Meredith Ann, MSW

Insight on the Conflict of Our Mental Health Diagnostic Process

February 25, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

We are undeniably living in an overdiagnosed society. What we are in desperate need of is to slow down. One of my best colleague friends and an amazing trauma therapist describes the therapeutic process as painfully slow. I will expand on this to say not only is this the case, the framework for therapy altogether is narrowed to the class of people who tend toward higher intellectual capability as well as some level of financial stability. This creates extreme prejudice to whether then therapy is beneficial to everyone in the way it is being applied. I will argue that it is not. In training for CANS/ANSA—a prominent screening tool for directing treatment currently, the leader acknowledged “we know what we are doing is most effective for those who need it the least”. In taking the defensive state, he defended why this would be the case and then proceeded with the training without taking pause for consideration that perhaps this model was only effective for those whose brains worked neurotypically, or as the laws of nature would anticipate.

Over the course of obtaining my Psychology degree from Purdue University, the overlapping of symptoms in the diagnostic manual for mental health disorders were so convoluted and glaringly obvious. As I briefly entertained the dream of a PhD, I envisioned my dissertation being one that would tear apart the DSM to expose its potential contradictions. As I have continued in both my studies and my practice, I definitely understand the value the DSM provides the professional clinical community. This is a language to differentiate trending patterns of symptoms through discussion in a language of “diagnosis”. These groupings allow comparisons for most effective treatment and have an important place in treatment. As for the layperson and even current professional application of the DSM, consider it about as valuable as WebMD. No wonder we’re all dying of mental cancer at this point!

The diagnostic process should be considered the most fascinating and intimate component of mental health treatment. It is multifaceted and should be considered ongoing and ever evolving. Most clinicians will rightfully agree that an accurate diagnosis is most imperative to an ability to provide sound care. The jump to conclusions approach we have developed is far from a means to achieve this end. Many clinicians are unfamiliar with their own implicit biases which are having negative projections on the lens through which they are observing behaviors. This is too often resulting in extreme misdiagnosis and malcare with real, long-term consequence. It has been through the misinterpretation of externally observed behavior without enough additional investigation to the source of the thoughts producing these behaviors where assumptions have been made. In my home it was well reinforced that assuming something only makes an ass of both parties. My literal brain has cautioned me from assigning similar values to behaviors before enough information has been gathered to do this. These quick diagnosis are the most widespread conflict in mental health today. We have Alpha doctors acting from a point of all-out authority making declarations that they do not have the baseline information nor additional follow-up information to make.

Many licensed-level professionals do not possess authentic curiosity to what has produced the outcome in the form of individuals behavior. They lack as much patience. This can be seen as a major conflict to having persons in treatment to individuals whose lives they are not interested in. Meanwhile, the majority of their advocating is for their own positions and personal raises. Thank you to the individualism of U.S. of A. Of my own situation I will say that one of the primary issues I had in recovery was the ability to be upset with my early providers. I say this because by the time I was in front of any “professional” to speak of, my symptoms were SO acute, I doubt anyone could have gotten it right. Though, I will never be able to say what official neuropsychiatric testing could have led, it isn’t a helpful thought to entertain for me. I will say as a person of privilege; I have been forced to reconcile that my family did not access their privilege for my diagnostic process. The benefit I can draw is that I received the same run of the mill treatment that others in my same rural town were subject. All that I have gone through since that time allows me to give a voice to so many individuals who were affected similarly and did not get the same chance I did to make something of it. When I did go to treatment, I was completely miserable and had been for some time as previous posts reflect. I had no doubt in my mind I would end up on a full tuition scholarship to a private school, just as both my older siblings had, I just desperately wanted to stop wanting to kill myself. It was my lifelong neighborhood friend who was also going to treatment that convinced me to approach my mother. During the time leading to assessment by local psychiatrist, I saw someone who was not qualified to assign diagnosis for poor counseling. I find it ironic that the date of my first psychiatric assessment was 4/1/2003 – some April Fools that would turn out to be. Still, I struggled to be mad at this dude, who was willing to take on a rural environment. I truly thought he was well intentioned, he was just a shitty doctor, trained by shitty doctors before him.

I am in the current position that I possess both an atrocious first assessment in the form of my own and an exceedingly appropriate assessment which took place in the form of my child’s. The distinct difference is that mine was done under the traditional medical standards availed to the public forced by the standards of insurance and my child’s, through a psychology research clinic at a major university. We need to remember that the symptoms for mental health conditions are the same symptoms able to be experienced by any person. We need to be focusing on not only what the abnormality is but to what degree that abnormality is impacting lives. In my time observing, studying, and working in the field of mental health I am inclined to perceive all mood disorders identifying an underlying condition that may be revealed over time as information surfaces. A person’s awareness of their own symptoms and whether or not their thought is irrational should have direction in the stage of treatment they are at. In reviewing diagnosis such as ADHD, it can be easy to associate this with some level of trauma history. For example, we see inattention and this is from a desire to be distracted from a negative thought potentially. With various types of OCD I have deduced them to organized type reactions versus that of disorganized. Those with what I describe as disorganized type OCD, think of things like skin-picking, hoarding, stacking, affinity for ones own waste, the counterintuitive trauma responses. These I have related to those with a trauma that does not make sense to laws of nature in terms of a threat presented. This can be closely linked to paranoia due to the irrational nature. Those who have been through an event that the brain could understand to be threatening leads to organized type reactions. We need to be treating mental health from the inside out rather than the outside in. So often, we are realizing a sensory processing issue has gone missed due to the appearance of irritable, defiant and/or aggressive behavior. This has come to light with our expanded understanding of the autism spectrum specifically. And being attentive to all of this takes both the time and desire of properly trained individuals that the current system does not allow.

