Grayson Best
University of Texas
Austin (30.2° N, 97.7° W)

featuring Elvin Aydin Keles, Online Life Coach and Psychotherapist, Houston (29.7° N, 95.3° W)

Dr. Elvin Aydin Keles is a web-based life coach and psychotherapist currently based in America. Originally from Turkey, Elvin ended up studying in Istanbul, the US, and the UK before graduating with a PhD in psychoanalytic studies. Having also worked in these countries, she is able to point out some of the key differences within the mental health field in the US and how it can change for the better, along with what we can do as future mental health practitioners to improve the field. Elvin and I discussed her background and educational process, the intricacies of working online, and her personal experiences that highlight the diversity of the mental health field.

Elvin did not intend on studying psychology at first, but she fell into it once she had been accepted to Boğaziçi University in Turkey. After two years, her father encouraged her to transfer to a university in America, with the hope that she would take her studies more seriously. She then transferred to California State University, Los Angeles where she experienced the different approach of American psychology professors. After finishing up her degree in the states, she moved back to Turkey and worked in human resources for seven years, eventually realizing she needed the ability to work with people’s internal dynamics. This spurred her to get a master’s degree in psychoanalytic studies in the UK, followed by a PhD in the same area. At the same time, she completed a four-year post-graduate psychotherapy training in the largest humanistic psychotherapy institute in the UK.

Currently, Elvin is in the process of getting licensed in the US, which means she’s getting another master’s degree in counseling. But along with this, she has her online private practice. Because her clients are outside of the US, she does not need an American counseling license to work. She explains how online counseling is very similar to counseling in person; there are things to take into account, though, ranging from assessing the client’s risk to harm himself or others to making sure you both have a solid connection or the client is in a private space to talk. Elvin has noticed, however, that psychotherapists tend to be more conservative and oppose this oncoming wave of online therapy. For Elvin, there are clear advantages with online counseling, and it should not be brushed off as easily as it is. It is important to have a consistent relationship with your counselor, but not everyone can come in for an in-person session; this would be an inherent challenge for certain lifestyles. Elvin also brings up the dilemma of someone living in a foreign country, where it can be difficult to find effective counseling in your native language. In our bustling and diverse world, the audience for online counseling may only grow, so it’s important to acknowledge its presence and encourage its growth.

When talking to Elvin, one of the most interesting things she brought up was the conservative nature in American psychology. She explains how, in her experience, America’s mental health program is very different. It is heavily regulated, which is typically a good thing, but this removes the ability to be flexible in the field. This contrasts with the UK and Turkey, she explained, as insurance companies and the government do not interfere with mental health regulations. She also brings up how instead of feeling ethically driven, the mental health field seems more litigiously motivated; people care more about not being sued than what is right for the client. Along with this, in the UK there are many places for training psychotherapists to do volunteer work under supervision and see hundreds of people for free, greatly expanding the reach of mental healthcare. Since US counselors need to have supervised experience in order to be licensed, this would be a great addition to the American health system. Mental health is still a heavily stigmatized field in society, and the introduction of these clinics would not only help with destigmatization but help counselors-in-training reach their required hours while helping many people in the process. Finally, in America, it is generally encouraged that a counselor have a counselor of their own to avoid burnout, but it is not required. In the UK, however, even though it is easier to be licensed, you are required to have your own personal therapist. This promotes not only the importance of mental health but also a dependence on others in our traditionally conservative mental health field. Elvin describes attempting to work in the mental health field without seeing a therapist of your own by saying, “You can’t. It will be very, very confusing and difficult.”

It’s important to remember that while psychology is an old field of study, it is still a developing discipline with many areas to be improved upon. There are plenty of areas for growth; no matter what you decide to specialize in, you can learn from the trials and efforts of other countries. By challenging the traditional process in an ethical way and attempting to advance the field as a whole, we can improve mental health for clients as well as counselors.

Highlights from the interview

Could you tell me about how growing up in Istanbul fed into your decision to be where you’re at right now?

In Turkey, typically for the university entrance, you take a centralized standardized exam. And as I took mine, I was sure that I was going to study either economics or business, but my grade wasn’t high enough, so I got into psychology, and I thought that was a failure. But after studying two years at that university in Istanbul, which was like the best university in Turkey, Boğaziçi University, I ended up transferring to California State University Los Angeles because my father said that I would be taken more seriously when I’m in the states. Once I came here to study, the professors, the approach to teaching, everything was very different, and I really liked what I was studying then, so I finished the four year and all the residence requirements, and then I returned back to Turkey. I worked in HR, and then seven years later I realized that you need to be able to work with people’s internal dynamics, for which I decided to do just a master’s degree to have a bit more insight. So for that reason I chose England, because it’s closer to Turkey and it was an easier way to go. So I did my master’s there, and that was followed by my PhD because once I got there, I fell in love with what I was studying, which is not the typical road, by the way. I studied psychoanalytic studies; it’s a bit more philosophical than the typical psychology master’s.

