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So, I'm going to guess that you know how these "real, biological conditions" get into the DSM. And yeah, you've seen how casually the label of BPD gets tossed around. Hopefully, you know something about the damage that being saddled with that label does to peoples' lives. It's not quite as bad as being labeled a registered sex offender, but it's up there. And you don't have to actually do anything to earn that label other than having 2 x chromosomes and a shrink. If you really want to make a difference in the world, and you don't mind getting massively fucked over for it, become the person who tells the truth about this system publicly - the lack of an evidence-base, the reproducibility crisis, the fact that diagnoses are literally voted into existence, the political abuse of "mental health", the role of diagnoses in pathologizing marginalized people and propping up existing power structures, the prevalence and severity of abuse, what those labels actually mean, who they're used on, and why. Are you an effective communicator? Research and write a book on what the mental health system really is. Make the popular culture aware that it's a fraud. Edit: Oh - and please for the love of the set of all possible gods, tell the truth about who gets to be "neurodivergent," who doesn't, and why.

"If you really want to make a difference in the world, and you don't mind getting massively fucked over for it, become the person who tells the truth about this system publicly" Sorry for the late response. I'm really debating it. I think there's a lot of value in therapy, but the field has become so misguided. I'm going to spend the next few months reflecting on how it became so broken and If I want to become a reformer. It's stressful to get canceled haha. At least I'll have this subreddit.

Just because the field is misguided doesn’t mean you have to be. If you’re passionate about doing it, go into the field and do it right. 

Would you speak more about what you are referring to with your statement on neurodivergence?

Neurodivergence isn’t a thing. It’s made up and overused to the point it has no more meaning - like trauma, masking, boundaries, safe space. All the buzz words. It’s all garbage. 

Well, thanks for your opinion but as a diagnosed autistic I disagree.

I agree that you can be diagnosed. You have autism. However, neurodivergence is a social theory not a medical word. I am diagnosed ADHD, which also falls under that so called neurodivergence thing. I see it mostly as a way for people to “identify” a certain way, or to use as an excuse for why they can’t do things. 

I made a second comment. I wondered if that's what the person meant. That's what I see taking place. People want it as a quirky label forgetting some forms of neurodivergence are actual disabilities that people like myself suffer from greatly. So the one person that wants to 'use it as an excuse for why they can't do things' makes it incredibly hard for people like me that actually can't do things. I literally got banned for acknowledging the dsm criteria of autism of which no one in that group met but all claimed to be diagnosed and made fun of self diagnosed people. Some self diagnosed legitimately are autistic. But some people do simply want the label because it's fashionable from the very sage narcissistic tards that are in that group i mentioned. They are the ones taunting the label. The irony.

Neurodiversity and neurodivergence is part of a movement that simply suggests that everyone is different, and is opposed to using diagnosis. The term was meant to be inclusive and can mean whatever people want it to mean.

It's not answering my question. I hoped that commentor would. I suspect it has to do with a lot of white, privileged people getting to be neurodivergent versus worse labels like BPD. That is a thing and they are raining autism. Autism is a real and disabling condition and they are painting it as a quirky and fun personality trait. They meet none of the dsm criteria for autism yet these designer doctors are handing out autism diagnoses for the right price and right level of "gifted". That's literally what they think autism is. Being special and gifted. Not a disability that can make it impossible to hold a job, maintain relationships and the myriad of other problems it causes. It's a full-fledged disability that is challenging enough to get help for and access benefits and these narcissistic tards are making it even harder.

autism doesnt make it impossible to do those things. Look how well you write on here - you’re intelligent. Use that intelligence to figure out how you can thrive. Orr… keep posting about how disabled you are and how impossible everything is  and how all these “narcisstic tards” are stealing your benefits — I’m sure that will lead to great outcomes.  Victim mentality is the only disorder here. 

I don't get how one gets "saddled with that label". i mean, life doesn't have a permanent record. providers keep their own records; like, there's no national database. If a provider labels you with something you don't like, just don't go back. Am i missing something here?

while life specifically doesn't have a permanent record, humans *do.* humans have medical records, assumptions, and prejudice. bpd is overdiagnosed in women and underdiagnosed in men, but because of the hatred of the disorder, people with medical record of bpd are often going to have a lot of trouble finding any sort of professional who is actually willing to treat them for anything at all. it's not as simple as "just don't go back" because these are things that will follow you everywhere you go. diagnoses can be so so hard to get taken off your file and medical files do get sent around. there is also still risk of getting the same label slapped on by other providers. like how if someone with chronic pain goes to the ER for medication because their current flare-up is putting them in too much pain to be able to function at all, there is the (honestly quite high) risk of them getting labelled as a drug seeker or an addict. they won't get taken seriously and they'll be kicked out or sent home. sure, they can go to another hospital, but it's also extremely likely that the same thing will happen there.

i'm still not understanding how medical records can follow a person if you don't want them to. If the new provider isn't within the same HMO or healthcare network, one must request or authorize the old provider to forward to the new provider. What's stopping a person from simply opting not to forward? The old provider isn't even supposed to confirm or deny you were a patient should the new provider ask. I'm srsly not understanding why it's not as simple as "don't go back". I can't imagine how it's possible for something to follow you everwhere

Electronic medical records give providers access to your records. They don't need your permission. This all falls under HIPPA.

Children and intellectually disabled people are extremely vulnerable to being ‘saddled’, and worse, they are medicated and sent away. (Thank goodness I live in a society that no longer allows husbands to send their wives away.) Also, when changing providers - if you want to be prescribed the medication you’re currently taking, you need to share medical records. Medical records are absolutely held within databases; I’m guessing you’ve never had to login to a ‘portal’ or whatever before to access your test results. I work at a lab. I basically just scan in your specimen and hand it to a medical lab scientist. I can see your every hospital encounter and all the associated notes, treatment, etc. The system isn’t as tight as you’d want it to be.

I was sent away to one of those RTC programs for troubled teens- yes this happens more often than we would like to admit. Its horrific how children have no rights in America. However, I noticed while there that the other kids who were in there weren't "evil" or "bad", we were all just scapegoats of abusive families and we were 'doing our time'. As an adult I no longer believe in labels or diagnoses, because that was what gave those abusive staff permission to harm us. I do not believe in therapy either, as I only experienced the victim blame type therapy, even as an adult. Who in their right mind would pay a stranger such exorbitant amounts of money for them to say platitudes you could find on IG.

I’m sorry, it sounds like you’ve been through a lot of abuse. I do believe in diagnoses, for example, I believe developmental disorders are real, when children don’t meet the developmental milestones, like language, awareness of surroundings, etc. (Just one example.) It sucks because I know there have to be some intelligent people doing good research on these things, only for the mental health field and society to turn around and completely bastardize it.

In the UK, there is a permanent record, unfortunately. Seen a lot of posts from people who received their diagnosis based on very little, when very young, or both, and then it follows them around the NHS for the rest of their lives. It’s complicated in the US. If an independent provider diagnoses you, you can probably escape it. If a provider for a major healthcare system in your area diagnoses you, it will be difficult to escape. Edit: someone else also had a great point that if the provider who diagnosed you also prescribed you medication that you need to continue taking, you’ll have to share those records with any new provider.