My personal opinion of diagnosing is to use the least invasive diagnosis possible in order for the person to obtain the necessary level of care for presenting concerns. For example, I have a child with combined type ADHD who showed some symptoms of autism that the university wanted to test further. For people with higher functioning autism, it may be best to avoid an official diagnosis due to the limitations of service options that may be imposed. It should instead be seen as information for the provider working with the person that they have a sensory mind in their processing of the world around them. Currently, we are so confined from providing best care in part due to regulations, For example, we know that an accurate diagnosis is imperative for directing care properly. I have worked with many clinicians who have worked for entities who pushed for specific diagnosis due to an increase in funding that would be associated. Those providers are forced into an ethical dilemma of having the money to provide treatment at all versus the long-term consequence to misdiagnosing an individual with something they may never part from. Many providers currently fall on the diagnosis of “adjustment disorder” which falls under the category of anxiety and is descriptive to most transition periods in life. This tends to be a luxury used by private providers and especially those who do not contract with insurance. Once a person needs medication or hospitalization specifically, the need for specific diagnosis increase – even when it is not most descriptive to the person. This is just a quick run down of the surface level conflict of our current diagnostic process. I fear over time the snowball effect of observation and reflection will produce equally large effect in every direction we choose to explore.

#alternativeswithcare #melodramaticmeredith #dearmelodramaticmeredith #holisticcounselor #holisticcounseling #alternativemedicine #mindbody #mentalhealth #mentalhealthawareness #suicideprevention

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My Earliest Experiences with Mental Health Providers to My Near Demise

February 21, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

Today I will discuss the first three “professional” mental health providers I saw. Each whose flaws would set me up for an incredibly long and tumultuous battle with the mental health system and within my family. The first occurred around 7^th grade. My mother took me to the Christian counselor that she herself had seen for three years. This woman was dumb enough to have attempted use of negative reinforcement on my mom and I can only think of the extended damage she caused. By this time, I had long been considered “difficult” and had a lot of somatic issues or physical complaints without recognizable medical cause, most notable were severe migraines and food regurgitation beginning around school age. This person was located in a nearby small town, above a shop downtown. I definitely wanted to speak with someone at that point. I was so confused by emotions and my brain. I knew enough to know I needed to infantize myself in some ways to this woman and I definitely knew my faith in God could not be called into question. I decided to give her just a couple of tidbits of information to see if she could be trusted. I remember expressing to her a lifetime of feeling overwhelmed by my emotions – specifically that I would begin to cry without knowing why. I remember telling her I was confused and would sit in front of the mirror to watch myself. And I told her I had always felt a tendency to feel down without a reason. I’m sure somewhere in there had to be the primary underlying theme of not living up to my mother’s desires. At the end of our session, my mother and the Christian counselor spoke privately and then we were on our way. It was left up to me whether I would see her again. On the drive home, my mother said back to me verbatim the information I had chosen to disclose. That was one hell of a foreshadowing to the rights I could one day expect in my mental health treatment. And no, I did not return.

My second interaction would be three years later with, you guessed it – another Christian Counselor! This one is a helluva story. She was another middle-aged woman, similar to my mother. She lived in a townhouse on Purdue’s campus and was studying to get her master’s degree in counseling – she was not even done, yet felt qualified to offer services. She knew just enough to be damaging in making me feel seen but did not know how to direct it, making me feel more like a freak than I already had. And she did not know enough to ask the right questions to be guiding in her diagnosis. What she found out very quickly with me was that she was in over her head.. After telling my mother that I could not drive down the street without wanting to drive my car into a tree and being unable to trust myself enough to promise her I would not, I was sent to West Lafayette, in a vehicle, to see an unlicensed, not even graduated, super unqualified woman who had no trouble with my parents paying her to be in negligent treatment towards me. For my mother, it mattered less that she was qualified and more that she was Christian. This counselor would refer me to a psychiatrist because she had no idea what she was doing and never had any business offering counseling at that period in her learning. I have looked her up online recently. She has a practice in Indianapolis now that she actually has a degree and her license. Twenty-one years later, I wonder if she ever thinks of me, the one she really got it wrong on.

The third and absolutely most damaging provider I would see was the first encounter with a licensed mental health provider. Of course, I was already on some psychiatric medication. They were being used off-label to “treat” my physical health symptoms I had battled more than a decade at that point. It wouldn’t be until the last year I was given the diagnosis for the autoimmune disorder I was most likely born with which provides much explanation to my lifelong physical and mental health symptom — something that psychiatrist actually predicted in the last line of his assessment before he continued to maltreat me all the same. At that point in time, I was still very strong in my belief system which was Evangelical Presbyterian. I was a straight A student, and I had no doubt that I would go to a private university with full tuition scholarship just as both of my older siblings had – I just desperately wanted to stop wanting to kill myself every moment of the day. As he worked his way through his assessment, he had a clear agenda for his diagnosis. He was looking at this through a lens of mood turbulence and little else. He assigned me the same diagnosis he would one day give the Purdue shooter – where I was a student at the time. It really was his pop diagnosis and favorite for this well-known over prescriber. The medication he would prescribe was pointed out by the Clinical Psychologist I was a research assistant for was not even correct for the diagnosis he gave. His final words with his prescription to me were “I am going to put you on a double dosage of antidepressant to ‘jump start’ you out of depression – even if it throws you into mania” without further explanation, I was to see him 3 weeks later. It wouldn’t be until I worked in acute mental healthcare 15 years later with an amazingly knowledgeable LMHC that I would learn – if you put someone with ADHD on an SSRI it can induce symptoms of mania. This doctor essentially created symptoms and in the long run, he used them against me. The analogy I have used to describe what these doctors are doing is giving people a gun and bullets without teaching them how to use them properly, hoping they’ll get it right. I guess I was just playing Russian roulette with two bullets instead of one. This doctor created behaviors that were out of line with my values. I was literally behaving in impulsive ways that I did not recognize. And three weeks later, the intrusive thought I had successfully fought on my own without medication successfully took over. The last thought that went through my brain was “anything has to be better than this”. I can tell you everything got much, much worse. This provider was at the beginning of his psychiatric tenure. I can only imagine he got a bonus for serving a resource deprived area – one that would have done better altogether without him if you asked me.

