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The decision to integrate

Updated: Nov 3, 2019

Or, why I chose to launch Clarity Decision Mentoring

Image of me with a backpack setting out for the weekend
It's always about the journey

The inception of Clarity Decision Mentoring is the product of a long incubation process in which many decisions have been made. I’d like to share a little about this complex process, particularly how dialogue and a focus on values helped me navigate an unexpected challenge that required revising my original vision of what I was committing to.

The challenge arose in the context of the dialectic between mental illness and wellness. My journey into the field of psychology began with a personal immersion into meditative practices and the application of Buddhist philosophy and psychological to address my issues with anger and frustration. I had no real awareness of mental illness, and I was not seeking to alleviate suffering of others, I just realized I was getting in my own way and that there were ways of thinking and being that could smooth the path. I had no idea just how extensively I was the agent of trouble in my own mind and heart and thus I felt a huge impact as I experienced the benefits that came with devoting time and energy towards my own wellness.

Eventually I began teaching these techniques to others in informal community settings and then I entered graduate school with the explicit goal of using an academic credential to gain entry into institutions such as prisons to offer these tools to folks who would otherwise be unlikely to find them. Unbeknownst to me, the field of Counseling Psychology was a great match because its roots are grounded in notions of wellness and social justice and the field mostly steers away from pathologizing human experience.

While the roots of counseling psychology eschew pathology, the contemporary reality of the field is that the vast majority of trainees get their clinical experience in the domain of mental illness treatment – community mental health clinics, hospitals, and college counseling centers (which used to be all about the developmental transition from adolescence to young adulthood but now is primarily about treating mental illness). My advanced training was in the University of Wisconsin’s Department of Psychiatry and it led to my internship at the University of Washington’s Psychiatry department, both located in medical schools. The predominate concern in these settings is the treatment of mental illness. My internship led to a postdoctoral fellowship focusing on geriatric mental health as well as research training in mental health services – a subject that falls under the rubric of public health. In this context I learned several influential realities, including: a) the majority of people in the U.S. seek their mental health treatment through their primary care doctor in the form of prescription drugs; and b) a tiny minority of adults will ever see a psychologist for mental health care. The takeaway message was that if you want to help the most people with mental illness you need to do it in a medical setting and it needs to be focused on a medical model of mental illness, not a wellness model of human potential (insurance pays only for the former).

I made the decision early in my career to separate my personal wellness practice from my professional mental health practice. I would steer patients towards meditation and other mindfulness-oriented practices if they were inclined, but I didn’t offer them myself. I did continue to offer these services in the community through my Buddhist center, but it was very distinct from my professional identity. Then six years ago I took a job in Boston that replaced the clinical component of my job with teaching and I stopped providing services altogether. During this time, I thought about private practice and my thoughts focused on the separation of illness and wellness – I was sure that I wanted to focus on wellness if I were to do it again.

All of this background is setting the stage to present my conundrum. The conscientious adult in me thought it prudent to check with the state of Vermont prior to launching Clarity to be sure there weren’t licensing issues for someone providing wellness services (called life-coaching in the field of psychology) verses providing mental health treatment. And herein lay the can of worms –although I was clear to them that I was a licensed psychologist in Massachusetts but that this practice was not aimed at treating mental illness, they apparently Googled me and found that anyone who did so would likely get the impression that I am a psychologist who treats mental illness and thus in order to prevent confusion on the part of consumers, they advised that I would need to be licensed as a psychologist in Vermont to have my wellness practice.

What arose for me was a personal dilemma, if I became licensed in Vermont then I felt I would have an obligation to address mental illness (because I can), and that this was not what I wanted to focus on.

Here is where we get to the role of dialogue and values. To help me figure out what to do, I turned to two confidants who know me reasonably well, are not psychologists or mental health workers themselves, and thus are mostly naïve to the whole context I described above. The first thing that became apparent in describing the situation to them was that this dilemma was really a product of my own thinking. They were free of the historical baggage that I carried with me and did not see why I needed to make a hard split between wellness services and mental health services. A part of me attributed this to their lack of knowledge of my field, a move that discounted their input. However, in explaining my thinking to them, I could not even convince myself that regardless of whether I adhered to the dichotomy, or I applied a more integrative approach, the idea of ruling out the formal treatment of mental illness wasn’t making sense (to me or to them). I had created an either-or situation where it wasn’t necessary. I also had ignored a number of advantages of working in both domains that my previous bias had refused to consider.

Part of the reason my self-talk wasn’t convincing me, was because of apparent conflicts between my story and my values. Specifically, the value of seeing human beings in a wholistic manner that does not divide mind and emotion, person and spirit. Although the medical model inherently reinforces this dichotomy, a humanistic approach absolutely does not. As a mental health researcher, I also knew that the evidence does not support a medical model approach but favors a more diverse view that therapy works so long as it fits within some parameters that are specific and broad at the same time. I also recognized that a big part of taking on both of these dimensions simultaneously would require that I integrate my personal life-path and my professional path. I would have to figure out how to bring together two important aspects of my life that I had spent considerable psychic energy splitting. This spoke to my value of integrity and authenticity. I have long recognized this splitting challenges my ability to be fully authentic in either context, whether I am with my meditating friends or my medical colleagues I am not fully authentic about what I bring to the table.

The issue of wholeness is relatively easy for me to resolve, in addition to the research evidence showing what types of therapy are helpful, there are many influential thinkers and doers in the world who have provided ideas and methods for doing so. So once again I had created a dichotomy where there didn’t have to be one. Resolving the issue of authenticity has been the more challenging. To make a shift in my professional identity (one that has been very successful) is scary, it requires me to put myself in a position I don’t like very much, to assert my beliefs in social contexts where there will be disagreement and disbelief. I realized I fear the prospect of losing the respect I have of those in my profession, and I fear the loss of respect from some friends who know me through that lens.

As evidenced by my website, blog, and YouTube channel, I have decided to dive in and do the work I need to do in order to integrate my knowledge, skills and commitment to helping others. It’s still very fresh. I have not yet sent out an email to everyone I know asking them to check this out, the real test (in my mind) of whether or not I’ve actually committed to this path. As my fear bubbles up, I return to the feelings I had in talking with my confidants and I return to the values I am supporting, both of which help calm me down and bolster my resolve to move forward. The creation of the videos and the writing of the blog also reinforces my commitment as I focus on the feelings I have while doing these activities and looking at the fruit of my labor. I also have the advantage of some life experience and the repeated occurrence of worrying out future outcomes that never manifest.

In many ways, this posting is a personal journal entry, a way of reinforcing my commitment through putting my thoughts out there and through remembering how I got to the place I am. It is also a reminder that while the resolution of a dilemma is often short and to the point, the context in which it arises must be acknowledged in order to get there.

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Enjoyed reading this Dharma brother. I always admire anyone who can share, with a sense of modesty and humility, how they traveled a challenging section of their journey through life. I'm excited to hear about your plans to integrate wellness into your professional offerings.


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