TRANSCRIPT
Over the years, I thought a lot about what would best help someone who wanted to become a therapist become a therapist most efficiently, most easily, and allow them to bloom in the best way that they could, cause them the least amount of harm in the process, and also make it as easy as possible for them to become a therapist at the least cost.
The basic thing that I have to compare to that ideal is to my own experience of becoming a therapist, which in some ways was kind of good and in some ways was kind of horrible. So, I feel like I’ve learned a lot from my own experience. During the whole time I was becoming a therapist, I was thinking about it a lot and thinking this could be done so much better, and why isn’t it?
What I noticed is when I tried to talk about it, basically nobody who had any power over me at the time really listened. I noticed that they were really committed to doing it their own way, and they were pretty confident that their way was the right way and it was the standard way. I noticed, certainly even into the time where I became a seasoned therapist and was very confident in myself, I noticed the people who were in power were still criticizing me and telling me to do things about how I should become a therapist the way that they thought I should be.
What at least I’m glad for is that as time went on, I became more and more confident and realized that they basically didn’t know what they were talking about and it was stupid. But I still was left with a lot of feelings of like, why did I have to do it that way? What a stupid way! And how expensive! I mean, in some ways I did it a fairly simple, quick way compared to a lot of people.
I, at 27 years old, went back to grad school. I went to New York University. I went to NYU and got a master’s in social work, and it was a 2-year degree. Basically, before that, I’d only had one psychology class, and that was in college six, seven years before. I’d taken an intro to psych class, and my major was in biology. It really didn’t have much to do with psychology. I didn’t really study anything about therapy, and aside from what I’d read on my own and the little bit that I’d been to therapy before I went to grad school, I really didn’t know almost anything about it.
Well, yes, I did. I talked to some friends of mine who were therapists about their work and heard them talk about it, but I really didn’t know that much. So, in many ways, I came in quite naive, quite innocent, and I think that’s a good thing. I didn’t come in with a lot of preconceived ideas about what therapy was.
So when I did start becoming a therapist, I was left with all these big questions about what am I supposed to do and how am I supposed to figure it out? Pretty much what I discovered is that the people who were in the field who were tasked with the responsibility of helping me become a therapist—my professors, my supervisors, my school—were not very helpful. And that really troubled me because I was desperate for help. It’s like becoming a therapist for me was not easy. I don’t think it is for anybody, and if it is for somebody really, really easy, then I kind of question that. I think inherently there’s a lot of struggle in taking on this role and really learning how to do it well.
So my idea is how to make it as easy as possible, how to make it as efficient as possible, how to allow someone to become a therapist in the most efficient, simple, healthy, non-confrontational, non-abusive way possible.
The first thing that I think—and this may be a little politically incorrect, but I think actually I know it is because I know so many people that contradict it—but I think the first most important thing is to, I don’t know who would do the picking, but to pick the right people or at least to have the right people make sure they know why they’re becoming a therapist. Because I think so many people become therapists, and probably the best thing that they could do for other people’s mental health is not become therapists.
So who should these people be? In my opinion, at least, and why them? I think the first most important thing is people should just be really healthy when they become therapists. They shouldn’t be all messed up inside.
The reason this is not politically correct is, well, actually probably most people who go into the mental health field think they’re fairly healthy, but so many are not in so many obvious ways. I mean, I could just go down the list of ways that I saw people who became therapists were not healthy. I mean, I met a lot of people who were becoming therapists and who were long-term therapists, longtime therapists, who were taking psychiatric drugs just straight up. I mean, I knew people who were really like well-respected therapists who were charging a lot of money who were taking antipsychotics. It’s like what’s up with that? That, to me, is just not a healthy thing.
It’s like if a person can’t even manage to regulate their own moods and their own feelings through their life, through their inner world, and through their lifestyle, then I question what they really have to teach other people who are going through life’s ups and downs, or maybe even worse, life’s big ups and downs.
So that gets into the question of what a healthy person is. My point of view on what a healthy person is, is someone who really has become an individual, someone who really has worked out a lot of their childhood traumas and really has separated from their family of origin in many ways. But the main way is internally, has really on an individual level become an identified self where they have a strong relationship with themselves and they can parent themselves. They’re not looking for outside figures to parent them.
That’s the whole process in and of itself. I think it’s a lot easier for some people, but I feel anyone who comes to therapy as a client deserves to have a therapist who really is an independent person and isn’t leaning on their parents psychically or even financially.
I think that that’s something that I remember as a therapist. There was a supervisor at a clinic I worked at, and she wasn’t my supervisor, and I was grateful for that. But I remember this one friend of mine who was a therapist. He was an older man who became a therapist later in life, and he told me he couldn’t believe it. His supervisor used to say, “Well, my mother says.” Then he was like, “Wait a second! I’m getting supervision from someone who I don’t respect who’s in toning her mother to tell me what to do.” He’s like, he said the supervisor didn’t even have a clue on what to do.
Interestingly, I will talk about supervision, but man, my supervision experiences were pretty horrible—the formal supervision experiences. But I’ll get into that in a bit.
So, people who have broken away from their families, who have become individuals, who’ve resolved their childhood traumas to some great degree, who really have a sense of how to take care of themselves, how to heal, really understand the healing process well, have gone through a ton of it, really understand the difference between dissociation and depression, understand the difference between depression and grieving, don’t get mixed up in these different things, understand the difference between self-actualization and dissociation. Because a lot of times therapy, as a field, and therapists mix these things up. They think just ’cause someone’s happy, that must be a good thing. Whereas no, people can be very, very dissociated. They can be very, very shut down and be happy, which is why so many people in the field want to help troubled people get on psychiatric drugs so they’ll dissociate, so they’ll just find a way to be happy without actually having done the inner work.
I think a therapist should be someone who, at the very beginning of the process, before they’ve even started seeing clients, should have a very comfortable sense of their own inner world.
And the inner world of other people in general, that’s the building blocks that they’re working with. Those are the tools that they work with. That’s the area where they’re the expert.
