Tuesday, November 18, 2008


I have had people ask me lately what is the hardest part of this whole social work school/single parenting gig. Thinking about it on my drive back and forth to the nursing home I visit in Everett today, I want to say that what feels the hardest right now is doubt. It is the sense of not knowing and being so unsure. Of course, that is developmentally appropriate for me as a neophyte psychotherapist. I should feel unsure and uncertain. I don't know yet how to respond appropriately to any number of different types of concerns I will be facing. I have an awful lot to learn.

So that's one type of doubt--the doubt engendered by a lack of confidence. And while that doubt is very uncomfortable, I hope I can trust to time to cure it. Knowing me, there likely will be some point in time when I will have entirely forgotten that I felt this type of doubt at all. I will at some point feel confident I know how to handle most issues and feel I can compensate for what I don't know--access the resources I need to help me.

Okay. I can imagine that future. I don't know how long it will take to get there, but I can imagine it. Then there's another type of doubt--the doubt of not knowing about what to think and believe--theoretically and historically.

This is such a conundrum for all of us post-modernists--and by this I mean all of us raised in a post-modern era. All of those duly influenced, like it or not, by post-modernism. We know how caught we are in conditioning, in the social influences of our time--but we have no idea how to escape that sticky web. Most of us feel comfortable with the fact that we are products of our culture. We just are, okay? That's fine, until you encounter the kind of conundrum I am facing now.

Our culture is one in which medication plays an increasingly intimate role with psychotherapy. I underestimated the role that it plays in social work, but it is a very intimate one. Social workers are considered incompetent and even unethical unless they encourage clients to go on medication. If they fail that mandated role, they are letting their clients down.

Given that we are now increasingly suspicious of the role of commerce in the medical world--it is hard to know for me what is truly therapeutic for clients or if, in the words of one of my roommates, all we therapists are merely whores for the pharmaceutical industry. This really is not as rhetorical as it sounds. He has a lot of data to back up this stance; and though it isn't the way he would phrase it in public, it is basically what he means. So I agonize about our sociological conditioning and what I can do about it. I guess that's all I can say at present--I have to run off and get the babe. This post probably makes no sense at all. Ah well. Doubt really has a life of its own, and its own rhyme. And its own reason.

All those clients, frozen in decaying and malfunctioning bodies and terribly psychotic minds. All that suffering. It is tempting to think that a pill is indeed doing the trick; but the science would tend to tell us otherwise.


Gertrude's granddaughter said...


i am sure you are well read on this topic, but you may find it new today.

Mama said...

Thanks so much. I had not read that. It is such a complicated question for me--basically confronting the long-term data for the majority of people. In other words, I guess I am pondering the non-anecdotal evidence and the big, sociological conundrum of medication which I feel I can't effectively ponder, since I am a part of it all myself.

Blicky Kitty said...

Oh so sad what some people go through in life...

I agree on the whole medication thing. I think I want to do something about it...just was soon as I get of of the uppers, downer, zanex, zantex. ritalin, and viagra. Viagra's fun if you smoke it. I just plan to use a little recreational epidural and write to my congressman about the drug companies.