My Story

30 is looming closer and closer: How should I move forward with my career?

birthday cake large

The work I’ve done on this blog and the positive responses I’ve received (thank you all so much!) have opened up new ideas for me.  In the month and a half since I started working on this blog, I already feel as though I’ve been able to make somewhat of a difference in others’ lives.  I know I don’t have a ton of readers (yet), but it seems as though people who’ve faced similar issues to me have really appreciated the information I’ve collected here.  I’m incredibly gratified, and inspired to do more.  But how?

I’m definitely going to keep working on this blog, and possibly purchase my own domain name and create my own website on pain science in the future.  Right now that actually seems like the best way to get information out to people.

But as age thirty looms closer and closer, it would be nice to advance along my career path as well.  I would like to make a career out of helping people who have faced similar issues to mine, but I’m not sure of the best way to go about it.

I have a Bachelor’s degree, and for years and years I’ve been considering different options for graduate school.  I’ve been holding off because I can’t quite figure out what would be the best use of my time and money.  Here are the possible career roles I have considered going back to school for:

Social Work & Psychology

Throughout most of the time I was in college, I wanted to be a social worker/mental health counselor.  But as I got more experience with the field, I realized it wasn’t the career path for me.

I have always found psychology fascinating, and have the utmost respect for the vast majority of psychologists.  But in my opinion, the field of psychology is moving in the wrong direction on the subject of pain.

Though most psychologists and social workers today would be pretty quick to dismiss the ideas of Sigmund Freud as wacky and outdated, the one area of mental health where he still seems to hold an influence is in the treatment of pain.  It was Freud who first came up with the diagnosis of conversion disorder (where a patient’s “unconscious psychological conflicts” manifested themselves as unexplained pain or numbness in the body).  If you read this article by Toni Bernhard, you’ll see that as we enter 2013, today’s psychologists haven’t strayed very far from these ideas.

Diagnoses such as “somatoform disorder” and “psychogenic pain” imply that the patient is in pain because something is wrong with his or her mind.  Not only is this mindset disempowering, but it doesn’t take into account any of the things that neuroscientists have learned about pain in the past two decades.

Freud. Image provided courtesy of

In my opinion, there’s no good excuse for this, really.  It seems like people who are already established in the fields of psychology and social work haven’t done a great job of opening themselves up to research in fields other than their own.  Critiquing work done by someone trained in another field just seems to be something that “isn’t done.”  Graduate students in these fields learn about the discoveries of the psychologists and social workers who came before them; and, for the sake of their own career success, learn to follow the rules and blend in.  Future therapists must protect themselves from liability by knowing here their limits are, and they are definitely not trained to dispense medical advice.  So it appears that these inaccurate, harmful conceptions of pain and illness are passed from one generation of mental health counselors to another.

Becoming a doctor

Having ruled out a career in mental health, I sometimes think about becoming a doctor.  I have met some pain specialists and physiatrists who I believe are really brilliant, intelligent people.  But with that being said, it seems their primary role is to order tests, rule out more serious conditions, and then refer the patient elsewhere for treatment.  Whether that’s physical therapy, occupational therapy, or mental health counseling, it’s always go see someone else, and I am interested in being the person who works one on one with the patient and helps him or her over time.

Additionally, the majority of the doctors I’ve seen over the years have all seemed to be short on time.  Rush, rush, rush: the next patient is always waiting.  Many times during my appointments, I haven’t had the chance to ask any of the questions I came there with until the doctor is halfway towards the door telling me it was nice to meet me.

I have heard of doctors setting up private practices.  That seems like a way to have control over the number of patients one sees.  However, I believe that is mostly something that primary care physicians do… I’m not sure how often doctors in physical medicine and rehabilitation or pain management do the same.


Thank you to timefornurses on Flickr for the use of this photo.

Nursing is something that seems to hold a little bit more promise.  I once had a conversation with a fascinating doctor of nursing (yes, as much of an oxymoron as that sounds, you can actually earn a Ph.D. in nursing).  We had a great conversation about everything I’m interested in regarding pain and the nervous system.  She told me that once you get to the master’s and doctorate level of nursing, much of what you do is research.  She also told me about translational medicine, which is literally a branch of medicine/nursing that attempts to bridge the gap between what researchers are discovering, and the treatments actually given to patients.  This sounds absolutely fascinating to me, and I must know more.

That being said, I believe that the majority of nurses, including nurse practitioners (those with a master’s degree) spend most of their time doing what doctors do: running tests, ruling out serious conditions, and referring the patient elsewhere for physical therapy, etc.  I’ve never heard of a nurse that meets with patients regularly just to talk; at least not about the issues that I’m concerned with. Even at the Ph.D. level, I know there is often a huge divide in the academic world between those who research and those who treat; I’m not sure how much time a translational medicine researcher would be able to spend treating patients.

Physical therapy

pt with little kid

This is the career path I am probably focused on the most.  I have met some truly amazing physical therapists over the years, and in many cases they have helped me more than the doctors that sent me to them.  I would leave their offices basically wanting to be them, because I was so blown away by their knowledge and ability to understand both the body and my fears as a patient.