And I know it gets risky because I’ve heard a lot of people say, “Oh, I don’t want to go to an expert. I want to go, you know, go to someone who’s open-minded and humble and is not pulling the power thing on me.” But in a certain sense, it’s like, what is an expert to me? An expert is someone who has a lot of experience at something.
And I think when someone goes to a therapist, they deserve someone who has a lot of experience in the workings of the inner world and primarily has worked out a lot in their own inner world, has a grasp on what’s really going on.
It’s scary, but what I’ve seen in the therapy field is a fair number of men who I was fairly convinced were gay, and yet we’re like with women, we’re married, and we’re like, they were pretty obviously gay. And it was just like, whoa! It’s like they didn’t even have a sense of their own inner world in terms of their own sexual orientation.
And I remember in my first three, four years as a therapist, I got criticized a fair amount for saying, “I don’t understand how that person can be a therapist. They’re so obviously gay, and they haven’t even figured it out yet.” And I remember people who I worked with, other therapists, was like, “How could you say that? That’s so critical! You don’t have any sense of if they’re gay or not.” And it happened twice, actually, with two different guys who I was like, “They’re gay. It’s so obvious. I really trust my gut.”
And the funny thing is, I don’t even think it’s a bad thing to be gay. I think it actually can be a really good thing for a person to be gay. If they’re gay, be out, be gay. It’s like I refer people to gay therapists, and I don’t think that that’s a bad thing. So it’s not that I was being homophobic by criticizing them. It was the fact that they were just so out of touch with themselves.
But what happened twice with two of these guys is later they both came out as gay. And I remember therapists coming to me afterwards and saying, “Sorry I was so critical of you. I really didn’t realize.” I was like, “Wow! I was picking up on their gayness.” And these are people who were therapists who were working with people, who were working even with gay clients, and hadn’t figured it out or haven’t even admitted it to themselves that they were gay.
Questionable. So I think basically people who really know themselves very strongly have a very strong sense of their own core and are very conscious of it. And I think that’s just a vital, vital thing in being a therapist.
Then the other—there’s many more qualities I think that make an excellent therapist that are really, really important that every therapist, in my opinion, should have. And that’s people who are really flexible, really caring, really nurturing, have an ability to be really, really honest.
Um, people who do not shy away from confrontation. If they’re being criticized, they can handle it, and they don’t just shut down. But people who can actually engage in dialogue that might be fairly critical toward them because I think every therapist should be very comfortable being able to be criticized.
So if people are really super insecure and can’t handle being criticized, which sadly is very common in the therapy field as far as therapists go, they shouldn’t be doing it. Like Freud flipping out when his followers criticized him or came up with a theory that opposed one of his theories, and he’d cut them off and write them off. It’s like, “No! That’s not a very good sign for a therapist if they can’t handle criticism.” Because clients do criticize, and clients often have a very good right to criticize.
And a desperate need sometimes—they need to be able to challenge the boundaries of the relationship, need to challenge the person that they’re sitting with. They need to be able to say, “I don’t agree with you,” and they need to not be crucified for it. They need to not be rejected for it.
How many people have been so attacked in their childhoods by their parents, by the people whose job it was to love them and accept them and nurture them and care for them? And they got attacked by their parents because they criticized their parents for very, very legitimate things.
And what do children who get abandoned and rejected by their parents for criticizing them learn to do? They shut down. So when people come to therapy, they need to be able to open up. And sometimes the stuff that comes out of a client in therapy is not necessarily processed. In fact, almost by definition, it isn’t processed. It comes out.
So if the client is criticizing the therapist, they may be criticizing the therapist for very accurate things that they’re picking up. They may also be criticizing the therapist for things that go back to the client’s own childhood, and they may be, like for instance, projecting stuff onto the therapist.
Or they could also be criticizing the therapist for things that the client really can’t acknowledge is going on within themselves. But that can be really tangled, and for a therapist, a person—a therapist has to be really secure to be able to handle that because every therapist, sooner or later, is going to get criticized. And sometimes very immediately by clients who see things about them that are really flawed.
And so the therapist also has to be really desirous to grow him or herself. He has to want to be able to look in the mirror and say, “Yes, yeah, I have flaws, and I am a growing person. I’m not a person who’s completed my process.” And it’s very troubling when therapists get to that point that they think, “I’m done. I’ve done my work. I have this degree. I have this license. I have this many years of experience. I’ve helped this many people. I’ve been in therapy this many years. I now have all the answers.” And I think, unfortunately, it’s very, very common.
Now, what’s interesting is when you get therapists who write a lot and they publish books, it’s very common that they take a very “I know everything” attitude. But a lot of therapists, when they’re with each other, they tend to be more humble because they know they can’t get away with it.
If you have five therapists in a room, not all of them can be complete know-it-alls. Unless, of course, with an exception that they’ve all trained in the same school and they’ve all sort of achieved the same level, and then they can all have this confidence that, “Oh, all five of us know best.” Or “My whole school knows better than all the other schools.” It becomes like religions where they say, “Oh, those other religions are wrong. We’re right. We have the corner of the market on truth.” And that can be very troubling.
And a lot of schools of different therapy, of psychology, have that attitude when they train people that if you get our level of training, the highest level that we have, you get our license or diploma or degree or whatever it is that we offer, then we give you the right to consider yourself a person who knows everything. We give you the right to say you’re an expert, and you don’t have to keep challenging yourself. And that’s troubling.
But what I think is the most troubling is that maybe therapists will be more humble when they’re around each other. They’ll tell their flaws, they’ll share some of their insecurities, especially new therapists will. But as time goes on, I think what happens—and I’ve certainly heard this no lack of times from clients of mine who have told me about the things that therapists have done behind closed doors—is when that door closes, the therapist’s office becomes a very different person than they become in the outside world.
And they transform into this person who is the one-on-one guru. And so I think this is what draws many therapists to stay in the therapy field. And often, I think, draws many people to become therapists in the first place. It’s a place where you can close the door.
With the vulnerable person and know better and get paid for it, and to me that’s very, very, very troubling. That’s backward.
