Psychiatry & Counseling - The Great Divide

I started another post but couldn’t really address that topic without addressing this first. The divide between psychiatry and counseling, in short, needs to be bridged. Anyone who has ever spent time in the mental health system knows that it is incredibly flawed. Now, everything man made is flawed because there is no way for man to create a perfect system when we ourselves are not perfect. However, it could be vastly improved.

The separation between psychiatry and counseling goes waaaaaayyy back and is too much to get into here. Essentially, psychiatry began as a form of medical science, and counseling was an offshoot of that as more of a social science. It’s continued that way over the decades for no real reason other than tradition, and is doing a great disservice to mental health clients. Many people in the mental health system (and certainly the majority who are diagnosed with a serious mental health condition) partake in both psychiatry and counseling services (and sometimes even more services such as dealing with case workers/social workers, etc.) Yet often, there is no communication between the psychiatrists and counselors. This is a BIG problem. Psychiatrists are the ones prescribing mind altering, behavior altering psychotropic medication, yet they (for the most part) do not address “life issues”. In order to deal with your “life issues” you must turn to your counselor.

Now I’m just going to talk a little about my own personal history to make a point here.

When I was a teen I was in the mental health system for a time, and I recall then the horrible discrepancy between psychiatry and counseling. The counselor I had dealt with the “social” issues and the psychiatrist with the “biological” issues. The counselor was the one meant to help me actively work on or deal with my issues, while the psychiatrist was giving me medication to treat these issues, and I doubt they ever spoke to each other about my case. See the problem here? Biology and social factors influence each other tremendously, and a holistic view should be addressed when dealing with mental health patients. However, it seems to be one of those things that no one WILL address. Maybe because if clinicians did address it, it would be to admit the system is lacking and really does not work efficiently.

Fast forward about 10 years. If you’ve followed my blog or videos, you know that I was hospitalized in 2010 and diagnosed with bipolar (essentially self-diagnosed). There were no counseling services available while I was an inpatient (about a week stay). I met with the psychiatrist daily or every other day and he/they prescribed me medication (I saw a woman once, then a man the rest of the time). I spoke briefly with a social worker once (who was the closest I got to a counselor). I had to retell my story to about 5 different people in the system and that was mental agony in itself. Essentially, I had to wait until exiting the hospital to even begin counseling, so those 5 times I retold my story were of very little help to me anyway. As you can see, there was a whole lot of jumbled up stuff going on then.

The only real “counseling” that occurred while I was hospitalized was between patients! Some of us would sit and discuss why were there, what had brought us there, etc. (in private, on our own, not assigned.) One woman, God bless her, was on somewhere around ten psychiatric medications at the time. Was that really necessary? I doubt it. They had been prescribed by different physicians as well. A very egregious lack of communication on their part. Another woman who was there for suicidal ideation, told me that talking to me had helped her more than any treatment she had received while there. I too felt after leaving that I really had received no help, other than some hastily prescribed medication and appointments for counseling and psychiatry to begin as an outpatient upon leaving. I remember addressing the lack of counseling with some of the staff. I was told that the hospital was simply to stabilize people and get them back to their lives where they could get long term help. Yet for some reason, counseling didn't seem to be viewed as important enough to begin while an inpatient! Basically, the psychiatrists gave out diagnoses, threw medication at a person and figured that was enough to help them until they could get into some regular services. 

However, I think often, the opposite would really have been the best. SO many people were there for suicide related reasons (the vast majority). Wouldn’t it seem that they would benefit more from a counselor to discuss things with than hastily prescribed medication? If it was a persons first admission, how could a clinician possibly have enough information in one short 30-45 minute session to know A) what the diagnosis is definitively and B) what to do about it? But again, the great divide prevails. I think part of the problem is that psychiatry and meds are often viewed as a quick fix, an "easier" fix, while counseling takes time. But that is such a wrong view. Meds are not generally a quick fix, nor are they something to take lightly. In my own view, in retrospect, I'd say even with a "serious" mental condition like bipolar, I benefited FAR more from counseling than medication. Counseling (when done correctly) can help teach a person how to live better, recognize things in themselves, make changes. Psychiatry relies on "correcting" problems in the blink of eye with altering brain chemicals, many times without even educating the patient about prescribed medications or alternatives. So often medication does not correct the problems and at times only masks them (or sometimes makes them worse.) Sadly, there are no pharmacological cures for mental illness. Why? because it isn't simply our biology...it is our social world, and our environment that also play a part of the symptoms we exhibit and the way we behave. You can't "treat" biology without addressing the social and you can't understand the social without understanding the biology when it comes to the brain.

