I
Get asked all the time. Why did you quit being a therapist?
I was a therapist for a little bit over ten years
With a job that I'd loved I was so passionate about it. I gave my heart and my soul to it and
It was something I did in a lot of different contexts
I did it in different clinic situations
And I ended up working the last six six and a half years just in private practice
I worked with a full range of types of people except for children. I didn't work with children
I didn't want to do that because I didn't believe children belonged in therapy, but I worked with all sorts of adults
I did couples therapy at it mostly individual therapy. I did some family therapy also and
It was something that totally consumed me in terms of just my passion my intellect my emotions
I was really really really into it. I loved it and
Yet, I quit and so I think it can be hard sometimes for people to get why I quit I actually haven't been a therapist
now for almost eight years and
so I've had a lot of time to think about it and
Here are my reasons
the first reason that I quit being a therapist is it was such a struggle for me to be a
Therapist in a system that was so messed up the mental health system
Was not a healthy system, and that's the irony. It's a system. That's supposed to help Bing bring people who have mental health problems
Back toward mental health yet
The system itself is totally mixed up and screwed up the system presents itself as science, but it's not science
It's not even really social science a lot of its antisocial
anti-science or maybe antisocial
pseudoscience for starters therapists are supposed to diagnose everyone I was a
therapist in New York State a licensed clinical social worker with my our letter meaning
I had six years of supervision which allowed me to have the highest level of billing to insurance companies
Now social workers in New York have to diagnose everybody. They have to diagnose every client. They see in therapy and
Diagnosing people is incredibly stigmatizing it can really actually cause people a lot of harm
And when you're in a field where you don't want to do any harm. Why do you want to do something?
That's an intrinsic part of the field, but actually so often harms people also these diagnostic categories are quite arbitrary
Basically you can stick most people in any number of these categories at any given time
So really what that does that gives the therapists a lot of power to?
Label someone with something that really doesn't have a lot of meaning
But that's just one thing that I found ridiculous another thing is this whole thing about medication psychiatric drugs suppose
We're supposed to push people therapists are supposed to push people into taking psychiatric drugs for if you have this problem
You're supposed to take this drug this problem. You're supposed to take this drug
Oh, you have sleep problems you can take this drug, and oh you have this kind of mood problem
Or this kind of mood problem
Well you're supposed to take this drug or this drug
And if you have a side effect of this this drug you're supposed to take this drug and it becomes really ridiculous
Especially we can consider how?
Unhelpful and downright dangerous so many of these drugs are and how difficult it is to get off these drugs now there was another
problem in being a therapist being a social worker being a
Psychotherapist was that we were trained to help
People get on these drugs to refer them to
psychiatrist or medical doctors whenever they were having any sort of problem considered outside the bounds of
What we were able to help them with now
That really could be interpreted very broadly
such that therapists could are supposed to and often do refer people to psychiatrist for
Basically just about every problem
there's lots of therapists that refer to lots and lots of not most of their clients to psychiatrists for
Medication and medication is supposed to be very helpful in tandem with psychotherapy now. I don't agree with that
That was not my observation and certainly from listening to tons of clients and tons of people in my life
I see that a lot of times the medications weren't helpful at all, but therapists
We were supposed to according to our education get people to go to psychiatrist. We're supposed to up talk
Medication like you know how waiters to make more money they up talk selling alcohol because that's how they make a lot of money well
Therapists are supposed to up
Talk medication, and they never ever never get in trouble when you're op talk medication when you suggested people well
Maybe you have some sort of chemical imbalance or maybe you have some sort of biological
Problem that requires some sort of medication adjustment, and it sounds very scientific and so many people buy into it
But the truth is what really was our education in terms of medication of social workers psychologists. It's ridiculous
It's so unscientific
It's basically the bottom line is what therapists are trained is when you can't deal with someone's problems when it's too stressful
That's when you send them to a psychiatrist to get evaluated for medication, but you never get in trouble
It's considered totally within the bounds of our
competency of practice within our sphere of practice to send people for medication
Evaluation now where it gets ridiculous is the opposite what about when people want to come off?