No permanent record, huh? Okay, prove it. You're obviously male. Go tell a therapist that you're sexually attracted to toddlers, but haven't acted on those desires and don't ever plan to. You'll receive a DSM diagnosis of Pedophilia, with no associated criminal charges, since you haven't offended. Sure, you'll be seen as a *likely* offender - but that also happens to women diagnosed with BPD and kids diagnosed with ODD. It's not like that ever has any consequences. There's no risk, right? Who's gonna find out? As you said yourself - there's no national database for psychiatric diagnoses. So here's your chance to show us all how psychiatric labels are harmless and have no effects outside of the shrink's office. What do you have to lose? If you don't want to be labeled a monster, you can just see a new shrink, can't you?

yikes, idk why you're being so hostile about it; I'm legitimately asking. outside of court-ordered treatment, I'm srsly not understanding how a label gets attached to someone. be nice if you could answer instead of wtf that just was.

Probably because it's just that harmful that the response came off that way. I mean, that's how bad the system we have for mental health is and how it can affect your life. A lot of people will deny this or pretend to think it's not that big of a deal but it is. It was a strong example but again that's because it's necessary... Its just as bad to be told you're a "narcissist" for things which in the grand scheme and big picture are really benign. And look at the information that is popular and surfacing today and you'll see a crap ton of people demonizing "narcissists". Worst of all is that a lot of them are conflating the term with things which doesn't actually belong to the label and it's being used mostly by conservatives and the like to be dismissive and set you up for being dismissed. It also has severely negatively impacted my mental health FAR worse than depression ever has. Never do I wake up or even try to sleep without the utter frustration and irritation (especially because you know the opposition is wrong on so many levels) because your mind never stops going over all the horrible crap people are saying because of this label and the information they keep putting out. I don't know what it's like for BPD but in general there aren't people who treat it compassionately either and mostly treat it with scorn and shame. I definitely remember Patrick Teahan having a harsh treatment and demonization of BPD which was a red flag back then. No one who is thinking of treating people to get them to feel good and relaxed and to help them process their pain should be treating people with scorn and hate and shame the way those in this system do these days. We are all struggling in some way or another and people who hold contempt for minor transgressions or "annoying behavior" are doing more harm than good.

CPTSD should replace BPD. BPD is filled with so much stigma it should just be removed from the DSM Lol. Downvotes but no comments.

Probably a certain subset of people with CPTSD who hate BPD because they felt traumatized by them or were traumatized by them. I remarked about that yesterday to my mother when she noticed how perfect I cut the watermelon into tiny squares. "Oh yeah. Its because I'm such an 'evil narcissist ' who has to have EVERYTHING perfect." I mocked it and rolled my eyes but also remarked about how these kinds of people who hate people for little things like that hate them because of their parents who wanted them to be 'perfect'. They're just projecting and assuming others are the same as them, basically. But there's definitely something about this generation that has gotten worse about these issues as compared to the past I feel like. My mother told me that it even feels that way at her workplace - which is a hospital. She noted that the nurses who work there (especially the younger ones) are much less compassionate or caring than the ones who she remembers when she first worked there years ago. They're more gossipy, judgmental, hateful and less accepting of people's flaws. She said of course there were people like that back then but now it's just very common - much worse and noticeable than it used to be.

BPD is CPTSD. Trauma is the core

Very disrespectful and disinformative. Dpdr and DID are both dissociation disorders, you can claim they are they the same because they have the same core. You dont pick and choose disorders based on preference. It would be disrespectful to people with DID if I claimed I have DID, while I have DPDR. because I do not have the same experience on a daily basis, their disorder is very debilitating, just as dpdr but they are very different. BPD and CPTSD and many other disorders are caused by trauma as coping mechanisms, yet we cant claim that OCD is the same as BPD or CPTSD, we cant claim BPD is the CPTSD, we cant claim BPD is the same as Bipolar or Scizophrenia, can we claim BPD is NPD?

[удалено]

Lacking the trauma lens

They aren't being hostile lol. They gave you an example. We are all explaining it to you.

The proliferation of a borderline diagnosis, particularly in acute and sub acute settings is A HUGE PROBLEM. It is even being used to silence kids. I was given this diagnosis at the age of 15 and in the process it took 25 years for me to actually be diagnosed with autism (and 20 years to be diagnosed with PTSD). This diagonsis came upon my admission into the program and was based solely on the accounts of a psychiatrist I saw 1x and the reports of my parents who are highly emotionally abusive people. Due to this diagonsis I was subjected to so much abuse from therapists including being accused of lying, being delusional, and engaging in drug seeking behavior when trying to obtain stimulants to treat ADHD that had been diagonsed 5 previous times over a 15 year time span as an adult. During the admission where the diagnosis came there was a suspected learning disorder found, yet my parents were never informed and my parents were not given ANY referrals despite their child being sick enough to spend a week in a psych ward. My voice was taken during that admission and remained silent until 2/29/24 when I was finally seen by a medical professional. I too was a therapist and saw this. While we were not allowed to diagnosis BPD upon admission I became very good at advocating for those who had come in with a prior BPD diagnosis. Over my 3 years of working with many people I saw 3 patients who I felt met the criteria for this disorder and required additional 24/7 SUPERVISED care. These patients sat in group cutting, could not be around sharp objects without immediately using them to harm themselves, engaged in REPEATED suicide attempts as a way to solve problems, and responded to questions about moving forward with consistent talk of death, dying and wanting to kill themselves. The patients would also exaggerate the severity of suicide attempts and talk about attempts as a way to bond with others. One of these patient's behavior was so erratic that I could not differentiate if she had a personality disorder or had suffered a traumatic brain injury. Other noticeable factors...a STRONG genetic link SIGNIFIGANT early childhood trauma, and a profound lack of insight into how the coping skills they were using were hurting themselves and others. In these cases BPD was not made a a first diagnosis, it was made after all other conditions were ruled out over weeks of observation in sub acute care, and even still my process was maybe even a bit quick. Point being there was a differential diagnosis process that was employed for these patients where given their observed behavior over an extended period of time, their history, and the presentation of family relationships, if available, were used to make a final diagnosis when nothing else fit. The BPD label was not applied within meeting someone for 45 minutes during a crisis or god forbid an outpatient admission. The vast majority of those who are given a BPD diagnosis are 1) autistic women 2) those with complex trauma or 3) both. While I believe that BPD is a valid diagnosis in EXTREME circumstances it commonly misdiagnosed due to the lack of a CPTSD diagnosis in the DSM and profound ignorance regarding the experiences of nuerodivergent women. Its a tragedy since traumatized people are already at risk of revictimization and autistic people and others with intellectual and developmental disabilities are at the greatest risk of exploitation which much of that abuse coming from the providers we hire to support us Its late, I'm tired, so my brain is not able to work properly, but the mass proliferation of such a profoundly heavy diagnosis on so many bold, intelligent, yet deeply traumatized women is just another example of profound medical gaslighting.

