What's your Specialty?

People ask me all the time, "What do you specialize in?" This is a complicated question for a couple of reasons: 

  1. The first obstacle is the question itself - what exactly do you want to know? Are you asking with which population I prefer to work? My clinical orientation? Or my particular sub-field: Clinical, Educational, Industrial, Forensic, Community etc.?
  2. The second reason that I have a bit of difficulty with this question is because almost invariably, when a fellow Clinical Psychologist asks you that, what they really mean is, "Tell me your interests." I love answering this question, but I realize that if I was to start rattling off my answer to a lay person, they would definitely fall asleep.
  3. The final reason I stumble here is because I feel, sometimes pretty strongly, that there is a much better question that I wish more people would ask their therapist and that is, "What is your clinical orientation?" 

The truth is, most people are not familiar enough with psychology to know that there are several subfields of which I am Clinical Psychologist. This means that I am primarily concerned with the assessment and treatment of mental illness and disability. However, there are all types of psychologists that are concerned with the study of all types of things. Here is a pretty thorough list from About. So when you ask me, "What do you specialize in?" I think Clinical is a fair, very brief answer in the broadest terms. 

But there is another deeper level of specialization. For instance, within the field of Clinical Psychology you can become an expert in all sorts of disorders, populations, age-groups, and interventions. Hopefully, a good Clinical Psychologist is a generalist. That means they are comfortable working with most disorders and age groups along a wide spectrum of severity. Although, it never hurts for a generalist to have a couple of areas of practice in which they have expert knowledge. On this level, I would answer that I specialize in Church Psychology or Church and Psychology Collaboration. This is essentially a fusion of community and clinical psychology meant to collaborate with religious organizations as a way of preventing mental illness and strengthening the emotional functioning of their participants.  

I do not however, only work with Christians or with Churches. Consultation is only one part of my professional self and it is an important skill set when working in underserved areas of the deep south. I am also an Adult Psychotherapist. Which brings me to the question of "Clinical Orientation." When you ask a Clinical Psychologist what they specialize in, and you hear anywhere in their answer "Psychotherapy," the next question to leave your lips should be: 

What is your Theoretical Orientation?

This question is important because it means, How do you think change happens, What kind of relationship do you have with your clients, and ultimately What do you value? My theoretical (or clinical) orientation is Psychodynamic. A few other popular camps are Cognitive-Behavioral (CBT), Acceptance and Commitment (ACT), Gestalt, Humanist, Feminist, and a few others. 

Psychodynamic is a shorter term, less frequent version of the very extensive and powerful psychoanalytic psychotherapy. Although I am a candidate at a Psychoanalytic Institute, I am a few years from being a certified psychoanalyst - a process that takes quite a bit of time, post-doctoral training, supervision, and my own on-going psychoanalysis. But I still value many of the same things that analytic therapists value. I believe change happens differently for different people and disorders but many people benefit from the re-orientation of a strong and supportive therapeutic relationship. The psychodynamic relationship in particular is focused on the here and now interactions and includes an emphasis on the way the client's past surfaces and contributes to the present. We work with internal objects and representations, dreams, and fantasies. The goal is self-awareness, symptom reduction, and conflict resolution. 

Psychodynamic psychotherapy is my preferred mode of operation but more than anything, the psychodynamic inclination is a way of being that I take with me in my work with every client. So in the cases of more chronic and pervasive mental illnesses, and for those disorders that have verified standards of effective treatment and practices, I consider myself optimally flexible. I can take the relational values and my appreciation of past and present as I integrate manualized techniques such as systematic desensitization, mindfulness, breathing exercises, assertiveness training, progressive muscle relaxation, hope-focused marriage therapy, motivational interviewing, etc. 

It is good to have a theoretical orientation as it keeps a good psychologist grounded and focused. It helps create a frame of effective action for psychotherapy. If you ask your therapist, "What's your theoretical orientation?" and they can't give you an answer..…call my office at…….251.625.4011……………

But seriously, it's a good thing to be curious about the assumptions and inclinations of those who will presume to take care of you, nurture your strengths, and work to mend your wounds. Next time someone asks me, "What's your specialty?" I'll probably stutter around a bit but hopefully, after some meandering I'll be able to say: 

Clinical, Adult, Psychodynamic, Psychotherapy. And if you need someone to work with your Church - well I can do that too.