Consider that medical maltreatment only goes back two years. Do we really think that is enough time for anyone who has had severe mental illness with horrible treatment to be able to clear up and defend themselves? I can tell you from experience, even if you could, no one is there to stand up for you. My mother went to a presentation by a psychologist at Purdue where she would share my story in brief and he looked at her apologetically stating that was not the way it was supposed to be carried out. It is unfortunate that so many don’t realize a psychiatrist should be considered a last resort and so far from the end all be all of mental health treatment. It is as unfortunate that individuals allow faith to impede appropriate care. I will repeat to the end of time, poor mental health treatment is far worse than no treatment at all. We have currently over professionalized the mental health field. There is an attempt to sell a narrative of assurance surrounding effectiveness of evidenced based practices that if they were being honest, they don’t have adequate information to prove in many ways and is continuously disproven through subgroup populations. Since all of this time that has passed, my small hometown has had what little services they did have removed. I have been affiliated with two agencies that had claimed to serve that county but did not. Now that I have put more than 2 decades of research into the phenomenon I experienced I am foregoing licensure. I am doing this in attempt to bring services to the level of need currently happening and to highlight the limitations to individual treatment processes due to regulatory standards. The community I grew up in was effectively destroyed through an outsider with limited understanding to relational and generational psychological effects and wreaking havoc through the overprescribing of medications. Now that I have paved my own path to recovery, I want to share with others the power of their own light.

#alternativeswithcare #melodramaticmeredith #dearmelodramaticmeredith #holisticcounselor #holisticcounseling #alternativemedicine #mindbody #mentalhealth #mentalhealthawareness #suicideprevention

#msw #socialwork #psychology #selfcare #selflove #communitycare #communitylove #mutualaid #neurodivergent #recovery #equality #equity #inclusivity #antioppresive #hope #supportsmallbusiness

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Dear Melodramatic Meredith..

February 20, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

Dear Melodramatic Meredith,

My son is neurodivergent. When we are around other kids he just. does. not. fit. in. We walked into a birthday party last week – one of those “everyone in the class has to be invited” gigs. I could feel the tension as we entered and the mothers sneaking bothered glances at one another did not go unnoticed! By the middle of the party, he was sitting there eating cake at a table all by himself. I could not take it anymore, I was mortified. I grabbed our stuff and we were out of there! I know you have said that you felt like you were “too much” as a child, is there anything I can do to help make him more aware?

Signed, An emotionally exhausted momma.

Dear Emotionally Exhausted Momma,

Soooooo…. Unfortunately, I don’t think there’s anything you can do to rush self-awareness. That’s something that comes in it’s own time for us all. Because of this I can’t really provide perspective on this from a personal level – after all, I was unaware at the time! I can speak to it as a mother. In moments similar to these what I have found comfort in was not focusing on the other kids but on my own. I tuned in to the fact that by not being aware, it actually wasn’t bothering them. I focused on the confidence which with they played in active use of their imagination. By focusing on the positives they experience, it stopped being about me. I hope you take comfort in knowing you are not alone and keep searching for your people. How lucky this kiddo is to have a mother that loves him in the way you do!

Take Care,

Meredith Ann

On Early Grief, My Place as a Woman, & Shaken Faith

February 18, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

My first experience with death was incidentally the first time I was put into my place as a woman. It was the death of my 95-year-old great-grandmother. I don’t remember her face but I recall her presence. I was born to a home just around the corner from her and I was only 4 at the time of her death. I remember going into the funeral parlor – one of two that would be frequented commonly by my friends and family in our small town. I was not allowed in the main viewing area and instead sat in a front room with my dolls and the man that would take over this funeral home decades down the line. To follow, we were at my grandparents’ house with all these antiques lining tables. The “Big 6” as I liked to call them, were all there. My father, his sibling and their four male cousins on that side. Later in time there would be a male-like figure that didn’t quite fit with the Big 6 and wasn’t always there. Once I was older, she began to come around more, I learned this was my father’s only female cousin on that side, and it began to make more sense. What I learned in this experience was what it meant to be a woman growing up in my family – which is that no matter how hard I tried, it could never be enough. You see, my grandfather had attended an all-male college with both of his sons a nearby rival school instead. One of the Big 6 had attended, in these moments, he was always shown favor – the psychology major’s moment to shine, I suppose. Anyways, that day they were giving my two siblings and one male cousin a hard time about the potential of them attending said all male school – by this era, nearly no one was interested in anything but unisex experience. I chimed in with how I would attend that school and become a doctor, and in my spirit I added and carry on the good work of the family and make my grandfather proud. At that point it was snickers all around. My grandfather came to my level in attempt to explain this was an all-male college and I wouldn’t be allowed to attend. My then precocious self exclaimed, “I don’t care, I’m going to do it anyway!” And my grandfather just smiled. Unfortunately, the Big 6 had erupted into laughter with this and what I overheard them whisper to one another was “what she doesn’t know is that would make him more ashamed than anything.” Core memory activated.

My next two experiences with death would come in the same year occurring during second grade. The first was the other great-grandmother I had the fortune of knowing and having regular interactions. She was ninety-nine and had fallen to break her hip – a story that leads to the demise of many late-stage deaths. For whatever reason, someone decided I was old enough to say goodbye to the physical body that had housed my nana. What I can tell you of that was that a person of her age and frailty looked no different in a coffin than she had in her chair at our weekly visits. And her withered and wrinkled skin was cold and firm to the touch, but no more than it had been This induced my night terrors of her attempts to claw her own way out of her coffin – no cinema needed, my brain thought up that one all its own. I always wonder, had that been able to be avoided would someone have explained the embalming process to this obviously precarious young girl, maybe I would not have had those fears. Even at the age of nanna’s death, I will always remember witnessing the deep sorrow of my mammaw and her sister. I can picture her bringing that handkerchief to the corner of her eye so vividly.

