How do we explain what we do and why an MFT is needed in a profession where we already have so many competent professionals with other credentials?
Embarking on a new career is so formidable at times. It feels like my background in biomedicine puts me at a bit of an advantage in many ways, especially when it comes to working within the medical culture, understanding the pathophysiologies, and having a grasp on illness presentations and treatment.
And the lingo. Good God, the lingo. Medical terminology can often feel like a second language. My Dad has very good physicians; they explain things fairly well most of the time; but even so, he's constantly coming to my wife (a nurse, bless her) and me for clarification with his lab results and the medications he's been prescribed. It's no wonder the most prolix people are suddenly inarticulate when they're in the exam room, and defer unquestioningly to their providers' advice.
But... it goes both ways.
My colleague, a neuroradiologist, is well-respected both on the floor and in research for two very good reasons. First, he's brilliant. This is just an outsider's view -- I'm not an MD -- but I do work closely with physicians and specialists across a lot of different departments, and I see how everyone defers to him, not because of his degrees or even his experience, but out of true regard for his solid expertise. And second, he doesn't hesitate to say "I don't know" when he feels he's facing something he has no experience with. Competency and honesty -- that's all anyone can ask for in a professional, right?
So the first thing he said, after he'd picked himself off the floor when I told him I'd be changing careers, was...
What's an MFT?
And suddenly it dawned on me that I'd begun to develop a lingo unfamiliar to most of the physicians and researchers I'd been working with for most of my adult life. I'd have to figure out how to answer it concisely, without resorting to terms like relational-systemic or cybernetics or recursion. MDs and RNs are familiar with "behavioral health," of course, but how do I answer the question when asked by family and friends outside the medical field? How do we explain what we do and why an MFT is needed in a profession where we already have so many competent professionals with other credentials?
So I took a deep breath...
What's an MFT? Well, we work with families. I mean, lots of therapists work with families, right? LPCs, psychologists, LCSWs. But to us as MFTs, the family is the naturalistic setting for humans. We all like to think that we have a “work side,” a “school side,” a “friends side,” a “home side”… but if anything, we’re more “ourselves” at home than anywhere else: we come home, take off our shoes, let our hair down, and it’s more than work clothes and work cares that come off. Home is where we first learn to be social beings as kids. It’s where we first learn whether we’re “safe” in the world or not and where we start collecting our dreams and our fears. And as adults, it’s the principal stage where all those hopes and fears and social exchanges play out. Take an individual out of the family and they’re not going to act the same. You’re not going to see how they really interact with others. You take a person you’ve analyzed in your office for months, and you think you’ve got a feel for who they are. Bring in their family and a whole dance plays out in front of you: this person is who they feel close to, this one is who they distance themselves from, this is who they blame for issues, this is who they trust. And at the same time, you can watch how a family interacts and you see that back-and-forth — and it’s always back and forth, it’s mutual, and so much of it stems from unconscious assumptions and behaviors we’ve accumulated over a lifetime. But you can see that that mutuality has established a status quo for the family. That status quo is symptomatic of who a person is, and who the family is, and how they interact: whether they’re close or distant, whether they can ride out a crisis in a healthy way. You can see why they continue to be that way. So, take an individual out of that context, and you get a psychological profile, but set them back into their family life, and a whole dimension emerges that’s neither individual nor collective. We say the whole is greater than the sum of its parts.
I went on to explain that I'd be specializing in Medical Family Therapy; that I'd be using my biological and biomedical foundations as a neuroscientist to help families who are dealing with a medical crisis. People who have become caregivers for a family member who's been diagnosed with a chronic or a terminal disease. People who've recently lost someone they love, parents who’ve lost a child, couples who've just found out they can’t have children of their own. I explained that I'd be helping the family understand their diagnosis or their loss and what it meant for their lifestyle, that I'd help them pull together and come to terms with the illness or loss. I'd help them voice their feelings and concerns, and find ways to become active agents in their own care and diagnosis, always from that perspective of people who are part and parcel of a larger system: individuals -- yet part of something collective.
My colleague sat back and smiled. "I think you'll be great. What can I do to help?"
Thank you, Jason, for your compassion and friendship. You were so supportive when I needed it most.
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