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LOVE FOR SALE: the trouble with professional caregivers 04/04/2011

Posted by ALT in Mental Health News.
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Remember Dr. Levin?  He was the psychiatrist featured in the New York Times a few weeks back as a case study in the new, industrialized form of psychiatric care that is increasingly becoming the norm: he describes himself as similar to “a good Volkswagen mechanic” and offers his many clients 15 minute in-and-out appointments, which start off with a symptoms checklist, move on abruptly to diagnosis, and finish with prescription(s) for psychotropics.  There simply isn’t time for exchanging pleasantries – like the patient’s actual name – or for suggesting alternatives to medication like talk therapy or mind-body healing practices. 

LOOK OUT: Dr. Levin isn’t a scary singularity, and neither is psychiatry as a field. 

The article describing him was part of a series (Doctors INC), in which the NYT is documenting a similar shift that is happening across all fields of Western medicine.  A shift from individualized, long term care of a small number of patients (50-60) taking place in modest clinical practices (maybe even home-based!) to industrialized, “efficient,” high volume traffic of literally thousands of patients taking place in hospitals.

In the series’ most recent article, “More Physicians Say No to Endless Workdays,” we see this theme as it plays out in a single family composed of three generations of doctors.  Grandpa had a private, mostly home-based practice (Grandma used to boil urine samples on the stove!).

"Grandma, why does dinner smell like Kevin's diaper?"


Father had a private practice but spent most of his hours at the office and was always on call; and finally Daughter, Dr. Kate Dewar, is working in a hospital emergency room, a salaried doctor for a private corporation.

She cites several reasons for the shift – in her current position she is never on call, she has the opportunity to perform more “interesting procedures… collect[ing] rare and difficult interventions like merit badges,” and she can “fix stuff and move on,” not having to worry about pesky follow-up or long term care. 

But Ms. Dewar’s primary motivating factor was the birth of her twins in February.  As a salaried ER doctor working for a corporation, she can work fewer hours, spending more time with her children. 

Understandable.  And admirable!

But wait…

“Look, I’m as committed to being a doctor as anyone. I went back to work six weeks after my boys were born. I love my job,” said Dr. Kate Dewar. “But I was in tears walking out of the house that first day. I’m the mother of twins, and I want to be there to feed them, play games with them or open presents with them on Christmas morning. Or at least I want the option to do those things without fearing I’ll be called back to the hospital.”

The pain of that first week’s separation was lessened somewhat because she worked in the hospital’s new pediatric emergency department. “I felt better knowing that at least I was taking care of somebody else’s babies even if I couldn’t be with mine,” she said.

(from the NYT article “More Physicians Say No to Endless Workdays;” emphasis added)

I thought she wanted to spend more time with her kids?  At 6 weeks old, her babies are still well inside the gestation period, three pre-natal trimesters plus the post-natal “fourth trimester.”  Put simply, though they’re not physically connected by umbilical cord anymore, they still make up a mother-baby dyad.  Those babies need mama.  24/7.  And mama needs them, too.  It’s biological, instinctual. 


The Vicious Cycle

So this is how the vicious social services cycle begins.  Instead of directing her instinctive surge of mothering energy towards her own children, Dr. Dewar directs it – for profit – towards the children of strangers [probably using some of the profits to hire a professional caregiver to direct inferior mothering energy at her own children]. Finding themselves out-of-place and re-placed in the professional setting, the mothers of Dr. Dewar’s surrogate, hospitalized children will then be forced to redirect their own energies, starting a double-edged chain reaction: all of the mothers continuously frustrated by failed attempts to mother other things (not the children they were designed to care for) and none of the children benefiting from the highly personalized and unconditional-love-charged energy of their own mothers.

When professionals take the place of parents, everyone suffers – biological parents, children; the surrogate (professional) parents, their charges, and their true (biological) children.   No one is completely free to give the gift nature designed us all to give [unconditional love!]; no one fully experiences the benefits of such an amazing gift successfully given/received.  Will the defecit created in all of these [physically, emotionally, spiritually] frustrated  folks pave the way for more social “services” later in life?  It’s a strong possiblity. 

No matter how well paid, professionals simply can’t love children like biological parents can.  And love is what a baby needs, above all else — even the most critical condition, premature baby.  Skin-to-skin contact.  The reassuring voices of people baby knows well (though she has only recently been able to see them, she’s been hearing their every word for the past nine months!). 

Love.  Free.  Unconditional.  Forever.

