Language barriers and the underpants gnomes

My original intent with this blog was to describe my experience chronologically. I'm going to interrupt that flow right now, however. Last night I was in the office with my current therapist trying to find a way to cope with feelings of panic and despair that have prevented me from working for the past three days in a row. I realized two things. One: Therapists as a community are very much like the underpants gnomes of T.V.'s South Park. They seem to lay out three phases of treatment which go something like this

Phase one: Collect underpants (Tell your therapist everything)

Phase two: ... (No one seems to have quite put their finger on it)

Phase three: Profit (Feel better)

Now, I'm not saying nobody ever benefited from what is called "supportive therapy" which seems to be based on the idea that simply talking about your feelings and circumstances will help alleviate them. In fact, it may be ideal for people just beginning therapy who are struggling to understand what is happening to them, newly diagnosed people who are just wrapping their minds around their symptoms, or even as an adjunct to other therapies for people who are in long term treatment but who have little support. However it's been my experience that staying with this type of therapy exclusively does not help you to learn to manage your feelings, and change them (or at least your response to them) so that you can live an enjoyable life. It can leave you feeling stuck, ineffective, and powerless. Unfortunately, even therapists who claim to take a more cognitive approach are often way more support based then "skills based". So the patients are left with a big whole in their treatment between talking things through and feeling some relief and no practical way of breaching it.

The second thing I realized is what a large proportion of mental health professionals in this country do not speak English particularly well. I do not pretend that this makes them any less knowledgeable or empathic, or any less valuable in a country full of different languages and cultures. Indeed, for people who do not speak English, or who are bilingual, they are probably a godsend. However, I do sort of take issue with the fact that these people are often assigned the care of monolingual Americans like me. This is a profession where diagnosis and much of responsible treatment relies solely on the ability of the two parties to communicate with each other. If one cannot make herself understood to the other, treatment becomes ineffective at best and harmful at worst. And I'm not talking about an accent here. I'm talking about my actual words being not understood. I'm talking about my therapist repeating the same non-helpful phrase over and over because she does not have the words to paraphrase. Should I broaden my horizons and learn to speak Spanish, Russian, Polish, Chinese, or Hindi? Probably. Would it make me a better, more interesting and possibly more empathic person? Again, probably. Does the fact that I have not done so mean that I forfeit the right to be helped psychologically? God, I hope not.