WHEN YOU
DON'T KNOW
WHERE
TO TURN
_A Self-Diagnosing Guide
to Counseling and Therapy_
Steven J. Bartlett, Ph.D.
Contemporary
Books, Inc.
Chicago -- New York
* * * * *
ALSO BY STEVEN JAMES BARTLETT
_Normality Does Not Equal Mental Health: The Need to Look Elsewhere for
Standards of Good Psychological Health_
_The Pathology of Man: A Study of Human Evil_
_Reflexivity: A Source Book in Self-Reference_
_Self-Reference: Reflections on Reflexivity_ (co-edited with Peter
Suber)
_Conceptual Therapy: An Introduction to Framework-Relative Epistemology_
_Metalogic of Reference: A Study in the Foundations of Possibility_
_VALIDITY: A Learning Game Approach to Mathematical Logic_
As editor of these books
by Paul Alexander Bartlett:
_Voices from the Past -- A Quintet of Novels_:
_Sappho's Journal_
_Christ's Journal_
_Leonardo da Vinci's Journal_
_Shakespeare's Journal_
_Lincoln's Journal_
Library of Congress Cataloging-in-Publication Data
Bartlett, Steven J.
When you don't know where to turn.
Bibliography: p.
1. Psychotherapy. 2. Counseling. 3. Consumer
education. I. Title.
RC460.B28 1987 616.89'14 87-20045
ISBN 0-8092-4829-8
Copyright © 1987 by Steven J. Bartlett, Ph.D.
All rights reserved
Published by Contemporary Books, Inc.
180 North Michigan Avenue, Chicago, Illinois 60601
Manufactured in the United States of America
Library of Congress Catalog Card Number: 87-20045
International Standard Book Number: 0-8092-4829-8
Published simultaneously in Canada by Beaverbooks, Ltd.
195 Allstate Parkway, Valleywood Business Park
Markham, Ontario L3R 4T8 Canada
Project Gutenberg 2014 edition
Note that this is a _copyrighted_ Project Gutenberg eBook; it is _not_
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_When You Don't Know Where to Turn_ was originally published in 1987 by
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This book is dedicated to Karen,
my love, wife, and friend.
Preface to the Project Gutenberg Edition
Nearly three decades have passed since _When You Don't Know Where to
Turn_ was first published. In that time, psychiatry, clinical
psychology, and counseling have changed a good deal.
Psychiatry has continued on a now well-worn path leading to a more and
more inflated universe of diagnostic labels, the majority of which have
no known organic basis. Few readers who are not themselves mental
health professionals realize that these diagnostic classifications are
_voted into existence_ by committees of psychiatrists whose
pronouncements magically summon into being a lengthening list of
so-called "mental disorders." These pronouncements are then applied to
people in order to label their problems (as well as the people who have
them), to match their problems with allegedly effective treatments, and
in the process to give the impression that a respectable medical
process of diagnosis and intervention has been undertaken.
And yet these so-called "mental disorders" do little more than equate
designated patterns of behavior, emotion, or thought--called
syndromes--with alleged psychological malfunctioning. Such syndromes
are no more than sets of symptoms that can be collected together in a
wide variety of different ways, but depending upon how they are
grouped, distinguishable syndromes can be pointed to and named. This is
a highly arbitrary process very much like fortune-telling using tea
leaves, which depends on the pattern seen or imagined in the tea leaves
at the bottom of a cup.
During the past three decades, clinical psychology and its less formal
cousin, counseling, have also undergone noticeable change. They have
been the traditional sources of a large number of diverse approaches to
psychotherapy and counseling. But in the past thirty years, the large
number of approaches to psychotherapy and counseling has, in practical
reality, shrunk considerably. This has been due to the rapid dominance
and virtual monopoly that has been gained by cognitive-behavioral
therapy, also known as rational-emotive therapy. Insurance companies
have been attracted like flies to the sweetness of the comparatively
brief treatment period touted by cognitive-behavioral therapy, and
practitioners have similarly been attracted by the ease of using its
one-size-fits-all approach.
