I think I am flattered to have been included for discussion in Shrink Rap's latest podcast following the interesting exchange Roy and I had about brain illness vs the worried well. Listening to it this morning, I wished I could have been there to participate in the discussion and clarify a couple of small points. So I will do that here.
I do believe that all humans are wounded, varying in degree and type of wound, but we are all wounded. My first professor in abnormal psychology put it this way -- from the moment of conception we are bombarded by influences of all kinds, both noxious and helpful and as adults we are who we are at least in part de to the effects of these influences. Some of us will be more scarred than others, but none of us will be unmarked by the experiences of our lives. So wounded per se is the normal state, not a state of ill-health.
Now, the extent to which our wounds make our lives complicated and/or difficult is where therapy enters in. Problems in living are what bring most people that I have seen into therapy -- the desire to experience life in a different way is the motivator. There is no procedure or pill or technique I can apply that will close the wound. Whether or not healing is the appropriate description for becoming conscious of something that is an integral part of us, an unerasable part of our history, is something I balk at a bit. I can become more conscious of the ways I have internalized people and issues in my life. Becoming more conscious of them increases the array of possible responses I have available to me, so I can choose differently and thus find myself not in the old familiar ruts but in very different relationship to myself and those around me. That is what I believe therapy does for people and indeed is what I have experienced in my own therapy. I cannot be what I might have been had I not had the mother I had or the experiences in life I have had -- I am indelibly marked by them. But I can be freer in how I live my life and perceive my possibilities through the process of examining my thoughts, behaviors, history, dreams, reactions. That is what talk therapy as I know and do it is about.
So, in my mind, wounded does not equate to ill. And, as I have said before, I see those in hospital, who are acutely psychotic, hallucinating, disabled by their illness as suffering from something different from what I see in the run of my practice.
And, Roy, I do not accept third party payment. My patients self-pay and I offer a sliding scale for fees, something I can do because I do not accept insurance. I do not assign ICD-9 or DSM IV diagnoses.
I also have some thoughts on the Newsweek article Roy mentioned but I will get to that tomorrow.