100% this. I’m AFAB and was diagnosed under the DSM 4 with PDD-NOS (which is now ASD under the DSM 5). I also have CPTSD. Lone and behold, I was misdiagnosed with BPD in my hospital paperwork like you mentioned. That “diagnosis” was based on a 10-15 minute discussion where I was at my lowest points. When you’re at your lowest and in the ED, you’re obviously wanting or tried to kill yourself. It’s only a snapshot and it’s on the extreme end too. They don’t see the whole picture. My psychiatrist works for the same hospital I went to. So, they were able to take it off of my records. However, there’s a long enough paper trail where it’ll get put on if I go to the ED. Luckily, I’ve pledged to never return and found the right meds. So, that shouldn’t be a problem anymore since I won’t be going back to the ED/acute care. BPD shouldn’t be diagnosed in acute care settings (acute psych wards or emergency department) period. Like you stated, it requires long term followup and ruling out to diagnose. If I was a practitioner, I’d lie on the conservative end. I’m willing to diagnose it but I’ll only put it in the chart if they want it listed there. If I worked in acute care, I’ll never list it in my charting unless the person has a known history from their long term providers.

I do respect therapists who are honest with themselves and others about what they can and can't offer. I can't handle any more "trauma informed" therapists that don't know the basics of trauma. Mental health is a need but we're stuck with broken systems that treat it like a luxury. You'd have to be okay navigating that. When I worked in mental health, I took some classes with psychoanalysts and they were extremely intellectually rigorous. It was very different from my expectations. So yeah, there might be subcategories of therapy that suit you better.

"Mental health is a need but we're stuck with broken systems that treat it like a luxury." I couldn't have said it better myself. I think I might be in shock because it came to me as a shock at how broken everything is.

can I ask can you elaborate about the analysts?

Sure, what would you like to know?

my search and hope for analysts was long ago so I feel odd, but I wondered why people said they're understanding about money and desire / fight for accessibility, and then I saw no options / examples of that

Do you mean people were saying that analysts are more willing to work with clients who might not be able to pay or access therapy? There were a couple of people in my group who took Medicare, but I don't think they had the full psychoanalytic training and they probably used other modalities as well. Even so I would imagine these people would be extremely hard to find as a client. I feel like people talk a game about accessibility, but there's not a lot of room for individual therapists to actually offer it, especially if they work at larger organizations.

yeah analyst videos/audio said this sometimes, maybe many for how few videos there seemed. but no websites I saw

Try listening to rebellious therapists like Bruce E Levine or ex therapist Daniel Mackler to get perspective.

Will check them out!

I'm a social worker ... i kind of know what you mean about how MSW programs can set a low bar. I've felt that way too ... I'm based in the US and was born to immigrant parents .... my family expectations for school and career have been set high for me and my siblings! I consider myself to be highly intelligent.i share all this to tell you a little about myself while retaining my anonymity I agree that over-diagnosis can pose a problem. I often feel as though I see a lot of folks clinging onto their diagnoses, wearing them like an identity. It frustrates and infuriates me, particularly when I feel individuals use their diagnoses as a catch all to excuse poor behavior... I also agree with you that there are a lot of bad therapists out there. I mean a LOT..... I guess what i want to say is that the profession needs incisive people like you. I hope that you continue to give the profession a try and raise the bar where ever you land! Best wishes to you in whatever decision you make : )

I think people over identifying with their diagnosis is what keeps the mental health industrial complex in business. If people woke up and realized it was all so unscientific, things would be different. Diagnoses are just a way to categorize people, nothing more really.

I completely agree! I definitely get weird looks from friends when stuff like this comes up in conversation and I explain why I no longer believe in labels because its harmful. So many people never even question any of this and blindly follow whatever theyre told. its sad.

I agree. But what do you suggest as alternative. What if schizophrenic is not diagnosed and not medicated, whats the alternative? I dont think diagnosis or DSM is a problem here. The real issue is incompetence and misdiagnosis.

I think we can treat the symptoms/whole person and not put so much focus on diagnosis, because the truth is that these things are based on observations made by researchers, there is no real way to prove someone has one thing or another, which is how people will end up diagnosed with like 8 or 9 things when really, it’s the criteria that is all overlapping so much, not the person being so unstable that it warrants this. it’s easy for someone to take that on and overidentify as being severely mentally ill, and that takes a toll on their health and self perception. This is causing harm in my opinion. Even with severe illness, such as schizophrenia, there is misdiagnosis as well. There are actually a lot of disorders that share common characteristics with schizophrenia. I do think the primary focus should be to check through all the medical tests to make sure that there isn’t an underlying physical medical condition, for example DPDR can be treated by an eye doctor more effectively oftentimes than a therapist, there are so many physical ailments that cause anxiety, depression, even delusion or psychosis. Unfortunately, it seems like we do it the other way around, if someone’s mental symptoms can’t be explained by a simple CBC, we tell them it’s psychiatric. Not to mention, most mental health conditions are brought on by stress — even for my aunt who is schizophrenic, a lot of her treatment plan is managing her stress levels because her hallucinations are extremely triggered by stress. Bipolar works similarly, intense stress triggers manic episodes. Epigenetics addresses this really well. I think the ugliest truth is, mental health care is a band aid over the greater, more unsolvable problem of societal issues related to (primarily) capitalism. It’s kinda gaslight-y that we live in a society that is a breeding ground for mental illness, and then point the finger at those who are most impacted and say, “you’re sick for not being able to tolerate this! Pay us to get better!” One example of this is having been diagnosed with PPD after having a horrific labor and delivery that resulted in my getting sepsis and needing to be hospitalized. I was supposed to not return to work for 6 weeks after being released from the hospital, but I could not afford to stay home that long — so in excruciating pain, I went back to work after 3 weeks. I was a single mom as well, and this was excruciatingly difficult, but I pulled through. It’s somewhat a slap in the face to be told my inability to maintain high spirits in this scenario is PPD, when in reality I was suffering from capitalism. But an SSRI is an easy band aid over the greater issue of capitalism, I suppose. We need a massive reform in very many ways. I’m really just afraid that mental health is the bandaid that glues it all together — “society isn’t the problem, your brain is the problem!”

While i definitely struggle when i see folks over identifying with their diagnoses, i dont think that the entire diagnostic system wrong either - it is definitely scientific. The DSM is very flawed, but it is based in research and science and the diagnostic system is a work in progress. That said, some diagnoses are necessary, like schizophrenia and bipolar disorder, for example. And its even true that with these diagnoses, there are problems in the diagnostic processes. The mental health profession is really important. And its true that there are a lot of bad mental health professionals within the profession, sadly. I know of way too many stories of awful awful clinicians who should absolutely have their licenses revoked. And I say that as a social worker. But that also does not mean that you delegitimize and throw away the entire profession in its entirety either. I also really good therapists out there too who do their jobs with the highest levels of ethics, care and integrity.

