques and clear tools for folks to understand their bodies and their environment.
I apologize this is so long, yet clearly I have some rather big responses to the poor quality interactions you had with “therapists” a nd psychiatrists (prior to Dr R)
You're so amazing, Teyani. The work you've done! It was many years ago, and I hope these places have changed. So fascinating that many of the people in group lived alone. And yes, I have many, many tools now and understand my brain and body from an evolutionary perspective, which has been immensely helpful. Coming soon...
Thank you for your perspective on this. As a person that has been on SSRI’s for over thirty years, had a frontal lobe brain tumor and suffered chronic depression and anxiety all my life I can attest that the choices to remain on or of medicine is not an easy one. For me I had been poly drugged and it ended me up in the hospital because of the abuse and lack of consideration with these medicines that doctors took when prescribing them. I am tapering off my last med at 1.20 ml of 20 mg/ml Sertraline. I chose to do this because the medicines just stopped working . Does this mean I am better without the therapeutic dose? Not great but better in a different way. I was never right on these meds and for me they just covered up the emotional state. I lost my sex drive and have severe anhedonia. While I feel meds have there place I was fed the diabetics need insulin line to justify the use of long term and life long meds. I think they can be mind altering and damaging for a life time and withdrawal is hell. I have a long standing distrust now of the psychiatric field and the use of any intervention. It is sad really that I feel this way . I feel damaged and mislead.
“Can you be ‘healed’ and still on meds” is a demon that has been plaguing me for the last several years. The mantra “healing is not my purpose” has been an ongoing lifeline.