The Truth of Mental Health

 

 

Have we learned anything about mental health? Oh!! Wait a minute. I’m a psychologist with a Ph.D. I’m supposed to know about such a thing.

In reality the first question above is very much to the point. Over the decades of my career I feel like I’ve seen a wrecking ball taken to the field and in some ways it seems like no one noticed. In my head I’ve had to dismantle the whole system a piece at a time.

A Rough Division

It is impossible in a small space to be comprehensive and totally informing. But let me offer something of a view.

First off:

Why do we call it mental health? We had to get these troublesome issues away from the churches. We were beginning to see that God was not misdirecting much of this in our lives and neither was the devil. So if we moved it over to “health” we could take other more functional approaches.

When I Came To The Field

I came to psychology wanting a career with a science. But shortly after I began my doctorate I found I was not drawn to the form of science I was seeing. In fact my intuitive personality had put its foot down. I wanted to explore what might be and there was much more of an open door if I moved my studies over to the the clinical arena.  

Here Is A Noncomprehensive List of Sorts

In a sense the field had been broken up with a pitchfork. Psychoanalysis had different parts but its focus often was on self exploration. Fair enough. A person might not see themselves as sick but wondered what they might find with self exploration.

There were general studies of a life going wrong. Entry was through a rather large door with a lot of possibilities. It might be truly troubling or simply problematic and in need of work.

Then there were relationship issues. Failure to find a deeply engaging other. Questions about sexual identity. And on and on.

Family issues related to marriage and the functioning of children, our parenting ideals are examples. Again, it might not be very pathological but intriguing or just plain troublesome.

At a larger focus there were community and socially based issues including the effects of financial and job factors.

And then, of course, there was biological/congenital issues and that may well mean insanity and other such deeply dysfunctional and disturbing issues.

What Is The Point?

From the list above it is apparent that it is almost impossible to be totally comprehensive and perfectly organized when it comes to human functioning.

But it would be useful if we did a better job of organizing the issues because that leads to more focalized approaches. And then, of course, there is the matter of personal and bias agendas.

In future posts I’m going to give some specific examples which demonstrate why we need greater clarity in our focus and organization. Human needs in our functional and emotional elements are important and evaluation is crucial. I found exactly the same set of issues when it came to testing for intelligence. We can come up with basic data but it is immensely more complicated than the scores achieved with intelligence tests.

Lying Before Us

Challenges in human existence are everywhere. We can see that as troublesome or we can work to organize and focus the challenges. Decade after decade I’ve felt the same way about getting clearer foci and dedication. In coming posts I’ll give some examples.

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 Coming Soon

Gaia’s Majesty-Transformation: Life Forces Revealed

(Book 3 of the Gaia’s Majesty Trilogy)

The child of prophesy is coming of age.

Earth has descended into almost biblical chaos.

        Then comes an opening to a future never anticipated.

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Gaia’s Majesty-Mission Called: Women in Power – Book 1   (Click to See)

Avery’s life of dedication is enhanced when she meets the love of her life. They could not know that they shared a destiny and that a mission set long ago by our Earth Goddess was ordained.

      Available Now in Kindle and Paperback on Amazon

Gaia’s Majesty-Challenge: The Chosen Rise – Book 2   (Click to See)

The Tethyan people of the sea have been joined by the Andromeda warrior women. They fight for the future of humankind. Then will come the Child of Prophesy.

Available now in Kindle and Paperback on Amazon.

Are We Kidding Ourselves – Pt. 1

 

Gaining Perspective

I’ve been sharing my experience of writing the Gaia’s Majesty Trilogy—that it started out as one book and now may actually be four books. One of the problems is that demanding characters keep showing up and so do intriguing twists to the plot.

That’s one set of issues, but there is another set which is related. It requires me taking my psychologist off the shelf. Being a clinical psychologist has been interesting and demanding, but after all these decades it seems I have no greater fixed clarity.

Essential Questions

I still have to ask, What is reality? And I also still have to ask, What is mental illness?

Okay. There, I said it. There is a fundamental problem. Well, two fundamental problems. First of all reality is maddeningly unclear. Second sanity and mental illness have no bounds.

The Matter of Reality

Beauty is said to be in the eye of the beholder. And reality is in the eye of the beholder as well. Is that bad? After decades of dealing with psychology my answer is clear. Reality is a matter of what is serviceable and functional—broadly defined. We don’t have to agree and our respective viewpoints may serve our respective purposes. If we have the same job and the same focus, that is another matter.