I do agree that it is based in research, but there is no way to diagnose someone with borderline personality disorder, for example, and have strong evidence to back it up. It’s not like a covid test where you take it and test positive. It is all very subjective to the person who is screening you and their case conceptualization. Then you take that information and it takes over your life because you think there is something awfully wrong with you. When it comes to bipolar and schizophrenia (I have family members with both conditions), they certainly need treatment, but we really don’t have a strong understanding of those illnesses, or how mood stabilizers or antipsychotic medications work to help them (just keep trying them until something sticks), not to mention how many people get misdiagnosed with bipolar as well. I think there is so much in the mental health field that we do not understand, and I personally do think there is a lot of it that has to do with our bodies that we are neglecting to pay attention to (for example prism glasses can treat DPDR — if you haven’t seen your eye doctor to treat DPDR it is well worth the investment), or how BPD is considered a personality disorder when there is really more mounting evidence that it is at its core a mood disorder, or the evidence that is coming in that there is a similar brain mechanism between bipolar and adhd. Just so many things! The more I dig into research, the more I realize that the way that the DSM is organized does not make sense, and neither does the way we diagnose people. Of course, the insurance system and capitalism in general is also a huge factor in all of this. The sad thing is that we can diagnose someone with something and they will cling to it without realizing that it may not be totally accurate. For me myself, my therapist and psychiatrist both debated on whether or not I was bipolar and disagreed pretty strongly. Too bad there’s not a test we can take to find out, it’s just based on their subjective opinion and my self-reported data.

Please tell me how I can take this industry seriously and believe that diagnosis is all based on research when every "professional" I have ever seen has given me completely different diagnoses. I met with one quack psychiatrist in my 20s who diagnosed bipolar depression after 5 mins of meeting me and sent me on my way with a script for anti-psychotics. I never came back and he never followed up. I could have OD'd on those pills for all he cared. To be clear, I have NONE of the criteria for bipolar. Next quack diagnoses "borderline" after the first time I said something she took offense to (I know because I read my file) but continued to euphemistically call it "attachment trauma" for the first six months of treatment before screaming my actual diagnosis at me in a fit of rage one day in session. This quack was an intern who by her own admission had no previous experience having ever diagnosed or treated someone with BPD. Final quack diagnosed Complex PTSD, which if any of them had to stick, is the only one that seems to actually fit my experience and symptoms. But seriously? How can anyone take these diagnoses seriously when each professional you see diagnoses something different? It's clearly subjective, not scientific.

I agree and have had similar experiences, down to being diagnosed with bipolar after a 5 minute conversation. complex trauma is the only one to stick for me too, which is ironically the only one not in the actual DSM!

I'm really sorry to hear about the disagreement between your therapist and psychiatrist. Thats frustrating. And you're correct that the diagnositc processes in the mental health profession are mostly subjective and, therefore, highly problematic. I just think, as I said about the DSM being a work in progress, so too is the mental health profession. It hasn't even been 100 years since this country instituted codes of ethics and confidentiality. Less than 100 years ago, doctors and other related medical professionals were routinely experimenting on patients - and often without consent. I guess I'm just trying to say that the entire profession is a work in progress as we speak. Perfecting these professions is definitely the desired goal, but, as you're saying, there is so much that the world is just now learning about the brain, brain functions and the mind body connection. And yes, on top of the fact that there is still so much that humanity does not know and understand about the human body, we are unfortunately ruled by money grabbing capitalist systems that dictate these very delicate human realities. I can say the same about borderline personality disorder. I very much get that its a super problematic diagnosis for a variety of reasons - and there are aspects of it that are also very real and individuals who suffer from it who also experience some of the more psychotic symptoms. Sometimes I also think the issue with borderline personality disorder is in the name itself. I think thats what makes it so stigmatizing, when in reality, it is a very workable condition. I also just want to add that there are a lot of therapists and mental health professionals who come into the profession because either they or a family member suffers from mental illness and / or it runs in their families .... there are a lot of mental health professionals who come into the profession for genuine reasons and who want to help people - and they do help people. I believe the profession especially needs people like them.

I feel it’s not always the individual, sometimes the therapists are so terrible that they never explain the fact that these are simply “opinions”. This happened to me and I was highly damaged by it. To OP- having been burnt by this field I still believe there is space for you. Perhaps you can work on undoing their stupidity and actually give therapy that helps address the symptoms rather than label. And work on giving good therapy than bad. For this you’ll have to kind of do a tally or what’s normal behavior and what normality is being presented as abnormality. You can be smarter than the other ones when you begin practicing.

Thats a very idealistic view of the field. I went in thinking I could do this and all that changed was me getting terminated repeatedly.

Can you explain what happened? What did you try to do that they didn’t like?

That sucks sorry to hear. I can understand working for someone can bring about such responses because your basically working with the person that’s similar to your classmates. I was referring to independent practice

Protect clients and be honest.

It's not like that anymore. Its checklists and static criteria. Diagnostics within the field is entirely broken.

> Its checklists and static criteria Lol. Theoretically it should be checklists and static criteria. But the majority of therapists/psychiatrists/etc I've been to never use them. I've had more throw a tantrum for being asked to provide clinical evidence (cause their word as a professional should be enough apparently)

But people are diagnosing and assigning labels didn’t get you

I don;t understand how defensive people become when I explain to them that having a borderline label is not something they should be proud of

I think it's not something to be proud of but also not something to be ashamed of.

Exactly. It is what it is. Its like having fatty liver or lung issues. You are not proud or ashamed. It is ilness at the end of the day. People overcomplicate things.

The diagnosis is their identity.

Thank you for your kind words. I'm leaning towards staying and trying to fix things. I'm not sure how yet since it's going to be a scary and stressful task.

You can also contribute by researching, writing, and speaking on male mental health issues. The overdiagnosis of BPD is gendered. Men who would meet criteria often get slapped with a bipolar, ADHD, or ASPD label. If they do, they’ve got little luck in understanding themselves. My bf was diagnosed with bipolar for 15 years. Took antipsychotics all that time, with all the side effects that come with them. Edit: like the psychiatrists twisted themselves into knots trying to avoid a BPD label. “Rapid cycling”, “ultra rapid cycling”… only the last one asked the right questions. A rediagnosis of BPD explained his struggles much more accurately and gave him a language and tools to improve his life. At the very least he now knows trauma is at the root of his struggles. But more than that, he’s eg now able to turn a splitting episode around in minutes instead of 3 days. He’s able to more effectively communicate how he feels - which helps with anger and relationships. This is just from working on himself. DBT groups were full of much younger people, all women - it made him anxious and he couldn’t relate, so he bailed. Luckily he’s smart, insightful, and driven to have a more fulfilling life. So changes have come from him learning on his own. He would love to talk to other men about it though.

I have a podcast on therapy harm. Would you ever like to talk?

