There is an acute shortage of mental health professionals in the world, even as more people than ever before need help.
Why more people are needing it may be a combination of factors, such as the world being more stressful, but I like to think that a lot of it is simply bringing awareness to issues we’ve been suffering in silence with for millennia – for example, more adults are getting diagnosed with ADHD than ever before, and PTSD’s pervasive prevalence is becoming more known.
The Academic Method
When it comes to training mental health professionals, things often get compared to medical doctors: “you wouldn’t want just anyone treating your physical ailments, all the more so you wouldn’t want to entrust your mental health to the hands of an untrained professional”. And so we ensure that therapists have years of training, have masters and PhDs, and only then do we go to them.
This, of course, creates barriers to entry for many people who would make great mental health professionals but can’t, for a variety of reasons, jump through those hoops – maybe they’re not academically minded? maybe they can’t afford it?
I am very critical of academia – how they’ll let anyone become a therapist as long as they have the right grades and the willigness to pay. Is that the way to screen for people who’s emotional maturity and self-awareness will be their primary tool when helping others?
How their slow, ponderous way of educating is deemed the only way to acquire knowledge. Reading voluminous, dense textbooks. Writing papers.
How much of an average therapy training program is devoted to self reflection and personal growth of the individuals? For their own ability to take a hard look at themselves and acknowledge their weak points?
Academia is notorious for taking something human and transforming it into an abstract series of ideas, the opposite direction of where we need to be taking ourselves if we want to prepare for healing others.
It’s an art, and it’s everywhere
Because here’s the truth of it – mental health is more art than science. Even psychiatry these days has been compared by some to “pouring cow piss on a brain”. Our understanding of the mind is so limited that we’re standing on the mountain of 100 years of pure psychological trial and error; even the most established methodologies like EMDR, have little concrete explanation as to how they actually work.
Here’s what we do know: far more than any specific therapeutic technic, it’s the emotional connection between therapist and client that is the most significant influence on the positive outcome of therapy.
So how come so many therapists are total asses? So many lack self awareness of their own shortcomings, brining them to every session with their clients?
How come the only way to find a good therapist is to just try multiple ones, at great personal expense and expenditure of emotional energy, neither of which we probably have, until we happen upon the right one?
And in reality, the world of emotional health is far more nuanced, a continuous gradient. How often has a good talk with a friend yielded more insight than weeks of therapy? How clearly is it necessary for us to have a closeness with our therapist that we don’t need to have with our family doctor?
We are all continuously helping each other get through life, having a bigger emotional impact on each other than we probably realize.
A better way
Here’s my thesis, it comes in two parts:
- We need to screen mental health professionals for their character first, and everything else second. What kind of humans are they? How compassionate and open minded are they? Can they sustain eye contact with you? Are they comfortable around vulnerability and difficult emotions (their own, first and foremost)?
- We can vastly simplify what people actually need to know to really help others. Training can be short, concise, and powerful. We should prioritize what is crucial to know and what has been proving to work. 20% of the knowledge can lead to 80% of the impact. Trainings should be practical, hands on, experiential. Because that’s what teaches us most quickly and empowers us most immediately.
With this combination of better people and better training, we can be introducing more emotionally supportive people into the world at a much faster rate.
Will this be perfect? No. Will more mistakes be made? Yes. But I believe it’s still worth it.
Do no harm?
We need more people with less training trying their best in the mental health space.
We should not let concerns about harm hold us back, as long as we’ve done our best to implement the two principles suggested above. Firstly because I believe this will actually make them more effective than most therapists, and secondly, because of the following arguments:
- People are more resilient than we think. It’s not as easy as we think to further damage a person due to a lack of training. Our mind has sophisticated systems to protect itself, which it regularly uses, such as resistance, suppression, and disassociation.
- Are we every fully responsible for other people’s mental health? Just as we cannot take credit for client’s successes, we cannot take the blame for their apparent failures. If you believe in free will, it is ultimately their responsibility to choose who they work with, and to internalize what works best for them. If you don’t, we are all equally at the whim of influences that came before us.
- Would more training really make a difference? Being that therapy is all art, it can be hard to know if a different approach would have led to a different result. Human behavior is chaos. If anything, it’s more experience that might make a difference, but two years of academia does not yield more experience.
- It’s a numbers game, and the results will undoubtedly skew to the positive. I belie it’s worth helping nine people even if the 10th ends up worse. It’s a sad reality, but even patients die on the operating table, and therapy is not nearly as precise as surgery, we are bound to make mistakes. We cannot afford to stand by and watch people suffer just because some of them might be harmed along the way – the good Samaritan principle protects people who try to administer first aid even if they make things worse, we all are all first responders to each others crises.
The Jewish community in Israel and other parts of the world has implemented a great system of first responders who provide first aid way before an ambulance arrives. There is an understanding that any response is better than no response, that sheer numbers are necessary to provide timely response, and a focus on the most impactful, practical training.
We should adopt this same approach to mental health – maybe a person selected for their character and trained to be practically effective won’t have the years of knowledge of a psychiatrist, but they can do a damn good job with what they’ve been handed, and you’ll probably get to seem about 9 months sooner. That’s a lot of suffering we can reduce.
A vision for the future: transferable skills
This is the approach I’d like to see when bringing Hishtalmoot to the world:
- To select peopel based on character and train them with a fairy simple metholdogy that can have a profound impact on people’s lives.
- To create a community of laypeople who can still share the resourcse Hishtalmoot offers with anyone in their cirlce: I want to see many more people teaching others progressive relaxation and guided meditation, helping people achieve their inner resource states, encouraging others to lean into discomfort while reminidng them that we are all just six year olds roaming this planet.
How often, in regular therapy, do you walk away with set of principles and resources that you can readily share with others? To me, Hishtalmoot therapy sessions are weekly practices of a set of principles that can vastly improve your lives and those of others, principles that can be packaged and shared with far greater ease than much of amorphous training and abstract ideas so common in conventional academic therapy training.
Let us not settle for old ways of doing things, just because that’s how things were always done. Let’s look for the shortcuts, the gems hidden in the chaff, the way to be most effective with the least amount of effort. Because the world needs it more than ever.