Later that same school year it was the death of my first dog that would create severe eternal contemplation. This cocker spaniel had been with us my whole life. She was approaching fourteen years old, and her hind legs were starting to give out. My parents would later share that they prayed over her every night that she would go in her sleep, alas, the decision had to be made. So, my parents planned the one and only Spring break trip we ever had – my father is a CPA and break is in the middle of the heat if tax season. My grandmother drove down with us and we flew her home while simultaneously flying dad down to Florida for the last weekend. And in all of their emotional intelligence my parents did this and still told us the plan to put her down the night before we left. Instead of reminding us she is old and might die, they told us she was so we could say our goodbyes –perhaps appropriate for my brothers whose ages were six and eight years above mine. That morning before we ran out to the school bus, as we were saying our final farewells, my what I describe as “aemotional” younger older brother and really my security person, fell into a puddle of tears and I didn’t know what I was to do. I can tell you with as much vivid visual imagery as I have experienced in my life, I don’t remember a damn thing from that trip other than my father walking down the tarmac. An official representation it was done and my dog was dead. This is the death that began to shake the ground of my faith. A faith that was bragged upon by others. That’s what happens when you are around conservative Presbyterian men who are more concerned with arguing the indoctrination of their own theology than the comforting of an innocent child. For those who practice or have been exposed – I of course am referring to the argument of whether animals are in the after-life referred to as “Heaven”. For the record – in the Presbyterian Church it should be known that animals do not have souls and therefore will not be in heaven. My mother tried the consolation of her belief to little avail. She attempted to share the thought since they didn’t have souls they automatically passed to Spiritual Nirvana because they hadn’t fallen to begin. My mind had silenced her, the patriarchy was speaking at the fear of the wrath of God, hush.

The death that would have most significance on my life would occur in February of my 8^th grade year. It had only been in the past two years that I have realized when my grandfather died there was a part of my soul that completely stopped spinning on it’s axis altogether. Like, everyone around me just kept going and their worlds kept moving, and mine just ceased. I am not certain this was in any way avoidable. I lived my whole life waiting for him to die. An amazing core memory that I can pull from is the resilience that comes from my extended family when we stay and rally behind one another. I knew I came from fighters and survivors. This memory comes from before I began to second guess myself as a woman and can only be described as pure bliss. About three and a half, my mother’s parents moved to a single-story small ranch which I grew to adore. The move took place while my grandfather was recovering from a heart transplant, when a hospital born infection led to a six-month stay and almost taking his life. He was one of thirteen siblings who had experienced getting behind each other when times of need arose. He witnessed the death of his own father by heart attack on their living room floor at age 11. This threw him into the tobacco addiction that led to his heart disease. The eldest three siblings, who were grown, took care of their mother and younger children. As a family, each time they would get together conversation produced would surround “who the next one to die” was. And my grandfather was next for my whole life until his death. A year and a half before my grandfather was taken, there was an accident where he was ‘supposed’ to die. He was listed as a DNR and it didn’t get passed on. He was on a ventilator and so angry to be. My science fair project that year was an investigation of which cigarette produced the most tar. I won. I can still see him coming into the school gym with a cane, only recently home from the hospital. Over the next year and half, I would spend as much time as possible with them. I remember sitting in the other room and feeling such mixed emotions. My grandfather was so hateful towards grandma out of the resentment he felt. He never wanted to be on a breathing tube again – the reason he was a DNR. I remember feeling such guilt to witness that but to not be able to help be grateful his was still there. The day he died was a Sunday. We were in church and someone happened to be in the office to take the call. We beat the ambulance to the hospital. After making the decision to tell them to stop working on him, I stood in the hallway as my mother, aunt, and grandmother went to be with him. The double doors swung open wide as I heard the flat line. The look on my mother’s face as she screamed at his death is ingrained on my memories. After a lifetime of fighting to save him, he was gone. And I was stuck like “what do we do now?” And a hole which had once been filled by his ever-present love was there for me to carry, wherever I was.

There would be four more deaths that had incredible significance on my evolution as a grown woman. This includes the real drive to create more meaningful opportunities for individuals to participate in life after mental trials. It wasn’t until almost a decade later when I was pregnant for my first child that my mother would come to realize just how impactful her father’s death was on me. It is that same emptiness I felt that has allowed me to see a need in others. It allowed an ability for me to recognize authentic need and provide comfort through what was completely ignored for me. Outside of traumatic events, I think the hollows of grief of loss of an individual to be the most problematic in terms of finding a means to cope. The unexplainable and unresolvable nature of death creates increasing levels of inner turmoil. As we are observing a decrease in the levels of connections and a lack of meaning in relationships in modern society, I anticipate this will only become more dynamically difficult to navigate. The DSM 5 has given specific attention through the naming of Prolonged Grief Disorder (PGD) for those experiencing long-term and complicated grief. If one were to review my earliest Psychiatric assessment, there are clear indicators, this is what I was experiencing. If only they asked more of the right questions with curiosity and without agenda – maybe they would have gotten to know me and my needs. Maybe then the maltreatment they provided wouldn’t become something else I would have to one day learn to mourn.

#alternativeswithcare #melodramaticmeredith #dearmelodramaticmeredith #holisticcounselor #holisticcounseling #alternativemedicine #mindbody #mentalhealth #mentalhealthawareness #suicideprevention

#msw #socialwork #psychology #selfcare #selflove #communitycare #communitylove #mutualaid #neurodivergent #recovery #equality #equity #inclusivity #antioppresive #hope #supportsmallbusiness

#spreadlovenothate #unitedwestand #dividedwewillfall #meetmeinthemiddle

Dear Melodramatic Meredith…

February 13, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

Dear Melodramatic Meredith,

I am an LCSW and therapist with a specialty in ADHD. My son has ADHD. I keep trying to get him to have conversations about this and how it affects his life in the long run. He is not interested. He does not want to do his schoolwork and resists added support. All he talks about is baseball and wanting to be a professional ball player one day! I know he is only in elementary school, but I am worried if he does not take this seriously, it will mess up his entire future. Did you talk to your child about their diagnosis and how did you get them to be open to it?

