Pagan Therapy and Counseling for a Pagan World

I’m struck as I look at the past few weeks at the power of trances to get to the root of the issue. Therapists with hypnotherapy and hypnosis training should be looking at how their skills overlap with guided journeying and astral travel in Neo-Pagan rituals.

One of the differences between the two is that Pagans believe their soul really is traveling to a distant realm on the astral and that the Beings that they talk to while there are real and constitute contacts outside of themselves.

But the techniques are highly similar. A Wiccan coven might decide to do a guided journey to meet an aspect of the Crone to determine what their needs are for the coming year. This might very well be done in the next month or so as this is the dark time — the time of the year where you rest up from the efforts of the past year, take stock of your gains and losses, then start planning new projects to coincide with the spring. This coven would likely invoke sacred space, dim the lights, light candles and incense, and then have members relax and close their eyes while the leader walks them through a visualization of going down a tunnel into an astral realm. There they meet a goddess and are asked to individually hear what She has to say and what gifts She gives them. The coven members are then walked back up the tunnel and bought back to wakefulness — possibly soon followed by cakes and ale (food) which further brings them back into their bodies. The experiences are often then shared (which reinforces their validity since most people had them) and helps the group support everyone in attaining what the message said they needed.

Compare this with the guided meditation I recently ran with a client (and I’ve done this or similar several times). The client is trying to figure out the proper direction to go in life. So I have the client close his/her eyes, do some deep breathing for relaxation, then I have the client walk down 10 stair steps — each step taking the client deeper and deeper into relaxation, closer and closer to the place where they can see within themselves what they most need to do. We get to the bottom of the steps and I suggest all manner of possible places they might find themselves while leaving details vague. I suggest that parts of themselves or spiritual guides might show up to help them. Soon the client is describing being in the middle of an activity that feels completely right, peaceful, exciting, and productive. We close by going back up the stairs, turning the lights on, and standing up and clapping our hands a few times to fully return to room. The remander of the session is spent discussing what first steps in the real mundane world might be taken to realistically work towards the envisioned new long-range goal.

The similarities are incredible. One protocol uses words like trance induction, deepening, and calling on inner resources. The other protocol uses words like astral travel, magick, and goddesses. I’m not saying they are exactly the same — they are the same only if you don’t believe that it’s possible to leave the body, or don’t believe goddesses can actually speak to you.

But for therapists counseling Pagan clients, using the toolsets they already believe in and have practiced can make a world of difference.

To a typical Pagan client, being contacted while in trance (on the Astral plane) by an entity or God is a religious experience. It brings a whole new level of importance to the message. The message is not “merely” from the person’s own mind — it is often a Divine message to be taken much more seriously and acted upon much more promptly. There is much greater authority and belief vested in the message.

And so we reach another choice point or ethical decision point for the therapist. If you happen to be a therapist who is religiously Pagan, this is all well and good (and ordinary) for you. If you are not a Pagan therapist, how do you feel about using techniques that may bring along a Divine message? One that you don’t really believe in yourself? Do you worry that a “Divine” message may come through that the client will feel obligated to act on that you may not feel is good for the client?

Honestly, I’ve usually found such messages to be highly useful and to the highest good of the client. I’ll leave it up to you to decide then whether higher power or the client’s own unconscious was the source.

— Michael

I seem to be on a Christian counseling kick right now. So be it — this one will be shorter, I promise. I’m reading an intriging book by James R. Beck entitled “Jesus & Personality Theory”. I’m on page 36, so I reserve the right to be wrong or change opinions as I find out more while moving through the book.

The book has two theses:

1. “Jesus is a counseling model for Christian counselors in that his teaching speak directly to the five major structural components of human personality”

2. “These teachings (Jesus’ counseling) are indeed wonderful because they speak so perfectly to the composition of the human personality.”

Now I have not read enough yet to form an opinion on the above said theses — that is, if Christian counselors should counsel like Jesus and if Jesus’ methods as portrayed in the Bible speak perfectly to the human personality.

However the background set-up in the first few chapters really has me thinking how this all impacts us Pagans.

The Five-Factor Model of personality theory is a very, very well-tested theory that says there are (you guessed it) five traits that are common to all personalities:

• Openness to Experience
• Conscientiousness
• Extraversion
• Agreeableness
• Neuroticism

I won’t bore you with all the research studies backing this up — read this or one of many other books and studies if you are interested.