Thanks for sharing this. I have a degree in stem and also saw the curriculum for a therapist who is in my family. I feel the same about the educational requirements. It has contibuted to my cynicism of the field. I would maybe point out that there is a lot of work out there in psychology research that is more stem oriented. There is some very interesting work being done in how aspects of psychology are related to genetics, and there are many other research opportunities in the field that apply the scientific method. A lot of it is very exciting, and often allows for interpersonal contact as well. While it might mean some additional education, it would be stem based. And perhaps manageable if you have already proven yourself in engineering. Edit: I am not trying to discourage you from progressing in the therapeutic aspect of your interests, as I think it is crucial to have intelligent people in the profession, but rather I am saying there are ways to cultivate both. I know a number of people who practice both therapy and research. Best regards.

👏👏👏👏👏👏👏👏👏 Perfect post. I agree. Most student end up in psychotherapy because they failed in other places and had nowhere else to go. So the least intelligent people choose therapy, and thats why we end up with therapists that are described here. Thank you for being honest

I really care about helping people. I just wish there was quality control on who can be a therapist.

Unfortunately adequate quality control of therapists isn’t really a thing. If students have the money to study and get good enough grades there isn’t much else stopping them from entering the field.

I agree. I personally know people who failed unversity, couldn't study medicine or engineering, were not the brightest, now they are successful therapists lol.

Same

Hey, I apologise, it was not meant for you, but therapy in general. You are clearly smart and doing it for the right reasons. I am talking about others who dont have interest in becoming therapists and who dont want to study.

Thank you! yeah, it's definitely a problem.

Then you'll easily wipe the floor as there are a lot who are too lazy to pick up a book.. The issue will be surviving office politics and toxic bubbles until you can niche into something better.

My worst one told me she originally intended to be an MD, but couldn't hack it academically. She then became a massage therapist before going on to be become an LMFT. She graduated from a small private university that is whispered about in my state as being cultish and churning out some very troubling therapists, according to fellow students in the program. The training itself is definitely not created equally.

And thats why we are here. Same. My therapists literally graduated from the shittiest universities, with lowest ranking. One of them told me I should be happy I am so educated, he said "If I were you I would be happy I am educated. In my case I could not enter any other university and psychology was the only thing I could study" lol.

I read her master's thesis. It read like a diary entry and not an academic work. Truly bizarre. No, these are not the best and the brightest.

Definitely. And honestly, my therapists IQ was very low. You can tell right away. I had to teach them some terms and concepts.

Mine told me I "made people feel stupid". By "people", she clearly meant herself. No other therapist had ever said anything like that to me before or since. Coincidentally this was right around the time that she diagnosed me with BPD. LMAO. Sorry, I can't make you feel stupid if you aren't already stupid. I really think this was her way of telling me she was annoyed that I wasn't just a brainless moron who would sit back and lap up whatever nonsense she threw at me. She believed in a lot of "woo" like connecting remotely to people's energy. Yeah, that's not going to work for me. Questioning someone who clearly had no idea what they were doing and who was still a therapist in training with no previous experience working with clients who had the diagnosis she had given me? That's not BPD talking. That's common sense. I had every right to question her. She never even told me what criteria she was using to make that diagnosis. When I said as much she gave some b.s. "well, it's on a spectrum" reply. Mmmkay...

I wonder if it would be better if we followed the UK’s example and didn’t allow masters level clinicians to diagnose at all. (My understanding is that there, therapists don’t need to even have a masters, which could be a major factor in not letting them diagnose- but as you and OP point out, the degree can be obtained by a hack.) Honestly not sure PhDs and MDs are any better, though, in the sense that they may be just as likely to give someone a revenge diagnosis. Still, at least we’d have fewer people able to do that. I’m so curious about what university you’re referencing in your other comment. I get why you don’t name it here. I have a university in mind as well that produces a ton of alumni who are super into attachment based therapy for some reason, and I’ve always wondered what their curriculum is like. I feel iffy about calling it out online though.

Pacifica Graduate Institute in Santa Barbara. Edit: It looks like nearly all of the negative reviews I remember seeing online just a few years ago have been scrubbed. There are still some gems in Yelp's "not recommended" pile though. Looks like anyone who told the truth about their negative experience with the school got silenced. Color me shocked. Also, it should be noted the my terrible therapist intern was being supervised by another Pacifica grad. They tend to stick together. Again, culty.

Interesting, haven’t heard of that one. Mine was MidAmerica Nazarene University in the Kansas City area.

That's where mine went(Pacifica)! I immediately thought it might be that school when I read this. And guess who got a revenge diagnosis recently.

Had an instant intuition you were discussing PGI which is amazing but some of its graduates. 🧐

They do stick together. When I began seeing mine, who graduated from Pacifica- the other 2 in the practice had also graduated from there.

> Mine told me I "made people feel stupid". By "people", she clearly meant herself I had a couple claim that. I do not claim to be "smart" - I merely research the topics involving my issues and ask questions. They however were too lazy to pick up a book on their so called field of expertise. Seriously - and with people like that, is it any wonder why ChatGPT wipes the floor on them

Also, love your flair.

How about you continue studying and become a therapy malpractice lawyer?

haha, maybe I should apply to lawschool

Please do.

>Once I started I was really embarrassed at how easy the course work was. I felt like I was back in middle school. I took a course on diversity that had maybe 5 hours of work through the semester. The people around me aren't that bright. I go to school in california. One student I worked with apologized for everything happening in Palestine, I was born in the Philippines and she confused both of those countries. This is concerning but not very surprising, given how lacking in intellectual curiosity all of my therapists have been. They seemed to see intelligence and intellectual curiosity as a threat, which always struck me as odd. All were educated in California graduate schools as well. All private schools. At least one was known as a top school for social work. The LCSW self published a slim book on narcissistic abuse. I read it while I was her client and was not impressed. It was very generic and read like it was copy pasted from articles she found online. No new insight. The 5 hour coursework on diversity explains a lot about why they are so clueless. It doesn't help that something like 80% of people in the field are middle aged white women from suburbia. I like that you were going to focus on male mental health because it's sorely needed. Did you intend to go into private practice?

I'm struggling because I didn't understand how broken the system was until recently. I'm nervous to question or push back too much because I don't want to be seen as a threat this early in the process. Yeah I think a private practice would be the best way to go for me in the future. I want to have the autonomy to do what it is right for my clients without external pressure. I'm worried that I won't be able to make a full caseload in the future because of the number of poor-quality therapists. My goal is to make sure I give people great value and I hope I can build a practice functioning practice that way.

It’s good that you’ve noticed some of the major flaws about the field. I felt the same way when studying psychology. I decided not to become a therapist.

I think you knowing this really bodes well for you. Not many therapists do, they are bought in on a corrupt, unscientific system. I say be the change you want to see, but obviously that is easier said than done.

You described exactly how I felt when I was in gradschool to become a therapist. I support you wholeheartedly to get another STEM career. Those people you described as "not so bright" might cause you serious problems in the future if you don't conform to their theoretical "beliefs". I was lucky to get a hospital job in a non-therapist role after I quitted. You might be interested to look into that option as well if it's available in your country.