Sincerely, A Frustrated Professional Mother

Dear Frustrated Professional Mother,

I did not bring up a specific diagnosis until they started to ask about it. In general, I don’t think the diagnosis is important to talk about. It is so much more important to normalize what they are going through. I had a child receive social skills support outside of what other children were receiving. When they started to show resistance to that I pointed out their advanced placement in Math and how some kids have to have extra help with that. It is important to relate to them so they know they can talk with you. I told them how hard social life was for me in middle school and high school and how I wish I had those supports early on. And it’s true, I do! Now a couple years later, my child became curious about his diagnosis and asked about ADHD, then conversations in that language started.

When it comes to where you are with your son right now. I would encourage you to look to get creative. Ask him his favorite baseball player. Look into that person’s life – everyone has a life outside of what they do. This will help you show your kiddo a bigger picture. As a therapist, you know how much ADHD impacts relationships. It could help to focus on that player’s family and any special interests outside of sports and go from there.

Hang in there,

Meredith Ann

Picking a Bone with Regulation through a Different High

February 12, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

I have never been a food driven person. I am, however, a fact driven person and by connecting through dialogue with like-minded individuals. In a nutshell: I love to learn and talk about what I have learned more than anything else. There’s a popular assessment called Strengthfinder that was utilized both by the graduate school I attended as well as an organization I previously worked for. My top two on this, Learner & Input – and if you’ve been a colleague or classmate, you likely concur with this finding.

The scrutiny I have with the structure of the licensing process is both personal and professionally based. The original intention of the licensing process is amiable. It can be recognized as a standardized means to assure your provider possessed adequate credentials to fill the role they are in. It was supposed to protect the consumer. What it has become over time is a way to protect the system – both the larger business entities and the individuals who call themselves professionals. As the great-granddaughter of the town doctor before licensing was considered and the granddaughter to one of the first of Board certified physicians, I can understand the intent. As a person who has been diagnosed with PTSD to do with the treatment received by medical providers, I personally experienced the negative impact. I have worked in the professional field of mental health for a decade now and have been studying it twice as long. The intention of application of services is so far awry, I fear it may need shattered altogether for repair.

One of the ways that I believe most notably reveals how different my brain works from those around me has always been my takeaway from readings. In school, this resulted in the unnecessary reinforcement of second guessing myself and affected my confidence in my abilities. It was during my first Abnormal Psychology class, where the classifications of licenses and their intended roles that I could immediately relate back to my own experience as having been carried through in an in appropriate manner. I attempted to type an explanation of these licenses in longform, but it came off fairly dense and will say couldn’t help but pick up the undertone of my own disdain and judgement. As much as I want a platform for my own voice at this time, I want the ability to provide sound education for others to draw their own opinion more. So I have decided to provide it in a more broken down and digestible form. This should highlight some related facts that I believe are relevant to the potential of the quality of care. **My synopsis should not be considered all-encompassing and is a generalization to be used as a tool for broad understanding, I recognize exceptions exist**

Psychiatrist – A medical doctor, M.D. or D.O. who has also gotten training from a 4 year Psychiatric Residency Program – intended to role of medication expert– GPA to get in program: 3.8+
Psychologist – Doctor of philosophy in psychology. PhD / PsyD – 5 year neuroscience/behavioral work who also does 4 years of postdoctoral work – intended role of diagnosing and directing treatment method2s – GPA to get in program 3.8 -4.0+
Therapist – This role is trained in the theory application methods – the tools to use to help certain diagnosis based on Evidenced Based Practices from Research in the above roles. These roles should provided information to and direction from those same roles. These are divided into 3 types of licenses.
- LMHC – 2-3 year Master’s in Psychology or Counseling – studies are geared around structural mental health + 2 years under LMHC – Licensed Mental Health Counselor GPA for program 3.2-3.5+
- LMFT – 2-3 year Master’s in Psychology or Counseling –studies are geared around relational psychology + 2 years under LMFT – Licensed Marriage & Family Therapist GPA for program 3.2-3.5+
- LCSW – 1-3 year Master’s in Social Work + 2 years under LCSW – studies geared around community care and recognizing oppressive tactics – Licensed Clinical Social Worker GPA for program 3.0

This is as concise and limited to a general factual basis. I intend limited personal prejudices of any kind. I am positive there are discrepancies, but this allows potential for understanding and laying ground work to assess the current system. The intended application in the current mental health field based upon decades longitudinal research would be for a psychologist to diagnosis and direct the treatment. The psychiatrist should take direction of diagnosis from the psychologist and provide medication. The therapist would use theory to target behavioral change based from what has worked with this diagnosis in similar situations. All three of these providers should have ongoing continuous conversation with not only each other but any other medical provider of the individual. This is best practice. And even this takes far more cultural humility to the populations being served than has ever been availed. Unfortunately, the people of the United States have been provided a romanticized version of what a psychiatrist does through the portrayal by Hollywood on the big screen. This depiction shows what would be most ideal, which is a medical doctor who also has psychology doctorate who is able to fully provide both therapeutic support as well as medication management. It takes a remarkable amount of work and ability to train for the described role, in excess to what the majority individual may be expected to achieve.

Over time what we have seen, largely, is coastal driven policies which we in the Midwest have done our best to adhere though we do not have the same resources. This has included the demotion of individuals who were, by skill, qualified for their roles but forced into lower positions. I had the honour of my first lead supervisor being a woman closing on her retirement who had filled the role of an intake counselor for substance use disorder for twenty years prior to legislative change stripping of her title due to missing those letters at the end of her name. It was a shame to witness professionals undermining what they could have learned from her. I felt like the lucky one and absorbed all that I could from her.