Keep in mind that according to Beck (backed again with his cited research) a HUGE percentage of the variance in these factors (33% to 65%) is GENETIC and only 0% to 11% is ENVIRONMENTAL (and the rest — who knows…). Furthermore, according to Beck (and cited research) these five factors change barely at all throughout adulthood…

Here’s where the difficulty for me comes in. You are supposed to try and behave like Jesus would behave, even if you have a very different five factor trait profile than Jesus did! You don’t have to have Jesus’ personality, but you should act like Him as the perfect rolemodel.

So, let’s say you are cursed by genetics to be very introverted (is it really a curse?). Is it fair to have to strive to be at least as outgoing as Jesus was? Jesus is judged to be about average on the extroversion trait. What if you are extremely extroverted? Is it fair to have to reign in your tendencies?

Furthermore (according to what I’m reading), these traits don’t change much in adulthood. So you are going to be fighting against your natural tendencies your whole life.

Now don’t get me wrong. By and large I think Jesus is a great rolemodel. He was loving, peaceful, forgiving, and a host of other worthy traits.

It’s just that I think here is where Paganism can really shine. I think there can be MULTIPLE rolemodels. Given a genetic predisposition towards certain traits (and behaviors), why not pick rolemodels that are reasonable and attainable for the person exhibiting that given trait set?

Why not work towards a balanced society or balanced workgroup of different types of people rather than asking for perfect balance within each individual?

Granted some people need stretch goals — to work on behaviors that are difficult to attain for their own good and the good of those around them. But it seems to me that having only one perfect model, Jesus, sets up people with the wrong genetics for failure. Of course, this fits in well with the Christian doctrine that people are inherently flawed and sinful. I tend to think that in the infinite wonder of the Divine, there can be many types of perfect jewels.

So, why not have clients pick patron deities that help them develop into the best version of their particular trait pattern? Why not search the earth for deity pantheons, archetypes, heroes out of mythology, etc. who present a balanced catalogue of the various trait combinations likely to be found in people?

I think that this has in fact been going on in one form or another for eons. Frankly the African diasphora religions like Santeria, Umbanda, Candomble, Voudun, etc. are suddenly looking much wiser to me. In these religions, followers are generally assumed to have an “orisha of their head” — that is, an orisha that they most resemble that they are  trying to be like as much as possible as they mature. There is also a sort of balancing of the personality (that I don’t understand fully) that is supposed to occur as the follower goes through a series of initiations to accept other orishas and powers into themselves. IMHO this all bears much further psychological study.

For Christians who follow one perfect rolemodel, Beck’s approach makes sense and I honor the book he has written. I am thinking, however, that matching the various Powers to five-factor personality theory is an exercise to be taken on by Pagan counseling theorists enthusiastically.

I look forward to the rest of the book.

Christotherapy

Yes… you read that right…

I recently came across a description of the Christotherapy system developed by Bernard Tyrrell which seeks to integrate psychotherapy with spiritual direction in an (obviously) Christian way. I don’t know enough about it yet — I have used copies of his books on the way in the mail — but I find the description of the system very interesting both in terms of how it could work for Pagan clients (in a modified form) and in the clear ways its values system sometimes conflicts badly with Pagan values.

I’m thinking brainstorming on the Christotherapy counseling system as to how it does and does not fit Pagan clients could open up a path for the development of a Pagan pastoral counseling system (at least one such). Doubtless we’d need some original thinking of our own and would need to pull from other writers too, but I think there are some advantages to using Christian counseling systems as a launching-off point of discussions in the development of our own counseling models.

An excellent synopsis of the Christotherapy system is posted in the discussion forum of the www.christotherapy.com website
at http://www.christotherapy.com/messages/1393.html

Here are my initial thoughts on the Christotherapy model. I’m going to do it in the form of reacting to quotes from the article linked above:

**

“Why should we accept the current distinction between spiritual guidance and psychotherapy?”

**

I’m generally of the opinion that a Pagan pastoral counseling (or Pagan spiritual guidance?) technique could and should merge psychotherapy and spiritual guidance.

This is going to get tricky if the spiritual guidance portion ends up including things like divination, exorcism/spirit releasement, and soul retrieval — topics I don’t think licensed professional therapists want to touch. I suspect we’ll end up with a version practiced by licensed professionals and another version practiced by clergy.