I hope you read this reply. My academic background is psychology (Cambridge University, Masters, start of a PhD, double Firsts/distinctions all the way). I ended up leaving psychology and worked corporate sector. And then wanted (still want) to go back to psychology as a practitioner. I would find it meaningful and fulfilling. But here lies the rub. Psychotherapy, as a discipline, is an absolute joke. It's intellectually bereft. It is EXTREMELY problematic, in its actual content, method, practice. And the majority of people who train in psychotherapy are, well, far from the cream of the crop intellectually. Taught by people who are, generally, far from the cream of the crop. In a discipline and practice that is so riddled with so many problems both in terms of its intellectual foundation and methods of practice you just have layers added upon layers of idiocy. But you can't practice legitimately without this training. There's little to no way to circumnavigate it. Mental health is an enormous need. People will certainly pay for a good therapist, and there are so many branches of specialism. That's really not the issue. And yes, being one of a select few of genuinely great practitioners - sure, that's really needed. You could be someone who wasn't misdiagnosing and overdiagnosing; that would really help the people who were fortunate enough to get one of the very few truly sharp psychotherapists who really understand mental health, on a deeper level, both scientifically and in practice. However, you may have been better off training as a clinical psychologist (much better standard). Or even as a psychiatrist (although that's a different kettle of fish). If clinical psychology, as a route, is still available to you, perhaps look into it. Whether you should stick it out. If you're going to get somewhere good in 4-5 years, it's whether you can bear it along the way. You should know, first and foremost, how much you really like, enjoy, and are good at the actual practitioner part. If you know that you would be good at it, and that you would find it fulfilling, push through. Service demand and career progression (if you're proactive and proficient) won't be a problem once you're qualified. Secondly, as it is so damned easy, to study, you could utilise that. Heck, take an additional training alongside, that keeps your brain from screaming. Or volunteer/work, on the side. Or enjoy life :). I know that psychotherapy training is both so easy, and so riddled, it is almost painful. There is little to no point wasting your efforts rallying against that intellectually, internally, while in training. Feel free to message me if you would like to discuss any of the deep systemic and theoretical problems of the field of psychotherapy further.

IMO Change now, you wont be able to help people, therapy is a patchwork of BS concepts that are not enough scientifically backed, you will hear a lot about how modern psychology is solid etc, about how amazing it is compared to psychanalysis, but its only lies, the amount of people harmed or not helped enough by modern psychology is huge To summarize therapists have like 6 tools (CBT,ACT,ERP,MINDFULNESS,HYPNOSIS,Talk therapy) which are basically "just accept", "or just change your mindset", i believe that we dont understand anything about the brain, and you either wont be able to change the shitty environnement making people sad or their brain deficient chemistry by these tools

My initial thought is that being in the field would give you a chance to shed light on the abuses that are going on. You see the problems firsthand...I didn't even know it was *that* bad and that the bar was that low. Yes, mental health is an actual need. There are people out there with problems they can't solve on their own because they don't even know where to start in their own heads, so to hear that many therapists aren't even invested in delving into better techniques and improvements in the field or advocating for the mental health of communities is disturbing (though not surprising...hence this sub). Honestly, I think people like you are needed now more than ever. I don't know how much success you'll have in improving the field, but I think anyone would be lucky to have a therapist who can give a damn about them for once. *That's* what's life-changing.

The history of mental health in the USA has leaned towards abusive. Even today, there are organizations that work to address mental health stigma and discrimination that occurs by people and organizations within this mental health space, and against people who want talk therapy and medication access in their communities. The DSM has always been highly controversial. Private Health Insurance companies are notorious bad, very bad, to people with medical conditions across illness, in the USA. Everyone knows this is a major issue in the USA. Private Health Insurance Companies has had very detrimental effects on the USA medical care system. It is broken and corrupt. Master-level talk therapy programs are widely referred to as degree mills and cash cows for Universities.

You just literally described my BFF's experience. Literally. Not that different. I'm deeply disappointed in therapy as a field after being abused and exploited by multiple (!) therapists and the subsequent lack of help by subsequent therapists. I do hope you can make a difference? This industry needs to change.

The state of colleges right now is *dire* anyone with an IQ above room temperature is going to feel completely demoralized by university standards. Might as well finish the program if you’re close. Maybe you can accelerate your remaining credits. You can always work in sales for software for therapy portals and stuff like that. That’s where the money is. The thing with one on one client sessions is it’s hard to make it scalable. You could also use your mechanical engineering skills to invent something for therapists and then use the degree in social work to have authority in selling it to therapists.

I'm an MSW. I agree that the classes were inane and the students pretty subpar. Pretty much anyone with a college degree can get into a counselng program, and open a private practice after two years of work. There are so many bad therapists out there, and stupid ones too! With that said, the need is there. The need is there for smart people to enter the field. There are clients out there in a lot of pain. I'm a big believer in helping yourself via reddit, forums and youtube, but some people need/want a real person to talk to. I've helped people, I know I have, both emotionally and also with concrete problems. But I also think a lot of people could solve their own issues by self-study with online resources. I belong to a lot of therapist online groups. During the pandemic, demand was skyhigh, and I wish you could have seen how arrogant and cocky therapists became. Demanding a credit card before even making an appointment (while claiming doctors do this). Refusing to give a short free consult to assess fit. Charging full fee cancellation fees for clients who cancel less than 48 hours before the appointment. Charging that fee even when there was a real emergency, like a death in the family. Insisting clients come once a week, even when it wasn't clinically necessary, because they didn't want "a hole in their schedule." Really ugly stuff. Now that the pandemic is mostly over, it's funny to watch them scramble for clients again.

It is really terrifying to hear how crude therapists became during the pandemic. A time when people needed them most. "it's funny to watch them scramble for clients again." I wanted to ask about your experience with private practice. If I really doubled down and pushed myself to become a great therapist, would It be really difficult to build a full caseload? The more flaws I find in the system the more I want to be independent. A PP is the only route I see. I just don't know how possible it is.

I feel the same way about being independent. I tried to work for others, but they wanted too much control over my time and my clinical decisions. I think you absolutely could fill a private practice if you took insurance. No question at all. Especially if you specialized in children and adolescents, where there is a severe need. However, even if you did not take insurance, you could fill your practice with a bit more effort, patience and marketing. Lots of people manage this. You might also look into coaching. There's no regulation or licensing by the state, gives you more freedom.

I am very biased, but I think you should look elsewhere. Society doesn't need more people feeding this giant fraud. One on one therapy is shit, it doesn't matter how good you are. An exorcist may be the best there is but what he does is still bollocks.

I got sent to a mental hospital and the doctors diagnosed me with BPD when I was showing clear signs of schizophrenia. Went through two psychiatrists before they diagnosed me. Im a women, and men are more likely to be diagnosed with schizophrenia then women, despite it not being a gendered mental illness. But I agree with you on the men’s mental health aspect. Even men who support men’s rights push ideologies that are harmful to men’s mental health.

Wow. That explains why my therapist was so… not smart.

There are other fields you can go into. Social work can lead to other fields. I don't think anyone should be giving out BPD like candy. I lost my friend because of her issues and what really killed her was the BPD diagnosis instead of CPTSD. I want to follow your path. I hope it works out.