Medication because lots and lots and lots and lots of clients really do want to taper down off their medication or just stop them entirely
so how
How do therapy is help them well what we're told is oh no. No, that's not within your area of competency
You don't even talk about that
That's very risky
You can get a lot of trouble for that and who wants to work in a field like that
And there's so many other
Ridiculous things I can go on and on and on but I think of one I think of someone I worked as and this happened
multiple times
But I think I'll keep it kind of general and anonymous
And I'll even I'll even blend it a little so someone who had been hospitalized in multiple times
I was working with this person
to I think three times a week and the person had been a stayed out of the hospital for about six months which was the
Longest in their adult life. They'd ever stayed out of a hospital wall. I got a call from their insurance company
You're not authorized to see this person two to three times a week. That's considered completely unacceptable
We'll only authorized once a week, and I was like yeah
But it's actually considering how much it cost to go into the hospital for this person
It's like a thousand dollars a night to go into the hospital and this person was going into the hospital all the time using it
Basically as a sort of therapeutic help even though it wasn't helpful
Now how much was I getting paid for a 45-minute session?
I think I was getting paid thirty seven dollars a session thirty eight dollars
So basically one night in the hospital was the equivalent about what was that? What's about 28
Psychotherapy sessions with me
And so I was only seeing the person two to three times a week now the insurance company didn't agree with that
They said well. No we can't pay for that and then fine
I kept arguing I said you gotta do it come on
This is actually helping this person, and they said well, what's your treatment plan now? I know the mental health field loves confidentiality
Except when it comes to insurance companies who don't want any confidentiality at all they want to totally
intrude
Into the therapy and they want to know everything that's going on so for people who are already have some sort of fears in paranoia
About people knowing what their business is it's not very comforting to know that the insurance companies can dig right in and basically
Legally before they pay get all the information
So the insurance company asked me well. What's their treatment plan?
I said well, they're Streetman funds actually very simple keep them out of the hospital, and they said well
that's not a sufficient treatment plan I
Was like well how about the treatment plan is doing all the things that hospitalization should have done?
But didn't do because it wasn't effective
Well if funny thing is the insurance company after
About two months of arguing and I think not even paying for some sessions finally agreed to give two to three times a week
therapy to help this person stay out of the hospital because they realized actually they were saving tens and tens and tens of
thousands of dollars just by helping this person
Come to therapy and actually get better help to stay out of the hospital because what did this person really need the person needed somebody
To talk to it wasn't like genius
I think actually the irony is so much of psychotherapy is made into this mysterious world of wow the
Therapists sir what they do is such brilliant stuff, and there's so much insight involved well
actually
I think a lot of people can do exactly what?
Psychotherapists do and do it much much better if they just have a gift for being able to have a comfortable
Caring respectful conversation with another person and lots of people can do this
Second reason that I quit being a therapist
There was a lot of pressure on me to make money and to run my business the last six years
I was paying for a place to see clients. It was expensive. I wasn't working in a clinic
I was working in New York City and when you consider some of those insurance companies
Were really paying very little
thirty-five forty dollars a session and a little bit more sometimes and
That's if people could afford the copay sometimes. I'd have to write down
They just couldn't afford the copay
and so it was like it wasn't a lot of money and
then also with a lot of the people that fee paid I worked on a sliding scale it wasn't a very high sliding scale I
Could understand
Why some therapists would charge a hundred hundred and fifty or more dollars a session just to survive in New York City?
