Skip to main content

Let's Chat About Being "Eclectic"

One of the projects our summer intern is working on for us is compiling a list therapists who we can refer people to who aren't a good fit for our practice, whether it's the type of therapy they need (i.e. couples) or distance/scheduling issues.  Our goal is to have a nice list of therapists in our area as well as outside of Chicago that we can reference and give a few names of potential providers.  You may be thinking, can't they just get that from their insurance company?  Or a website like Psychology Today?

The short answer is yes, they can.

But who am I to write about short answers?

I gave our intern a few criteria to screen out therapists to contact: 1) they must specifically state they work with patients with chronic medical illness and/or chronic pain; 2) they cannot describe their therapy style as "eclectic."  I cannot stand the use of that word to describe an approach to psychotherapy, and I think when you're shopping around for a therapist you should pause when you see that in their profile.


Let's just start with a simple definition of the word Eclectic:  deriving ideas, style, or taste from a broad and diverse range of sources.  There were some ancient philosophers who described themselves this way, picking and choosing from several schools of thought rather than adhering to one.  Sounds like a good idea, doesn't it?  In many ways, being eclectic is a good idea.  To a point.  But to define your approach to the science of psychology in this way is a problem.

In my graduate school program, we were required to learn the 4 major theories to psychotherapy, each in its own dedicated semester-long course.  These included Family Systems theory, Psychodynamic theory, Cognitive Behavioral theory, and Existential/Humanisitc theory.  After these introductory courses, we then chose which one fit our fledgling professional style best.  I chose Cognitive Behavioral and went on to complete additional coursework, while those who chose Family Systems went along a different path.  Our 3rd year we had to present a case as part of our passing the program, and we had to conceptualize the case from our chosen psychological theory.  Eclecticism wasn't an option.

If you ask me today, I say I'm a cognitive-behavioral therapist.  Do I sometimes borrow from the other 3 theoretical orientations in my day-to-day practice?  Sure.  To ignore family systems theory when working with a teenager or existential issues when someone is facing end-of-life decisions would be incredibly short sighted.  But I would never describe myself as eclectic as some of my peers do.

Wondering if psychology is unique to the use of this term, I poked around the Google to see if it's used in similar fields such as medicine or physical therapy, or in any profession.  I did find that in the late 1800s to early 1900s, "eclectic medicine" was a thing where herbal remedies and other practices borrowed from Native Americans were used.  The last eclectic medical school closed in 1939.  Other than a practice with eclectic in the name, I couldn't find much in physical therapy; same for veterinary medicine.  It does show up in fields like music, architecture, and art.

So why do many of my colleagues describe themselves this way?  And how many of them truly have expertise in all 4 major areas of psychological theory?  I'd never work with a client who was interested in psychodynamic therapy because I'm not good at it.  Sure, I took 1 semester-long course on it but I spent the remaining 6.5 years of training doing therapy from a CBT approach.  My supervisors were all CBT therapists.  It'd be unethical, in my opinion, to take on someone looking to explore their unconscious processes that derive from their childhood experiences.  Technically, I could do it.  My training is sufficient, on paper anyway; but I would refer them to someone who was an expert on that treatment.

There's a saying an old boss of mine, a physician, used to use - "Jack of all trades, master of none."

Perhaps that resonated with me.  When I looked for a gastroenterologist for myself, I sought one with expertise in Crohn's disease.  Most people prefer a physician who is confident in their understanding of, and is up to date on, the disease they're going to the doctor to treat.  Can they be eclectic in their approach to treatment in that they're open to trying medications, dietary treatments, and stress management?  I'd prefer it.  But I expect them to also have a solid foundation from which they operate, based on the latest evidence-based treatment and theory of inflammatory bowel disease.

As a therapist, I think it's only right to be able to say the same thing to people who trust me with the care of their mental well-being.  Defining myself as an eclectic therapist doesn't impart that.

Best,
Dr. T.

Popular posts from this blog

Game of Crohn's

There are 2 days left in 2017 and I've considered writing this blog post for most of the previous 363.  It's on a topic that nobody wants to talk about. Ever.

Let me start by saying Crohn's disease is a stigmatized disease.  A recent study found it's more stigmatized than HIV/AIDS and genital herpes among the general public.  And this topic, I think, takes that stigma and multiplies it by about 8.

Most people who know anything about IBD know it involves a few main issues:  diarrhea, abdominal pain, and sometimes blood in said diarrhea.  Because Crohn's is a giving disease, it also comes with a slew of other problems including joint pains, eye inflammation, skin inflammation, bone density loss, mind-numbing fatigue, and fuzzy toenails.

Ok maybe not that last one. 

Around 1/3 of us develop "fistulizing disease."  Or what I like to call body termites.  Fistulas aren't unique to IBD and can happen for other reasons, but IBD is a main source of the fistula…

The Long Shot

I don't even know where to begin as my head is still spinning with the news I received today.  So I'm just going to put it out into the ether:

Entyvio (vedolizumab), which I started for my Crohn's disease about 6 months ago, did what no other approach has:  cleared my eosinophilic esophagitis. 

But wait, isn't Entyvio a drug for inflammatory bowel disease?  Yes.

Is Eosinophilic Esophagitis a type of inflammatory bowel disease?  Nope.

Are IBD and EoE related at all?  As far as we know today, no.  There are very few overlapping cases.

So WTF happened?

Without getting into the biomechanics of a drug that's way over my pay grade in medical understanding, my gastroenterologist had a theory that the way Entyvio works would block the cascade of eosinophils (a part of your immune system, a type of white blood cell) through it's magical way of selectively keeping my immune system from attacking my digestive tract.

She was fucking right.

Since being diagnosed with EoE in ear…

Bubbles

I've been thinking a lot about how we live in an era of infinite access to infinite information (thanks, internet tubes!) yet we still fall into many of the well-established psychological laws, if we can call them that, of human behavior.  Don't worry, this isn't going to be some drawn out post on social psychology. Wikipedia is great for that.

I want to talk about bubbles.  Information bubbles, that is. And how each one of us lives in one to some extent, no matter how educated or enlightened we see ourselves to be. And even if we know we live in said bubble, it takes being shown information that directly conflicts with how you think things are, or should be, and the result is you feel kinda ew - the technical term for "ew" being cognitive dissonance.

I live in a bubble.

In my bubble is the world of academic medicine, academic health psychology, and a circle of psychologists dedicated to people living with chronic digestive illness.  I live in Chicago, a major me…