As someone who was a nontraditional adult student for both my undergraduate and graduate level degree, I was in a unique space of bringing lived experience to the lessons learned in each. What I have come to learn through many observations is that a person with intuitive clinical knowledge, or learned through lived experience, and that which we have learned and shown through theory are matching one another. This is incredibly great news. One of the conflicts we are seeing in an increasing way, is that those who have the lived knowledge are too often not the same who become privy to theoretical learning. And yet, these are the best individuals to be awarded this knowledge. Not only do they deserve the opportunity from a basis of equity, but they can help others through what they’ve gone through. In my own recovery, it was direct exposure to educating myself that allowed ultimate understanding and is tremendously useful in my efforts to help others.

I was meeting with a Clinical Psychologist who utilizes EEG for the purpose of diagnosis in a way that is way over my head. I know enough to know we need more biomedical ways to rule out mental health diagnosis based from external symptoms. It was during this time that I was experiencing a health phenomenon that made me ever grateful for his expertise in working with manic-depression and manic-like symptoms. His nonjudgmental compassion with my impulses and inattention over the conversation show how a genuine nature and a mind like mine could really work well together. Our meeting took place in the latter part of November 2024. He was fairly disheveled in appearance, no doubt to do with the feelings someone in his position was having surrounding that tumultuous election. There was a push-pull over the conversation in a way that made my intellectual heart giddy. At nineteen minutes exactly before the end of our one hour slotted meeting, my frustration with liability and regulation and its negative impact on the field of mental health surfaced. He looked at me with a bit of disgust and said “I think this is where we stop talking”. I looked at the clock and saw what time it was and the voice inside my head started to panic. This is where further explanation of my observations and insights in the ten years since I worked for him that led to his intrigued expression of “Let’s keep talking”. I included reflection on how there is a lack of interdiscinplinary care taking place. Specialties are specialty driven i.e. Psychiatry research is only interested in pscyhiatry research. Social workers are interested in social work research and active in legislative process at higher rates. Meanwhile the psychologists keep being excited about what they are learning with the false confidence that what they are passing down is being applied appropriately. It is not common that someone whose brain works like mine would rise to a level such as Clinical Psychologist with the way the current system is set up. Though I would argue someone like myself would aptly fill the role.

We ended our conversation with a plan to touch base in six months or more. I am learning that starting a large business is playing the long game. In his parting words he shared the sentiment “Keep your vision” with regard to the business plan and proposed partnership this meeting had all been about. That moment, right there, was the highest I have ever been in my life. And I can tell you with the mental status I had at the time of our meeting, the last thing I was in need of were any extra hits of dopamine and oxytocin. Now, here I am. Leveled out and in pursuit valuable use for all of the knowledge I’ve acquired.

#alternativeswithcare #melodramaticmeredith #dearmelodramaticmeredith #holisticcounselor #holisticcounseling #alternativemedicine #mindbody #mentalhealth #mentalhealthawareness #suicideprevention

#msw #socialwork #psychology #selfcare #selflove #communitycare #communitylove #mutualaid #neurodivergent #recovery #equality #equity #inclusivity #antioppresive #hope #supportsmallbusiness

#spreadlovenothate #unitedwestand #dividedwewillfall #meetmeinthemiddle

Living as a Neurodivergent Patient-Professional

February 6, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

My best nurse friend describes me as a medical anomaly. I will extrapolate to say I am an anomaly to life in general. We are in a world of labels. I think there is some misconception that with the right label we will find resolve. This has not been my experience. There were times a moment of clarity was found, sometimes deceptively so when it was an inaccurate label. There is no individual sustaining form of peace that comes from a label. That has to come within. The label I have come to utilize outwardly and embrace is that I am neurodivergent. This is the most simple way to concisely describe my presentation and needs. On an individual level, yes, it is far deeper and more intricate than that as I would presume it to be for every person. There will be plenty later in time on my specific diagnosis and the process to achieve it as well as what adequate labels brought to my treatment. As a system we cannot broadly recognize so many hypervariances and expect it to be effective in making changes across the board.

The concept of neurodivergence by definition is that we all are. It quite literally refers to the idea that each of our brains develop differently. As a social movement the term neurodivergent is one I lean on as a way to encapsulate “the other minded” or those whose brains have developed in a notably different way from what is typical. My belief is that grouping a variety of those with similar struggles allows much more opportunity for growth rather than forcing a larger whole to recognize many subgroupings of people. Before you attempt to refer to this as cold or oppressing understand that I am interested in real systems changes. As an “other” myself and in combination with my long-term social studies, I know joining forces is the most likely pathway to achieve anything. We are at a point in time when it is imperative for a broad movement for social justice on behalf of everyone who has experienced trouble with their mental wellness.

As a neurodivergent, I think one of my favorite descriptives of this yet was to present the idea that we are walking around speaking a second language constantly without the recognition of it. The term “neurotypical” is what is used to describe individuals who have experienced traditional stages of development and nurturing in a healthy or more anticipated way. It replaces the less accurate descriptor of “normal” and catalogs those whose brain activity falls within the majority. What I have added to this idea of our duolingual nature is how it relates mental breaks. This occurs when we have made repeated attempts to convey our message in a way that is understood by those around us and then eventually our brains just break. And that’s where you get word salad. This is the term used to refer to nonsensical loose associations and garbled words uttered by many experiencing severe mental illness symptoms. It was interest during my time working in a group home over my graduate level practicum, I was able to access this theory of mine to enable a communication pattern with a resident. In my mind I laid out the words he used as he said them. I did my best to attach a synonym to each of his words and then pull out the true nonsense filler words and was able to make sense of the rest. Staff there were truly impressed at this ability to communicate with him as I was and his eyes lit up at our connection. This is just one benefit in having those who think like us be made to be those who are in treatment to us.

