Today’s blog is specifically addressed to those in the alternative helping fields who may be working with or have an opportunity to act as a source of support for those struggling with the symptoms of mental illness. As practitioners, we need to be aware of our professional limitations and to know how to identify when an outside referral may be necessary. Additionally, we need to be cautious when the denial or bargaining faces of grief may be determining our client’s motivations. Today’s blog explores these issues.
I want to preface today’s blog with the acknowledgment that there is SO MUCH we do not yet understand about the effective treatment of mental illness. While many (70-90%) are able to find relief and even recovery through a combination of supports, including medication, therapy, good nutrition and exercise, mindfulness and stress-relief practices, support groups, etc. we are still a LONG WAY from finding treatments that are 100% effective 100% of the time. As a result, many, including myself, have searched outside of the traditional model for alternative treatments. Many of these alternative treatments have proven for some to be supportive of their goals for healing and relief. For example, NAMI advocates meditation and mindfulness practices as beneficial for those suffering with some forms of mental illness: http://www.nami.org/template.cfm?section=mindfulness. Clinical trials have also demonstrated acupuncture to be effective in relieving some of the symptoms of mental illness. In 2003, the World Health Organization published these findings and issued guidelines for the use of acupuncture in treating certain forms of mental illness: http://www.acupunctureresearch.org.uk/papers/KeyTexts/keytext_acupguidelines.pdf. From my own personal experience with depression, anxiety disorder, obsessive worry and panic attacks, I can attest that I found support and relief through a combination of non-traditional means including spiritual direction, contemplative/meditation practices, talk-therapy, acupuncture, massage, acupressure, homeopathy, quantum bio-feedback, yoga and Reiki. I also know many (including myself) who have also found relief when integrating these non-traditional practices with the traditional Western model.
A wholistic approach which combines tools from both Western and non-traditional medicine can be an effective approach to finding relief and even recovery from many symptoms of mental illness. Unfortunately, sometimes the denial and bargaining phases of grief prevents the patient from getting the best possible care, especially when they are using alternative methods of treatment to enable their denial or their bargaining. (See the blog post of May 14, for more on grief as it relates to mental illness) Denial says, I don’t really have mental illness. I’m not depressed. It wasn’t a panic attack. I’m not bi-polar, I’m just misunderstood. I don’t have ADD, I’m just super creative and highly energetic etc. etc. etc. Bargaining says, If I do this…my symptoms will go away and I won’t need to take medication or see a therapist. If I can just find the right combination of foods, my symptoms will go away. If I take a drink or smoke some pot, I feel better, so I can’t have a mental illness. etc. etc. etc. We need to be cautious of the use of non-traditional practices during the denial and bargaining phases of grief, especially when delaying necessary treatments might cause further harm or even death.
From the Practitioner’s Perspective
As a professional in the field of alternative treatments (Reiki, Spiritual Direction), I have seen firsthand the results of denial and bargaining in those struggling with symptoms consistent with mental illness. Many understand the importance of an integrated approach, but for some, alternative treatments provide an easy escape from a medical diagnosis and medical treatment. In these cases, what drives their search is the hope for “the magic pill” that will cure their symptoms without diagnosis and Western intervention. And in a minority of cases, alternative protocols not only enable their denial, but enable the delusions associated with their diagnoses and when pursued could cause further harm. (NOTE: watch this blog for an upcoming blog on Mysticism and Psychosis) As practitioners, it is our responsibility to know our professional limitations and to make outside referrals when our limitations have been met. This will not always be easy, especially when our clients are firmly rooted in denial and bargaining. It is in these situations that we need to exercise “tough love.”
Some Helpful Ideas
As alternative wellness practitioners, we are vulnerable to those who might seek us out during the denial and bargaining phases of grief. Fortunately, there are some simple steps that we can take to protect ourselves while better serving those who seek out our services:
- We can become educated on grief and the grieving process
- We can learn about the symptoms of mental illness and how to identify these symptoms in potential clients.
- Offer a pre-treatment interview with prospective clients. Get to know their expectations, motivations, etc. Watch for signs that other interventions may be more appropriate. Don’t be afraid to say NO and make an outside referral
- Require all clients to sign a release form.
- Include an “emergency contact” entry on the release form in the event that your client demonstrates signs of needing medical or psychiatric intervention (becomes delusional, paranoid or threatens suicide).
- Know your local mental health professionals – psychiatrists, psychologists, counselors. Find out who is most highly recommended. Initiate a collaborative relationship with these professionals where appropriate.
- Develop a professional relationship with a local therapist or social worker who you trust and to whom you can go for guidance when you have concerns about a client.
- Maintain your own professional health through peer-supervision and support groups, by doing your own work with a mentor, Spiritual Director or Counselor when appropriate.
- Maintain strict professional boundaries. Don’t give your personal number to clients. Don’t become their friends. Watch for signs of attachment or dependency.
- Become familiar with local support groups for those struggling with mental illness (See if there is a NAMI chapter near you.)
- Carry Professional Liability insurance
- TRUST YOUR GUT – Your inner wisdom will tell you when something isn’t right with a client and when it is time to make an outside referral or to refuse further treatment.
An Invitation to Practitioners
Now, I would like to hear from the professionals out there. What are some of the tools that you have used to ensure proper treatment for your clients while protecting yourself? What resources have been helpful to you? What are the tools you have used to identify when an outside referral is appropriate?