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1. stevebMD - 04/05/2011

Another fantastic post! It is astonishing how we are so willing to turn over the care of our loved ones to someone else– and, similarly, to assume the care of others for whom we have no genetic commitment. It’s almost as if we, in present-day American culture, have been led to believe that we are inherently incapable of managing our offspring (and, in many cases, ourselves!) and must hire others– “experts”– do to it for us.

You hint at the most likely explanation when you mention “profit.” Caring for someone else (as physician, therapist, life coach, teacher, nanny, etc) can lead to great material gain , while the rewards of caring for our own kin are more emotional and sentimental. The latter rewards are longer-lasting and more intrinsically meaningful, but our society imbues the “professional” caregiver with greater status.

It’s such a shame when “love is for sale,” as you put it, but then again, there’s obviously a market for it.

2. Anne - 04/06/2011

You put into words what i have known for many years. I am looked down upon for being a stay at home mother by women in the helping professions. Parenting has been commodified and sold back to us in the form of Kindermusik and camps and cooking classes. I opted out of that weird cycle and just decided to mother directly. I ignore the ones who tell me they could never do it, or that I am too close to my child…..

3. Teresa - 04/06/2011

Thank you, very much, Almentalities!

As a survivor of extreme domestic violence, with children who were toddlers when I divorced their father/my would-be murderer, I have been subjected to professional “helpers”[controlling, abusive, power-hungry, social “service” oppressors, I have since realized] ever since.

Many of them actually indicated that they would be taking the place of my and my children having a real family, [while they would profit from it, I soon realized.]

Many of them did incalculably huge amounts of damage to my children and me, in my opinion.

While I have many strengths as a mother, they repeatedly sabataged my parenting via their oppressive social “services” system, in my opinion.

I strongly preferred to be supported and empowered in healing and recovering, but I found very few unselfish people truly wanting to be of real service. Most of the ones who truly did empower and support me were those on hotlines for battered women and survivors of sexual assault and job survival. [Even then, I often have had to wade through abusers, sometimes, even there.]

I strongly believe a more empowering healing approach, instead of letting these fake “helpers” take over our families and our lives, for their own selfish agendas, that we need to return support and honor to parents, and support them in doing their best, instead of constantly blaming them.

Words cannot describe the emotional pain and outrage I feel as a result of having to perpetually sidestep these abuser/oppressors who society has given control over needed basic-needs-meeting resources, who abuse and oppress in the name of “helping,” in order to heal from extreme ongoing original trauma and then their RE-traumatization in the name of “helping” me.

I have had to fight tooth and nail, so to speak, in order to heal, and to find ANY support in healing, it has often felt like.

I was taught as a child that I would be a leader in a democracy, and that we leaders were to protect our democracy from oppression. I grieve that, instead, I have felt subjected to something far, far unlike a democracy, in my time of need as a mother, subjected to the very undemocratic process of child abuse as a child, then and as a battered wife, then as a single parent being so “uppity” as to not to want my children and me to be targeted for extreme violence, terror, torture, and murder.

I wanted to be supported in being whole and well, in having a meaningful career which would support me and my children well, and in being connected in community with others, and in contributing, in a meaningful way, to my community.

Instead, it has often felt like these “helpers” trashed my and my children’s lives , wasted my life energy and my positive intention to contribute to my community [I am gifted, talented, and educated, and love to be of genuine service to people (NOT doing an abusive oppressive, power trip in the name of “helping” people when I am actually selfishly injuring them for my own self-gain, the way these imposters do.) ]

I intend to still do this, am in the process of doing this, yet now I have to deal with multi-layers of re-traumatization from these creepy manipulative “helpers” whose lies and manipulations repulse and disgust me, and leave me feeling very betrayed, at this point.

I pray for the American people to wake up, and stop letting these super non-democratic phoney “helper” people take over our lives!!!! I pray for justice for all the damage they have already done, to so many people, and to our society, being greedy and power-hungry in the name of “helping.”

Fortunately, I am very resourceful, creative, intuitive, inventive, resilient, and , best as I can, reclaiming my civil rights, my dignity and self-worth, and my win-win peacable power.

My supporters tell me I am very strong, am a loving, caring, peacable, good-willed person.
I have achieved, am achieving, and will achieve what I intend, despite these snakes-in-the-grass/wolves-in-sheep’s clothing. I am older and wiser, now, and very, very pissed. [I am working on forgiving them, so I can be at peace.][Also, I am trying to transform this outrage into creative, life-giving channels and alternatives…]

4. Teresa - 04/06/2011

P.S.-Take a look at the PBS documentaries, The Taking of Logan Marr, and Failure to Protect.

