This past weekend, a friend I met in college came to California from Shanghai for a business trip and stopped by my small town to hang out with me. The place where I go to school is a newly developed area that combines urban and rural elements. It is quiet and boring, with rows of small houses and camping tents arranged in an orderly or disorderly manner, without disturbing each other. They say you can't survive in Northern California without a car, but I've been here for almost a year and still haven't finished getting my driver's license (I only took the written test and was too lazy to take the road test). In my daily travels, I either rely on the help of friends or reluctantly take Uber.
Due to the busy workload of my studies, I rarely have weekends off. I usually spend my free time between doing homework and working. However, I can't let my friend just watch me do homework on the computer all the time, or see how I make dumplings in the kitchen (which I actually did). In order to be a good host, I had to find some entertaining activities that I could show off. There is an art museum in the city that is not very well-known, but it is interesting and decent. I went there a couple of months ago and had a good impression, so I decided that would be our destination!
Yesterday was Easter, and because it was a special day, we noticed that almost all the Uber drivers were Asian. The longest part of the journey from my house to the art museum was with a Korean driver. Since I came to the United States, the skill I have improved the most is small talk with strangers. One of my guilty pleasures is telling Uber drivers that I just moved to the United States not long ago and had never been here before, and then enjoying their shocked faces. I don't know if this approach is not very friendly to ABCs (American-born Chinese), and if it reinforces the stereotype that all Asians are foreigners.
Anyway, this was the first time I had encountered an East Asian driver. While waiting, I checked his Uber profile, which showed that he was Korean from South Korea (probably a first-generation immigrant) and had previously worked in the army. When I got in the car, we, as East Asians, had tears in our eyes. He asked where I was from, and I said Chinese, like Chinese Chinese. He said he was Korean, the kind of Korean that eats kimchi. I thought to myself, this guy can make jokes about his own ethnicity, so it seems like we can get along.
He lived not too far from me, so we started talking about the neighborhood, the nearby Asian supermarket, and then why I chose to live here. I briefly talked about my educational background and what I am currently doing, and in response to his questions, I mentioned my bittersweet history of switching from business school to studying psychology. Along the way, he said, "Your experience is interesting and similar to mine. If you're interested, I can tell you my story later."
Then it was his turn to speak. The first sentence he said shocked us: "I'm 59 years old this year and I just decided to retire last year." So Korean skincare has already reached men, huh? He really looked like he was in his forties. But the second sentence shocked me even more: "Before I retired, I was a clinical psychologist, so our stories are quite similar."
Oh my, what kind of fate allowed me to meet a "colleague" as an Uber driver! He continued to talk, saying that he chose to retire because he found himself burned out and started experiencing severe symptoms of depression, including suicidal thoughts. So he immediately decided to quit his high-paying job and check himself into a hospital for treatment. Since he had previously worked at Kaiser in Northern California, he chose a branch where he had no previous work connections. After being discharged, he started working as an Uber driver, enjoying the process of driving and occasionally chatting with passengers. In this way, most of his symptoms improved.
While I was telling my story, he asked me what career I wanted to pursue in the future. I said it was psychotherapy, thinking that as a layperson, he might not understand the industry. Later, I realized that he was asking what specialty I wanted to focus on. In the United States, clinical psychologists can usually diagnose mental illnesses and provide psychotherapy, but they do not have the authority to prescribe medication. That responsibility usually falls on psychiatrists who have graduated from medical school. However, in states where mental health services are relatively scarce, clinical psychologists can become prescribing psychologists after additional training (such as a relevant master's degree or a certain number of clinical hours), which allows them to prescribe psychiatric medications to patients.
He said that before retiring, he was a prescribing psychologist, seeing a patient every 15 minutes, almost like a psychiatrist, with a very tight schedule. At the same time, the salary was very high, almost reaching thousands of dollars per hour. Currently, prescribing psychologists are not allowed in California. His private practice was in another state in the south, so he would fly there to work during the week and fly back to California on weekends. I had heard that a few states allow psychologists to become prescribing psychologists, but I was not very interested in it. On one hand, only a few states have passed relevant laws, and on the other hand, I always feel that psychotherapy can truly change a patient's life, and the irreplaceability of practitioner work is higher than medication treatment.