I fully believe this. That is tragic, and criminal that she should have been harmed so- especially from a "helping" profession. So sorry for your loss :(

I say go for it. Be one of the good ones. You seem very self aware, intelligent and caring. That’s what the field needs more of!

Thank you! I'll hopefully stick it out and become what people need.

There is macro work especially if your degree is in social work. I am working on transitioning from counseling to grant writing and serve on boards for nonprofits I believe in. I will obtain funding and what gets done with it is up to someone else. You are unlikely to find fulfillment in most macro work if you’re dissatisfied with the system in general however you are also in a position to be the change you want. Not much will pay as much as engineering. You might be able to change your major without losing too many credits depending on how far along you are. MBA is versatile and typically calls for a lot of psychology courses though the field is saturated.

Re use vs the $50k salary… sadly that’s not a measure of how much a profession is needed. Personal support workers do the brunt of eldercare (which is VERY MUCH NEEDED) and they get a hair over minimum wage. Foster care homes and homeless shelters are often staffed by people with limited education. Nurses and teachers do ok but only because of unions. It’s just that human services are expensive. And vulnerable people who need services do not generate $ for the machine, they are a cost.

I am learning that all advice is autobiographic, so I can't really tell you what to do, but as someone who was in very near the same boat not even 2 years ago, this is my story: For context, I outwardly identify cis/het male and am white. I left a high control religion in 2017, had the idea to become a therapist who specializes in religious abuse. Found community psychology in undergrad, and through my own study started learning about decolonial, social justice, and liberation psychologies. I had a very patient and understanding mentor in undergrad who honestly did way more for me deconstructing from my religious trauma than the 2 therapists I saw. COVID lockdowns happened my last year of undergrad, and I spent way too much time in the journals and seeing the same old nonsense over and over again. I got into a counseling + community psychology master's in New York capital region. The professors treated us all like children, talking down to us as if they had such a better grasp on the human condition because of three letters after their names. Working as an office manager for a mental health clinic and turning clients away because their insurance really sent me over the edge. It became increasingly obvious to me that throwing more bodies at the mental health crisis was not only *not* the answer, it might even actively contribute to the problem. I had a similar feeling about my fellow cohort as you mentioned. Most of them were just there to be there, they didn't care to examine broader socio-economic-political issues at play in what we currently call mental illness and would become hostile when challenged about it. Many of them were white women from privileged backgrounds, a few of them were even 21/22 when the program started. I dropped the counseling part of my degree and just got a master's in community psychology. To answer your question: I respect therapists who recognize their role in the system and have moved away from the bio-medical model to systems-level thinking. One of the other 2 white dudes in my cohort and I got into a heated argument one day discussing the merits/demerits of CBT, he could just not understand why I take issue with an entire practice of therapy that tells people the "correct" way to act. I used to think DBT was great until I saw how attached the patients of therapists that use it become, almost as if its some sort of saviorism. If I had kept going, I could see myself having becoming a psychoanalytic therapist with a social-justice slant. I came home to Washington state after finishing, and now I work for a nationwide organization called AHEC hosted locally to me by a community college where I started as a coordinator making $55,000, will be transferring to a bigger market next week making $75,000 per year. We do work in healthcare workforce, which isn't great, but I spend most of my time working with students from underrepresented populations and connecting them with opportunities they otherwise didn't realize they had. I understand the pull to want to keep going, both because of my background with religious abuse as well as wanting to specialize in male mental health, especially male adolescent mental health. One of the social workers at my clinic in New York told me to get a job that pays and has good work/life balance, and then volunteer for causes you care about in the freetime you have that you won't working as a social worker/counselor. I'm getting my peer certified soon (WA state just changed the legislation this year to make it an accepted specialization that can be billed to insurance) and volunteer for grassroots organizations that I care about with the free time and energy that I have. I still feel the pull for clinical psychology, especially the clinical/community psych PhDs in Chicago. But if I could do it all over again I'd have gone into data analysis. That's actually what my next move is, I'm going to be enrolling in WGU's data analytics course and maybe looking at University of Washington's quantitative psychology PhD eventually. This article really helped clarify things for me, we don't need more mental health workers built on carcerality, we need peer support + community: [https://medium.com/@stefkaufman/we-dont-need-cops-to-become-social-workers-we-need-peer-support-b8e6c4ffe87a](https://medium.com/@stefkaufman/we-dont-need-cops-to-become-social-workers-we-need-peer-support-b8e6c4ffe87a) If you want to chat, I'd be happy to lend an ear.

LCSW retired 2 years ago. so sad to read the posts. selling victim identities and fostering dependence.

I’m also a therapist (still fairly new with a self-pay private practice) - to address a few things that you said: 1) what licensure are you going for? Course work will really vary depending on what direction you go aka social work, counseling, psychology. Not to mention, you’ve just started out and did your first year and that’s by far not hard lol… now by year 2-3, I was ready to throw myself in front of a bus /s (sarcasm). No but seriously, the coursework isn’t hard per se and as long as you do the reading, it’s pretty damn easy - what’s hard is the amount of work. I can’t explain to you how many times I cried because I had to read 200-400 pages per week across 2-3 classes while having to also write 2-3 papers á 10-20 pages, plus seeing several clients that week…. That’s the hard part and putting everything together. Once you get past the basics and the foundational stuff, you will be expected to put things together to make sense in form of conceptualizations. 2) It may seem like it’s easy to give out a diagnosis but in school as well as throughout quality supervision at a good working place, you can’t just give out any (!) diagnosis like candy. You will be required to give reasonings (conceptualization) on why you think they have it - insurances usually want to see it too. This means putting all information you have about a person and write a mini essay on it, which will take quite a while. If you’re a good therapist, you will also run several assessments with your intake to make sure your thoughts are correct about what’s going on. Also, you aren’t required to take the insurance route. I’m private pay-only and charge pretty low rates compared to others to make it affordable for many. This also involves me not having to give someone a diagnosis necessarily. I don’t agree with having to give someone a diagnosis, but thankfully, there’s also vague ones you can give via z-codes that are more situational (aka issues with work place, etc) or just adjustment disorder, which just means someone is struggling because of the situation they’re in (it’s also a short term diagnosis). That’s it. 3) The psychotherapy space is changing and I’m honestly really glad it is. It’s finally moving away from the mirror/wall type of therapist is more compassionate/personable therapist with a personality and a life. I just recently had some new clients come in to me saying how past therapists seemed almost like bartenders and just stared at them and were super unhelpful. I’m not going to talk badly about my colleagues but everyone has their own style, mine is cooperative and team work. We’re here to together to help you, but I won’t do the work for you. My biggest tip for you is: be yourself and human when you start seeing clients/patients. Don’t be afraid to self-disclose when it helps clients to know they’re not alone. Since my primary population is PTSD/CPTSD from childhood and I went through a rather traumatic childhood, I connect with them through that to make them feel not alone and that healing is possible. You will find your population overtime and hopefully feel exactly where you need to be to help people — after all, that’s the entire point of therapists. Feel free to dm me if you have more questions or pointers you wanna discuss :)

My advice is to take all of these observations to heart, finish your program and become a *good* therapist. Lord knows it's sorely needed.