So you mentioned that your dad wanted you to come over to United States for studying, was he a big part in making you who you are today?

Yes and no. My work ethic comes from my parents; they were both working very hard. They both worked in international companies, they travelled a lot, and they were working very, very hard, so for me it was—I wanted to be like them. I wanted to have a good job, and be able to travel, and have contact with different cultures.

Were they supportive of your pursuit of psychology?

They wanted me to get a degree, that’s for sure. But I don’t think they ever wanted me to become a mental health professional, because—I think that generation, for them, being a psychologist is working with crazy people. Literally. So I think my dad still doesn’t really understand what I exactly do, even though I tell him a hundred times. They just can’t relate. My mother is not alive anymore, but they just can’t relate to what I do. But I understand that. It’s a different era—it was different—they have no concept of what I do really, even though I explain it to them. It’s very, very different. So in many ways yes, but not the subject I chose.

So you’re in private practice. What exactly are you doing currently?

So, I’m in the US because we came to Houston, Texas because of my husband’s job; we had to relocate. We used to live in England before, where I was working in my own office seeing clients—not patients, because they’re not patients; they’re not sick. In the US, I’m in the process of getting licenses, which means I’m doing another master’s degree, this time in counseling, just to get my LPC—license professional counseling licensing—which I will get in December of this year. But at the same time, I have an online practice, where I see clients from all over the world. They’re not in the US; that’s why I don’t have to be licensed.

When you started working online, was there anything…you thought was going to be easy, or set out for you, that wasn’t initially, that you kind of had to work around?

Well…people’s attitudes. Especially my colleagues, not the clients. So this started out because one of my clients referred me to someone who was in the states; I was in Turkey at the time. She said to me, “I have a friend who’s in Chicago. She’s doing a PhD. She needs support. Can you help her?” I said, “Well, I can try.” I started out with this person, and I saw that it’s working amazingly well. She had this connection over Skype, it was like a lifeline for her, and I worked with her for over four years, I think, and it was really amazing. And during that time I got other requests as well, and I started doing this, and I got better and better at it.

The one thing that you need to do is that [you] need to remind your clients they need to be alone whenever they’re going to talk to me. Like not in a coffee shop or outside in a park. So there should be some privacy and a good connection, because there’s nothing more annoying than a substantial conversation being constantly interrupted with bad network or something like that. So once you set those things in place, it’s not much different than proper psychotherapy. You still need to have proper supervision for seeing your clients, you still need to be very careful around everything. I mean you still do the job; it’s just online, the person doesn’t come in.

Are there any personal skills that you’ve found most helpful in your job setting? 

In my job setting meaning online therapy or doing my psychotherapy or being a psychotherapist? Which one?

Either if you want to explain both.

So I am…okay, the thing I found most helpful doing my job is that I have a background in human resources consulting. I have seen very, very different industries, very different jobs; I have a very good understanding of the business world. And that makes a substantial difference in the way that I relate to my clients. They know that I can really understand where they’re coming from, mostly because I mostly work with people who are self-paying. Obviously the conversation comes to their work, you know, professional life as well, and I really can understand where they’re coming from. Also, having had a business background was very helpful in me setting up my business, because it is a business. It is psychotherapy and psychology, but it is a business. So I’m very good with taking care of accounting and getting my company registered, getting my cards printed, advertising, networking; I’m very good with those things as well.

What’s been your favorite part of everything so far?

That I get to listen to different life stories. It’s mesmerizing for me. You get to meet people literally from all walks of life. I do. And I see it as a privilege. And people share with you their deepest, darkest secrets and their—literally—their hearts, and it’s a privilege. I find it very uplifting and energizing that people see me worthy enough to talk to me.

What’s the typical team dynamic among your colleagues?

Usually typical psychotherapists tend to be a little conservative, so they don’t like the idea of doing online therapy just because they really haven’t tried yet. They have in-person practice, which I respect; there’s nothing wrong with it. I think it’s wonderful that you can have that, but for people who can’t have that—like, if you’re travelling a lot. Say you’re a professional business person, and you have to travel a lot, or you live like my first online client—you live in another country, and you need therapy in your own language—and you can’t find anyone around you like that. So all those are lifelines for people who need help. So before you judge, you need to see whether it works or not for yourself. There are very conservative psychologists and psychotherapists, and there are more openminded ones and the most important thing is you’re ethical. No matter what you do, how you do it, that you do it ethically. That’s the most important thing.