So what else would make a good therapist? Someone who’s, again, really open to growing, really open to looking at their flaws, really aware basically of what their flaws are, and is really working on them. So using all their internal skill that they’ve developed to look back at themselves and to grow, but also to really have a sense of their own inner dynamics.
So even if they’re not fully healed, which I’ve never seen anybody who is, if something is going on in the therapy relationship and they’re trying to sort out what’s happening, because every therapist naturally is going to be thinking about what’s going on in their client, but they also need to be thinking about what their own role is in this relationship, what their own part is. Are they in some way provoking this, or are they misinterpreting it because of their own flaws, of their own lack of assuredness about their lack of healthiness?
So I think, I think of myself that whenever I was formulating sort of an understanding of what was going on in someone who was working with me, with a client, I was also looking simultaneously at my own limitations, my own flaws, my own immaturities. So to the least degree possible, my insecurities and flaws would be reflected in my assessment of that client, so I could come up with a more accurate understanding of what was going on in a person without my own bias. That is so that I could be optimally helpful to that person, because anybody who comes to therapy, to my mind, deserves to be with someone who really sees them for who they are, not someone who sees them through the lens of their own distortions.
Now to some degree it may be inevitable, but at the same time, for a really self-questioning therapist, a therapist who’s massively engaged in their own self-therapeutic process, simultaneously the therapist can see way, way more what’s going on.
So I think, and okay, so let me try just a couple more things. I think a therapist also, someone who would become a really good therapist, would be really, really creative. Someone who just naturally has an artistic, creative flair. Because I said it in a different video, therapy to me isn’t a science. Yes, you can use the scientific method, and a scientific frame of mind can be very helpful in being a therapist. But ultimately, a therapist, to my mind, is an artist.
And interestingly, I would say artists are probably the same thing. They can have a very scientific frame of mind, they can understand a lot about proportions and dimensions and all sorts of the different sciences that go into understanding whatever their art is. But ultimately, they’re an artist. They’re using their scientific understanding and they’re mixing it with creativity to create something beautiful and special.
So a person who is going to be a therapist should really have that artistic flair and just have that wild creativity to see things in different ways, to try different things, to explore, to experiment, to consider different options, to try things that maybe they’ve never heard before, to really have that spark of something magical. And unfortunately, I think a lot of therapists don’t have it, and I think also a lot of the training that goes into making therapists kills it in people, because therapists are told there’s a right way and a wrong way so often, and that can be very stifling.
Training for Therapists
So the next part I would like to get into is what kind of training would be good to help a therapist really flower and become the best therapist they could be. The first thing that I would consider would be just get rid of school, just get rid of all this university, and get rid of all these training programs, and get rid of curriculum, get rid of professors in any sort of conventional sense, get rid of having to pay tuition, get rid of all the licenses that we have, get rid of all of that.
Because I think just so much of it is silly, it’s nonsense, it’s bureaucratic, it’s bunk, it’s there to make somebody rich, and there are so many loopholes in it, and so many people slip through or walk right through that really just have no talent at all and shouldn’t be there. So many of the people who are there as professors are just like, they’re not good teachers, they’re not good therapists. And so I’d say just scrap the whole system and start over again entirely.
Now, in one sense, it could sound like I’m talking, wow, just totally imaginative and idealistic, but actually I’m not, because one thing that I’ve seen that’s happening more and more now is especially with younger people, is they are becoming therapists. They’re just not calling themselves therapists. They’re becoming things like life coaches and things like that.
So even though I was trained as a therapist and I have a license to be a therapist and I have all the years of supervision to do that, and I can bill insurance companies and do all that kind of stuff, it’s like I think some of these people that I see out there who are calling themselves coaches or whatever they call themselves, they have no degree, they have no formal training, they have no license, they’re not authorized by any state agency. I think some of them are actually really good and getting better also.
And it’s really interesting to me because that’s why when I talk about this, I don’t see myself talking about this in idealistic terms, because you know, yeah, I don’t see the mental health system going under. It’s a huge major multi-billion dollar industry that’s all tied into big pharma and tied into universities and tied into state licensing programs, and it’s tied into, you know, government money and blah, blah, blah, blah, blah. So it’s probably not going down anytime soon.
But I do think this alternative whole system springing up to the side that’s much more efficient and often can be much cheaper is there and it’s valid. But anyways, I’m still going to talk about it idealistically, imagining that the system were done, and but knowing that this really can be applicable to stuff that’s really going on now.
So what would help people? So getting rid of all the school, getting rid of the teachers. I think the first thing is let people choose what they want to do. Let them choose who they’re going to get their help from. Let them choose who they want to learn from. Let them choose the books that they want to read. And I’m talking people who are becoming therapists. Let them choose their own curriculum. Let them make it up entirely themselves.
Forget writing papers for grades. Maybe people want to write papers. Sometimes people really do like expressing themselves through writing, and they find that that’s a very good learning tool. But some people don’t. Some people don’t like to express that way, and that’s not part of their educational way of learning. And I don’t really inherently see any reason why a therapist should know how to write well.
I think it could be very helpful for a therapist, but to be able to write papers, not really necessary. I often thought when I was a therapist that I was doing a job that actually I didn’t need any technology for whatsoever. There’s no reason to think that if I went back 10,000 years in time, before there was even writing, as long as I could speak the same language as the person I was sitting with or could learn their language, then I could have been a therapist with the exact same skills that I had. Just the ability to make eye contact, to think, to know how to connect to people, to understand human psychology, to have caring, to have compassion, to have an altruistic desire.
So, and a great example for me was we had a blackout in New York City in 2003, and the whole city shut down. There wasn’t electricity, it was really horrible. People were like, you know, the refrigerators were all hot and food was going bad, and there was no light. No one was going to work, the subways weren’t working, the telephones weren’t really working. And what was interesting is I went to my office that day. I had a private office at that time, and I wondered if my clients would show up, or at least some of them would. And by…
That time my clients pretty much knew me well, and they knew that it was a good chance I was going to be there. The problem was I was on, I think, the fifth floor of a building, and the elevator was out, and the doorbell was out. But I could go down and wait for them, so I did. What happened is people showed up, we walked upstairs, and we sat in my office in the dark. But there was light coming in from the window, just like there is here now, and we did therapy.