I just felt that was ethically wrong. I had a lot of clients who were paying more in the thirty to forty to
fifty dollar per session range
but there was a lot of pressure on me therefore to see quite a lot of clients that was exhausting but
The problem is especially after I made my first movie and actually it was even before that once
I started getting popular at getting a reputation for being able to work with people who were in that state known as
psychosis or diagnosed with schizophrenia or bipolar
One with mania stuff like that people who were considered by the system that I hated the word
But the system that considered them mentally ill
well
What I found is a lot of those people discovered, ooh
Here's the therapist that we could talk to and they told people about me and even in clinics
I got a reputation as someone who this guy can work with work with people who have those more serious problems
He's willing to listen to them. He has the tolerance he can sit with him. He's curious about them
They get along with him
They keep coming they don't skip their sessions all the time
So I started working with a lot of those people and in private practice especially when I had much more
Pressure on me to make money and run a business because I had a lot more expenses
The problem is the people who had the most pain
the most problems and the most need the most trauma
the most difficulties in life the most stress that it would cause a therapist were the people who could actually afford it the least and
That just always troubled me, and I really fought to work against that I was like you know
I'm not going to turn people away because of their ability to pay
The consequence though was I ended up having a practice that was very
Weighted toward people who could pay a lot less money also because I was willing to charge a lot less money
I ended up get people who are the therapists didn't want a lot of therapists work with a kind of a simple system and
If you're psychologically clever even in the first telephone call when people call up you can kind of figure out who this person
Probably has some more problems going on often because people directly say it and you can kind of get a lot of them
Well, you know actually this person doesn't have much money to pay and sometimes therapists
Just write away over the telephone tell what their fee isn't oh, I can't afford that and so what therapists do is
It's actually a very good business strategy
They weed out the people who can pay less they weed out the people who have insurances that can pay less and they weed in
They filter in the people who can pay more
That felt unethical to me. I hated working in that kind of system
so another reason that I quit being a therapist it actually was just an
utterly
exhausting job I
Was fried at the end of ten years really fried
There's a word we learned we learned it actually in in Social Work school, and it's written throughout the literature
But they really don't emphasize it that much vicarious traumatization
I worked with tons and tons of people
Who had horrible horrible traumas from their life from their adulthoods?
But mostly from their childhoods from their early childhood in their family of origin
and
I was on the front line of listening to them and feeling what they were going through along with them
Empathizing listening to their pain look listening to them cry watching this also crying along with people
I was crying a lot I cried every day
It sounds kind of ridiculous eight years later for me to imagine that I sat with people and I cried in
Therapy with people every day it almost sounds like it's not even believable
But it actually was true. I wrote it down
I talked about it all the time back then and I remember a lot of therapists really didn't relate to me
Because they were they were distant from people they they kept people at a distance they kept all those therapeutic boundaries which
In my experience really don't help people very much, but they do help protect the therapists from the pain
So what I went through. Yeah was a huge amount of pain just listening to it listening to the horror
Although it's like did I get tainted as a person just
Listening to too many horrible things. I thought about that I
Thought when I was a think before I became a therapist if I had been a parent
I think I would have been much less protective of my children after all those years of listening to
horrible horrible things that happen to people in their childhood and
The range of the horrible things were quite beyond anything I could have previously imagined. It's kind of an
Amazing when I realized what people went through so often. I wondered and I even asked people
After hearing your story
After hearing what you went through went through on an ongoing horrible basis the rapes and the horrible
Molestations and the brutality and the beatings and the abandonments and all this stuff
How is it that you didn't kill yourself?
I asked people that and that's again and again when I heard people give me the answer to that
It's that they love their life. People are incredibly strong
Incredibly resilient and also people do have defences to keep their pain at bay
And that's part of what's so horrible about being a therapist is
That therapy is the place where people do let down their defenses and their pain
Can come out the confidentiality the safety the privacy the intimacy of the therapy
Relationship does allow that pain to come out if it's a good therapy relationship so often what I've heard from people might own
Experience also being having been in therapy was that therapy relationships were not a safe place for me to feel my feelings therapists
Just wanted to get rid of me. They were threatened by me
I I kicked up their own defenses because I was more vulnerable more open more honest than they were
But what I found is if I was able to be with people in their pain wow people really
felt safe in a relationship with someone else to
Feel their feelings when they were mirrored for who they really were as people and not
Criticised and attacked and put down and reach Ramat eyes for it not pushed
To go on medications are called crazy or labeled all sorts of horrible things that the mental health field labels people
So what I experienced yeah?
