Dr. Daniel Trussell - Positive Pyschology

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A Letter From Dr. Trussell

Dear Reader,

I was a psychotherapist for about 25 years before I became interested in revitalizing my skill set and reinventing myself. Trained as a family, group and individual therapist , I met my calling to help people learn how to live a rewarding and satisfying life.

When I started practicing psychotherapy, I went about the business of counseling people in a rather passive way. I used a lot of "uh-huh", "I see" ", "tell me more" statements as people talked about whatever came across their minds. My clients reported that I helped them feel better. Yet the behaviorist in me kept thinking "don't just talk about changing your life, take action!"

Unfortunately, two or three years would pass and these clients were still talking to me about the same things that bothered them and the same dreams about how life could be. If I stacked a nickel for every "if only…" I have heard over the last 30 years, the stack would reach to the moon.

A disturbing trend I have noticed over my career has been the increase in treating depression and other "mental illnesses" and the increase in the billions of dollars spent each year on psychiatric medications. Equally disturbing is the drive toward diagnosing people with a mental illness simply because they are having difficulty coping with bad situations in their lives.

I am not naïve. I recognize that this is partially driven by the insurance industry because they pay only for medically necessary treatments and people do need support when bad things happen in their lives. Therapy is expensive and not affordable to many without supplementation of insurance payments.

I do not deny that a small percentage of people are mentally ill and do require medication and other treatment. However there seems to be no scientific evidence to support an increase in mental illness over the past fifty years, only an increase in diagnosis and treatment of mental illness. I might add there have been no corresponding advances in medical science to diagnose mental illness that is generally available to mental health counselors. Diagnosis is still made based on the reporting of symptoms to a mental health provider.

I had the privilege of working in a psychiatric intensive outpatient program (IOP) for the last five years of my psychotherapy career. AN IOP, sometimes known as a day treatment program, is comprised of the sickest population whom the organization attempts to stabilize in all day every day treatment in order to avoid hospitalization, or those just released from a hospital but still quite emotionally fragile. It was the most rewarding work I ever did as a therapist. I worked internally for an HMO with a membership of about a quarter million.

When I began working for this organization, the IOP population was stable with about 12 patients being treated at any given time. When I resigned, the average daily census in the IOP was 45, but there was not a corresponding drop in hospitalizations or alternative IOP referrals and the membership base had only increased by about 30,000 over that five year time. Moreover, the average length of treatment when I began working at this program was 2 -3 weeks. When I left five years later, over half were still in treatment after10 weeks. The only evidence based difference was a shift in therapy orientation (from action oriented to psychodynamically oriented) and a belief by the staff that people were sicker today than they were five years ago.

This led me to conclude that something was very wrong. Either the city's drinking water had been contaminated with a drug to cause more mental illness or psychotherapists, me included, had contaminated their view of what comprised mental illness.

In the 1990s I began to read the works of Martin E.P. Seligman and recognized that mental health counseling, as I had been taught to practice it, simply didn't work over the long-run. There were many short-term successes, but people returned to therapy over and over. I have had several private practice clients with whom I have worked, episodically, for over 20 years. Although they get better and become happy each time we worked together, the happiness is short lived. Is therapy a life long process? Yes, for most people because they are not exposed to a set of skills that builds and broadens their base to find lasting happiness.

Today, I work with people who want to grow out of psychotherapy and into a life more worth living. I work with people outside the boundaries of resolving childhood trauma, learning coping skills, and managing depression. I work with people ready to accept the challenge of taking action on constructing a satisfying and meaningful life. So few things in our lives are unchangeable if we apply the skills of positive psychology, the psychology of optimal human functioning.