Separating "Crazy" from Counseling

I have a client who continually refers to himself as “crazy” and wonders how I work with crazy people all day.  He pessimistically believes that everyone is messed up (or uses some other choice words) and that there is just suffering in the world, no joy.  We often have existential discussions on the meaning of life, why society is the way it is today, explore beliefs that society is in a state of decline, and how he can create meaning and purpose in his individual world despite the world at large. 

Every time he tells me he is crazy, I counter with he is normal – a person going through a difficult time who has sought some support.  Yes, there certainly is a sector of the population that struggles with true debilitating mental illness.  These are people who require psychotropic medications to stave off thinking patterns that are not based in reality or to regulate moods because unmedicated, they have extreme moods and impulsive behaviors that are detrimental to themselves or others.  These people receive services at community mental health agencies that are adequately equipped with multiple service options to meet their needs.  Or they are receiving inpatient/residential care because they need constant supervision and help.  There is also a section of the population whose functioning is temporarily impacted (can’t go to work, isolate themselves significantly) due to a situation, circumstances, trauma, etc., and for a while they may meet criteria for a mental illness.  And then there are those who are struggling with serious addiction issues who are treated with inpatient services and then the appropriate drug and alcohol counselors. But that is not this client, nor is it the majority of our clientele. 

So, who do we work with at Knoxville Counseling Services?  I work with adults.  My clients are largely working professionals: engineers, scientists, pastors, lawyers, law professors, physical therapists, professors, teachers, managers, CEOs, creatives, entrepreneurs, therapists, business owners, financial planners, graphic designers, accountants, new moms, stay-at-home moms, working moms, nurses, PAs, flight attendants, pilots, and students… just to name a few. They range in age from college-aged to late 60s.  They are working through issues such as challenges in their relationships/marriages, vocational stress, career identity, anxiety (e.g., perfectionism, general anxiety, and social anxiety), depression (e.g., situational and seasonal), self-esteem/self-worth issues, figuring out why they get into the same relationship pattern over and over, adjusting to transitions (moving here, new jobs, becoming parents), grief, past traumas, divorce, divorce recovery, and navigating family relationships. 

My clients are trying to figure it out and become the most emotionally healthy adults they can be.  They are being courageous and asking for support, a place to process, a place to feel heard and validated, and a place to learn skills and new ways of operating.  They don’t teach classes in high school or college on how to be emotionally healthy or how to have a healthy relationship. You aren’t taught that you can change your ways of thinking and re-wire your neural pathways and then actually how to do that step-by-step.  I wish they would teach all of these skills and I have had many clients voice the same desire after they’ve finished therapy.  We all just operate with what we know and what’s been modeled to us until we gain some self-awareness and insight, and then most importantly learn how to do and think differently.  As counselors we act as confidants, supporters, encouragers, and also teachers.  If I was in a car crash and needed physical therapy for recovery, I would go to a physical therapist.  This person has been to school, completed licensure requirements, completes ongoing continuing education, and does this day in and day out.  They are sharing their knowledge and expertise and will teach me how to do the exercises necessary for healing.  Of course, I have to do the work and push myself to heal, but I wouldn’t know how to do the exercises if it weren’t for them. 

We have come a long way in reducing shame and stigma about seeking counseling services.  I am confident we will continue to make progress. The majority of my clients do not even meet criteria for a mental illness.  People. They are just people who are doing the best they can in this thing called life. We aren’t meant to do this alone.  Perhaps you can relate.  I know I can. 




If you think you could benefit from some support, learn more about yourself, and ways to become a better version of yourself, reach out to me or any of the providers at Knoxville Counseling Services.  We are honored to work with you and find fulfillment out of seeing our clients grow.