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Should I Become a Psychologist?

Posted Oct 23 2008 11:28am

This question seems to come up a lot from readers, so rather than answer thousands (dozens) of emails let's just address it here.

I would never dissuade someone from going into a helping profession. We are a society that is so focused on money and accumulating assets that to have someone want to help and give to others is a fantastic personality trait. That being said becoming and being a Psychologist is definitely not for everyone. There are many positive things about this line of work but you must be able to answer affirmatively to some important questions.

(Note that these points are not necessarily applicable to those who want to become Social Workers, Psychiatrists and other types of mental health professionals such as counselors and substance abuse case workers. I addressed some of the differences between those fields and if enough questions come in regarding specific details I'll post on that in the future. The details of this are also based on my knowledge of practicing Psychologists in the United States, although most of this is likely applicable to other countries as well):

1) Do I want to commit to the extensive schooling?

Virtually all graduate programs require at least five years of graduate education just to get a doctorate and another year or two to get a license to practice independently. This usually means that if you are hard-working you'll have your Ph.D. (or the less commonly obtained Psy.D. after four years of formal education and one year of internship.

If you attend a program that has a strong research component you could easily be in graduate school for more than seven years. I met a Psychologist who went to a program that forced him to do so much research before graduating that he could have easily gone to medical school twice in that same time period. He didn't realize that going in and I'm still shocked that he didn't go postal during his training.

I got my Ph.D. at 29, which is considered fairly young. But during that schooling most of my friends were establishing careers and starting families. Of course it's possible to get married and have kids while in school. However, because you need to complete not only your course work but also work in clinics and hospitals, assist your professors with their research as well as complete a Master's Thesis and Doctoral Dissertation, time can be at a premium. Miraculously I learned to play golf (poorly) and guitar (even more poorly) during school but that was simply because I forced myself to take up hobbies to take my mind off of psychology and to keep myself balanced. But if I hadn't kept my focus on school I might have become a mediocre golf instruction at some non-prestigious country club or the rhythm guitarist for an unpopular chick band.

I was lucky, too, in the fact that I always knew I wanted to be in mental health in some capacity. I was always fascinated with what made people do what they do, what made people tick, and I've always liked sitting with people and simply talking with them. That helped me keep my focus during my graduate work. Not everyone has a similar experience and many people go into mental health as a second career. I've met many Psychologists who began their training in their 30's or 40's after trying their hand in business or real estate or the arts. This can actually be a benefit for some given the life experience they bring to the table. But to go back to full-time schooling and the demands that come with it requires a very serious commitment.

2) Do I want to spend the money?

A little-known secret is that, depending on where you go to school you can get tuition wavers and stipends. Professors' research grants will often fund students' education so you may not have to pay for anything. Directly. However, unless you live the most meager existence you will likely be taking out some loans to pay for your day to day operations (e.g., pizza, beer, waffles, soap, Axe Body Spray, etc.) because your stipend is truly a pittance. So while you don't necessarily have to go hundreds of thousands of dollars in the hole for your training, many people will have at least $40-50K in loans by the time they graduate. If you attend a school that doesn't offer such assistance I would imagine you are looking at least $175K in debt by the time you are done.

3) Can I be happy without being rich?

While it is possible to make a nice living as a practicing Psychologist (consider Dr.Steve who makes well over $250K), more often than not you will be making significantly less money than your medical peers or your friends on Wall Street. Psychology doesn't have to be purely a labor of love but if you lose sight of what the goal of the field is (i.e., the assessment and treatment of psychological distress) you can end up bitter and resentful. This will invariably hurt your job performance. Graduate school teaches you little about running a private practice so the more successful Psychologists have developed a rudimentary knowledge of business and finance. I was fortunate enough to meet a seasoned Psychologist who took me under her wing and taught me how to market a practice, speak with clients about the realities of paying for services, how to work with managed care companies and how to invest both time and money into my practice. And as painful it is to admit, watching Dr. Steve's practice grow didn't hurt my knowledge base.

Some Psychologists simply take a salaried position in a hospital or clinic and leave it at that. As a whole that group makes less income than practitioners in private practice. As an example, in 2002 I was offered my first job at a hospital in New York City that paid $60K. Most private practitioners in this area probably clear six figures but New York is a "therapy friendly" city with a lot of people seeking services. I have colleagues in the Midwest who make under $50K per year.

4) Can I actually do the job / Am I insightful?