was
swallowing a lot of trauma it went into my body it went into my mind I
Can't became jumpy. I I would noticed a car horn would go on the street
and I'd jump and it was like what's happening to me, and it's like yeah, I'm sitting around and an
Interfacing with intense trauma all day long it
affected me I
Got sick. I think it was how many
six years into being a therapist that I
Got ulcerative colitis
my gut my inner gut my intestines went crazy and
Yeah, I've since learned it the the gut is like the second brain the second mind
There's so many you know
Receptors for some of these same chemicals that go in our brain serotonin and whatnot are also in our intestines well god my intestines were
profoundly affected by being a therapist
It's like I was on a lot of medication toward the end - for all that ulcerative colitis
It seems ridiculous to me that I was so like
skeptical and critical of the psychiatric medication yet, I was taking medication for my gut to soothe it and
You know what it didn't help, and I got hooked on it
And it was very hard to get off it took me six months to get off my medication
Which actually considering how long it takes a lot of people to get off their psych drugs actually isn't that long?
But I was able to get off of it and being away from being a therapist you know
unlike exactly what the doctor said the doctors plural said I
Got better
So another reason that I quit being a therapist is I had very little collegial support
I kind of mentioned this already, but basically I was not well supported at all
Yeah, I did supervision. I did years and years of supervision as a psychotherapist, but that wasn't supportive mostly
it was like it was really good training to learn how to play the game to learn how to say mmm if I tell the
Supervisor this they're gonna punish me or punish my clients or harm me or harm my clients in this this in this way
So I had to learn what I could share and what I couldn't share and that was a very unpleasant frustrating process it was
Disgusting basically but learning how to play learning how to play the game was actually very very useful to me be it translated directly
In me being able to help my clients learn how to play the game especially clients that we're getting
sucked into the deeper mental health system into psychiatry into into mental hospitals and basically for those clients to learn how to
function outside of psychiatry how to get out of the mental hospitals out of the hooks of their
psychiatrist
they had to learn how to play the game - and often the skills that I learned were very very useful to them and a
Lot of it
Yeah
People who've been in the Mental Health System a lot as clients learn these things
Don't say trigger things like if you tell people you're you're suicidal
Maybe okay, maybe you don't really want to follow through to kill yourself
But even if you start talking about suicidality a lot of therapists and psychiatrists plumbing. They're trigger-happy
They'll send someone right to the hospital well
I learned the same thing for my
Supervisors if I was really open with them like I was supposed to be like I was trained to be
About what was going on with my clients?
They were less supportive of me less supportive of my clients
They wanted to just do what do to my clients what they did to their own clients?
Which was sent him to the hospital forced him to get on medication evaluations kick them out of clinic
Clinics say you need a higher standard of care
Basically be incredibly unthe Arup utak and so what I learned is that I couldn't talk openly with
My colleagues about what was going on? I could yeah, I could be friendly with my colleagues
it was always a good idea especially when I was working at clinics to get along with them and
Well and even with a little bit that I did tell my colleagues a lot of them figured out
oh
This guy actually can work with really troubled people and they didn't want to work with really troubled people most people wanted to get rid
Of the really troubled people so they would send them to me so yeah, I had good relationships with colleagues, but I was very unsupported
The end result with that was that professionally I was very isolated
Now I know I shared this at times. I'd feel in more intimate moments
I would share this with colleagues and often I was burned when I shared they said oh you're professionally isolated
That's your problem as if there was something wrong with me
And I was being pathologized in many ways the same way my clients
Were being pathologized by the mental health system there were a lot of parallel processes going on, but what I learned is mmm
I really can't share with them now. Where did I get my support? I?
Got my support
I
Would say from four different places one. I got my support from my friends
I had a few friends who I could really talk about
What was going on with I couldn't really talk?
