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Life Coaching and the Stigma of Psychiatry

Life Coaching and the Stigma of Psychiatry


When I began my career as a psychiatrist back in the 1970s, there were many other mental health care disciplines. These included psychologists, psychiatric social workers, psychiatric nurses, and occupational therapists.

Given how community mental health care in the 1960s focused on underserved people from poor and minority communities, paraprofessional staff often came from the same culture as their patients and were therefore able to appreciate their particular values. Some of them became case managers. Occasionally, others were patients or ex-patients who eventually became peer specialists.

My interest in the benefits and problems of these overlapping disciplines led to a book that I edited, A Clinician's Manual on Mental Health Care: A Multidisciplinary Approach (Addison-Wesley, 1982). Pulling it out recently, I noticed that not only did it include chapters on the major mental health care disciplines, but also on psychodrama, art therapy, dance therapy, and music therapy—these modalities are less prominent today as a result of cost-cutting. The book does not mention life coaching.

Supportive psychotherapy
One of the overlapping skills these disciplines required was supportive psychotherapy. In contrast to insight-oriented, psychodynamic psychotherapy, supportive psychotherapy did not try to examine underlying conflicts that contributed to symptoms. Rather, it emphasized a casual and conversational interaction that focused on everyday life. The therapist could provide realistic praise, advice, guidance, and, at times, confrontation.

Supportive psychotherapy was most commonly provided for persons with severe and chronic mental illness in order to help such patients develop, or re-develop, life skills in relationships, work, and daily living. It was sometimes thought to be “second-rate” psychotherapy, especially compared with psychodynamic psychotherapy.

life coaching©OlivierLeMoal/Shutterstock
Although not a major component of psychodynamic psychotherapy, support can be incorporated. Freud discussed such cases, as with the composer Gustav Mahler, with whom he and Freud took walks to discuss Mahler’s problems.

Life coaching
Life coaching is a relatively new concept. Informally, coaching has probably been around since humanity began, in the sense that someone with more life experience helped another person develop their skills and capabilities. Of course, sports coaches have been around for a century or more.


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