Last week, Brian became licensed as a mental health counselor in the state of Florida. It took several years for him to reach this point, including the completion of a master’s degree and several hundred hours of supervised experience as an intern. And even though he’s now licensed, it doesn’t mean his work is done. To maintain his license, he has to earn continuing education credits every year. It’s a lot of work to become a therapist, and understandably so, as therapists are working with people in their most vulnerable places. The potential to help is enormous, but so is the potential to cause harm.
Why am I telling you this? As much as I just want to brag all over my husband for being awesome – and goodness knows I do plenty of that already – I’m sharing this because lately I’ve been seeing some things that I find incredibly troubling. I’m part of a lot of online communities that are focused around women and fitness, and a couple of times in the past week, I’ve seen women show up and ask questions that indicate they are struggling with serious mental problems, like apparent eating disorders and professed self-hatred.
As saddening as I find those women’s stories, what bothered me more was some of the responses those women would receive from some members of the group, who encouraged them try different diets or to hire a coach to help them get through their issues. To be fair, plenty of other group members were like, “maybe you should consider professional help,” but enough of them suggested a coach or a new diet that I really felt moved to write about this.
This is the thing – I’m not anti-coach. Not even close. I have friends who are coaches and who do bang-up jobs at their work. if you are looking for someone to help motivate you or keep you accountable or help you develop a training/nutrition plan so you can reach specific performance goals, an experienced, credentialed coach can be an invaluable asset. Even a less formal arrangement, like a mentor/mentee relationship, can be a wonderful thing.
But shit starts getting sticky when you move into the realm of mental health. My friend Josey recently wrote a post on her blog at The Span of My Hips in which she took a critical look at health and wellness coaches who cross over into mental health care:
Anyone can be a coach. There is no legal restriction on who can be a coach. There is no regulatory body that ensures all coaches are certified. And then there’s that question…certified in what? There are lots of health coaching certifications. They seem to span from a weekend to months. But, to paraphrase some graphic novel I haven’t read, who certifies the certifiers (sorry)? What does it actually mean to be a certified health coach? Who are you capable of responsibly and ethically working with?
Here’s another post, this one from Psychology Today, that talks about the potential issues that can arise when life coaches – which is something else I’ve been seeing more and more of, particularly outside of the realm of health and wellness – try to provide mental health care.
(And to use a recent example from my own life: I’ve just completed about 30 hours of classroom and online training to become a guardian ad litem. Doesn’t mean I’m ready to be a social worker. Not even a little bit. Not even close.)
It’s one thing to provide some guidance and structure to help a person achieve their goals in life, but it is entirely another thing to go wading into the thicket of a person’s psyche in an attempt to help them make sense of things like addiction, eating disorders, post-traumatic stress disorder and anxiety. There is a reason why the professionals charged with helping people with these problems are governed by licensing bodies and codes of ethics and professional requirements, and that’s because the potential to cause serious, lasting harm is so great.
So it seems to me that there are two factors at play here. The first, I imagine, is based in economics and class. There’s a reason why mental health coverage was one of the big selling points of the Affordable Care Act, because health insurance providers haven’t covered it particularly well in the past. (And despite the passage of the ACA, mental health care coverage is still woefully inadequate.)
And of course, that’s the situation for people who actually have health insurance. Those without health insurance most likely have to pay out of pocket or seek counseling from community based care programs, which are staffed by people who bear staggering workloads. Brian has worked in similar programs, and it’s easy to see how people burn out and, if possible, leave for private practice. The people who work in these kinds of programs are asked to bear the brunt of our broken society, and with extremely limited resources through which to do so. It’s a goddamned travesty.
BUT, as important as discussions of class and economics are when talking about mental health in the U.S., I also have to say that I’m not really sure that’s the biggest factor at play when it comes to what I’ve seen. Rather, it seems to me that what’s actually happening is that, even in the year 2015, the stigma associated with mental health care persists. Thus you end up with people who will pay a coach to tell them exactly what to do in hopes that they will achieve a temporary sense of relief from their internal turmoil, but will never ever ever consider seeking therapy. Because seeking therapy means you are broken and you are weak and you are a failure, but seeking a coach just means you are trying to achieve a goal, and who can find fault with that?
And in the world of fitness and athletics, there’s also this idea that if you can eat a certain way, get enough exercise of the right kind, make your body look a certain way, bring a certain number up on the scale (or increasingly, in your weight stack), then all the pieces will fall into place. All anxiety and depression will fall away, you’ll stop hating yourself, your relationships will be flawless and angels will sing your hosannahs every time you walk outside.
But as Moira wrote at Fit is a Feminist Issue, running – or exercise – is not the same as therapy:
But exercise – even in the great outdoors – is not equivalent to therapy in the psychotherapeutic sense. We generally cannot gain deep self-understanding from distance running in the way that we can from therapy. Therapy helps us get at the roots of our suffering, whereas running helps us cope with its branches. For deeper traumas, we must devote time and effort to therapy just as we must train for a marathon. It will be painful, but the gains in psychological well-being from therapy can be genuinely life-altering.
I’m perhaps biased here, not just because of Brian’s profession, but also because I personally have gained so much from therapy in my own life. Running and lifting weights and eating as healthfully as I can have done a lot to help me keep a lid on the anxiety I used to feel all the time, but what really helped me get to the core of those things? THERAPY.
Have I had shitty therapists? You bet. I’ve had my share of therapists that I’ve met for one session, never to return. But I’ve also had a couple of outstanding ones, and I also have the incredible good privilege to live with one. They were the ones who got me started on the path that led me to where I am today.
Because the truth is that sometimes we do find ourselves facing problems that are just too damn big to tackle on our own, and there’s no shame in that at all. Life can be a challenging fucking thing, and sometimes it knocks us right on our asses. Why wouldn’t we take advantage of every tool at our disposal to get back up on our feet?
So yes, by all means, hire a wellness coach or a life coach if you think you would benefit from it, but if you need help from a licensed professional, then please don’t be ashamed to seek that out as well.