Nerves

I just returned from a long weekend of meetings. It was an historic meeting that several of us planned for the last 10 months. We brought theologians, mental health practitioners, and educators together to discuss how our religious tradition and mental health practices can be supported, integrated, and encouraged. There were about 25 of us who went out to Rancho Palos Verdes to a convent that is adjacent to some of the most expensive homes in the country (I was later to learn).
I have to say, our accommodations were rather austere. When I swept into my suite, a gasp escaped my mouth. It was a veritable cell with a single bed, a dilapidated lamp, a desk and chair, with an attached bathroom that was almost as big as the bedroom. Oh, and a built in clothes storage system at the foot of the bed and a chair. I'm not sure why one would need two chairs in there. For a visitor? My friend who was in an adjoining cell (and whom I could hear breathing during the night!) frequently knocked on my door and plunked down in the chair at the foot of my bed. But had I not been in bed with my legs pulled up and her legs on the foot of the bed, we could not have fit in there at the same time.

Anyhow, we had a most stimulating conference. It was called, "Symposium on Christian Worldview and Mental Health: Seventh-day Adventist Perspectives." We had all sorts of presentations. George Harding, great-nephew of President Harding, and son of the founder of the Harding Hospital in Ohio, gave the first presentation about the history of Adventist psychiatrists in this country. Fascinating. The majority of this man's male and female forebearers were physicians, mostly psychiatrists.
We heard from a theologian from Andrews Theological Seminary, who presented, "Christian Epistemological Foundations for Behavioral Sciences." This was followed by a Fuller Seminary PhD (marriage and family therapist) who reported on her dissertation entitled, "The Sabbath as a Resource for Marriage." Very interesting empirical findings that indicate when a couple has a high level of intrinsic religiosity--that is, religion that comes from a desire to serve God rather than to merely do what is required--along with the desire to spend time together, these couples reported a much higher level of marital satisfaction after observing Sabbath for 24 hours each week.
A clinical psychologist gave a paper entitled "Clinical Implications for the Practice of Psychotherapy from the Seventh-day Adventist Tradition: A Summary." Now, I don't know why, but I could barely follow this speaker. Some people love to use big words and take a sweeping approach to covering topics. He covered every major Christian doctrine plus some.
An Australian psychiatrist presented a paper entitled, "A Personal Integration of God in Psychiatric Treatment--Alcoholics Anonymous as a Paradigm." This was a wonderful paper in which the quite charming speaker pointed out the parallels between AA and the verse, "As ye have received Christ, so walk ye in Him."

Harvard researcher David Williams, who holds an MDiv, MPH and PhD, and who is the 6th most quoted scientist in the country, gave a paper entitled, "Scientific Research on the Study of Religious/Spirituality and Mental Health: Lessons, Positive Affirmations and Disquieting Questions." The stats just roll off this man's tongue. I've never met such a bright and also engaging man in my life. He has been part of many of the epidemiological studies on health and religion, health access, and lifestyle issues in the United States.
Then we were hit by a philosopher who gave an interesting talk that was way over my head: "The Science of Psychology and the Ethics of Freedom: An Adventist's Perspective." I hope we have a good perspective on it because I just couldn't take it in. But everyone else loved it. It was about how we are responsible even though we are free, and he quoted people like Polkinghorne and Stuart Kaufmann. As I listened initially, I was envious of his brain. But I think I'll stick with what I've got because I can understand mine at least.

A theologian gave a most fascinating talk called "Mental Health and Human Wholeness: Implications from Biblical Anthropology." We then heard an excellent paper by a psychologist that pointed out the psychopathology that occurs when Christians get all caught up in legalistic practices. His paper was entitled, "For as He Thinketh in his Heart, So is He: Maladaptive Beliefs and Compensatory Strategies in Psychotherapy." Some of this was about how conservative beliefs (read prudery here) about sex can set people up for the need of therapy. Another concept, which I and others call "Worm Theology" (Oh, what a worm am I in God's sight!) can reduce a healthy self esteem to nothing which we all knew but were interested in hearing his take on it.

