Why ‘Dropping the Disorder’ is so important in my counselling work with Children and Young People
Goal - Diploma in Counselling
Header image: Back where it all began (2006-Joseph Priestly College)
So, at 26 years old, I knew my heart was with pursuing a career in counselling, alongside that was a passion to work with children and young people. I myself had benefitted as a young person from strong role models and counselling. I had grand aspirations to give something back (and in my own way change the world)!
I’m guessing I must have done something right when I was accepted for a Counselling placement at a Third Sector Charity working with 11-25 year olds which is Person-Centred in approach – little did I know at the time, but a place that I would come to think of as home.
Naivety and being a little green…….
Let’s talk…… ‘Mental disorders’ and the DSM (Diagnostical and Statistical Manual). You might think that Diplomas in Counselling would talk about this area or perhaps alternatives to psychiatry and the medical model.
Sadly, back in 2006, my course didn’t offer an alternative to the medical model of diagnosis, and hence I entered the world of counselling simply thinking young people with ‘severe mental health problems’ (Yuk just look at my language back then!) just wouldn’t be people that I would encounter. How wrong could I have been!
To this day I thank my lucky stars I was accepted in a Person-Centred organisation that quickly instilled in me the notion that young people are not the labels they have been given. Whether a young person has been given a diagnosis, is searching for one or is inherently against the idea, instead, we work with them as human beings searching for a deeper meaning to life beyond a label.
I quickly learnt that the young people I encountered could certainly, on paper, be classed as having ‘severe mental health issues’. However, through the guiding hands of my work colleagues, my supervisor, group supervision and further training I learnt that there were other ways to talk about ‘mental health’. In fact, I soon changed to talking about ‘emotional health’ instead.)
‘You do know it’s usually trauma, crisis and life events, right…?’
After a while working at the charity, I confided in my manager how many young people were coming to me with a ‘Personality Disorder’ label given to them by doctors or CAMHS (Child and Adolescent Mental Health Services), and sometimes by the young person searching Google and applying it to themselves. I said how dismayed I was and how hard I was trying to help them believe in themselves and see beyond such labels. My manager’s response was that many young people, especially girls, were being given diagnoses after events such as abuse and trauma…… ‘It’s dreadful and simply unjust, they are just trying to cope!’ shouted my passionate wonderful manager.
I knew I had to up my game, I researched into trauma, read more literature and searched for more training that would help the young people I worked with.
Several young people who had come to me on waiting lists for a diagnosis/assessment, successfully engineered their own way forward, coming away instead knowing and believing that their past and their environment had heavily contributed to their emotional health issues. It was uplifting, magical and inspiring as a counsellor to see how after long term therapy they took themselves off waiting lists, rejected assessments and were truly empowered.
Not all cases turned out so well and often my well-meaning challenges to the medical model fell on deaf ears. I often couldn’t dispel the ingrained belief that for some young people their diagnosis defined them and validated them. (Indeed, it is their right to have and keep these beliefs, but I continued to plant the seeds of an alternative narrative).
The penny drops!! Manchester, November 2017 ‘A Disorder for Everyone’
I remember myself and two work colleagues huddled together at Leeds train station, half talking about Christmas shopping and half talking about what was about to be probably the most influential training that would inform my counselling work to date.
Upon entering the large hall at the venue in Manchester I looked around at the different stalls. I later purchased several books that I still use with young people today, including ‘A Straight Talking Introduction to Psychiatric Diagnosis’ by Lucy Johnstone.
The day started with an overview about the DSM was created and lots of other facts and information that I knew I could use when offering young people an alternative to the medical model. This felt crucial, as often young people’s initial perception is that it is just about ‘chatting’ or getting advice, while the real help would come through hospital or basically anyone with ‘psych’ in their job title.
Speakers included the founder of Drop the Disorder, Jo Watson, Dr Lucy Johnstone who went onto talk about The Power Threat Meaning Framework, and Dr Jacqui Dillon Chair of the Hearing Voices Network in England. There was poetry from survivors and workshops to choose from. I was like a sponge soaking up new information and also having my own person-centred values confirmed and validated. I discovered that poetry from survivors of the psychiatric system would move me to tears and that I was indeed doing my bit as a counsellor……., and it’s a big BUT, I knew I needed to do more for the young people I work with.
As soon as I got back to work the word was out in the staff room……
‘You must read about Drop the Disorder!!’
‘Look, they’re on Facebook too! and they are doing training next year as well.’
2018 Leeds-St Georges Crypt……
Yep, most of my workplace were attending the Leeds ‘A Disorder for Everyone’ event. I was secretly revelling in the fact that I had played a large part in getting them all there!
Fast forward to 2020………..!
In the meantime, out of my weekly workload of 15 clients, at least a quarter have been given a mental health diagnosis, or are in the process of being assigned one. The struggle is real and frightening!
I’m undoubtedly privileged to be able to offer up to a year’s worth of person-centred counselling, with the option of the young person coming back after a 3-month break providing they are still in the right age range. In the world of IAPT and CBT, I’m really aware of how rare this is.
Maybe I sound like a robot, maybe I sound like I’m being endorsed by ‘Drop the Disorder’ (I’m really not!)…But the one thing I will never stop saying to clients is…
‘It’s not about what’s wrong with you, but what has happened to you?’
Eleanor Longden/Jacqui Dillon
(original quote coined by Dr Vincent Felitti)
For many young people, this is the light bulb moment. Amazingly, many young people never make the connection that their reactions and ways of coping are perfectly normal ways to cope with the atrocities they have been through. Instead, I hear stories from young people believing they are “worthless’, ‘stupid’, and that they deserved the trauma and abuse they have experienced.
I will never stop promoting an alternative to the medicalisation and pathologising of our young people!
So that young people can be empowered. So that they can learn they are amazing and that their voice matters.
I feel it is my duty as a counsellor to remain true to my person-centred background, but I cannot withhold information about what can and still does happen when young people are given a disorder label to wear round their necks for the rest of their lives. Many of my clients have gone on to challenge the medical model. They tell me stories of speaking out on social media, attending conferences, activism, telling their psychiatrist they disagree, telling other mental health organisations what is unhelpful, and what isn’t working. They realise their voice can make a change!
I think I have the best job in the world planting seeds in a society dominated by the medical model of psychiatry. I will continue to challenge and question those who are determined to promote the medical approach. I’ve had my professionalism questioned and my integrity and training put under scrutiny, but that is nothing compared to the pain and suffering young people are often subjected to at the hands of psychiatry.
(A thank you card to myself from a wonderful young person/client)