**

“At the center of this approach is Tyrrell’s assertion that Christ is directly and intrinsically related to the healing not only of sin, but also of psychopathology. Tyrrell argues that Christ, not any therapist, is the healer, and his healing is intended for the whole person.”

“Whether or not he recognizes Christ’s presence, Christ is in fact present in all healing and growth.”

**

I find it interesting when to “let go and let God(s)” versus when to push for personal power and responsibility. Clearly there’s value in both approaches.

I suppose one Pagan method along these lines would be to assert that we are all connected into one universal nonpersonal spiritual power and that taking the personal responsibility to align yourself with it brings you back into harmony with it and is intrinsically healing. This approach allows for the idea in Christotherapy that there’s a universal healing power (they call it Christ) whether or not the client understands or names it – yet this Pagan method mostly gets rid of the implication of Christianity being the only True Way.

There could be all sorts of methods of aligning one’s self with said Power.

One could then ask for direct intervention by various healing deities on top of that. (I tend towards hard polytheism with an acknowledgment of a universal oneness or connection of some sort beyond the individual gods that is more remote and impersonal than the gods.)

**

“Tyrrell… [identifies] the four basic functions of christotherapy as reforming, conforming, confirming, and transforming.”

“First week: to reform the deformed”

“This is an unmasking of personal deformation (sin), and an awareness of the need for the redemptive grace of Christ. In christotherapy reformation is this same process of repentance for sin. An awareness of who we are before God and the awful reality of our rebellion against him is the beginning point of all true psychospiritual growth.”

**

Last Fall I went to an AAPC regional pastoral counseling conference on the topic of sin and forgiveness. I thought it would be awful, but actually I got a lot out of it – made me think through rather than just react against this topic. Paganism generally views the idea of mankind as inherently sinful very negatively, instead preferring doctrines like inherent divinity — that we are all fundamentally perfect and Divine and just need to take responsibility and mature into our abilities.

I think a Pagan pastoral counseling system could replace the ideas of sin and divine forgiveness with the ideas of harmony, grace, and connection. That is, clients get sick and/or off their true path when they are out of contact with the Divine, and when they are out of balance/harmony with nature. We don’t look at “sin” and evil so much as whether or not the client’s actions are helpful to the health of the client and perhaps to the greater community. In so doing we can trash the Christian idea of inherent sinfulness and “rebellion against God” and replace it with an ideology of inherent divinity and perfection and a personal responsibility to bring one’s self back into connection and balance. Some Pagan therapists may see a need for a karmic backlash for past actions, but it’s no longer God’s personal punishment for being naughty children – it’s a rebalancing and growth tool.

I don’t think I wish to imply that to be sick is always to be out of balance and/or to be at fault for falling in personal responsibility. Other factors may also enter the picture.

While my Pagan worldview rebels at the idea of needing divine forgiveness, the power of personal forgiveness between individual humans remains a power healing tool.

**

“Second week: to conform the reformed”

“Conforming is the active turning toward Christ, which must follow turning away from sin. Here the goal is conforming the self to the mind of Christ (Rom.8:29), bringing about a new disposition of heart and mind that will allow a person to grow and deepen in love of God.”

**

Well, I definitely don’t agree that humanity’s proper path is total submission to the will of one god. Yet the idea I espoused above of coming into harmony with nature or better communication with the Divine (whatever Divine that may be) sounds quite a bit like what Christotherapy is saying here.

Certainly, in my opinion, there is some sort of synching-up and alignment with the greater Powers of the Divine and nature that is called for as a condition of mental and spiritual health.

The difficulty I’m having is what conformity/connection/harmony rules need be imposed.

At the moment I’m more of a mind to do some existential counseling along the lines of finding meaning in life and that which brings joy, then to turn to spiritual techniques and Gods and Goddesses to see how the individual client needs to custom tailor a connection to the Divine and nature that allows for the full expression of their personal joy and life meaning.

I’m also more of a mind to let the client find their own Divine relationships that feel right and help them on their own paths rather than imposing rules on them.

**

“Third week: to confirm the conformed”

“Confirmation is the affirmation of our death to sin and our lives as new creations in Christ. We confirm our initial turning from sin through the sure knowledge that we are baptized in Christ’s death and thereby raised to life in him (Rom.6:3-4).”

**

I agree with helping clients strengthen themselves in a new way of living and being that is healthy for them. In Paganism we often use rituals and initiations as means of affirming and strengthening and even changing people so they move into a new phase of life – a “rebirth” if you will.