Then it really crystallized it for me that this really could be a stone AG job, and chances are people have been doing this forever. So probably everything I’m saying is not really new. Hopefully, I’m just trying to focus some of this knowledge a little bit more to make it more clear in some ways.
So, what else with this program? What about supervision? Yeah, I think I’d like to talk about supervision something because supervision was something that really hurt me. It hurt my growth as a therapist, and it hurt my soul. It hurt my work with my clients, and it made me very uncomfortable. I did learn a couple of things, and I will talk about those things. CU, they were very interesting what I learned in supervision.
But in my first, oh, five years as a therapist, I think I had maybe six or seven different supervisors. All of them were assigned to me. I didn’t choose any of them. I didn’t have any choice in the matter. Now, the interesting thing is I don’t know that I necessarily could have chosen anybody better because I looked around the agencies that I worked at and/or interned at, and I didn’t see anybody who really inspired me. So basically, as far as I was concerned, it’s like I got who I got, and they weren’t particularly any better or worse than anybody else there. But they weren’t really good.
The other funny thing was these supervisors were all assigned to me. I had to have supervision when I was in school. They were writing up reports on me, essentially evaluating my performance, and this was going to affect my graduation. This was going to affect which placements I got for, you know, the next therapy placements I had, my internships. They affected what clients I would get. So for me, it was like I really had to get along with these people. I was forced to be there, and that was really unpleasant.
Because my first supervisor, he didn’t like me at first. He thought I was too young. I was working with Vietnam Vets; they were much older than me. He was like, “They’re going to eat you alive.” He was saying all this. He’s like, “Look at you, you’re wet behind the ears.” He said, “You know you’re going to have to hit the ground running, and don’t break your ankles when you jump out of the helicopter.” He was really scaring me. He was a Vietnam vet himself, and he wasn’t like a super educated intellectual guy, but he’d been a therapist for quite a while. Looking back on it, I think he was threatened by me in a lot of ways, and I think a big part of him wanted to see me get eaten up.
I also think he thought I was really, really soft, and he thought I was just an educated, arrogant bookworm. So he really just, I think, wanted to put the fear of God into me. I think he wanted my clients to just scare me. Maybe he wanted me to run away and come crying back to him, and I think it was ’cause he felt really insecure.
The first person he ever sent me as a client was someone who didn’t want to work with me at all. He was just overtly like, “I don’t want to work with that young guy. He’s not what I want.” My supervisor forced this man to work with me and forced me to work with him. And I say forced me because I was like, “I don’t want to work with someone who doesn’t want to work with me.” That kind of goes against why I came into this field. I want to work with people who actually choose to work with me. And he’s like, “It’s an order. You have to do it.” He was playing like we were in the military or something, and I was like, “What else could I do?” I did it.
The sad thing was I desperately wanted clients ’cause I needed practice. Now, one great thing about my graduate school was that immediately they put us in internships, like even before I started classes. I got put in this Vietnam vet internship, and I was working with combat vets. Pretty quickly, I was seeing clients with a door closed where it was like nobody could hear what was going on except me and the client. Now, I was really scared. I didn’t know what I was doing. I was frightened, and I had this supervisor who was always telling me, “You know they’re going to eat you alive. You better say the right thing. Just do what I tell you to do.”
In school, they were giving us all these sort of lists of how we were supposed to be a therapist and what kind of questions we were supposed to ask and what kind of questions we weren’t supposed to answer if the client asked us, and all these different forms that we had to fill out. It was just so much. I was like, I was so afraid I was going to screw it up. Here I am sitting with guys that were 20, 30 years older than me, who, a lot of them had been in therapy before. A lot of them were just like not so pleased that they were with a 27-year-old guy who wasn’t a vet. But thankfully, some of them were open to working with me.
What I learned is actually where I learned the most was from my clients. I actually, I’ll take that back. I learned the most from my clients and from listening to my inner voice and trusting myself. So when I go back and think about it, if there’s one thing my supervisors, all the years I had all those formal supervisors I got stuck with, if there’s one thing they could have told me and just told me every single time they saw me, it would have been, “Daniel, trust yourself. Listen to your heart. You’re here for a reason. You’ve chosen to be in this field because you know you have a gift at it. You have a gift at it. Trust it. Listen to your inner voice.”
What I came to through my own experience, through years and years of being a therapist, was realizing the best supervisor I had was my own inner voice. I just had to learn to listen to it, and it was a skill, especially when there’s a lot of conflict going on. There’s really painful stuff I’m listening to, or a person has a lot of emotion, or they’re angry, or I don’t know what to do, or I’m trying to figure out what the rules are according to the state about what I’m supposed to do. It’s like that’s not necessarily the easiest time to listen to one’s own inner voice, but that’s the time when it’s the most important.
Because what I realized also, ultimately, is I had supervision, formal supervision, maybe an hour at most, two hours a week. I was sitting with clients from the beginning, 5, 10, 15 hours a week, and then eventually 20, 25, 30, 35. By the time I was really working hard, I was doing 40 hours a week, sometimes 40 hours sitting with people, talking to them, and doing one 45-minute supervisory session a week. It was like, even no matter how good supervision was, formal supervision, it wasn’t remotely enough to really help me.
The thing is, eventually, I was really, really glad that I only had to do one 45-minute supervisory session a week with a supervisor because I was like, “GH.” It was just such a boring, stupid thing where I had to accommodate these limited supervisors who themselves were therapists, who didn’t understand me, didn’t understand my relationship with my clients, often were kind of threatened by me. So I realized the way to deal with supervisors in…
The system, the ones that I had, these people who I was forced to see, who I didn’t want to see. If I could have quit supervision and just got the signature, I totally would have done it. But I had to go, and they were being paid, and they liked it. I saw it all. My supervisors, they all liked seeing me. They thought I was smart and interesting, and they listened. They liked listening to what I had to say, and I made them feel good. But really, what it was, was I was gratifying them. Or to use diagnostic terms, I was narcissistically gratifying them. I was using a lot of my therapeutic skill, like antenna, like radar, to pick up their insecurities, to understand their personality, to see what their limitations were, to see what their fears were, to see ways in which they were threatened by me, ways in which they were grandiose. And then I would just gratify them. I did a lot of that, trying to make them feel good.