This question looks deceivingly easy to answer because no one wants to admit they are not insightful, but give this serious thought before answering. Insight is not simply high I.Q. Insight is an understanding into the nature of human thought, emotion and behavior. Why do people make poor choices? Why are some people depressed when there is nothing overtly wrong with their life? Why can't that person just simply stop washing their hands every 30 seconds? These are questions without direct, linear answers and it takes patience, understanding and a lifetime commitment to learning about human experience to be able to help others.

Perhaps more importantly becoming a Psychologist involves insight into yourself. Before you can hope to understand the problems of those who come to you for help, you have to understand what is going on in your own head. ShrinkTalk.Net has always been about showing the "human side" of mental health professionals. If you're a regular reader you know the foibles of both me and many of my colleagues (most of them aren't pleased about that fact but I will not sacrifice my art). If you don't understand your own idiosyncrasies, neuroses and quirks, you could become cold or condescending toward your patients. Or maybe you just lack a real grasp of the dynamics that develop between you and the people you interact with. Just look at Dr. Pete who was in all likelihood self-medicating his Social Phobia and only recently decided to take a very close look at himself. If he hadn't taken that step I imagine his job satisfaction and performance would have ultimately suffered.

5) Can I accept the fact that I can't "cure" everyone?

The sad reality is that not everyone with psychological/psychiatric problems benefits from therapy and/or medication. Certain problems like Antisocial Personality Disorder and extreme Schizophrenia do not have great track records for treatment. For many conditions you must realize that there is a "ceiling effect" to treatment. This essentially means that certain problems, while they can be worked with to some degree, don't necessarily disappear completely.

For example, the treatment of Obsessive-Compulsive Disorder (OCD) has a success rate of about 80% when both medication and therapy are used. In other words if a client has very good results they can anticipate, on average, an 80% reduction in their symptoms. These facts are particularly important to know as a Psychologist because you need to be honest to both the client and yourself about what can be expected. Without this understanding you are likely to experience "burnout," which is usually caused by lack of results in the treatment room.

This was and still is quite a kick in the teeth for Allison who thinks that every person who comes into her practice is going to walk out a completely different person. The reality is that while many people can and do benefit from therapy or any other intervention there are often clear limits. And even though all of us in the field need to be striving for 100% success rates with all clients, until that happens those limits need to be recognized and acknowledged. This will keep you grounded, not too frustrated with anything short of perfection and ideally free from burnout. Fortunately I've only been practicing independently for about six years so it's probably a bit early for me to burnout (this usually occurs much later in a clinician's career). And I'd like to think that I've got these important points mastered in my own head. But then again what shrink doesn't think that?

6) Can I deal with and confront "neediness?"

Over the past twenty minutes I've received six voicemails. Three were from clients who "need to speak to me immediately," two were to change appointment times to "something that works better for me" and one was from a dad who "wants some advice on how to deal with his kid." Can you set appropriate boundaries so your life remains in your control? I put neediness in quotes because in my experience most people (although not all) don't maliciously try to exploit me or my time. Rather they are in psychological pain and don't know what to do about it. But you can't cater to every whim nor appear at every beck and call. Psychological difficulties are worked through over time as opposed to a phone call or a few magic words. To do the job well, not only do you need to be patient but you have to teach your clients that as well.

Similar to Tucker Max's advice on whether or not you should go to law school I would advise anyone considering this line of work to spend time in the mental health field. Volunteer at a community mental health center, do research in the field with a professor at your university, or even take a job as a receptionist at a large private practice. See what the day to day life in those settings is all about.

More importantly, go to therapy. Some graduate schools actually require this so you might as well get a head start and learn more about yourself. No one has the perfect life and everyone has "issues." Start to talk about them with a professional. This will not only help you to learn more about what therapy is but will also start to hone your insight about yourself and the way you perceive your world (see point 4). If you're not sure how to begin this process read my post on finding a therapist. If the idea of being in therapy seems ridiculous to you because you already know yourself, you have all the answers or that therapy is for crazy people then it's clear that another career path is probably best for you.

All that said, being a Psychologist is a fantastic profession in many ways. Whether you ultimately teach, work in a hospital, become a researcher or run your own private practice you will be contributing to the welfare of mankind. And helping someone change their life from one that is dark and painful into one that is hopeful and worth living gives you a rush like watching Dr. Steve's Lexus get crushed by an anvil. If you are cut out for it then climb aboard. But if you're thinking about becoming a shrink and writing an online column about the life of a Psychologist, think again. That is my gig and I'll club you to death if you steal my thunder.

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