So a Pagan pastoral counseling system may need to utilize some initiation or ritual techniques for “rebirth” into the new healed self at various times in treatment. Perhaps initiation into the service of gods/goddesses that help the client uphold their mission and meaning in life.

A really good question is how much of this a licensed therapist does versus how much of this is turned over to clergy?

**

“Fourth week: to transform the confirmed”

“Transformation is the movement from identification with Christ in his death to contemplation of him in his glorification. Rejoicing with and for Christ because he is now in glory, we are freshly empowered by the Holy Spirit to turn more fully toward Christ and thereby be transformed into his image (2 Cor.3:18).”

**

I think they are saying that the client, having completed being molded into the proper image of a right and functioning person, can now start living in health and vigor and spirituality. However, they would seem to have only one right model – Christ.

If Pagan counseling chooses to follow this model of molding people into proper forms of thought and behavior, what the heck will our models be? Should we be molding people in predetermined ways at all?

Certainly though, whether or not we admit it, we carry preconceived ideas of what is healthy behavior as therapists.

One model I’ve seen used in Paganism is the archetypes. Examining what archetypes are within a person and having them grow more fully into the expression of the archetypes that match them best. Another way of doing this is to balance archetypes, studying each in turn, and then having the individual take personal responsibility for how to balance these many archetypal models within the self so as to create a healthy and unique person.

In a similar vein, many of our training schools seek to balance the 4 elements, and their associated correspondences, within the person.

African Diaspora religions seek to seat the proper orishas in the heads of initiates so as to balance them.

So it would seem that Paganism has many “Christs” to choose from, and it’s a complex mix of personal individual responsibility and clerical/therapeutic guidance in determining what the proper mix is for each person’s life.

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Further attention needs to be paid to the rest of the topics in the essay on Christotherapy including existential loving, existential diagnosis, existential appreciation, existential clarification, mind-fasting and spirit-feasting.

I’m also very curious what Pagan counseling techniques could arise out of the study of a book I recently got entitled “Jesus & Personality Theory: Exploring the Five-Factor Model”.

I’ve recently accepted a new position as the director of a psychiatric rehabilitation day program. The hours are such that I can continue my private practice as well.

This means that I will be front-and-center in confronting (at least occasionally) attitudes towards Paganism in the institutional and medical model setting.

It’s alot easier to handle Pagan clients properly in private practice. There, decisions are mostly just between the therapist and the client. There too, clients are usually much more capable and self-sufficient. It’s easy to accept a client’s worldview that they talk with tree spirits when they hold down a job and have friends and function normally. It’s much more difficult when:

• The client has a 10-year history of psychotic behavior such as screaming at voices on the street corner, burning down houses, & attacking police as agents of the Martian invaders.
• Medications are proven to help control the above symptoms.
• The whole clinic system is primed to watch for and interpret any unusual behavior as illness.

Luckily, its darn rare (so far) to encounter a practicing Pagan client who is majorly psychotic like in the above example. But its terribly difficult to try and explain to a treatment team that certain beliefs and practices are okay when the client so obviously has problems. And who knows when such a client’s “Wiccan” behaviors will veer off in a bizarre direction having nothing to do with Wicca?

As usual, the criteria of whether or not Pagan beliefs (or any unusual beliefs and behaviors) are hurting or helping the client is at least a starting point. (Evaluation criteria is the subject for another post.)

I’m just sharing my concern, but also excitement, with being in a position to handle Pagan client issues as they come up from within an institutional setting.

In the past part of what I’ve done has been to run a spirituality and world religions class for psychiatric rehabilitation program clients. One of many reasons for the class was to be able to provide education on all manner of spiritual beliefs (occasionally including Pagan), a safe discussion place for clients to talk about their beliefs, and support for there being many paths to the Divine — or at least that tolerance of your neighbor’s beliefs is a Good Thing.

So — I’m opening the floor to ideas. What sorts of support would you like to see in institutional settings (hospitals, day programs, etc.) for Pagan beliefs? How do you think staff should handle such amongst patients who are profoundly mental ill (schizophrenia for example)? Do you have stories about someone’s treatment in such a setting? As usual, do not post any information that names institutions or individuals or is specific enough to trace and identify.  If you say something about yourself, make sure you are okay with the whole world knowing.

Jerome Frank suggests the facinating idea that there is a common set of universal reasons all healing modalities work, no matter how different they may seem.