Throughout my years of outpatient service, the majority of the time, I have had a psychiatrist and a counselor who not only did not communicate but did not even work in the same building or part of town. It was very much a singular effort on their parts rather than a joint effort when dealing with patients, and that is the commonplace way of dealing with clients in the mental health system. (I’m not saying anything negative against either my psychiatrist or the main counselor I had for several years. They were both very kind people that I liked.) But nevertheless, the fact remains that I have heard countless personal stories of others who have gotten so fed up with the system, they didn’t know what to do. Sometimes they quit meds, sometimes they quit counseling, sometimes they gave up entirely. The “med-merry-go-round” as it is known, is frustrating enough for patients, then add in dealing with multiple people, for multiple different things…and UGH. Just UGH. So, in short, Psychiatrist = meds, Counselor = listening/therapy strategies.

Psychiatrists and counselors very much rely on each other yet they are completely separate. You don’t tell your psychiatrist your problems for the most part (or, if you do have a caring psychiatrist who does listen, you still hear “You should probably tell your counselor about that.”)  If you try to discuss meds in the context of counseling or personal issues, you may get some advice from your counselor but ultimately, given that they don’t prescribe medication, the answer is “Talk to your psychiatrist.” Why is this? Mainly, because psychiatrists are licensed to dispense medication and not to counsel, and counselors are licensed to provide therapy but not medication (there are some exceptions but for the most part, this is how it works.) See the problem there??? I do.

In order to function in a more complete and indeed a more beneficial manner, the mental health field needs to move away from traditional roles of psychiatrist and counselor and integrate the two into one person. Anyone dealing with anxiety, bipolar, schizophrenia, or anything else, should be able to see ONE person who gets to know their case and manages it as such. They would know all the details of the person’s life, all the outlying factors, internal factors. They would be able to judge whether the person even NEEDS medication (because, many times, they don’t. Medication is, I believe, overprescribed and dispensed in a flippant manner although they are serious drugs, but that is for another post.) Sometimes, all a person needs is someone to listen to them and understand, and to help them in non-pharmacological ways. I think until such an integration happens, sadly, those receiving services from the mental health field will always be getting the short end of the stick.

Is faith in God important? Can we believe in God?

I’ve been doing a heck of a lot of writing lately, both blog-wise and journaling. The stuff I have posted here is just a fraction of what I have actually written and truthfully, there are about 20 more blogs I have notes on with intention to write that I have not gotten to yet. It seems once I start to explore one thing, another pops up. And since I’m trying to limit my posts to one topic at a time, I end up with a lot of stuff!!!

Two things I know I want to focus on in this blog going forward are discussing mental issues (I really don’t like the term mental illness, but I use it because that is what mental issues, disorders, problems etc. are mainly referred to as now) and God/spirituality. Whenever I start talking about anything psychology, or societally related, it always circles back to God without me even trying. I think because in the end, there is no man made fix. I’m always reaching back back back, looking to the root cause of things and ways it can be fixed. But it really can’t be by any man made means, or it would have been done by now.

So this post is going to focus on faith, and how faith in God is important.

Someone I know is taking a religion class on the New Testament for their degree (required by the school, not the person’s degree program.) This person has never really been a believer in God or Christianity, in fact they don’t know anything about the Bible. So now they have been reading the New Testament for the first time, asking me lots of Bible related questions and so we’ve had some interesting discussions. Last night the topic arose of “How can I believe in God when there is no proof?” And my answer was something I only recently came to understand fully – that a person must have faith in God, in order to see that proof.