And why would I do that? Not because I liked them, not because I really cared about them, but because I cared about me. Because these were people who had a lot of control over my life. So I think really good therapy training would take all of that out of the equation. No one is forced to go to supervision; it’s entirely by choice. And anything, any sort of education the therapist is doing is going to be by choice. Now, you could say, “Oh, but you’re going to get all these people who are going to call themselves therapists, and they’re going to charge a lot of money, and they’re going to have no training, and they’re going to have no supervision, and they’re going to be running hog wild, doing horrible things, and they can really misuse people.”
Well, to me, those criticisms of what could happen, that actually sounds to me like exactly what pretty much does happen in therapy with all the training, all the great training in the world, and all the great degrees and licenses and licensing boards and rules and codes of ethics. It’s not really that good. Yeah, maybe the code of ethics do prevent a few things. Like, there’s some things in the social work and the psychology code of ethics that I really like, like don’t have sex with clients. But isn’t that obvious to anyone who has half a brain? You don’t do that to people when you’re in a power position and they’re coming to you for healing. You don’t take advantage of them that way.
But I think there’s so many other things that really real code of ethics, but I think people have to find these codes of ethics from within. And I think any good therapist is going to ding, they’re going to have that inner bell inside that tells them what good ethics is. Because good ethics comes from within; you can’t impose it on people. And what I found is that what I saw so often in my therapy training was that things were happening. Things my supervisors were telling me to do, things my supervisors were doing to me, were actually flatly unethical. And yet, according to the social work code of ethics, according to my school, according to my supervisors themselves, they were considering it perfectly ethical. And I knew there wasn’t a damn thing I could do about it, and that was really frustrating.
But through all that horrible stuff I had to go through in all those years of supervision and all that stupid graduate school stuff that I had to do, and all those classes that were dumb, and reading all these horrible, stupid papers that were boring, I actually did learn a lot. ‘Cause what I learned was how flawed the mental health system was. And I learned that if I really wanted to become a therapist within the confines of the mental health system as it is, that I had to learn to play the game.
And interestingly, I did. And I realized I wanted to become a therapist in the system. I was 100% gung-ho on doing it, which is why I was able to survive and do well at it for 10 years. Part of it was like, not just that I was a good therapist, but I was a therapist who knew how to play within the confines of the system. Now, part of my work as a therapist was to minimize the damage that playing within the confines of the system would, and you know, do to my clients.
So once I closed the door, it’s like some of the all bets were off. Some of these stupid rules of the system were off. It’s like, no, someone was coming in, and they were having a lot of problems, the kind of stuff that could be diagnosed, let’s say, as bipolar or diagnosed as schizoaffective disorder or schizophrenia, all these stupid labels. It’s like I was supposed to refer those people to a psychiatrist, get them a psychiatric evaluation, and pressure them to get on medication, maybe even hospitalize them. I’m like, no, I’m not doing it. No, no, no, no, no, no. I have a responsibility to the people I’m sitting with to help them evolve, to help them work through their issues, to help them feel safe, to be able to talk about what’s going on, not to get them on pills, which can often be deadly or, at the best, just stunt their growth.
Yeah, there could be sometimes where I do think some psychiatric meds are helpful. An example of that is in my open dialogue movie, where they talk about people who are really in this, you know, horrible psychotic episodes, if you’re okay to use that kind of terminology, and which is a lot of it’s caused by just not sleeping for five days. Well, sometimes there are certain meds, like benzodiazepines used short-term, that can really help people just get to sleep. And with some people, that can just break the psychotic episode and get them back into some place where they’re like, “Whoa,” and they can take control of their life again.
But honestly, past that, I’m not cool about psych meds. I was not cool about referring people to psychiatrists. But when I was working in clinics and when I was an intern with people, especially when they had the state insurance, like Medicaid for people who were really low income, I had to refer everyone in Medicaid to a psychiatrist for a psych eval. I didn’t like doing that. So what did I do? I talked to people about, “Listen, the psychiatrist, their job is to evaluate you, to give you a diagnosis, and in many cases, just to put you on medication. All day long, they’re evaluating people, and for the people that they see regularly, they’re medicating them. So be aware, you’re not going in there to talk to a friend. You’re not going in there to someone who’s really trying to love you and help you and care for you and figure out what’s going on. You’re there to talk to someone who’s trying to figure out how to medicate you and what label to give you.”
Well, so just to know what you’re getting into. Now, some people I saw, they wanted to be on medication, and I felt, well, I feel it’s my job as a therapist to talk about the pros and cons and to really, but also to sit with a person. If they really want to take medication and they really are dead set on doing it, then I don’t feel it’s my place to stop anybody from doing that. Because again, people need to be able to operate within their own choice. Life needs to be voluntary; therapy needs to be voluntary. But it doesn’t mean I like the system, and it doesn’t mean that I can’t speak my mind. And also, I don’t think it’s a bad thing for people who came to me who really wanted to take medication to know my point of view on things like medication, which is why it was in 2004 I put up my website and I became very, very public, like to anybody who wanted to just read it.
Anybody in the whole world could see I didn’t like psychiatric drugs. I wasn’t for them. I didn’t believe they were really helpful. And yet, even before that, I was telling clients because I felt, why should I lie to them? They have a right to know who they’re sitting with, and if they don’t…
Want to work with me given what they know about me? They don’t have to, and some people didn’t. Some people didn’t want to work with me, and I felt that that was fair. Now, I do feel alternatively that I shouldn’t have to work with anybody I don’t want to, and I think nobody, no therapist, should have to work with someone that they don’t want to. I think it goes both ways; that it should be a voluntary relationship on both sides, and I think that’s really important.