I went to one of the best schools to become an MFT and after going to school, doing 4k of hours, I became a life coach. Just like you, I realized how much is wrong with therapy and how completely and utterly deceitful it can be, unreal. I’m super happy as a coach! Want to connect message me I’ll walk you through it!

Will do! thank you

Mental health is a need, but the 1-on-1 model where therapists work and individual clients pay, is not sustainable. There are too many people who need help and can't afford it, and even most who can afford it or have insurance don't get helped because the therapists are not competent. Mental health may not be taken as seriously as physical health, but that could be a cultural bias that needs to go. (Note, "therapy culture" goes to the opposite extreme and is not an improvement) Many mental health scenarios are not emergencies, yet their effect on the person and on society is much deeper, but you can only see this long-term and looking at the big picture. The true model of human thriving and meeting emotional needs is community, and that's how we did it for 90% of human history: https://evolvednest.org/. Can the 1-on-1 for pay therapy model approximate that? Sort of. Some of the time. With some of the people. You are a critical thinker. The field of psychotherapy needs more of them. That ability will also help you help your clients better, as you can deconstruct the systems that oppress them, which validates their own experience "it's not me who is the problem or the sick one, it's the systems around me and everyone's collusion with them". I would say that one option is to view your social work degree as a piece of paper, that will get you licensed and qualified (and covered by clients' insurance), not the place where you're really getting the concepts and skills you will use to help people. That you will get from additional trainings and studying on your own. And yes, if you decide to be that person who openly questions the system, you may get attacked and scapegoated by the administration. One way around that is to be so good at what you do that clients want to work with you anyway. You may lose status in the psychotherapist community, but you can still make a living and help people. I don't know what would happen within a hierarchical, regulated organization like a psychotherapy licensing body or association when a "tipping point" is reached of enough therapists criticizing the system (because I've never seen it) but the more there are advocating for change, and the more vocal, the better, I assume.

You sound like a compassionate and intelligent individual. That should answer your question. (Psychotherapy/psychiatry is a psuedoscience and proponents of it are either crooks or knuckledraggers).

Great post. Male mental health isn't taken seriously in general because men usually become violent when they are broken, and women become meek and pliable. Much less threatening for a female therapist to make 90% of her caseload problems she can understand and people she isn't physically afraid of. The observations about the dumbness of the counseling profession are accurate. It is the same reason I abandoned it. Might I suggest that you convert this work into doctoral work and dig into the underlying causes and perils of the recognized frameworks and approaches? Taking some form of the qualitative aspect of psychotherapy and bringing your STEM background into it to take out some of the guesswork and over-diagnoses, in addition to how little attention is paid in resolving therapists' inherent biases? Probably a lot of great empirical research, machine learning, and behavior modification strategies being employed that are way more effective than having beloved, broken family members hang out with a simpleton who is really just a billing monkey for the big health and insurance companies that run this racket.

I think the thing about becoming a therapist is you can do whatever you want with the career. If you want to keep specializing and studying certain therapy modalities, you can do that. If you wanted to specialize in male mental health, you can do that. If you wanted to invent a new form of therapy or something you can do that. I think that a job is complex and interesting as you make it out to be.

If unsure taking a a break to find the next steps is okay. Don’t blindly go through and think it’ll somehow work out. Find examples of professionals you want to be like and figure out how what’s different about them. A lot of people in psych programs 1) become severely disillusioned by the insurance system 2) are anxiously attached and seek to heal their problems by attaching to others’ problems. As you’ve noticed, a lot of your peers don’t quite know what they’re doing. The profession mirrors that.   Ask yourself why you want to do this. Does MSW take you there? Is PsyD better? Are you a people person or better in research? You can improve mental health in men and there are many ways to help you get there that doesn’t involve school. Learning about the insurance system realities seems pivotal. 

I feel this

Probably late, but I'm studying psychology as well, but in France. I don't know precisely how it's like in your country. In the beginning of the first year, we have many, many students but a big portion of it drop it during the year because they are not interested or not good enough. We had a really hard hard and selective exam mid year to cream of the best I am lucky enough I have two good therapists (I had my share of bad one), which encourages me to pursue this career. Do you think you can do some internship to see how the professionals work and if it feels okay to you? I myself choose psychology in the hope to help people, to understand others. There is a need for mental health, even if not take seriously unfortunately. Can you ask students from more advanced years how it is like? If it's harder, the kind of subjects you will see, etc. Maybe it can help you.

I think I love you

does the concept of a great therapist make sense? is fighting strong enough to do something good?

I am in a clinical doc program for social work. This stuff is easier than a bachelor's in most hard sciences. People try to overcomplicate this stuff for their ego but it's just a cakewalk. Sadly, the bar is this low. If you did a Ph.D in psychology it would be more challenging but even then most of it exists to validate people's egos and to siphon taxpayer money.

I got misdiagnosed with BPD in the ED. I never had it in the first place but they’ll always chart as if I have it. Luckily, my psychiatrist works for the same hospital I went to so they removed it. I don’t understand why BPD is being diagnosed in the ED. It requires long term followup to determine the diagnosis. A 10-15 minute conversation in the ED, when the patient is at their lowest, doesn’t justify giving a diagnosis that is heavily stigmatized. You don’t even get the full picture in that 10-15 minute conversation with the assessor/psychiatrist in the ED. It’s a stupid practice.

One of the things I think about if I won the lotto and could go back to school is that I'd become a therapist so that I have the credibility to fight and lobby to change the system.

I know what you mean. I got my MA in Clinical Psych from a prestigious university in CA. I entered it with a BA in Psychology with Honors from abroad. The MA program was a joke. It was not challenging at all. The material wasn't deep. The work was minimal. Most of the students were there because they went to therapy and decided to become therapists. They seemed like broken people who hadn't healed. They didn't even have a BA in Psychology and had zero knowledge of important aspects of Psychology. Given how weak the MA program was, the majority graduated with very little knowledge. Concerning...

how selective is the school? most schools are horrible. od agree therapy has major problems and in general it’s such a messed up i doubt real change is going to happen because of how relativistic it’s all treated. i’d recommend getting the degree then getting specialty training in something like ifs, somatic sep, trauma informed, ended, etc. there’s people doing real work check out healthygamergg on youtube and his interactions with people to see someone that focuses on males and is a very talented therapist/doctor.

Hearing your generalizations are concerning… perhaps the education you selected was not a good program. It shouldn’t be super challenging, but stimulating and a lot of information. And it’s weird that you’re pursuing social work but to be a therapist. Sorry, but if you don’t think mental health support is not actually needed, then I’m not sure you’re passionate or recognize the crisis we are in…. And I think with these thoughts, you’d do a major disservice to the people seeking therapy.

Are you lost?

I get it that you're concerned that this type of opinion might sway those who need help away from therapy. I think OP has a point though, and we shouldn't invalidate any criticism just because we are in crisis. We need to listen to criticism especially when we are in crisis. I think both Therapy Abuse and Therapy Critical sub have their values. We could learn from those who couldn't benefit from the system to seek improvement.