The Outcome

The end point is respect and accepting that these different views need not be considered a problem so long as they do not serve negative purposes. Currently we are seeing the down side of this issue about reality on the political stage and the uproar and potential devastation are terrible to consider. 

So again, we see it is a matter of functionality, but in some instances there are destructive orientations. Reality may not be at issue but intent may be the key issue.

The essence here is related to intent and outcome. The wonderful thing is that in writing fiction we can serve whatever purpose we choose and it is up to the reader to love the story or to throw the book in the trash.

Mental Illness

Quite awhile back there was a movement to move virtually everything related to human nature into the health field. Our mental status and related functioning was dragged in kicking and screaming. To this day there is a dispute about what is and is not mental illness. 

Our differences are substantial and, especially thanks to Carl Jung, we understand that there can be vast differences in personality. That means those differences are often great but not pathological. The issue again comes back to functionality. We often have to see what the outcome is or how harmful the person is. It remains complex and we have to respect the complexity.

What Is The Point? (It’s about time you may be saying!)

While the issues of reality and mental illness do have real world consequences, the basic point is applicable to the world of fiction writing. In fiction we can swing open the door for exploration and what we see is generally safe and can be intriguing. As I indicated above I found that characters could be insistent and plots could be intriguing in many forms. In the end, in fiction we see how nuanced our lives can be and that our different realities and functionality enrich our lives. And that enrichment is not just in our books but in our existences. There is much to be enjoyed and savored and, yes, managed.

What have you concluded?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Time to Revise the Medical Model (PTSD)

The Medical Model and Diagnosis

By now I think it should be clear that I have serious reservations about the medical model and that includes diagnoses. As I’ve said, granted ,taking people out of the realm of possession by demons was a distinct move forward. But now it is time to reevaluate a great deal about what we call mental illness.. Once we have a diagnosis then we are supposed to have a clear course forward. As a psychologist I must say I do not agree with that viewpoint. I’ve seen psychiatrists recommending long term intensive psychotherapy for heroin addicts. I prefer to think of long term guidance and support to gain a viable life course. The difference is notable. Such can be said in many other places.

A Lifetime Issue

Now we have what is called PTSD or post traumatic stress disorder.  It seems to have arisen as a recognized disorder during the Vietnam War. Actually it was discussed at least as far back as World War II and possibly World War I as such things as shell shock. Probably though we have always recognized forms of battle fatigue etc. The problem now is that the disorder often gets in the way of people getting help. The military is struggling with simply adopting post traumatic stress and dropping the word disorder. And we need a clear view that reacting to living months in an environment where you are trying to kill people or be killed may overwhelm people. In fact many don’t seem overwhelmed but some simply shut down and close themselves off. I’ve met such cold and distant people.

What’s The Point?

The point is that we have yet to come to terms with the reality of human existence. It is not an indication of mental illness if a person is reacting to a high stress environment or sudden trauma. It is much more reassuring to tell someone they are having a normal and understandable reaction. Granted reactions can vary from person to person but that is to be expected.

We still seem to not have clarity about these facts. There have been several times when I discussed such a reaction with a veteran in a social occasion and they were then in tears. Often they would express relief that they weren’t pathological and that a burden had been lifted.

Just Recently

And just recently we seem to have jumped a barrier. Particularly after the mass murder in a school in Florida the students began to speak about PTSD. Yes! Of course! You go to school on a quiet day and suddenly someone is running through the halls killing your fellow students and friends. What would be wrong is if the other students didn’t have a reaction. They need to accept feelings and work to deal with them either personally or with others. But a reaction is to be expected and may be variable but above all it should be accepted as reality. Life delivers blows to us and we have to respond and cope.

Can we now take a different approach to trauma. Diagnosis really doesn’t show us the way forward. Each person may well have a different reaction or way of handling it. They may need to discuss tactics but need to accept that a reaction is understandable and is not pathological.

A Personal Story

I  can share a personal story. In 1984 I had a catastrophic auto accident when someone drove in my driver’s door at high speed. I went through years of surgery and recovery. Then ten years later I was waiting at a traffic light when a man turned a corner at high speed, spilled his coffee on himself and totaled my car. I got off with a light blow to my head. But within twenty-four hours I recognized that I had been hurled back to the other accident. I called a colleague and we spent three sessions discussing it and my reaction. I was then able to put away my experience with PTS.