What is faith, really? You hear Christians talk about faith all the time, faith in God, faith in Jesus. Faith, faith, faith. The New Testament is absolutely filled with scriptures talking about the importance of having faith. But most people never stop to think about what that really means.

If you were to say you had faith in your friend that they would be able to lose weight, or ace an upcoming job interview, what would you mean by that? You’d mean that you believed in them, that you had complete confidence in what they could do or achieve, even if you had no definitive way of knowing that they WOULD lose weight or get the job. To have faith in God MEANS to believe in him, whether we can see him or not, whether we have any proof or not.

So now I have to address the idea of what constitutes proof. I think it is so hard for scientifically minded or academically minded people to believe in God because they want “proof”. Generally this means some sort of physical, tangible thing. So if it cannot be tasted/touched/seen/smelled/felt then it is concluded that it must not exist. As an academically minded person myself, I find this thinking to be very strange. There are countless things that cannot be measured with physical means and yet we know to exist. When we feel we love someone, can that be measured with scientific or medical means? Is love truly in our “hearts” as the saying goes? We know it exists solely within our minds. The same is true for any ideas we have at all. They exist within our minds, in a place that cannot be measured. Yet nothing of man-made origin would exist without them. Can a doctor cut into our anatomic brain, remove a slice and examine it under a microscope and say, “Ahhhh yes. There is Nicole’s idea about faith. I can see it now.” No. The only way we even know ideas exist are because we see the OUTWARD manifestation of those ideas, which are created with our physical bodies and discerned by our senses, NOT because we see the ideas themselves. Ideas are esoteric, but we know they exist.

By the same token, if we have faith and believe God exists, we can see his hand in what we know, his supremely intelligent design. Years back, I took Human Anatomy & Physiology, not an easy class. I had to study an 1100 page medical book from cover to cover, dissection labs, the works. It was a very in-depth, holistic view, down the complex chemical processes that occur each second in order to sustain life. When you begin to see how everything is connected, you cannot help but be filled with awe. Nothing is superfluous. Everything has a purpose, a function. It all works together. The absolute magnitude of processes that occur simultaneously is truly mind boggling. When the slightest thing becomes out of alignment, it can cause sickness and death almost immediately. I honestly cannot believe that anyone who has ever studied medicine could deny God. We take our bodies and minds for granted every day. But if you stop to think about the process of anything in nature – the formation of planets, the growth of a plant, human life – the answer to me is beyond clear. The Bible even addresses this to skeptics of God:

“The heavens are declaring the glory of God; The skies above proclaim the work of his hands.  Day after day their speech bubbles forth,
And night after night they reveal knowledge.” (Psalms 19:1, 2)

“For his invisible qualities are clearly seen from the world’s creation onward, because they are perceived by the things made, even his eternal power and Godship, so that they are inexcusable.” (Romans 1:20)

A person doesn’t need higher education to be able to look at a sunset and be in amazement, or to wonder about the magnitude of the universe or marvel at the birth of a child. These are things each one of us is capable of seeing and knowing and believing. The idea that only certain people who are geniuses can understand things, is simply not true. God allows himself to been seen, if a person truly wants to “see” him.

It is interesting to note, that even in Jesus’ time when he WAS giving them physical proof, in the form of miracles such as curing the blind or raising the dead, many STILL did not believe, and they still had no faith at all. So, seeing is not always believing, as the saying goes.

Mankind seems, as a whole these days, obsessed with the idea that their knowledge and wisdom is superior. The apostle Paul had some great words in his letter to the Corinthians about man’s idea of wisdom and God’s idea of wisdom, and reminds us not to be led down a false path.

