Mental distress is a human experience that can range across a wide spectrum. It can be a depressive episode that comes and goes regularly, a relationship argument that triggers anger issues, or suicidal attempts to end all the struggles right now. When a person is struggling with such distress, it can be confusing to know who to approach to resolve these issues. In my work, I have seen clients who have sought each of these professions, and they turned out very differently, with horror and success stories. Hence, I write this post to highlight the differences between each of these professions, in the way they are trained, and the likely approaches they adopt to help. Share this post with people whom you know will benefit from this knowledge.
1.Psychiatrist / GP – The Medical Professionals
This is the most common go-to I see in my clients. When someone is in psychological distress, such as anxiety, insomnia, depression, they see a doctor, thinking that psychological and physiology can be treated the same way – through medications. Psychiatrists are trained first as doctors, through a typical medical degree, and specialised into mental health. The primary mode of treatment from the medical system is medications, such as antidepressants and mood stabilisers.
Pros: Medications are highly effective in reducing psychological distress on a biochemistry level. This approach is highly suitable when an immediate treatment is necessary, such as to prevent drastic self-harm or suicide. The medications increases the concentration of “feel good” hormones that balances the activity of the brain, so negative thoughts and behaviours get reduced.
Cons: Medication are just temporary stop-gap measures, with possible chances of forming dependency and addiction. I have clients experiencing severe mood swings and insomnia once the medications are reduced, which is not surprising because medications does not change the internal cognitive and emotional processes. The same patterns of thinking generating the distress will still happen once the biochemistry is reverted.
Indeed, research has shown that interventions using medications and therapeutic sessions have significantly higher improvements and less relapse rates, as compared to using medications alone.
I believe that a psychological distress is contributed by both biochemistry and dysfunctional patterns of thinking. And once formed, these 2 factors self-perpetuate into a negative spiral. Hence, the best way forward is to include therapeutic sessions. The latter three professionals are trained to provide these therapies.
2.Psychologist – The Scientist-Practitioners
My doctorate is in the field of psychology. Psychologists are first trained as a scientist of human experience, then a practitioner to help. Most psychologist have no practical experience in helping during the undergraduate years. Their orientation is to approach a client as a scientist-practitioner, and will be unethical to practice any therapy that has not been supported by science.
Pros: Any strategies adopted by a psychologist are backed by science and has been tested with many subjects. The chances of treatment success is high. Treatments are also highly based on scientific approaches, where pre and post-intervention assessment scores are systematically obtained and compared to determine treatment success.
Cons: Many psychological experiences cannot be generalised. What is supported by science may not work on the specific client. Under a psychologist, the client can only be treated with strategies that work on the majority of the population. There is a chance that the client can be better helped with an alternative therapy, which is hard to research on and so cannot be adopted by the psychologist – which encompasses many useful therapies other professions use (e.g., Hypnosis, NLP and Narrative Therapy). Counsellors and life coaches, as elaborated later, are not confined by these requirements.
2.Counsellor – Past & Present Orientation
Counsellors are getting to mainstream psychology. Counsellors are trained primarily as experiential practitioners, and less of being a scientists; hence, they are more flexible to attend fully to a client’s experience without the red tapes. They focus on helping an individual come to terms with life challenges by focusing on the past and present. They have wide access to many different approaches that have shown treatment success, which may or may not include those adopted by psychologists. Counsellors also treat milder levels of distress, such as time management, confidence, forgiveness, as well as tougher distresses, including mood dysfunctions and relationship problems. GP/psychiatrists and psychologists are more inclined to treat at-risk and near-clinical cases.
Pros: Counsellors provide a more personal touch to the treatment process. Some of my clients detest to the process of scientific measurements because those numbers do not represent how they really feel inside. A change in the numbers did not necessary make them feel okay to be let off the therapy. Some clients prefer a more personal approach.
Cons: Counsellors focus heavily in the past and present, including heavy exploration of the past. My experience as a life coach demonstrates that the conversation about a past problem is very different from the conversation about a positive solution-focused future. I have clients who relate to me counselling experiences that were so invested in past abuses, that they left the session not knowing how to move forward. And over time, it becomes a negatively geared therapy process. Life Coaching provides the “what now from here?” answer.
2.Life Coach – Present & Future Orientation
Life coaching is my preferred profession because I believe true treatment success has to be one that is unrestricted and authentically personal. It has to also include invested growth elements so that the clients not only improved from a -5 to 0, but also from 0 to +3. The client will leave being a stronger and more resilient person.
Life coaching has most of the skills and therapeutic knowledge a counsellor has. But a life coach focuses on creating a positive future, from a distressed past and present. The focus on moving forward is intense, and the client will be consistently challenged to be empowered. A frequent question we use is “knowing all these are happening or have happened, what is one small step you can take right now to change your future?”. Life coaching is a thoughtful and challenging process because the client has to truly show up authentically and start climbing up the rut.
Another key strength of a life coach is that we produce clients who can eventually self-coach. I see most clients not more than three sessions, with efficient treatment success, and little relapse rates because they know how catch themselves as they realised they are slipping.
Pros: A truly empowering and personal therapeutic process to restructure the thoughts and emotions to be more functional, without needing the use of medications.
Cons: Life coaching is not suitable for highly unstable or clinical clients, with a thick traumatic past.
Mental distress can be seen as mild or severe, and its treatment approaches can be taken from the medical or therapeutic processes. Also, both biochemical and psychological processes have to be accounted for, if applicable. Depending on what a client is experiencing, the right professional has to be selected to obtain the best care.
Share and spread this knowledge, and raise the global awareness.
Original writings by The Realist, inspired by encounters in professional work in life coaching, physical therapy and PhD research.