My children were never taken away from me, but I am aware many, many mothers’ children were wrongly taken from them and put in foster homes where they were sexually and physically abused, and never returned to them.

5. altmentalities - 04/06/2011

One of the watershed moments in my “career” as a children’s mental health researcher was a study we did a year ago. I interviewed about 25 different social service providers — guidance counselors in schools, CPS [Child Protective Services] administrators and caseworkers, clinicians, people who arrange for families in need to get financial aid, etc.

I was shocked, sickened, NAUSEATED by their vicious and hateful attitudes towards parents! See — I was in the club. They thought they were preaching to the choir. So they tore the lid off hell and said what they really thought about parents who have “let” their children become “problems” or “burdens on the system,” parents who weren’t ensuring that their children grew up to become “productive members of society.”

[Someday, as a parent, I will do my darndest to make sure my child knows he can be whatever he wants, can define so-called “productivity” for himself… and that happiness and balance are more important than “productivity,” anyway. I guess that will make me a bad parent?]

According to these professionals, whose job is to SUPPORT parents, parents are 1. dumb 2. greedy 3. uninvolved and disinterested 4. incredibly needy 5. did I mention dumb? 6. have the audacity to question the expertise of PROFESSIONALS who clearly know better 7. Ought to sit down, shut up, and do exactly as they’re told… just like the kids in school.

[And I need hardly mention that my boss, the Research Scientist, did a lovely job of white-washing all the terrible things these people said on tape. The “report” that was finally produced from the study addressed none of the isssues that were so clearly apparent… instead it made vague references the “community’s needs,” which included “destigmatization” to be accomplished by “public education.”]

This was when I began to realize… these “service providers” don’t care about helping families. They care about shaping families into some kind of twisted mold that many just don’t fit (and it wouldn’t be healthy if they did!), and above all else they care about job security. Making sure people “need” them so they can keep getting paid — all the while damning people for being so frickin “needy.”

I’ve seen a lot of horrendous things in my interactions with these providers, especially when I contrast them to my interactions with many of their so-called “problem” children — I could find nothing wrong with these kids! NOTHING. They were human beings. Human beings trying to survive and thrive, with or without the help of others.

Why do these professionals find it so hard to support that? To support our fellow humans’ attempts to just be.

And what lessons can we learn from their mistakes?

6. breths - 04/07/2011

This is a very galvanizing post for me as are all the comments…I studied women’s studies and have come full circle so that now I think women should be with their children 24/7 in whatever way that needs to happen, and that men shouldnt be near them unless supervised…coming from a physically abusive childhood and possible sexual abuse as well…we do not give parents enough control over their children and now so called professionals have stepped in to tell us how to raise our own flesh and blood

we have given all expertise into the hands of doctors and other professionals because of seeing science as the highest value, when instead we need to hold love and compassion as our highest values because that is what makes good parents, and if people were loved with a certain ethical faith systems, then they probably would not resort to other means of happiness, which is what gets parents into trouble – we have forgotten as a society what love is…

and it really is a biological reality which is why we honor it in marriage…it turns into children and no matter how it happens it happens and the point when they are here is when we need the love the most, for the child and for each other, and that takes work and in this society that kind of work is too hard for most people…because we dont honor it

which is why I have stopped seeing my psychologist…I feel like I am paying for friendship…for someone who is withdrawing from psychiatric meds I now desparately want and need to be making decisions for myself that are not obstructed or questioned by someone who is in a professional relationship with me… or even paraphrased – when I told him this he asked ‘dont you want to talk to someone to just throw out ideas, to paraphrase what you are saying as a kind of confirmation?’ and I said no…because I have been so questioned over my judgements all my life that even someone repeating what I just said feels like I need to question myself and I just cant do that right now, or maybe ever

the time it takes to go to someone and talk about all your heartaches or decisions or issues just diminishes the reality of actually living the heartache, decisions, or issues…I live them vicariously in his office and he cant see that, so when someone comes along I dont have the energy to be with them because all my energy went into blabbing out my heart to someone who really has little emotional involvement and even if he did what difference does that make? it is not going anywhere and I havent sensed any kind of transference going on even after seven years

but I am still withdrawing from the drug and think I may need his assistance as he is wellversed in the procedures involved so am at a standstill at this point

thank you to gianni and her ever poignant posts, which is where I found this wonderfula article, on http://www.beyondmeds.com

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