Complicated ideas have always come easy to me. Of course I didn’t notice it in that way. It is theories and patterns that are easy for me to see and point out in a way that did not appear as obvious to others. And so much of what they call simple provide me with daily challenges. In my mind this scenario allows room to call to question the very definition of the words “simple”, “obvious”, and “easy”. I think one of the most widely used cliches is that comparison is the thief of joy. Whoever it was that coined this was a master at misdirection. What steals someone’s joy is the value they assign this comparison and thus our perspective that is the real culprit. Over the course of my completion of my MSW I did a presentation on the unique takeaway I’ve noted when it comes to the practice of social work. The field as a whole has experienced a necessary theoretical shift towards strengths-based approaches to community need. This includes looking at the environment and the qualities it possesses as well as what that community describes as a need. It is my observation that this shift has yet to make it to the mental health division of the field. Clinicians are taking “strengths-based” approach, yes. But these are strengths as they are presented through a neurotypical worldview.

In a meeting with a Clinical Psychologist I am hoping to work with in a nonprofit I am developing, I commented to him how rare it is that someone whose brain works like mine would end up in a position such as his with the way the current system is set up. The term I have coined to refer to myself is as a “Patient-Professional”. This is a means to establish my difference as a peer from someone who is specifically a substance use disorder peer. It has had mixed reviews professionally. I can’t take credit for the term, I picked it up from an article assigned to read midway through my three year graduate program and it just seemed to fit. In my attempts to use it through a major corporation my director met it with the scoff of “what do you even mean by that” indicating the need to make myself small once more. I have chosen to enter my graduate level profession open about my experiences with severe mental illness. My experiences with it so far aid my understanding to the reticence by Kay Redfield Jamison, a clinical psychologist who came out about her own story with the famous work, “An Unquiet Mind”. Even more than I can relate to her ambivalence in sharing is the conviction of the responsibility to share. When I consider the invaluable information that has been dismissed if not lost altogether by those who would be able to provide the most insightful of viewpoints. What advancements have passed us by at this missed opportunity for those to feel safe in sharing that can most easily be credited to stigma!

The nature of the work that I do as a counselor is excessively benefited by the variances in my brain in a way that the neurotypical does not possess. In leading a group with an incredibly young neurotypical, the things that came out of her mouth showed just how unfit she was to be in the position she was. I am not taking away from this young woman’s drive, genuine caring nor her studious abilities. I am saying she is not suited to be in the position she is based on her limited understanding of the population she serves. The limited awareness of the experience of symptoms such as ambivalence. I recall her really not understanding someone’s inability to make up their mind and thinking, if you aren’t able to wrap your mind around that working with those suffering the most troubling mental health symptoms, you are really out of your area of expertise. Other small factors that made a big difference included my ability to recall details about these individuals in ways that became therapeutically beneficial to the group that proved helpful for documentation as well. In working acute care intake I would repeatedly receive compliments to my patient care. Usually I would deflect this compliment with the retort, “real recognize real” or something to that effect. But it was the truth. I’m good with those people because I am those people.

I am in constant recognition of the privileges I have had in the ultimate safety net provided by my family, the protective factors associated with having higher than average traditional intelligence, and the immense resilience that has been passed down to me. When it comes down to it people who have been through the maltreatment I went through over seven years have ended up in one of three places. That is they have successfully lost their lives to overdose or suicide, they are still lost in the system, or they have gotten out and got as far away from the mental health field as possible. There are individuals in the professional world, they fill up my inbox due to their awareness of just how unsafe it is to be neurodivergent and open about it working in the mental health field. I made attempts to address my concerns to the field through the D.E.I. initiative. In meeting with one woman, she went out of her way to acknowledge my servant’s heart – the look in her eyes told me she knew I was fighting an insurmountable battle.

Over the finalization of the twenty year backwards approach to my graduate level career I went back and forth on whether to stay within the limitations of the industry or to break out of it and attempt to make influences from the outside in. What I had to come to terms with is that the impersonal nature of the corporate world is not one I was comfortable continuing to pursue. As I pointed out in supervision – I can’t blow up the system if I am standing in the middle of it – I am not a suicide bomber…. So, I am starting my own business as a Holistic Counselor. Every day I feel the responsibility to be a voice for a group that has never had its own voice including the practice that was done on this group by Hitler to perfect his euthanasia chambers for the Holocaust. The way I love the hardest is to find a way to speak in ways that someone can understand. I hope for so many to allow me the opportunity to help them in this way. Just a neurodivergent gal, hoping to lighten up a neurotypical world.

#alternativeswithcare #melodramaticmeredith #dearmelodramaticmeredith #holisticcounselor #holisticcounseling #alternativemedicine #mindbody #mentalhealth #mentalhealthawareness #suicideprevention

#msw #socialwork #psychology #selfcare #selflove #communitycare #communitylove #mutualaid #neurodivergent #recovery #equality #equity #inclusivity #antioppresive #hope #supportsmallbusiness

#spreadlovenothate #unitedwestand #dividedwewillfall #meetmeinthemiddle

A Criticism of the Disconnect in Healthcare Leadership and Practice

February 4, 2025March 10, 2025 by Meredith Ann, MSW, posted in Blog Post

One of the primary conflicts we have currently across the board in the medical field, but definitely more pronounced in mental healthcare is that the people who have been trained to be in this service in many ways cannot identify with their clients. This has become the largest hindrance to the advancement of treatment. We have people at the top who have made “good choices” from “good choices” to choose from and had it work out. This has resulted in the disconnect of their understanding to anyone else. I have a relative who works in the healthcare industry. She emulates the practice what you preach of living a healthy life and showing an outward desire to help others. My recent attention on my gut health as directed by my rheumatologist led to my relative expression of empathy towards me by her sharing the lack of research given to females in the medical literature. I deal with complicated autoimmune symptoms which were made severely more difficult to manage after my COVID 19 shot back in 2021. To follow recent flare ups I reached out for some support and guidance from this relative. The delayed response to my at that point critically presenting situation showed how significantly different our worlds are, in both our distinctly varied day-to-day realities but also our prioritization of others needs compared with our own. After pushing for assistance what I heard back was, “Sorry, I don’t know much about helping people who are sick. I know about how to be healthy and give advice to stay healthy but once it is to this point, I am not sure.” We are only able to conceive the world as we have experienced and been exposed to it. The higher educated is at a place where what they are largely in need of is humility.