“And I came to you in weakness and in fear and with much trembling;  and my speech and what I preached were not with persuasive words of wisdom but with a demonstration of spirit and power,  so that your faith might be, not in men’s wisdom, but in God’s power.” (1^st Cor. 2:4, 5)

“Now we received, not the spirit of the world, but the spirit that is from God, so that we might know the things that have been kindly given us by God. These things we also speak, not with words taught by human wisdom, but with those taught by the spirit, as we explain spiritual matters with spiritual words. But a physical man does not accept the things of the spirit of God, for they are foolishness to him; and he cannot get to know them, because they are examined spiritually.” (1^st Corinthians 2:12-14)

Now, don’t get me wrong. Knowledge, and wisdom are important. We should always strive to gain knowledge and wisdom. However, we should never be so arrogant as to assume that WE are the most intelligent things in the universe. We need to remain humble and be willing to acknowledge that we do not have all the answers, we do not have all the knowledge and the wisdom. If we try to elevate ourselves to a level that clearly does not belong to us, it simply shows pride and arrogance in our own smarts and abilities.

“For the wisdom of this world is foolishness with God, for it is written: “He catches the wise in their own cunning.” And again: “Jehovah knows that the reasonings of the wise men are futile.” (1^st Cor. 3:19, 20)

“At that time Jesus said, "I praise you, Father, Lord of heaven and earth, because you have hidden these things from the wise and learned, and revealed them to little children.” (Matthew 11:25, New International Version)

So, getting back to the idea of faith. I myself have always had an inclination toward the sciences, with an unending curiosity and quest to find answers. I would consider myself to be a very intelligent person and enjoy research and study and learning the intricate processes by which things occur. But I realize not everyone is so inclined. I believe that the proof that God exists is clear to any who are genuinely seeking it, and seeking him in their lives – no matter what that person’s knowledge level may be. The realm of science and medicine and academia (in general) wants people to believe that they are the ones who have all the answers, and that if you believe in God, you are both uneducated and a fool. Yet, scientists constantly revise their own thoughts and theories about how things work, year by year, and it is always changing. Scientists and doctors and professors – the so-called “intellectual” or “wise” ones, according to our society, have not been able to cure the world of disease, get people to live peaceably with each other, or thwart every human’s ultimate foe – death, no matter how hard they try. It’s just a repetitive cycle as one generation dies and another rises up and takes its place. Paul reminds us about having faith in God, and warns us about being overly trusting of man's abilities.

“Therefore, just as you have accepted Christ Jesus the Lord, go on walking in union with him, being rooted and built up in him and being stabilized in the faith, just as you were taught, and overflowing with thanksgiving. Look out that no one takes you captive by means of the philosophy and empty deception according to human tradition, according to the elementary things of the world and not according to Christ.” (Colossians 2:6-8)

“It is better to take refuge in Jehovah
Than to trust in humans.” (Psalms 118:8)

God is timeless and unending and has created all that see and know. He was there at the beginning of it and will be there always. If you have faith, you can be assured that what he promises will undoubtedly come to pass.

“Do you not know? Have you not heard? Jehovah, the Creator of the ends of the earth, is a God for all eternity. He never tires out or grows weary. His understanding is unsearchable. He gives power to the tired one
And full might to those lacking strength.  Boys will tire out and grow weary,
And young men will stumble and fall,  But those hoping in Jehovah will regain power. They will soar on wings like eagles. They will run and not grow weary;
They will walk and not tire out.” (Isaiah 40:28-31)

“And the One seated on the throne said: “Look! I am making all things new.” Also he says: “Write, for these words are faithful and true.”  And he said to me: “They have come to pass! I am the Al′pha and the O·me′ga, the beginning and the end. To anyone thirsting I will give from the spring of the water of life free.” (Revelation 21:5, 6)

“For all the things that were written beforehand were written for our instruction, so that through our endurance and through the comfort from the Scriptures we might have hope.” (Romans 15:4)

Interestingly, I saw an omega sign in the sky the other day and thought of God. For those unfamiliar, here are Alpha and Omega (first and last letter of the Greek alphabet, hence the scriptural reference to first and last.)

Here are the photos I took from my backyard. First when I noticed it and second as it started drifting away. Yes, probably made by a plane but interesting how they made the Omega sign. And yes, it reminded me to have faith.