The importance of experience: an interview with Miguel Ángel Ruiz

This psychologist with more than three decades of experience talks to us about therapeutic practice.

Psychology is often spoken of as a subject of study; a field of knowledge that is contained in a book. However, the truth is that no science is valid or effective if it is not based on day-to-day practice and transcends theory, and the same is true of the science of behavior.

That is why psychology professionals with extensive work experience have a unique perspective that is difficult to summarize in words. In this case, we interviewed Miguel Ángel Ruiz Gonzálezfrom the Bilbao-based psychology center Psicología y Psicoterapia Miguel Ángel, to talk to us about the role that professional experience plays in the role of psychology today.

Interview with Miguel Ángel Ruiz, from Psicología y Psicoterapia Miguel Ángel.

Miguel Ángel Ruiz is a psychologist with more than 30 years of experience in the field of psychological intervention with patients. Since 1981 he has been working in psychotherapy, and somewhat later in the training of other psychologists, so he can give us a very complete vision of the path of this professional sector in Spain.

In the following lines we talk about the knowledge that only professional practice can provide and that is not explained in books.

Miguel Ángel, they say that experience is a degree, and you are a psychologist with many years of experience. What advantages do the years bring?

As in any profession, generally the main advantage is to be able to give a better service. Experience helps to increase knowledge and sharpen techniques and therefore, to do better and help the person solve their problems and achieve their goals more quickly. Experience improves expertise.

There is a saying that, in any profession, a minimum of 10,000 hours of practice is needed to reach excellence, which is normally achieved with ten years of dedication in any profession.

However, we must point out that this is not always and not necessarily the case, since there can be and in fact there are people, in all disciplines, who even with many years of experience are not good professionals.

Having many years of experience does not imply being a good professional. On the other hand, there are professionals specialized in specific problems, who can be much more effective than a therapist who boasts 30 years of experience.

Being up to date and continuously recycled, motivated and governed by appropriate values, psychological balance, and adding to all this a long experience, is very likely to result in a good service.

In our logo there is a phrase that says "in constant evolution since 1981". For me it is essential to be constantly updated. Science advances very fast and nowadays, thanks to the internet, we have immediate access to information.

It is disrespectful to our patients not to make use of it to keep up to date, although above all, the traditional means of training, such as the specialized studies provided by universities and research centers, are a good guarantee as reliable sources.

Of course, on the Internet, it is true that it is difficult to separate the wheat from the chaff, but on the other hand, the speed and quantity of information is magnificent.

You say that in your psychology center you have experience in the sector since 1981. How has society and the type of needs you seek to satisfy in therapy changed since then? And what differences are there between the way of working in the 80s and now?

The fundamental change is that today there is a greater demand for quality of life, and the role of the psychologist is better understood.

Although the social and cultural context has changed, and therefore the psychological problems may seem somewhat different at times, they are more or less the same. For example, in some of those derived from new technologies, such as online gambling, we did not have addicts before, but there have always been addicts.

It is true that, just as decades ago, Smoking was not considered harmful in terms of mental health, nowadays we consider a difficulty in personal relationships or a high level of nervousness to face objectively non-dangerous circumstances to be harmful, but not before. In other words, there is a greater search for quality of life.

We have also advanced in many other aspects, for example, in the first Diagnostic and Statistical Manual of Mental Disorders published in 1952, homosexuality was considered a category of mental illness. Subsequently, in the next manual (DSM-II), in 1973 homosexuality was eliminated as a diagnostic category in the section on Sexual Deviations and was no longer considered a mental illness, where it should never have been.

From my particular experience, thanks to the recycling we were talking about before, I have observed that the progress of psychotherapy has been enormous. The times demand it and in our Center it is one of the fundamental guidelines. We concentrate our efforts on the effective and rapid resolution of the problems that we are presented with.

Summarizing a lot, and it would only be an example, because there are remarkable changes in many aspects, such as the use of very different techniques, also the use of technology, for me it is essential that in the past, it was always necessary to focus on knowing "the why" of a problem, to go back to the remoteness of the patient's life, to understand in order to solve.

Today, at least in our center, and I know that an increasing number of professionals, we focus on the solution of the problem, on solving it, and very often it happens that it is only after the problem has been solved that we understand the structure of the problem. In other words, we focus on solving the problem, which is what the patient needs, and not so much on understanding its origin.

I do not mean to underestimate the importance of knowing the reasons why problems are created; this is essential to prevent and thus avoid the circumstances that generate such problems for other people in the future. But the patient who comes for consultation, what interests him is to solve his problem and as soon as possible.

Were the beginnings difficult?

Well, yes, because frankly, many people did not know what a psychologist was and much less what he or she was for. That made it quite difficult to anchor the profession as a health service.

Even today, the number of psychologists in relation to the number of inhabitants in Spain is far below that of the countries in our European environment.

As an anecdote, when I decided to study psychology my mother told me: "but son, can't you study a normal career like everyone else, as an engineer, lawyer, doctor...?" Beginnings are often difficult, but what would we do without the often groundbreaking initiative of youth?

