Marsha, Marsha, Marsha

I spent a portion of the last six months of my internship traveling around the country interviewing for a job. I came close a few times. One was particularly exciting: a community college in Oregon was hiring an assistant director of their counseling center. As I was for every other job I got an interview for, I was named the runner up. Runner up wasn't going to get me employed.

So my internship was coming to a close and I was become a little concerned. I call a friend, who calls a friend, who calls me back. They told me about this clinic in Cambridge that has a post-doctoral training program. I made a few phone calls and before I know it, I'm on Harvard Square for an interview. 

The whole interview experience was a hoot. It was a hot humid day, I was recovering from a minor surgery, and the person I interviewed was interested in giving me a hard-hitting stress interview. It took me nearly a year to forgive the psychologist who interviewed me. In the end, he became one of my favorite mentors. I'll have to leave this story for a future blog post.

In the end I was offered a part-time postdoctoral fellowship that paid just over the poverty level. I made a few other phone calls and arranged for another part time job at a local counseling center. I was busy--and barely made enough money to pay my bills--but I had the pieces I needed to get my post-degree hours in so I could sit for my license.

Apparently I interviewed for a fellowship that involved working with adolescents who were highly suicidal and engaged in self-injurious behavior. Who knew? I remember hearing something about Dialectic Behavioral Therapy (DBT) in my doctoral program. That was my main role in my fellowship: working with adolescents in an intensive day treatment program as well as in an outpatient clinic doing DBT.

Marsha Linehan and her followers can sometime take on the aura of a cult. Sometimes it feels that those "on the inside" think that DBT is the only treatment--the only way--to work with people. They have done some fantastic research. That's for sure. They've done some fantastic research in highly controlled settings with highly controlled patient populations. In real-world practice, DBT provides a useful tool to use in combination with other useful tools. Empirically supported treatments work a bit differently when they are taken out of the lab.

Below is a great clip of Dr. Linehan explaining DBT. She said something early in the clip--something important and worth highlighting (and is the point of this blog post). At 1:04 Linehan says "I love her so much." What? A psychologist loving a patient? That's not supposed to happen, right?

To date I have four examples of psychologists who I have heard talk about loving patients: Marsha Linehan, Irene Stiver, Robin Cook-Nobles (a former training supervisor and mentor), and Judy Jordan (another mentor who deeply influenced my training).  Check out the companion blog entry to this one called "A Few Notes on Love."

I think talking about love is an important dialogue for psychotherapists--and it's something that I'd like to hear Linehan talk more about. As a fellow, and then later as a psychologist in private practice, I've heard scores of psychologists, social workers, psychiatrists, and counselors talk with contempt about their patients. I watch in horror as these folks lose their ability to see the humanity in those that they work with and reduce their patients down to a list of bothersome symptoms.

One of the gifts of what Linehan offers in DBT is acceptance--acceptance of patients--acceptance of feelings--and acceptance that people are doing the best they can. Many get blinded by the tools, language, structure, and research of DBT. They loose the basic humanity--the acceptance and love--of the the patient.

Here is Linehan's entire talk. It's worth watching--especially the parts where you catch her humanity, acceptance, and love.

The Development of Empathy

Importance of Looking Deeply

One of the things I have valued most about my graduate education is that my mentors insisted that I look at things deeply. Don't be satisfied with how things appear at first glance or even after just a little investigation. Dig deep and look at all the sources. Confront my own bias and interpretation. This morning I'm thinking a lot about the encouragement my mentors gave me.

At various times over the last several months I've come across a controversy between the Humane Society of the United States and HumaneWatch. I got sucked right into the kerfuffle on Twitter when the HSUS retweeted one of my postings and suddenly my screen became filled with Humane Watch proxies warning me about the "evils" of the Humane Society of the United States. They were generally two different types of messages. The first generally communicated that the Humane Society wasn't very humane because they allegedly euthanize animals and the other is that the Humane society is allegedly an ominous force because they advocate a vegan diet.

Oh no. Not a vegan diet! That's just plain evil.

This morning I got a few invitations to join a  Facebook page for the Humane Watch. My curiosity was finally piqued about this group and their propaganda. My first question was who is behind the organization.   Was it a group of concerned animal activists? Disgruntled former employees from HSUS? I figured if I knew the structure under the organization I could understand more of where they were coming from. I figured it would be difficult to find out. In the end, this was the easiest research I've ever done.

Scroll to the bottom of the Humane Watch webpage. There is a copyright noticed saying all content is copyrighted by the Center for Consumer Freedom. This center is an organization run by restaurant, tobacco, alcohol, and other similar organizations. They run a variety of media campaigns supporting the interests of the various industries they represent. Want to do some of your own deep research about the Center for Consumer Freedom? Check out Sourcewatch. That's one place to start.

What things are the Center for Consumer Freedom supporting? They provide financial surveillance on organizations and individuals that support "anti-consumer" organizations. They campaign against animal rights groups. They go after watchdogs such as the Center for Science in the Public Interest. Suggest that we ought not to worry about the levels of mercury in seafood (they must be really concerned, because they have another website too). Then of course there is the kerfuffle that started all of this with the Humane Watch that is, among other things, warning that the HSUS wants us all to be vegan.

Yes, there is more. To round up the sites that the Center for Consumer Freedom sponsors we have one about Obesity Myths in which we learn it is lifestyle, not diet, that makes us fat. PETA kills animals, according to another website they sponsor.  Another goes after the Physicians Committee for Responsible Medicine because it has the gall to suggest that high fat fast food is bad for us and eating more vegan foods might be better. The Center for Consumer Freedom calls this one Physician Scam. Lastly, we apparently don't have to worry about too much sugar in our foods because it is all just a Sweet Scam.

What makes me sad here is that science--real meaningful science--gets obscured by propaganda that is trying to sell more fast food, support more factory farms, and manage our environment in thoughtless and destructive ways. Good people end up getting manipulated by the science that is intended to educate and improve the lives of society.

Carefully read what you encounter out their in the world. Look deeply before you click "like" on facebook. Give some thought to who is trying to get you to believe what--and why they want you to believe it.