Have you found a more conservative setting in the US or elsewhere?

Yes, definitely. US is very conservative and very much insurance-driven, unfortunately. Here the insurance dictates what kind of therapies you do, what kind of approaches you take, how you work with the client. I think that’s outrageous. 

If you had any changes you could make with the US system, what would they be?

In the UK, the government has psychotherapy clinics, where a lot of training psychotherapists come and work voluntarily, but they are supervised properly. And that’s literally free, and they see hundreds of people everyday, and they really help people. So that’s not rogue therapy; that’s proper therapy under supervision, where people who are underprivileged can get the care that they need. So, setting up clinics like that where volunteers can work and train and earn their hours—because to get licensed in the US as a counselor, you need to get at least 700 hours until you’re [licensed]. Until then, you cannot be paid anyway. So, if they would open these types of clinics, that would be fantastic. That would increase the number of people who can get help tremendously.

Since you’re working online currently, how do you see that developing for the future or your profession?

So that’s taken off because there are companies like Talkspace and iCouch. There are many more. They are offering online services to their clients. So there’s a problem. When you are a client to one of these companies, they claim that they are available 24/7, so you get to talk to a random therapist there, and they see all of your information in front of them on the system. That is a problem. But if you engage with a private therapist online, and they are using a HIPAA compliance method, like Zoom for example, where there’s full confidentiality and all, then I think it’s amazing. Because you don’t have to then leave your office to come see your therapist, you can just lock your office door during your lunch hour and have a proper session with a therapist. Or say you’re a mother at home, a nursing mother with a baby, while your baby is sleeping in the next room, you can see your therapist.

Otherwise, when you talk to companies with 24/7 service, your information is on a system, where different therapists can access it. And I find that a bit questionable. This is a very personal thing. You don’t want to work with a random therapist, you want to work with one person.

Develop a connection.

Yes, definitely. That’s like fifty percent of the work.

What advice would you give to students?

What I would suggest is…to become a psychologist, you definitely have to do a master’s degree in counseling, et cetera, or a PhD in clinical psychology. So I would suggest for them to get acquainted and do some kind of internship in a clinic to see whether they are cut out for this kind of work, because it’s not easy work. You are in there with them, day in, day out, and if you’re not cut out for this kind of work, it’s a very long education to go through.

All right, so are there any beginner jobs that students could go to…

Definitely, there are lots of mental health agencies to volunteer at. I think in every city there are agencies that accept volunteers who are working with the underprivileged. Just go there and observe what they’re doing. This is a difficult job; you deal with very— sometimes very tricky illnesses. You need to know what you’re doing.

Is that something you did?

Yes, I worked in London with people who were human rights immigrants. So they were people who have been tortured or they were asylum seekers. So when I was training, I did my internship there, and that was very eye-opening. I thought if I could do that, then I can do anything.

So what was your most memorable experience?

I had a client who had immigrated to England thirty-seven years ago, and she was an elderly lady. Not that old, but she looked older than she was. She was illiterate, and she came in to visits with a bag of medication. After seeing her only for twelve weeks—that was the time allocated to us—she ditched all the drugs. She was walking with a cane. She ditched the cane. She taught herself how to read and write. That was the difference between someone compassionately lending her an ear and not—I’m not a miracle worker. We are just people who are very good listeners and trained for being very careful. If you hear something you need to refer them on and work with the doctors, et cetera. But this was a very deep connection, and this poor woman was really suffering, and I was just so privileged to be able to see the change in her. And she was so sweet.

Is there a difference between private practice in England and in Turkey?

No, not really. Because the insurance companies and the government do not interfere with regulations in both of those countries.

In America?

Very different. Very, very different. It’s heavily regulated, which is good in a way, but it takes away some good things as well. It takes away the flexibility. What I notice here is that instead of being very ethically oriented, I think people are more litigiously oriented. So they care more about not to be sued than doing the right thing by clients.

In the US, there is no personal therapy requirement for a therapist. I think it’s recommended, but it’s not compulsory, whereas, funny enough, in England it is. I say funny enough because the licensing is way easier in England, whereas in the US, it’s very, very difficult, but there is no requirement for personal therapy. I think that if anyone is going into this job, they should definitely have personal therapy. This is not the kind of work that you can do without having been through an intensive therapy experience. You can’t. It will be very confusing and difficult.

(Interview excerpts have been lightly edited for clarity and readability and approved by the interviewee.)