Now, when I talk about my supervisors being bad and me not liking any of them, I stand by that strongly. But there’s a caveat, and that is from the minute I became a therapist, I realized actually I was getting a lot of really excellent supervision. I just wasn’t doing it in any formal sense of the word. So where was I getting my supervision? I was getting it from friends. I was getting it from friends, some of whom were therapists. I was actually getting it from other interns who were training. I was getting it from other therapists who I liked. Occasionally, I found some people, even occasionally at the places I worked. But in other parts of my life, I was getting supervision from therapists. I was talking about my clients in a very anonymous, confidential way, but talking about what the dynamics were in our relationship and what my conflicts were because I needed to talk about my insecurities. I needed to say to somebody, someone who could listen, someone who could understand me, “I don’t know what I’m doing here. I feel really insecure. I don’t know how to be helpful to this person. I feel like I’m getting thrown off here.”
What I also realized over time was that there were many circumstances where I could actually talk about my own insecurities with my clients themselves, right in session. I could say, “I’m not really sure what I’m supposed to do here. I’m a little confused. I feel a little secure.” Now, I wouldn’t say that across the boards I did that because there were many times I learned a lot of this the hard way. By saying that kind of stuff to clients, sometimes they would be like, “What? What do you mean? I can’t work with someone who doesn’t know what they’re doing.” They needed to look at me as someone who knew what they were doing. So sometimes it took a while for clients to get comfortable with my style of being kind of open about being unsure.
I took my unsureness and my ability to be conscious of the fact that I wasn’t really sure of what I was doing. I took that as a real strength. It didn’t mean that clients took it as a strength. It didn’t mean that my formal supervisors took it as a strength. Often, they took it as a weakness. They took it as something to pick at, something to criticize me for. I heard this probably no fewer than a hundred times from supervisors, from other advanced therapists, even from people who were at my level, you know, at my level of number of years of experience. They would tell me, “I think you need to go to more therapeutic training. I think you need to do psychoanalytic training.” Most of those people, those supervisors, had gone to these psychoanalytic training courses.
So I looked into some of those courses. I looked into a lot of them, actually, and what I just thought is, “This isn’t for me. This is like yuck, more school, more stupid professors, more boring classes where I have to read stuff that I’m not really that interested in and, you know, get more formal supervision.” I’m like, “No, no, no, no.” And also pay a lot of money. I think I went $40,000 into debt when I went to NYU for grad school. $40,000 to take all those classes, and now maybe I’m going to spend another 20 or 30,000 to do psychoanalytic training? I don’t think so.
And it wasn’t like I earned a lot of money when I came out of grad school. It was like I started. My first therapy session I ever got paid for was $15, is what I earned. I earned $115 for a while, then I went up to 20, then 25. Then at clinics, 30. Eventually, I was charging pretty much between $25 to my high. 45-minute sessions were $80 a session, and pretty much people could pick what they wanted. They could pay what they wanted, and I was always comfortable with people paying less if they felt it was a real burden for them. Because I thought, especially some young person who’s earning $12 an hour, they’re supposed to come in and pay me $100 a session or $150 a session? Because I heard stories of that. I heard clients of mine that came in, they’re 23 years old, they’re making 12 bucks an hour, and they said, “I couldn’t work with my last therapist. It was far too stressful.” And I say, “What made it stressful?” They said, “Well, one of the basic things, they were charging me $150 a session.” So I’d stress out thinking, “How am I going to even pay for this?” And it was causing me anxiety.
And I’m like, they’re getting anxiety from having to pay the therapist that much money? I think those therapists were criminal. I think that’s unethical. So for me, I think, well, therapy is hard work. It’s pretty stressful. But I think charging someone like that, 25, 30, 35, is not so bad. And I think a lot of my clients were willing to pay it. But I would also say to them, “What do you feel comfortable paying? An amount that makes you feel like you’re paying for a service that’s really meaningful to you but isn’t stressing you out?” A lot of them would come up with numbers that I thought was even higher than what I would have expected. And sometimes I’d say to people, “Are you sure you want to pay that much? We could go a little lower.” Sometimes they said yes, sometimes they said, “No, no, no, no.” And sometimes when they would get a raise, you know, at their job, they would say to me, “You know, I can pay you more now. I got a raise. I’m a manager at my job now.” And sometimes they would say even, “You know, I feel like the therapy really helped me do this. I have gratitude. I want to pay it forward to you.” Or maybe even it’s paying it back.
But I would also say, “So what? Helping someone who’s training to become a therapist not go into massive debt over this? Why should it be that expensive? Why pay $40,000 to learn something that anybody who’s really good at it is going to have the basic skill to do anyway? And they just need to be nurtured.” But I do think a lot of time talking with people about the different cases they have, the different people they’re working with, is very valuable. So I think if in my first year and a half, I was probably seeing 10 to 15 people a week on average, working with them, you know, sitting with people and talking with them about whatever they were going through for 10 to 15 hours a week, I probably spent 20 hours a week just talking about it with other people. Talking about what was going on in the sessions, talking about my fears, talking about my insecurities, talking about different ideas, talking about troubleshooting, talking about, and also listening to other people. Not in all supervision groups, ’cause I did those too, and I never felt good ’cause I always felt there were these arrogant jerks who were running the supervision groups, these arrogant therapist supervisors. But I did like listening to other people talk about what they were going through, and it gave me ideas. And it also made me feel like, “Wow, I’m actually not so bad at this.” ‘Cause I heard what some of the other therapists were doing, and I was like, “Actually, I’m better than I realized.” ‘Cause at first, especially, I remember this when I first became a therapist. I’m not even religious, don’t even know what God is, or I don’t think I believe in God or any of that. I used to get on my knees and pray in my therapy office at that Vietnam combat veteran clinic, just get down on my…
Knees and say please, please, please help me. Please help me be calm. Please help me be present because I was so nervous. I was so anxious. Now, what if I’d had a formal supervisor who said, “Daniel, you’re gifted, you’re talented, you’re good at this. Don’t be so afraid. Just sit with people and guess what? You don’t have to ask them all these questions that we’re telling you to do. Just have a conversation with someone. Let it be natural. Just do what you’re good at.”