It was so wonderful to be with top-notch mental health practitioners who were also devout Christians--people who are serious about forwarding the healing work of Jesus Christ through mental, emotional, spiritual, and relational healing.
Oh, and I gave a paper. That's why I entitled this post "Nerves." It was extremely well received but I was a weeping, tottering wreck only moments before I stood up to speak. Here's why:

There is an unfortunate pecking order in mental health disciplines: psychiatry is top dog, then clinical psychology, counseling psychology, social work, LPCs (licensed professional counselors--in states other than California) marriage and family therapists, and drug/alcohol counselors. Being down toward the bottom of the list doesn't feel good, especially when the others elbow you, cast aspersions, make disparaging comments about your life work, trivialize your skills, etc. I tend to take it personally. Now, this never happened at the conference this weekend because it was a collaborative group. But it has happened to me a number of times in horrid ways.

The first day that I worked for a group therapist practice, a senior social worker called me into her office and said (I still remember it exactly), "I just want to tell you that you are at the very bottom of the totem pole in this group. You will only be allowed to take whatever clients no one else wants to work with, and you will not take any capitated [insurance-paid] clients. Are you clear about that?"
I wasn't clear at all.
"Why is that?"
She glared at me. "Because you people don't believe in medications and these patients are really sick." She said "you people" with the same pathos as though she was cursing.
"Who doesn't believe in medications?" I was incredulous.
"MFTs. You."
"How do you know that I don't believe in medications? Do you even know me?" I was angered but respectful.
"I know how you've been trained and what Minuchin taught and if you believe that then you're a danger to clients."
"That's quite an assumption you're making." I was really mad now. "Did you know that I am also an ICU nurse?"
She just stared at me.
"Do you know any ICU nurses who don't believe in medications?"
She said nothing.
"What makes you so sure I'm a danger to clients? You know nothing about me or my training, and you obviously haven't kept up with Salvador Minuchin's work or else you would have a different opinion."
She wasn't going to back down. "You are going to be questioned repeatedly about this" she said with a very icy voice. "Do you feel that you can stand up to that?"
Very evenly I replied, "Do I seem to be having trouble right now with you?"
I know I didn't storm out or anything like that, but I can't remember what else happened. I just know that I left her office soon thereafter, determined to show her that she was wrong. I did. I had clients coming out my ears and a waiting list in two months.
That was a really rude wake up call. My graduate program director had painted a picture of the world on bended knee, waiting for us to just finish up our degrees so they could benefit from our superior work. She had failed to warn us of the elitism that can exist in the mental health field.

There have been other people, too. My own dear therapist, who is a psychologist, never did like MFTs. It's all about turf. He liked me and admired my work. But he had nothing good at all to say about my discipline. He even made a disparaging comment once about it in therapy and I very swiftly responded to that.
I also taught group therapy to a class composed of clinical psychology doctoral students and counseling psych students. Because I was an MFT, ABD (all but dissertation), and a new professor, those students had at me the entire quarter. It was truly awful: horrible course evaluations, students beligerrant in class, challenging anything I said. Just awful. I felt incompetent, bewildered, angry. So any time I'm around people of these other disciplines and they seem to be less than inclusive, I go to a really bad place in my head. "I'm bad--I can't do anything right--Why can't I be as smart as X, Y, or Z?" I get panicky and feel yucky.

In many ways, I suppose MFTs are analagous to the wild olive shoot that was grafted into the main tree (psychology) just like the book of Hebrews in the Bible. We need to hold our roots in esteem. The roots just have trouble with us and it is painful to be hacked at from time to time.

The redeeming grace is that the folks I was with this weekend--theologians, philosophers, psychiatrists, psychologists, church leaders, therapists, medical directors--all were respectful and delighted with the work and papers each of us presented. And I lived through my presentation by telling stories of training students and putting a human face on the theoretical paradigms and theoretical web spinning that they did--as good as it was.

So I have returned home with a head full of ideas, third editor for a book composed of these papers after revisions, and delighted to belong to a group of people who are serious about mental health services being as closely supported by our church leadership as we try to make vital connections with clergy, clients, parishioners.

I'm tired and glad to be home.