In his classic book Persuasion and Healing: A Comparative Study of Psychotherapy he crosses multiple cultures and considers healing modalities in the broadest sense — psychotherapy, religious ceremonies, shamanic healing, the medical model, modern, ancient, and more.

Like many “rational” authors, Jerome Frank can be subtly insulting in the implied assumption that there’s really no magic involved — that no gods or Powers are showing up, that its all explainable by psychology and science. Yet I find exercises to “rationally” explain how magic works (like shamanic healing for example) useful because they:

• remind those of us who do believe in Higher Power and magick that psychology is also involved and so such techniques are doubly powerful. (Most of the Pagan readers of this blog.)
• open the door to some respect and understanding from those who do not believe in Higher Power and magic but who, by virtue of believing in psychology, can give alternative healing techniques (and Pagan rituals) respect to the extent that they understand the psychology involved. (Some therapists reading this blog.)

So I’m constantly searching for explainations of how magic stuff works from a psychological viewpoint and I try to insert such into talks with other therapists as this is one way to buy understanding and tolerance for Pagan religions without having to convince them to believe in occult principles.

I will post such explanations from time to time on this blog. Speaking of which, I want to share one from Jerome. Towards the end of his book Jerome lists out four features common to all healing in all societies & cultures & circumstances. They are:

1a) Confidence in the therapist’s competence

• Having a socially sanctioned role and special training helps.

1b) Confidence in the therapist’s desire to help

• Belief that the therapist genuinely cares

• The therapist believes patient can master the problems

• Therapist acceptance validates patient’s outlook on life. Sense of being understood and accepted is a strong antidote to feelings of alienation and a potent enhancer of morale.

2) The locale is designated as a place of healing

• Setting itself arouses expectation of help:
  • Rituals are in a sacred temple
  • Therapy is in a designated mental health clinic
  • If done at sufferer’s home, there’s a purification ritual first

• Client is protected from life’s demands and can concentrate on prescribed therapeutic activities.
  • Client is not held accountable in daily life for whatever the therapy demands
    • It’s okay to go bald and throw-up in context of chemotherapy
    • It’s okay to scream and writhe in context of exorcism
• An aura of religious or scientific healing is ascribed to the location

3) All therapies are based on a rationale which explains illness and health, deviancy, and normality.

• If combating demoralization, must have an optimistic philosophy of human nature.

• The therapeutic myth is compatible with the worldview shared by the therapist and the patient.

• Western psychotherapies: problems arise from damaging early life experiences

• Magical societies: Problems arise from demonic possession or the punishment of the Gods or failure to appease spiritual powers. (Here is where modern Neo-Pagans differ from tribal cultures, Santeria, and Voudun in my humble opinion. We largely believe in scientific problem causes, although we think we can cure them magically.)

• Myths cannot be shaken by therapeutic failures — thereby strengthening the therapist’s self-confidence, thereby strengthening patient’s confidence, thereby strengthening likelihood it will work. (psychotherapy: “The client was resistant”, magical healing: “The intent was not strong enough”)

4) All forms of therapy help the patient overcome his demoralizing sense of alienation from his fellows.

• Interaction with therapist and group

• Shared conceptual framework

• Problems not unique

• Others care

All forms of psychotherapy, when successful, arouse the patient emotionally. Why is unclear.

Below is a snippet from a clergy ethics lecture I did for the WABAPLC (Washington-Baltimore Area Pagan Leadership Conference) February 2007 conference.   The topic concerns when Pagan clergy can handle counseling matters themselves and when they should refer out.  Two primary points are made:

My post about Friday’s workshop implied that psychiatrists are likely to be intolerant of Pagan religious views that seem too abnormal.  At least, that’s what some of the therapists at the workshop seemed to think.

 However, Kelly sent an interesting article entitled “Psychiatrists: Least Religious but Most Interested in Patients’ Religion“.  A few interesting quotes:

• “Although psychiatrists are among the least religious physicians, they seem to be the most interested in the religious and spiritual dimensions of their patients, according to survey data published in the December issue of the American Journal of Psychiatry.”
• Farr Curlin, MD said “several recent studies have found that religiosity is often associated with improved mental health outcomes such as quicker recovery from depression. Now most training programs teach developing psychiatrists about the potentially beneficial influence of religion and spirituality on patients’ mental health.”
• “Psychiatrists are twice as likely (46% versus 23%) as other physicians to say that patients often mention spiritual issues. They are also much more likely to both say that it is appropriate to ask patients about spiritual concerns (93% vs 53%)

I wonder what the Pagan implications of this are?  Would talking with a goddess or dancing around a fire be psychotic or positive religious behavior?