So much in specific detail about what was going on with my clients because of confidentiality
But I could talk about my feelings and I could talk about
Certain things as long as it wouldn't come back to my clients in any way and I found that very helpful
What I found also is that a lot of my friends who were not therapists at all actually
Had a lot more common sense I think the mental health system
Burned the common sense out of people it ripped it away from them
and it made people have a lot less common sense I've also seen that with some people who really had a
Natural gift for being a therapist and they went through all the training to become therapists
And the end result is they became worse therapists as the result of all their professional training once they got their license, but yeah
I got support. I got a lot more emotional support from friends. That was the first thing the second is
It's sad to say, but it's the truth is in my therapy with clients a lot of my clients gave me support back though
I didn't ask for it
But what they gave me was mirroring?
when they realized that I was actually helping them when I they realized that I was actually listening to them caring about them and
Really being useful to them often in ways that no one had ever been useful to them before
They turned around and they were like thank you my god. You're helping me. They were so appreciative and they mirrored me back
They said oftens. I couldn't believe how many clients told me
How do you do this all day this has got to be horrible to sit in to listen to my stuff I feel so bad
Should I come left people like even though it was helping them?
They wanted to come less because they knew it was really painful to listen to and I tried to be tough
And I said no no no no no of course not I can handle it, but the truth is it was difficult
But I really still did appreciate the mirroring and it was intuitive mirroring that the clients gave me
They mirrored me as I was mirroring them
So it really was a two-way relationship in a way that I never learned about that in training nobody ever taught me that was true
The third place that I got a lot of support was and this is more early on later
I got less, but I got it through reading
About psychology I also got it by reading about novels, but I remember it like Alice Miller
The psychologist Alice Miller she gave me a lot of support. I also got support by reading about other
You know critical psychiatry therapists and different parts of critical psychiatry or reading Peter
Breggin stuff like that that actually really helped me to get support, but but again
It's not like day-to-day support. I could get from reading, but it did it definitely did give me a foundation of some support
Wait a second. I'm not crazy this stuff is actually what I'm going through is actually healthy and good and strong and
The fourth way that I got support
And I think this was actually the main way that I got support was through supporting myself through doing my own
self therapeutic process my own self
supervision process
I did a huge amount of writing a
Journal, I wrote about what I was feeling I wrote in my notes what I was going through my with my clients
I would read the notes I would read about what they were going through and
Separately I would write about my feelings. What was coming up for me. I did a huge amount of dream analysis
I found my self therapeutic my self supervision process to be vital for me
To be able to function as a therapist to keep my sanity to not lose my mind
I mean yeah, you could say my colitis lost my mind for me, but pretty much
I kept it together in terms of being able to function as a therapist to the best of my ability
But man it was hard, but it was a struggle. I journaled every day for years
I also had to really really simplify my life. I couldn't I couldn't go out and drink
I couldn't go out and smoke cigarettes. It wasn't using drugs at all
I don't I couldn't even be in a relationship when I was a therapist. It was just like I really had to
Treat it as a holy dedication, and that's that's really how I felt so
a fifth reason that I quit being a therapist was the responsibility I
think people don't talk about this too much in the mental health field and
For me that was something that was one of the hardest things about being a therapist especially a therapist with people
Who had a lot of really serious stuff going on in their lives, but what it is in terms of responsibility? What is it?
That's so hard okay first. There's just the responsibility of being the point person and that person's life being the one
Who is the recipient for hearing the horror of what they've gone through that's an incredible responsibility because you know
That person when they leave the therapy session, and they go home, and they think about it for a week
I'm on their mind a lot and
That that's an incredible responsibility
It's like I had to be really careful about what I said people especially people who have been horribly harmed
By their childhoods by life in their adulthood and by the mental health field and by therapists
They can be pretty harmed by a
Wrongly used word an inadvertent phrase a lack of sensitivity or my mind would wander for a minute
and they would catch it people would catch it, and it was like I
Felt an incredible responsibility to be focused to be present to not drift to not
Not be thinking about hmm. I don't want to go see a movie
It's like no be there then also at the end of the day. It's not like oh
Therapists say I hear this commonly
Oh, you know you're supposed to leave therapy at home you supposed to leave what happens with your clients at home
You're supposed to have your own freedom afterward at night you supposed to have your own evening Yeah, right?
