How I'm Currently Answering the Question: "What's the Book Going to Be About?"

by Monica Ross

Dorothea Lange-Migrant Mother

I’ve run into people lately who know my intent of writing a book and they’ve been asking me, “Well what's it about?”  I say that I have a loose sketch.  There are several themes that I want to tie in together. The general themes are poverty, stigma, mental health, physical health, behavioral economics, and therapeutic techniques like cognitive behavioral therapy. 

I’ve thought about going back to school to advance my studies even further.  And recently, I applied to a couple of doctoral programs.  Both of these programs are online and shorter in length than a traditional PhD track program which would be geared more towards someone who wants to end up conducting research and teaching in academia.  The one doctoral program that I am looking at in particular would place the emphasis on clinical practice.

I don’t know whether or not I’ll get into my program of choice or whether or not having gained the acceptance I’ll sign the piece of paper that commits myself to even more student loan debt. But I thought I’d use this post to explain some of my background or reasoning for wanting to pursue the idea of writing a book.

I made some of the following statements in my personal statement submitted to the doctoral program that elucidate my intent a little bit more:

Extreme economic inequality is a public health problem. As a health care provider, I want to advance well-being practices geared towards overcoming the unique psychological barriers that economic inequality perpetuates in order to stimulate behavioral and economic change. The government focuses on prevention and early intervention for “at risk” youth, and this leaves out our adult population, an even larger demographic.

Some of the adults I have treated were not able to get early interventions and therefore find themselves struggling later in life. I am intrigued by the work of Eldar Shafir and Johannes Haushofer, both from Princeton University, who are leading the conversation linking poverty to psychology and tracing this linkage to its economic impact.

In my early years, in Texas, I saw the struggles my parents had with chronic health impairments and economic inequality. This influenced my decision to go into psychology and sociology as an undergraduate student and to focus my studies on resilience and well-being later in life.

I did not see the burden of my parents’ health and financial issues or my own issues for that matter as resting solely on our shoulders. Instead, I had some sense there were environmental and societal factors affecting our overall health and well-being.  I am an advocate of personal agency and responsibility, while at the same time acknowledging that we, all of us, live in systems.

After graduation I spent many years working in California at corporate, government, nonprofit, and academic institutions. I choose this path of work because I chased after the financial security that these roles provided. In 2010 I made the decision to come back to Texas to be with family and I came up with a plan to pursue my calling—to return to the study of psychology and to become a psychotherapist.

By August of 2011, I was enrolled full-time in a counseling program at St. Edward’s University. By May of 2014 I finished my counseling program and graduated with a 4.0 GPA. With my master’s degree and LPC-intern license in hand, I made the decision to relocate to rural East Texas because of the experience it offered.

I began working at Burke, a Federally Qualified Health Center headquartered in Lufkin. It serves a 12 county region and houses services for people across the lifespan, from children to adults, with mental health and medical issues. At Burke, I worked initially with the most severely mentally ill in vivo as a caseworker.

In that role as an in vivo caseworker, I came face to face with the devastating effects of poverty in America and its relationship to mental health. After a year as a caseworker, I transitioned to the office and provided psychotherapy at the clinic for our clients that included 50 to 90 minute individual counseling, group therapy, and psychoeducational sessions.

I discovered a wellness self-management personal workbook from the New York State Office of Mental Health and used that as a tool to lead a 12 week series of group therapy sessions. I also drove once a week an hour outside of Lufkin to Crockett, a town of less than 7,000, in order to provide therapy to the neediest in that community. Crockett has a 39.1% poverty rate.

In some ways, I had escaped the financial and cultural struggles of my early years for an interlude while in working California only to willingly come back to my home state and face those same struggles again, but from a different perspective. Once I finished the licensure process, I moved back to Austin to embark upon my own private practice.

Throughout my experience as a counselor, I have continued to work with clients of all ages in all levels of socio-economic status. I have clients who have been in and out of prison, who have had Child Protective Services (CPS) involvement in their lives, and who are struggling to maintain independent housing, access to proper nutrition, and transportation.

I have also worked with top executives of well-known companies who are somewhat more economically privileged, but often face similar mental health challenges and have had to overcome sometimes similar childhood trauma.

By addressing the unique psychological barriers that people coming from a place of extreme economic inequality face, we can more adequately advance long and productive lives.  This may come through a process of creating social responses that include therapeutic techniques to adapt to the changing social environment.

The experiences that I have had throughout life, the witnessing of the effects of extreme inequality, which are influenced by both societal factors and internalized psychological barriers, have taken on new meaning for me. These experiences were not random occurrences, but instead have prepared me for the work that I currently do and for the legacy that I hope to one day leave.