As an individual I have seen this conflict most frequently in the medical world through the tests ordered by primary care physicians. This is difficult to navigate on multiple levels. What I am about to describe is more unique to those who are not in the Medicaid class, nor the professional working class of the physician colleague. This is a plague that mostly impacts those in the middle class, particularly the lower middle class. This element is one I have identified as pitting those in the lower working class against those in the welfare class. It should be considered for small business owners and those whose best option for insurance is a high deductible plan. It is related to the position liability has put doctors in when it comes to their ability to discern their objective medical opinion. It is when you present with a symptom and they order follow up tests and specialty referrals at times without giving consideration to the financial component and how it may affect you. This was notable at one point during pandemic and my spouse was having some chest pains that were concerning him. This doctor ordered three tests that ended up totaling thousands of dollars that this paycheck-to-paycheck family just didn’t have. There were at least two of the tests that, had I been allowed to attend the original appointment, I would not have approved of due to my general medical knowledge combined with my observation of his symptoms and knowing WE JUST CAN’T AFFORD THAT. But doctors and advanced licensed providers don’t get it. The joke I always make about the big whigs versus the rest of us is, “I bet they’ve got their bills on autopay without thinking twice about it”. And let’s be honest, it’s the truth.

I remember one LMHC I worked with who was incredibly judgmental. Often and openly, she voiced her discontent with the field she has chosen. Repeatedly I heard her reference how she should have been a pediatrician – though I don’t think her demeanor would have flown in peds. One time she referenced how unfathomable it was that the majority of Americans would have trouble being able to cover a sudden five-thousand-dollar expense. I asked if she knew that 9 out of 10 American families live paycheck-to-paycheck, and the concept didn’t seem to fully register. As with so many that dislike working with people in this field do – she volunteered to be in a leadership role. Another voluntary leader and licensed clinical provider once pulled me aside after she had a “traumatic event”. She shared with me how there had been freezing rain after leaving a late shift for home. Her brakes had locked up and she slid down a country road hill with her husband safely to her rescue within thirty minutes time. She went on to share that now anytime there was freezing rain, she feels a physical trauma response. She had been a licensed clinical provider for more than twenty years and admitted to being paid to counsel people that she did not believe when they told her they had physical trauma responses. I should win an award for not blowing my lid and losing it on her right there in that room. One time my car needed a repair that I couldn’t afford and that same provider shared how when that happens to she and her husband they just put it on the credit card – as though she couldn’t understand a life where one’s credit cards were already maxed out.

Leadership and other providers in mental health are consistently filled with neurotypicals and those in a higher economic status. If they are someone who has had exposure to mental health treatment it was adequate care – which is far from standard. These people, albeit often well intentioned, aren’t most suitable for guiding and providing treatment to the vulnerable population of the most neurodivergent. In 2019, I finally received the paired entry diagnosis of ADHD Anxiety. This was Sixteen years after my first misdiagnosis by a psychiatrist. The therapist that diagnosed me was someone who struggled with ADHD herself. She sent me home with research articles as the most readily identifiable and consistent trait in my life is my love of learning. This allowed some normality to what I’d gone through. The article revealed that adults who receive an ADHD diagnosis have statistically seen and been given inaccurate diagnosis by 3 providers. My experiences definitely skewed this number in an upward manner, but still – I was not alone. Perhaps the most vital takeaway that could ever come for mental healthcare from a preventative lens is the aspect of understanding and companionship.

It’s time for the professional community to humble themselves to all that they don’t know. They preach “the science” as though there is any historical record that really indicates we are doing anything correctly or that change is not the one constant. We’ve invented these “norms” that perhaps aren’t as normative across the general public as we’d like to think. As a fourth-generation higher educated individual, I have to point out that the current state of the United States education system is the highest form of colonialism that there has ever been. Every BS position I worked was trainable with a high school equivalence combined with two years of life experience. I used to say that I never minded being overqualified for a position and at first and while on nightshift, I meant it. I loved my patient facing position. One of my specialties is to work with those in high levels of mental distress. This is likely due to my genuine interest in how the person came to experience the symptoms in combination with having had many of them myself at some point. The primary motivator for me to go get my MSW was just how arrogant and condescending individuals with letters are towards the knowledge of those without the same. It is nauseating. Then you add the fact that there is not room for economic advancement with only a BS. Even before I went for my graduate degree those who knew me well would say I knew more than at least half the therapists I worked with, and still, it didn’t matter without a degree to back it up. My continued disgust by those who were most unknowing to the client’s life caused me to pursue a means to make real system changes. What we are dealing with in mass proportion is the repercussion of the attempt to standardize individualized human processes. I want to be clear that I am not devaluing decades of research or that we may not take away brilliance from all that we have learned. I am completely calling to question our practical application of research and how disastrous it has been.

#alternativeswithcare #melodramaticmeredith #dearmelodramaticmeredith #holisticcounselor #holisticcounseling #alternativemedicine #mindbody #mentalhealth #mentalhealthawareness #suicideprevention

#msw #socialwork #psychology #selfcare #selflove #communitycare #communitylove #mutualaid #neurodivergent #recovery #equality #equity #inclusivity #antioppresive #hope #supportsmallbusiness

#spreadlovenothate #unitedwestand #dividedwewillfall #meetmeinthemiddle