Reflections on a PsiAN Externship
I have just completed my three-week externship at PsiAN. I really enjoyed working with my peers (fellow undergrads at Carleton College) and externship hosts to learn more about psychodynamic therapy! In this essay, I will talk about my feelings and observations during the externship, as well as how I have grown throughout this journey.
At the beginning of my time with PsiAN, I was surprised to learn about the arguments in opposition to “evidence-based” therapies. “Evidence-based” sounded wonderful to me, and I had not paused to think about how the term itself might be misused. It is a shame that such a compelling description cannot always be trusted.
Before my externship, I had a general awareness that I should research the specific studies cited whenever articles throw around “scientific studies have proven ...” to fact-check them before believing whatever they have to say. However, I had not come across a modern example of how blind faith in such articles can actually lead people astray. I really appreciated my externship experience for reinforcing that I should fact-check and form my own opinions around issues rather than assume others know more than me.
In the third week of the externship, I researched the website of an organization advocating for CBT. I was taken aback by the organization’s listed values: science, quality, diversity, mentorship, and accountability. I don’t think these values would have stood out to me as strange at all before partaking in my externship with PsiAN. However, I was quite surprised by the manner in which the CBT organization’s values seemed to desire objectivity, almost touching on the non-human, and nowhere mentioned empathy or compassion. In contrast, PsiAN’s website lists values such as freedom of thought, self-determination, and rehumanization. I believe the CBT organization’s listed values are important too, but the absence of any human emotional experience left me wondering, as it intends to be an organization dedicated to mental health. I think this was the most prominent example during my externship in which I noticed firsthand a stark difference between the discourse surrounding CBT vs. psychodynamic therapy.
Of course, I’m left with some concerns about psychoanalytic therapy as well. My strongest is that it seems it would be nearly impossible for one analyst to teach it to another because of how much changes based on individual differences. Attending to individual differences is of course one of psychoanalytic therapy’s greatest strengths; however, I think it could also lead to one of its greatest weaknesses because there emerges no standard way to ensure its efficacy or ethical implementation. Also, while I acknowledge that Freud contributed profoundly to the world of psychotherapy, some of his theories stand out as quite concerningly sexist, heteronormative, and violent (eg. the Oedipus/Electra complex or penis envy). I believe that, if there is to be more freedom rather than scripted constraints on the nature of therapy, therapists and psychological organizations should be clearer about which theories or belief systems they will abide by and implement during sessions. For instance, it is extremely important to know explicitly if a therapist who is a believer of a certain religion intends to bring that religion even subtly into therapy sessions, because not being clear could potentially cause significant rifts with certain clients, particularly those with different ideologies. With increased diversity in clientele, I believe clarity and specificity are key to building a trusting and healthy therapeutic relationship.
My concerns being noted, most key points we discussed I really resonated and agreed with in favor of psychodynamic/psychoanalytic therapy. As I briefly expressed above, the focus on individuals and the dynamics of human relationships I think are vital to therapy. Being so concerned with statistics as to forget that each individual has their own story would completely dehumanize the therapeutic process. I believe a process that is entirely symptom-oriented and calculative rather than taking into account the fluid dynamic of the human mind should be used to treat robots, not people.
Finally, I learned a fascinating concept during my externship, that there are certain aspects of life that simply cannot be quantified by modern science. One topic which led me to this conclusion was the ethics of diagnosis. I very much agree that using diagnosis-related words descriptively might change the discourse on mental health in quite a positive way. I had not actually considered this as a possibility before, because the general sentiment I have heard in the past has been more along the lines of: “Don’t call your feelings depression unless you’re really depressed, because you’re doing a disservice to everyone who struggles more than you.” I found this sentiment in the past to be oppressive both to people who are genuinely quite sad (albeit perhaps not “really depressed”) and people who are depressed according to the DSM. I felt that it reinforced a culture of needing emotional validation through external sources and comparing pain like a contest. However, I didn’t quite have the words to describe that discomfort. Thinking now that people might still normalize and respect language pertaining to mental health, but do so in a more fluid and descriptive manner than one of strict categories, makes me feel more hopeful about the future of mental healthcare. I also appreciated the point that the most variability in the efficacy of therapy is usually found between therapists, rather than between types of therapy.
Overall, I concluded the externship feeling fulfilled with everything I was able to say and do. I also feel grateful to my externship hosts for providing this externship for me. I am so happy I participated in this experience. I still do not know if I would like to pursue therapy as a career in the future, but it is definitely one of my top options right now. Partaking in this externship helped me resolve many of the questions and concerns I had about the profession, too. Thank you so much!! I hope you have a happy and safe 2021!
Written By:
Rehana Naik Olson, is an undergraduate student at Carleton College majoring in psychology.
Photo courtesy of @leliejens, via Unsplash