In most professions in life, average implies not too bad. One isn’t getting the best, but hopefully one isn’t getting badly treated. The average car mechanic will be perfectly good at doing an oil change or general repairs. The average family doctor will be able to handle most common ailments, like high blood pressure, sore throats or colds. This is because in many fields there are manuals and protocols to follow that ensure reasonable results. The same is not true in the mental health field. There are no good manuals, the research is confusing and often misleading, and there are often outside influences that lead to practitioners having more allegiance to systems than to patients. So the average mental health practitioner is often inadequate, frequently promoting their own brand of help, rather than focusing on the patient’s needs. It is a further problem that most orientations in mental health have a way of blaming the patient when things don’t go well. Psychoanalysts often point to the patient’s “resistance” or “defences”. One often hears that the patient has to go deeper into their problems, taking significantly more time, again with the implication that if a person is not feeling better it must be something locked deeper in their mind that is the problem. While this might be true at times, it also allows the practitioner to excuse a lack of progress. Cognitive Behaviour Therapists have many blaming mechanisms, with the underlying pejorative message that a person should be able to change their feelings by learning to banish negative thoughts. If people can’t then they clearly aren’t working hard enough or doing their homework. I have been told by numerous people that they’ve been told by CBT therapists that they have to believe in the therapy for it to work, so that if they aren’t believers then they won’t work hard enough at controlling negative thoughts, and therefore won’t get better. Biological psychiatrists just blame brain chemistry. Id a person doesn’t respond to one drug, they are treatment resistant, and if they don’t respond to many, they are a complicated case. If their symptoms diminish but they don’t feel good or can’t function then they are whiners.
Helping people in emotional distress is complicated. a practitioner needs to have a strong understanding of emotional development, trauma, and family and cultural issues. One has to understand the complexity of modern society. One has to always have empathy for the other, yet also be able to see the individual from an outside perspective to be able to understand the impact of the person’s emotional life on the outside world. To help people, being average just doesn’t cut it. All practitioners need to look outside their own milieu and orientation to learn as much as we can from available resources. We constantly need to challenge ourselves, and to take responsibility when a patient is not improving.