How many cases have you seen in your career to date and what kind of problems have you treated the most?

There are thousands of case histories in private practice. In my beginnings, I also provided my services in Osakidetza, the Basque Public Health System. What I have seen most is what we would call mild mental disorders. Psychological or emotional problems, couple problems, sexual problems...

The most frequent are anxiety disorders, although in the last decade, I don't know if it is because we are specializing in them, we also see many cases of eating disorders.

During such a long working career, isn't there a moment when you get comfortable or lose enthusiasm?

Psychology makes it easy for us not to get comfortable, it is exciting. I am fascinated by human behavior.

I have not stopped training and I read psychology practically every day. Although in the last couple of years I have reduced the number of days I spend in consultation and therefore the volume of work, losing enthusiasm has not happened and I don't think it will happen.

Accommodating myself would not allow me to do so either. The day I cannot work with the precise rigor, total dedication and dedication and one hundred percent, I will retire completely.

Nowadays, due to age, I probably could not maintain the level of work of 40 or 50 years old, so many hours and commitments. That is why I have reduced the number of days I dedicate to consultation, but I do it with total dedication and enthusiasm.

Where do you think psychology is heading or how do you see psychological intervention in the future?

Psychological problems can vary according to the cultural moment we live in. Our relationship with the context changes, therefore the specific social demands also change, and problems specific to a particular historical and cultural moment may appear.

I see psychological intervention as more scientific, rigorous, where there are no schools or currents, but rather well-established protocols that we all comply with, thus the efficacy, effectiveness and efficiency of psychological intervention will improve and evolve faster. This future is already here, with more and more strength.

In general, I would say that we are moving towards a clear improvement in psychotherapeutic work.

Beyond the work in the psychology center, you have also appeared in several media. Do you think that psychologists should be more taken into account in television channels, radio stations and newspapers when it comes to informing?

No doubt about it. We often come across beliefs and values that are socially very popular and yet are at the origin of many psychological problems that we will later encounter.

For example, some canons of beauty can lead to or favor the appearance of serious eating disorders, or there are educational guidelines that do not solve the problems presented by a minor, but often harm the child or young person, or are the reason for the problems they present, etc.

Therefore, in order to fight against this type of problems and many others, rigorous information is needed, and it is through the media that the general population is reached directly and effectively.

In addition to face-to-face psychotherapy for adults, children and young people, you also offer the possibility of online therapy sessions. What are the advantages of this modality that your patients appreciate the most?

Basically it is the impossibility of face-to-face therapy, due to distance or some particular characteristic of the patient, which gives sense to this format of therapy. Being present, communication is more fluid and gives us more information, since non-verbal communication in psychotherapy is very important.

Although online therapy, at least for me in particular, requires more effort and concentration, there is no doubt that it is a magnificent resource.

My personal opinion is that it will always be better to consult in person, unless the specialist we want to consult is far away or we have some impediment to do so. However, it is a very useful medium, due to the impediments it overcomes, and the enormous scope it offers us.

How is a psychology center such as Psicología y Psicoterapia Miguel Ángel organized? How is the team work?

The organization is very simple. Cases are referred, depending on the specific characteristics and demands of the patient, to the most appropriate professional, unless the patient asks to be attended by someone specific.

Also, to be honest, sometimes we have to respond according to the possibilities of attention according to the agendas. In any case, if a professional has difficulties with a patient, he/she refers him/her to another professional that he/she considers will provide a better service.

We meet fortnightly for clinical supervisions, where we pool all the cases. Here we will pay more attention to those in which any of us find greater difficulty. This is one of the great advantages of being several professionals with very diverse and complementary backgrounds.

In addition, if the case requires it, we maintain the necessary contact with other professionals, psychiatrists, neuropsychologists, nutritionists...

We also offer clinical supervision to other professionals who wish to consult us on any case that presents them with difficulties.

Whenever we consider that these issues are within our competence, we will be willing to discuss them with them and direct the therapeutic process or simply suggest what to do or where to go from here.

Finally... what motivates you most about working in this branch of psychology? The most satisfying thing

There are few things as rewarding for human beings as feeling useful to others, in that sense, few professions are more rewarding than this one.

As an example, to be understood, I will say that meeting a patient after years and hearing him say that coming to therapy is the best thing that has happened to him in his life and that this is transmitted to you from time to time, is the most satisfying thing that can happen to us. To be part of the transformation of a human being from suffering to well-being is extremely gratifying.

I would not like to go without thanking all my patients for all they have taught me over these almost four decades. This is something that all of us who dedicate ourselves to the practice of psychotherapy know, and that is that working with human psychology humanizes. Thank you.

To conclude... what recommendations would you give to new psychologists?

To study. To listen to all the professionals who are referents. To question everything. Be rigorous. To supervise. That they refer if they do not see themselves capable of handling a case. That they disclose with seriousness and professionalism. That they have respect for this profession, dignify it and above all enjoy it, because as we say, there are few things as rewarding as experiencing being useful to others, helping people to solve their problems, to have a better quality of life, in short, to be happier.