What are some of your experiences with psychiatrists?  Do you think they are tolerant towards religion in general?  Towards Pagan religions?  (Please do not post specific identifiable information about either the client or the psychiatrist — keep stories general and brief.  Thanks.)

The article can be found at: http://www.newswise.com/articles/view/536093/?sc=dwhp

I’m pulling this entry directly off Angela’s www.nineravens.com blog.  The kids need counseling and they are considered Pagan… so it’s vaguely on topic I guess, but more importantly it would just be a good thing to help out with:

I keep reading the stories about children in the Congo and Nigeria who are abandoned, beaten, and killed after being accused of being witches. It breaks my heart every time — to the point where I am shaking. I finally found an organization that is specifically working to help these kids. I am going to donate, and I hope you will too. — Angela

Stepping Stones Nigeria

Yesterday I did a talk at the Baltimore Lunch & Learn for the Licensed Clinical Professional Counselors of Maryland on the topic of counseling Neo-Pagan clients.

All in all, I thought it went well.  I was pleasantly and well-received, and if anyone thought I was a crackpot for being Pagan they fooled me.  The group was genuinely interested in the topic.  Another Pagan therapist was there who proved very helpful in educating the group on Paganism.

A few thoughts:

• I barely got to my planned material on how to counsel Pagans, topics Pagan clients are likely to bring up, etc.  Really — the heart of the presentation.  We spent most of our time on what the heck is Paganism and Wicca.  I sometimes forget just how far we have to go in educating the community at large.
• The “do you sacrifice…” question DID come up.  It is NOT too basic to keep reminding people that we are not involved in dark plots to sacrifice babies, etc.  I went ahead and gave Voudun and Santeria a plug by explaining why chicken and goat sacrifice might not be so horrible, although Neo-Pagans we generally don’t do that.
•  This was the first professional situation in which the other Pagan therapist had been out of the broom closet.  I suspect we have lots of Pagan therapists afraid or unable to be open professionally.  I think she had a positive and affirming experience.  Part of the reason therapists are not out with their religion is that, in many contexts, its considered inappropriate.  This is a whole seperate topic we could discuss.  However, spirituality IS a part of holistic healing and the trend in counseling is towards allowing discussion of the spiritual.  The trick is when to discuss the client’s spirituality (without revealing your own) versus when to announce your own spirituality in order to attract clients comfortable with the therapist’s religious/spiritual orientation.  Medical model clinics seem to have the most problems with spirituality being allowed and that’s too bad — there IS preliminary evidence of spirituality being effectual in healing.  Surely even within the medical model spirituality will become allowable if evidence of its usefullness is presented, right?
• While most of the room agreed in principle with the idea of operating from within the client’s worldview (such as allowing the client to talk to goddesses for example if it seemed useful to the client), they never thought such would work within their own agency.  That is, the therapists in private practice could see working with client’s Pagan beliefs, but the therapists at medical clinics, state-run organizations, and large agencies were quite sure that the client would be sent straight to the psychiatrist for a medication increase.   A few therapists in the room gave examples of not noting unusual beliefs and perceptions in clinical notes for fear the psychiatrist would try to medicate them away.  I find this very disturbing.  One implication of this is that, even if we succeed in educating counselors about Paganism, we will end up with a two-tier system.  Pagans with quality insurance or cash will go to private therapists for well-educated help.  Poor Pagans and the severely mentally ill will end up in institutional environments where their spirituality will be mistaken for psychosis.  It also suggests an ugly division in treatment teams wherein the therapists have different beliefs and goals than the psychiatrists.  This is bad for the patients and terrible for the mental health of the therapists themselves working in such environments.

Ranking America’s Mental Health: An Analysis of Depression Across the States

Believe it or not, the District of Columbia recently ranked as having the lowest suidide rate.  It was #23 in terms of rate of depression (#1 being best).  Maryland had the 5th lowest rate of depression and 8th lowest suicide rate.

Something is going right around here.   The ACA (American Counseling Association) credits access to mental health professionals and health benefits.

See:
http://www.mentalhealthamerica.net/go/state-ranking