He said that before retiring, he was a prescribing psychologist, seeing a patient every 15 minutes, almost like a psychiatrist, with a very tight schedule. At the same time, the salary was very high, almost reaching thousands of dollars per hour. Currently, prescribing psychologists are not allowed in California. His private practice was in another state in the south, so he would fly there to work during the week and fly back to California on weekends. I had heard that a few states allow psychologists to become prescribing psychologists, but I was not very interested in it. On one hand, only a few states have passed relevant laws, and on the other hand, I always feel that psychotherapy can truly change a patient's life, and the irreplaceability of practitioner work is higher than medication treatment.
Our conversation gradually challenged my preconceived notions. He mentioned the different perspectives in diagnosing and prescribing medication between a psychology background and a medical background. He talked about how medication itself can bring new life to patients and how rapid diagnosis and treatment can effectively help more patients. Of course, there is another side to the story: seeing dozens of patients in a day greatly increases the risk of professional burnout for psychologists themselves.
We talked about one topic after another, and he mentioned encountering an Indian practitioner during his own treatment who made judgments based on the patient's level of education. He would say things like, "You have a doctoral degree, so we are on the same level and you should understand blabla," while showing discrimination and belittlement towards patients with relatively lower education. I asked if the practitioner had a medical or psychology background, and he said it was a psychiatrist with a medical background. I said, "That makes more sense, as there is a higher chance of toxic competition in medical school. Sorry, I'm stereotyping..." He replied, "Indeed, but you can also say that all schools are toxic. After all, we are both East Asians, right!" By the way, the driver had graduated from one of the best clinical psychology doctoral programs in California (one of them) and was affiliated with a prestigious university. It was a school I couldn't get into, and I heard that the competition there was extremely fierce. I have a professor who also graduated from that school, and he is very strict with us. I currently have a precarious A grade in his hands. But I digress.
Anyway, no matter how impressive one's education and income may be, it cannot exempt them from inevitable suffering. When depression strikes, no matter how others perceive your life as dignified and full of vitality, only you know how close to death you really are. I said, "That's true. Before choosing psychology as my career, I also went through such dark moments." He asked if it was just a mood or clinical depression. I said clinically, and it took me two years to recover. He said, "That's a good thing. You will truly understand your patients in the future, not just superficial empathy." I said, "Yes, one good thing about being a psychologist for me is that whenever I encounter suffering, I tell myself that the meaning of experiencing it is to be able to better understand a patient someday. As long as I give meaning to the pain, it becomes bearable."
Later, we talked about his previous work in the military, in prisons, and in his own practice. He said that the most important thing in therapy is to provide patients with unconditional positive regard, even though many doctors who prescribe medication do not value this. What he mentioned is a crucial theory in person-centered therapy, which is one of my favorite theories. In the current dominance of CBT (cognitive-behavioral therapy) supported by research and medical companies, I feel very sorry for the decline of humanistic approaches. Personally, I really want to make humanistic psychology the main mode of my work, but I have always worried that this choice would lead to a bleak financial future.
The unexpected surprise was that a prescribing psychologist told me that he did not agree with CBT as the preferred treatment method and believed that applying humanistic approaches to medication treatment was feasible. Even in a 15-minute meeting between doctors and patients, the power of empathy can be profound. As we were about to get off the car, he continued to tell me not to limit my choices and to try working with different patient populations if I have the opportunity. He also mentioned that becoming a prescribing psychologist is a career possibility worth considering.
During our conversation, my friend didn't have much chance to speak, but he listened happily. He asked if we should exchange contact information to stay connected. The driver didn't hear what he said clearly, and I understood but evaded the question. When we got off the car, I told him that it didn't matter because he mentioned that he was trying to write a book about the different perspectives and experiences of being a psychologist, a prescribing doctor, and a patient. If it's meant to be, we will meet again at the right time.