Anyways, later when I was a much more seasoned therapist and I had my own private practice and I didn’t need supervision anymore, formal supervision, and trust me, when I didn’t need formal supervision anymore, I didn’t get it. I stopped doing it. But I still did occasionally talk with other therapists or sometimes people who weren’t even therapists about what was going on in my sessions so that I could get help, so I could get mirroring. I noticed it definitely, the amount I went for went down over time because my inner voice became stronger and I felt I really became very skilled at it, much better at it. But for a long time there, yeah, I was leaning on people.
The other thing that I really leaned on a lot, especially in my early years, which is why I think this whole idea of, you know, professors assigning papers and courses and being forced to read all this different stuff and read Margaret Mahler and Melanie Klein, like what I did was I went to the library. I went to just the New York Public Library. I went to the NYU library and I chose books that appealed to me. And guess what? I found them. I found a lot of them too. I loved reading books on case studies, other therapists who were experienced therapists who were writing about their work with clients and for me to try to understand, well, what was going on there? What were the therapists doing?
Occasionally, I found therapy writers who were really good, or at least were very clear about what was going on in the sessions. I also read different books written by people who had been clients in therapy and I asked, or in my own mind I was asking them, “What did you do? What did you find helpful?” Ultimately, what I started coming to was what I was there to do was to have just a good, healthy, deep conversation with my clients. A conversation that went at their pace, that really listened to them, that really allowed me to be present so I could listen to what they were saying. Listen just so I could feel through my listening, through my pores, what they were expressing, the emotion. And also so I could listen to myself, so I could listen to my own inner dialogue.
As time went on, I found that I wasn’t struggling so much with wondering what to say because early on I would always be like, “What am I supposed to say now? What am I supposed to say? God, I wish I was this therapist. God, I wish I was Alice Miller. She would know what to say. God, I wish I was Milton Erickson. I wish I was Salvador Minuchin. I wish I was someone who was really, really confident and knew the right answer.” Eventually, I realized I didn’t need to be any of them. All I needed to do was calm myself enough, really be present, almost be in a meditative state, that I was so present there that if ever I wondered what was I supposed to say, I could just ask myself right in the session.
What I learned to my amazement was that the answer came to me. It was almost like there in a teleprompter. And often the answer was not what I would have expected. Sometimes it would be like, say to the client, “Well, you know, is there something you feel like I should be saying now? Or is there a question you’re asking me that I don’t really understand?” Or I could say to the client, “You know, I’m feeling kind of strangely insecure now. I wonder why that came up. Do you have any idea? ‘Cause I’m not really figuring it out.” And often the clients themselves would be incredibly helpful.
That was something interesting that I learned. I actually got a lot of supervision from the people who were paying me. Now, you could say that that was unfair, but I think the greater lesson I learned is that, okay, I was a therapist, but what is a therapist? What is that job really? And what I came to is I’m someone who is being with people. I’m participating in their life process. I’m participating in their evolution. But ultimately, they run the show and ultimately, deep down, they know what’s best for them. My job, I think, is to help them get back in touch with themselves somehow. Maybe to be a mirror, maybe sometimes to challenge people in different ways, maybe to do it through caring, maybe to show them an example of someone who cares for them, who really listens to them, to listen really well.
Because often when I said things to clients that were really deep and profound, they would take it as like, “Whoa, that just blew me away what you just said about me.” Something like to the point that they could even start crying, which happened a lot. Underneath it, what often they would say afterwards is, “You know, it’s so funny. You said something about me that really touched me and something that I knew was true about myself and maybe I just forgot it or I couldn’t hear it or something that I so want to believe but it’s so painful for me to believe.”
Often it was like they were so crushed earlier in their life. They were so not allowed to listen to their instincts, to feel their own true feelings, that to be with someone who actually listened to them, who cared about them, a person to sit in the room with someone, therapist or otherwise, someone who was a true self by and large, someone who really was present, who like for me to be able to sit with me or anyone, someone who really loves himself. I love myself and care about myself and I listen to myself. Just by being with somebody like that, it can be incredibly heartening and encouraging. A therapist in that way can be a role model.
So, from my relationship with myself, I actually model listening to oneself. And now I don’t believe, and I would tell this to anybody who is just becoming a therapist, your job isn’t to heal people. Your job is to do what you can to be with them on their own healing journey, to be useful to them, to figure out how to be useful to them, but also to remind them that they have it within themselves to figure their stuff out. And when they start figuring their stuff out and they start gaining that sort of mastery over their conflicts and they start being able to parent themselves and love themselves and have their own self-reflective, self-dialogical relationship, that basically they start learning to do for themselves what previously you were doing for them.
And when they get good at learning how to do for themselves what you’ve done for them, then they don’t need you anymore. And it’s time for them to move on. Sometimes it may be good for the therapist to say, “You know, I think you’re starting to figure yourself out and I don’t think you need me so much anymore.” But often, I think in my experience, it often comes from the client. They start realizing it. They don’t need me or any therapist to tell them that. But sometimes it helps if a therapist says it or sometimes people need encouragement. They need the therapist at that point, in my opinion, to say, “Yes, you’re right, you’re figuring it out.”
I think a lot of times what happens in therapy is therapists are terrified to lose the business, to lose the money, to lose the client. They get attached. They’re getting their own emotional, their ancient unmet emotional needs met from the client. So when the client says, “You know, I think I’m figuring this stuff out and I don’t know that I need to be in therapy anymore,” a lot…
Of times, then the therapist goes, “Oh no, no, no, no, no, no, we’re just getting started here,” or “I think you’re really underestimating how troubled you are,” or “You know, maybe your diagnosis is this and that.” That’s another one. I don’t think there’s any good reason for a therapist to really understand diagnosis, any deep inherent reason.