It's like come on when people to share about horrible things you really think you're supposed to be able to leave it behind ridiculous
It's just ridiculous. I don't think you can leave it behind some of the stuff that I heard lots of it
It's like you don't just leave that behind. It would come out in my dreams. It would come out
It would come out sometimes first thing in the morning
Or I just think about it painful stuff the other thing is I had this happen
I took very very few vacations away from New York City when I was the therapist
Mostly because I was so into the work also
It's like I didn't take a lot of time off
But when I did I learned there was no such thing as a real vacation for me
It wasn't a holiday I'd be thinking about people I'd be checking my mail or even a few times
I was out of range of being able to check my phone or check my my voice messages and
It was like I worked with a lot of people
Who had suicidal feelings sometimes suicidal actions and it was like I?
Felt like I bore a lot of responsibility I feel a lot of the blame for that really is on the mental health system
There's this idea that therapists somehow supposed to
Totally be the the catch-all that prevents people from killing themselves well to me
That's ridiculous people have responsibility for their own lives
But the mental health system
With the rules of what it means to be a therapist puts a lot of pressure on therapists
They can get in lots and lots of trouble with somebody
If somebody tries to kill themselves or heaven forbid does kill themself and the therapist hasn't taken all appropriate actions to stop them
Therapists are supposed to use force to stop people from killing themselves. They're supposed to call 911
They're supposed to hospitalized people they're supposed to force people to go to
Psychiatrists to get meds all these things that therapists are responsible to do that to me like actually many of them are very
Irresponsible I you know and all those years. I was a therapist. I never actually called 911
I never got somebody forcibly hospitalized
I did have some people
voluntarily
Choose on their own volition to go to the hospital to go to an emergency room if they felt really suicidal or had other things
Going on, but it was never me pushing them and often it was like I would be the devil's advocate is saying well
Why don't you try something else you haven't tried this this this and this before you go to the hospital?
There's tooth loss certainly lots of alternatives that you can try that haven't been exploited
But some people wanted to go and I feel like that
That's certainly their right and the same thing with medications some people wanted to take medication
And I feel totally that's a person's right though. I feel it's my responsibility
To say well have you tried this have you tried this have you tried this do you know the side effects?
Do you know the dangers of this maybe you could try other things blotter de blah de blah?
But again those are big
Responsibilities to take but I think the main one also is that it's just that fear that if something goes wrong
If something goes wrong with one of my clients
I'm gonna get blamed for it, and I was like when I quit being a therapist man that
Freedom that I got just to be away from that incredible responsibility
So this brings me to my sixth and last
Reason that I quit being a therapist and this actually
May be as important as all the other ones put together. I became interested in other stuff
I wanted to move on with my life. I
Realized you know have interest in other things aside from just sitting in an office listening
To trauma and helping people work through their trauma helping people grieve
I started to want to make movies full-time. I started to want to travel
I started wanting to be I wanted to go and hitchhike around the world again
I hadn't done that in a long time
I wanted to learn other languages because the other thing was a lot of what I was helping people do was free up
themselves to go forth and manifest to be exactly who they wanted to be and
Eventually I realized wait a second. I kind of want to do that too
I want to do more than just spend all my time dealing with healing and grieving and pain and trauma
I want to do with beauty I want to deal with all
Sorts of freedom to try new things and explore and experiment and be in other countries for a long period of time and go see
Parts of the world that I've never been and I haven't seen whole parts of the world whole continents
So I've gotten to do that. It's been wonderful
It's actually been a really beautiful thing to not be a therapist and it's also given me a lot of time to really have
Perspective on what I did sometimes
I look back in it
And I say what is this world where certain people are designated to do this role of being?
Therapists and to listen to people's pain and trauma and to be healing conduits
Sometimes seems a little bit ridiculous it kind of seems better to me if
Everyone or almost everyone had some therapeutic skill and really could provide that for the people in their lives
and it wasn't put onto the role of people with titles and social workers and
Psychologists and therapists and psychiatrists and shrinks and all this stuff. It just seems like
Yeah, a more ideal world it would be
these
Helpful things these helpful roles the emotional support the emotional insight would be
more integrated into communities into our regular life and not not into roles and diagnosis and
This whole silly system
You