by Mike Bundrant, February 26 2012
The information in this article comes from my personal experience as a licensed mental health counselor. One of my missions as a member of the mental health underground, a secret society of rogue mental health types, was to infiltrate the massive system created by the managed care industry.
I was out to crack their code and bring home the details about 1) how mental health patients are treated 2) who is really in charge and 3) why typical psychiatrists and psychotherapists seemed so boring and incompetent.
It took me two years to complete the assignment. I secured a position at the largest agency in town, carried a caseload that included 25 billable hours weekly, dutifully completed mountains of paperwork, and received direct oversight and clinical supervision from a psychiatrist and a clinical psychologist. It was perfect! I had direct access to the inner workings of the managed care machine. We decided against secretly recording my weekly supervision meetings on ethical grounds (patient confidentiality). Yet, I almost wish I had. You wouldn't believe what went on.
Today's report includes seven things your psychiatrist would never want you to know.
1. Making money is priority #1. Of course, you can't hold this against anyone. Health practitioners need to make a living, too. More power to them if they do it while helping others, right? Maybe. The dirty little secret in mental health, however, is that some clients are treated as cash cows. Here is how it works.
A person with means to pay for therapy, Martha, enters counseling in hopes of getting to the root of problems and making some changes. The counselor arranges for weekly visits at $125 per hour. Great.
Two visits into the treatment the counselor discovers just what Martha needs to solve the problem at the heart of her dilemma. This could be a short-term gig. Not so fast. The counselor decides to hold off. Martha may not be "ready" for the solution yet.
The same logic applies when the counselor has constructive criticism or challenging feedback for Martha. Hold off. Let's not offend her. She pays my bills! Let's keep her around as long as possible.
2. They can't survive without insurance company overlords. The vast majority of psychiatrists and counselors are beholden to insurance companies to pay for treatment. This has many implications, but the most significant has to do with simple economics. People will not pay an average counselor out of pocket. Why? In most cases, isn't worth it. Who wants to pay $125 to talk to someone who isn't very helpful after all? So, most counselors get referred their clients from insurance companies. They don't earn the right to practice by creating real value that people are willing to pay for.
Really skilled counselors and psychiatrists have the choice to practice outside the system. You need to pay them their full fee directly. People do this because a skilled counselor is worth the investment.
3. Your diagnosis precedes your arrival. Most psychiatrists and counselors are sheeple, brainwashed into believing that human suffering can be categorized per the Diagnostics and Statistics Manual, which serves as the basis for psychiatric treatment, insurance billing and prescribing medication.
When you arrive at your average mental health practitioner's office, you are being viewed through a lens that includes cookie cutter categories. You will be placed in one of these categories, billed and prescribed accordingly. For the most part, you will be diagnosed with a condition that is likely to get your insurance company to approve the lengthiest treatment protocol.
4. You are not in charge of your treatment. As much as we preach that you are in charge of your own health, the APA doesn't see it that way. Psychiatrists like to pretend they know what is best for patients. In fact, to them it is obvious that you don't know what is best for you, so why should they waste time listening, especially if what you have to say challenges their predetermined treatment guidelines?
Case in point: Andrew Saul of doctoryourself.com worked with a severely depressed person using niacin therapy - high daily doses of vitamin b3. This person progressed from sitting in a corner all day long, emotionally disabled, to being up and around and interacting with the family. The depression lifted!
Until the psychiatrist got involved. When he learned of these developments he warned that taking a high dose of niacin could be harmful (blatant, ignorant lie). At that, the patient stopped the vitamin protocol and returned to the corner, emotionally disabled.
How about this as an alternative, Mr. psychiatrist: Wow. You've gotten so much better! And with vitamin therapy? How much niacin are you taking? Well, I am glad you are better, first of all, because that is our mutual goal. I don't know much about niacin therapy, but I will definitely look into it. If you are open to it, I will call your nutritionist and see what I can learn. In the least, I should do some research on potential side effects or long term risks. Keep doing what's working and I will get back with you shortly.
Is that so hard? Then, you could actually research niacin and discover that it has never killed anyone, is totally safe and healthy, and carries with it numerous health benefits. Armed with this new level of enlightenment, you are now on your patient's side, working together as a team.
Too much to ask, I know.
5. Liability is priority #2. Let's get back to priorities. Next to making money, the mental health system is most interested in covering its butt. I can't count the number of times I was given direct orders by my supervisors to refer a client for a mandatory medication evaluation. If I didn't make the referral, I'd lose my job - no negotiating.
Of course, this sends the wrong message to my clients. If they, for one, aren't interested in meds, now I am at odds with them, which is not helpful. Or, I could tell them the truth, which is that I am being forced to send them on to a psychiatrist, which makes the agency look as bad as it is. Bottom line, it sends a message to the clients that we can't work this out together. You are biologically incapable of healing on your own. You are broken.
The agency's justification is that if the client were to harm themselves or others while in treatment with us, we could be sued if we didn't recommend medication. So, throw a monkey wrench in the therapeutic process from the get go.
6. They flirt with pharmaceutical reps. Lunch every Wednesday with the rep from big pharma! Nice. All expenses paid, too. In our agency the head psychiatrist insisted that big pharma buy lunch, not just for the doctors, but for all the staff. After all, we were a team. So, I got to witness the pharma reps work their magic. Flirting season was open!
Those gals with the drug samples and slick brochures really knew how to work a room of old men in white coats. I recall one doctor who was particularly susceptible. He'd spend the first half of the lunch ripping apart big pharma's research, stating unequivocally that it was junk science. Then, the rep would come on strong with coy smiles, winks and an occasional shoulder rub or convenient lean in, and, shazaam! The old man would leave with his samples and a smile on his face.
Classic. Push her away. Be waiting with open arms when she comes back, more vulnerable. I'm sure our patients would be delighted to know their prescriptions were influenced in part by these mating games.
7. Although serious mental illness can be cured without drugs, they aren't interested. Depression isn't the only condition that can be healed with natural means. Even the big scary ones like schizophrenia can be resolved. As early as the 1960's pioneers such as Jay Haley were demonstrating that schizophrenics would leave their delusions behind with the application of family therapy. Yep, therapy. Haley could guide a family through a process that resulted in the loss of any family member's need to create delusions or hallucinations. No drugs. No dietary intervention. No biological explanations required.
Of course, it takes skill to create a context for healing. Most therapists and psychiatrists simply can't do it. Of course, working therapeutic miracles is the worst possible threat to the drug companies. Faced with their own inability to really help people solve complex problems though talk therapy (or unwilling to face it), psychiatrists and counselors were herded into big pharma's corral. It's easier to assume that human suffering is 100% biological anyway. Then, all you need to do is give patients the pill that the pretty pharma rep likes the most. Easy. Of course, you'll have to help a patient through all the side effects, but that is just as well. You don't know what else there is to talk about.
The above are just some of the reasons why so many competent mental health practitioners refuse to participate in the system. After two years of this sham, I was relieved to leave and start my own practice in which I did not diagnose anyone with anything, refused to bill insurance, declined cases that required supervision, declined cases involving the court system, and required my clients to be willing to build real emotional and people skills through NLP training.
This ends today's report. Next time I will tell you about my old supervisor's habit of falling asleep when clients were pouring their heart out to him.
About the author: Get the free mini-course Three Soul Stirring Questions That Reveal your Deepest Goals by visiting the iNLP Center.
Mike Bundrant is the founder of the iNLP Center, which offers NLP training and personal development coaching. Learn more about Mike's down-to-earth, skill-based coaching that comes with a lifetime membership to the iNLP Center's online school and receive a free life coaching consult.
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