Now, the one exception is because we live in a world that’s so diagnosis-oriented and a mental health industry that is so diagnosis-oriented. All these different diagnoses that some people, you know, psychiatrists have voted on, they’re like silly. That everybody has to understand these things to be a therapist nowadays. So I think that could be of value to understand the mental health system is to understand diagnosis.
I feel like I became a diagnostic expert. I had to diagnose people all the time for my job, but my goal always was to give a person the most minimal diagnosis as possible, and then so that they weren’t going to be harmed by it. Because a lot of these diagnoses, perhaps all of them, are harmful. Because do people really need these silly arbitrary labels attached to them? No.
I also found this: that they weren’t useful to me. They didn’t help me as a healer. They didn’t help me learn to help someone else become a healer for themselves.
Now here’s another question: Should a training therapist, someone who’s in training, learn about psychiatric medication? For me, it was very important because I have worked over the years with so many people who were taking different psychiatric drugs, and sometimes four, five, six, seven, eight drugs at the same time. And over their history, maybe had taken 50, 60, 70, 80 different drugs. So for me, it was very important for me to learn a lot about these drugs, to learn what they were, to learn their operations of mechanisms, if these mechanisms were even known. A lot of them really aren’t, but to learn as much as I could about them and also to learn really how to help people get off of them.
Because I felt it was my obligation, especially if people wanted to get off these drugs, that I should be an expert at knowing this. And how did I feel like I became something of an expert at that? One is by listening to a lot of people talking about how the drugs made them feel, how different dosages made them feel, learning about people’s experiences of coming off drugs. Because lots of clients that I worked with had come off different drugs over the years. Some had come off tons of different drugs, some had gone back on, come off. And so for me, getting a broad range of experience really was very helpful for me. And so I felt it was very important.
So I would encourage anybody who’s becoming a therapist, especially if they’re going to work with anyone who’s been on meds or is on meds, to learn as much about those meds as possible. Also, I felt it was important for me to learn all about the social welfare system, to learn about the difference between SSD and SSI in the United States, to learn about all the benefits that people got, to learn about Medicaid, to learn about Medicare, to learn about the different health insurances, to learn about what was considered a biological psychiatric diagnosis versus a non-biological psychiatric diagnosis. I had to learn how to bill. All these things were very important as part of my education.
Inherently, should they be for a therapist? No. I think ultimately it’s probably best if therapists just take cash for their work and just totally cut out any paper trail, cut out all insurance companies, cut out the state, cut out Medicare, cut out—don’t do any of that stuff, just take cash.
And I think one thing that’s beautiful about cash is that it doesn’t leave a paper trail. Because I think therapy should be private, totally confidential. How can people feel safe to talk about what’s going on in therapy if they’re talking with someone who they know is actually an agent of the state? Someone who they know, if this person and the client says the wrong thing, that the therapist might do something that gets them in trouble, might have to call the police and get them hospitalized or get them arrested, or, you know, having to call a parole officer? I mean, these are things that therapists get pressured to do. Maybe we’ll have to call, get their children taken away. These terrible things that I felt like when somebody came to me, I just couldn’t be an agent of the state. It just wasn’t in my nature. It’s like, no, I’m an agent of the person who’s hiring me. I’m not working for the state.
And so I think that’s very difficult, though, because I mean, it’s easy to give examples. Because any therapist could say, “Well, we’re all trained that if someone’s really suicidal and they have suicide ideation, they have suicidal thoughts, they have a—let’s say they have a plan and they have an intent to kill themselves, I have an obligation as a therapist to get that person hospitalized, to call the police, to call 911 on them, to, you know, have their rights taken away.” And I don’t agree.
I think actually if someone’s really suicidal and they have the intent to kill themselves and they have a plan to do it, then all the more reason for the therapist to work harder, see that person more, engage with them more, find ways to really connect with them more deeply. ‘Cause why is a person suicidal? In my experience, people who are suicidal are just really disconnected from other people. And when people really feel a human connection and they feel a lot of strong human connection and they feel a lot of caring and emotion coming from another person, just their suicidality is going to go down.
Now, there are, you know, exceptions to that. I mean, I’ve heard people who have killed themselves because of psychiatric medication. You know, it just totally made them whacked out of their mind, or they’re in such horrible pain, or they’re dying of cancer, things like that. But I still think even in spite of all that, it’s like I think the human connection can allow people to get a sense of inner strength that can fight through all sorts of things.
I’ve seen people who therapists, after therapist, turned away, or therapist after therapist said, “You need to go to the hospital. You need to be in a hospital. You’re dangerous to work with. No therapist should work with you. You need to be on psychiatric medication. You know, you’re way too suicidal, you’re way too bipolar, you’re way too depressed,” blah, blah, blah. And I’ve seen those people, if they’re able to come to therapy sometimes two hours a day, five days a week, six days a week even, I’ve seen it that their suicidality can go down.
Now one might say, “But that’s really expensive. Who can afford that?” Well, I could say alternatively, how much does it cost to go to a mental hospital where everybody wants to send these people? $2,000 a night? $1,500 a night? What is two hours of therapy if it’s $50 a pop? Let’s say that’s $100 a day, seven days a week. That’s $1,400 for one week of two-hour-a-day, seven-day-a-week therapy. That’s actually cheaper than one night in a mental hospital.
And what happens in the mental hospital? They take away your rights often. They don’t talk to you at all. Often you get no therapy. Certain, very rarely, the first day maybe you’re lucky. After a few days, you’ll see a psychiatrist. What is a psychiatrist there to do? To talk to you, to figure out, you know, have you answer very specific questions so they can get you a diagnosis and a proper medication. A proper medication.
Now what I’ve seen is often, most often, when people go to mental hospitals, it’s not a calming experience. It’s not actually a therapeutic experience. It’s not a healing experience. More often than not, it’s the opposite. It’s disempowering. People feel even more disconnected after going to mental hospitals. So a therapist, even a very new therapist, I think can be incredibly helpful at giving a person that sense of connection so that they don’t need to run to a mental hospital, so they don’t need to run to a psychiatric medication.
Can learn interpersonally how to find new ways to grow. So I do believe I have said my peace and hope someone out there finds this useful.