And so where the changes in psychiatry have been inflationary in its
authorized catalogue of "mental disorders" known as the _DSM_
(_Diagnostic and Statistical Manual of Mental Disorders_), clinical
psychology and counseling have been on a deflationary course that has
progressively narrowed the treatment options available to many people.
Despite the passage of time, _When You Don't Know Where to Turn_
remains the only step-by-step self-diagnosing guide to counseling and
therapy, a guide that seeks to direct individuals--by respecting and
responding to the very great differences that exist among
individuals--to approaches to counseling and therapy that may be most
likely to benefit them--taking into account the nature of their own
individual problems, their different degrees of willingness and
abilities to learn and to change, and their differing individual
situations in life, including their financial resources and the amount
of time that they are willing to devote to therapy.
Such a customized, individually-centered perspective is not popular
today. The human population continues inexorably to expand while our
healthcare system insists on general applicability and streamlined
efficiency. Individual problems in living are more easily and rapidly
"processed" when they can be subsumed under specifiable diagnostic and
treatment codes. In this increasingly mechanized process, the
individual person and the individual problems of living he or she is
attempting to cope with tend more and more to be ignored or neglected,
and his or her diagnosable "disease entity" becomes the object of
attention.
These comments are not a polemic against current trends and fashions;
they are rather intended to place in perspective the changes that have
occurred in the mental health field during the past three decades since
the first edition of this book came off the press. What a reader might
take away from these preliminary remarks are these suggestions:
* to recognize that, like so much that is a human production, today's
classification system of mental disorders is unlikely to be the final
word about the human condition, but that its proliferating list of
mental disorders should be taken by the humble at least with a grain of
salt, and rejected wholesale by those who are more critically inclined;
* to accept the fact that it is becoming harder with the passage of
time to find one's way to a mental health clinician who is _not_
recipe-oriented, due to the in-fashion monopoly that prescribes
cognitive-behavioral therapy, and due to the pressures on the
healthcare system to process people and their problems faster and at
lower cost; and, finally,
* to realize that, when it comes to problems of living, those who are
willing to accept a healthy measure of responsibility for their own
choice of practitioner and treatment are most likely to find a
practitioner and a treatment that meet their individual needs.
From this point of view, _When You Don't Know Where to Turn_ continues
to offer readers a heightened consciousness of alternatives to
treatment that do still continue to available, though they can be
somewhat harder to find in some areas of the country, and to give
readers a sense of what those alternatives have to offer and for which
kinds of problems and personalities they may best be suited.
Readers interested in learning more about the author, his research, and
publications by him, many of which can now be downloaded at no cost,
may like to visit the author's website:
http://www.willamette.edu/~sbartlet
Steven James Bartlett
Salem, Oregon
2014
* * * * *
This book offers counseling observations based on the author's
experience only and makes no specific recommendations for any
individual or group.
It is intended and has been written to offer the author's understanding
and opinions in regard to the subject matter. The author and publisher
are not here engaged in providing personal psychological or psychiatric
or other professional advice. For such advice, the reader should seek
the services of a qualified professional.
The author and the publisher cannot be held responsible for any loss
incurred as a result of the application of any of the information
contained in this book.
CONTENTS
Before We Begin ... xi
Acknowledgments xv
The Purpose of This Book 1
PART I: GETTING STARTED 7
1 Prisons We Make for Ourselves 9
2 Paths to Help 17
3 Bridges from Here to There 29
4 The Therapeutic Jungle, Part I:
Social Workers, Psychologists, and Psychiatrists 39
5 The Therapeutic Jungle, Part II:
Outside the Mainstream 48
6 Where You Can Find Help 54
7 Self-Diagnosis: Mapping Your Way to a Therapy 59
8 Emotional Problems That May Have Physical Causes 99