Good physical therapists are able to add a bit of counseling into the mix rather than just instruct you in exercises.  In general, I feel that when a physical therapist doesn’t appear to take the time to really try to relate to a patient, it is a reflection on his or her general inability to empathize rather than the field of physical therapy in general.

Much of the research I discuss on this blog was done by physiotherapists in Canada, the UK, and Australia (this is the equivalent of a physical therapist in the US where I live).  This bodes well for me: physical therapists have provided the most answers for me personally as well as academically.

The only limitation of a career in physical therapy would be that I wouldn’t have the ability to order any diagnostic tests such as x-rays or MRIs, to order blood-work to check for inflammatory conditions or Lyme disease, or to prescribe medication.  These are all things that must be done before any kind of diagnosis can be made, and before you can make any kind of pronouncement about a patient’s degree of central sensitization.   Since the field of medicine in general really has yet to catch up on issues of pain, I am afraid I would become frustrated as a physical therapist trying to treat patients who came in having been brushed aside by their doctors.  I am a very take-charge person, and I’m afraid I would regret going down a career path where I couldn’t just order tests and prescribe medication myself.


So there you have it.  These are pretty much the major options I am considering returning to school for, and I am very interested in any input my blogging friends can give.

Have you ever been in a similar situation?  What did you end up deciding to do, and how did you make your decision?

20 thoughts on “30 is looming closer and closer: How should I move forward with my career?”

  1. I am now 55, and have reinvented myself and my career many times over. Learning is a lifelong journey, and all we can do is to try something, and if it doesn’t work out, try something else. Our lives always make sense told backwards, but that view is not available day to day. We make the best decisions we can here and now, and adjust as we learn more and situations change. May your path ahead be filled with blessings and joy.

  2. I’ve read through all your options. You are suitable for each one of them. You’ve mentioned a few limitations but with all you have to offer, there won’t be limitations. You know the direction you want to focus on, and regardless of your final decision your experience will always show your caring, compassion and empathy toward others traveling similar journey you have. You will embrace those individuals and help them through this difficult time in their lives.

    Physical therapists are well-respected and deal a lot with pain. They use many modalities. It was through this I found Cranial-Sacral Therapy that relieves pain. I encourage you to sign up ASAP for graduate school in whatever your heart desires. Graduate school is very different than undergraduate studies … you have direction and hold promise to helping others. Keep us posted.
    Take care and stay safe.

  3. There is definitely a lack of psychologists who help with pain management, so that could be interesting. You could always look into being a naturopath who focuses on pain management. Change needs to come from within the medical professions and you could set your goal to be a mover and a shaker. Good luck and keep us posted. :)

    1. Hehe, thank you. I will definitely keep you all updated.

      After I wrote this post, I realized I may have come down a little harsh on the field of psychology. I actually did meet a really great pain management psychologist once–unfortunately, I wasn’t able to pursue treatment with him because he didn’t take my insurance. (Found that out once I was already at his office– he was nice enough to talk to me for a little while without charging me for that day).

      I’m just really frustrated by the changes to the upcoming DSM-V, which codifies “Somatic Symptom Disorder” under criteria that basically apply to anyone who has an ongoing health issue that negatively impacts his or her life. The criteria are way too broad, and many people, including many psychologists, feel this diagnosis will be applied to many people with genuine medical illnesses, in turn making it harder for them to get treatment.

      The psychiatrist who headed the task committee for the previous edition (the DSM-IV) wrote this great article summarizing everything that’s wrong with the changes:

  4. You have the gift of being able to make the complicated (science) simple and approachable. I think you’d make a brilliant doctor–and one who really understands what patients like us are going through.

    1. That would be pretty cool. In the states, I don’t think many options exist for that sort of thing unless you are already licensed as a social worker, physical therapist, nurse, etc.

      The only exception I’ve heard of is Tufts University, which offers a Master’s degree in Pain Research, Education and Policy. Anyone with an undergraduate degree can apply there. If I had unlimited funds, I’d totally be signing up for that right now, but as I don’t already have some kind of healthcare license, it wouldn’t really make me eligible for any new jobs afterwards.

  5. If suddenly got a load better I would definitely train to be a physio. The most helpful understanding person Ive met in medical circles was a physio, He really understood fibro and my other pain problems and gave me useful, gentle advice. I think its a field that can really help people with cfs and fibro.

  6. I can completely understand your concerns about psychology, but at least in Australia, once you’re qualified, you can really practice in your own way as long as you’re practicing ethically. My hope (if my body cooperates long enough!) is to help people manage their illness and live the best way they can, rather than working out why they might be sick per se. I think all practitioners are different though! Don’t rule it out, because you could be one of the good ones! :)

    1. Why thank you jezzybel :) From what I’ve read, I think the healthcare system in Australia is slightly better in general. You definitely have some of the best pain researchers over there. (I was actually going to include a section on geographic location in this post, but took it out because it was getting a bit long). I’m not sure if I missed this on your blog or if you haven’t written about it yet… are you interested in becoming a psychologist? Or thinking about other paths?

      1. Although I do get jealous of the more-socialised countries that have even better systems in Europe, I’m definitely lucky to be sick here if I have to be sick :)
        I’m in my Honours year (final undergrad year) of my Psych studies, and I’m hoping to end up working as a clinical psych specialising in pain management, if I can manage to get through my postgrad in one piece :)

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