The Bottom Line

Life can be difficult, dangerous and terrifying. We need not deal with such events and our reaction with a diagnosis and a declaration of mental illness. And we need to deal with insurance companies and their practices. If it is not pathology then they won’t pay for someone getting help with management of a reaction. But help is often essential. The bottom line here is that there is such a thing as life management which is crucial. And life management often requires help with understanding, restructuring and engagement of coping tactics. Its time to reframe mental illness and life management.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Health Care Alternatives and Reality – Series – Pt. 5

 

The Myth of Mental Illness

The above is the title of an important book by Thomas Szasz. Mental illness still dominates a significant portion of our health care system and it still has major conceptual problems. Of course, as a clinical psychologist, I was schooled in it. I actually came to love Carl Jung’s work a lot more than Sigmund Freud’s but his work still dominates.

Alternative Realities

And so we again return to where we live on the cusp. Over the decades I found nonphysical problems related to mental and cognitive issues to be far removed from “illness” and often nuanced. And when we move away from the dominant model, we find suitable alternatives. Unfortunately the insurance industry dominates the field and therefore may dictate treatment or at least what it is called. What it is called will often influence what is done. Substantial reform is needed.

Some of the Issues

When my wife and I personally confronted issues for remarried families (aka stepfamilies) we learned important lessons. An important initial lesson was that the process is a matter of adjustment, not psychopathology. Certainly there were some people with substantial disturbance from other causes but we learned to begin with our model of adjustment. The  couple was focused on initially. Too often the mother or stepmother was put in therapy as if they were the problem although they may have shown the greatest distress initially. And we were resistant to putting children in therapy because adjusting to a new family was not pathological in almost all cases. Because of our approach we could structure an information system and found that generally the family could take over adjustment and handle their own future after very few sessions. See our book Stepfamilies: Professionals and Stepcouples in Partnership by Mala S. Burt, M.S.W. and Roger B. Burt, Ph.D.

Another major issue is what is termed post traumatic distress disorder or PTSD. The military is wrestling with removing the word disorder because it proves to be a bar to veterans getting help with their adjustment. Does anyone really believe that someone should go to war and kill people daily or risk being killed daily while suffering stress and not need to cope with management and an enduring reaction. I shared my perception with some friends who were veterans and found them in tears when I suggested they were not “sick” although there were still issues decades after their war experience. 

Enduring and Broad Issues

Those are just two examples of the reality of a world far more nuanced than what is described as mental illness. We can go on between things like personality diversity, numerous personal management needs as we pass through stages of our life. When I first came into the field the predominant viewpoint was that our development was finished in early adulthood. Absurd.

Management of life experience continues throughout life and it would be best if we approached our lives in that fashion. Take an area of life experience and we see that there is change, stress and adaptation. It would help if we defined a type of insurance that was appropriate and took these issues out of the hands of insurance companies focused exclusively on profit.

Life on the Cusp

Yes, here is that cusp again. Each of us is different with a raft of different experiences. We work for stability and commonality and often success. But it would help if we understood the richness of our diversity in the sense that much of the issues are not pathological and that our views from the cusp feed creativity, diversity and innovation. And life can be difficult, even jarring. From time to time we need to seek expertise and guidance but we generally do not need to cast it all into psychopathology. There are problems out there with profound biological origins where the person needs substantive help but very often management and guidance are what is needed.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Diagnosis and the Real World

Under what diagnoses do you suffer? (Curious question isn’t it?)

Let’s Begin Here

Two definitions come to mind at once as we look at this post. Psychiatry is defined as: “the study and treatment of mental illness, emotional disturbance, and abnormal behavior.” Psychology has a variety of definition but I prefer: the study of human and animal behavior. The numerous other definitions suggest we aren’t actually sure what psychology is and I share that position. in fact, there is even a philosophical element which suits me just fine.

In Clinical Psychology

When we move on to the clinical area we quickly brush up against mental illness and as a student we quickly learn that diagnoses are generally expected. But how does mental illness fit with the broader definition of the study of human behavior. It seems like it must be a subcategory. What I found was that it is a restless subcategory and won’t keep its mouth shut.

Or at least it becomes a problem when we visit that devise place called the real world. And, of course, I believe in the cusp of reality which means I have questions. Are you hearing the pounding of philosophy at the door?

Then There Is Diagnosis

Freud defined a great deal of what is psychiatry and we entered a world of illness which required treatment and so there must be a diagnosis. The whole process was to be applauded because it moved emotionally disturbed people out of intervention for possession by demons  generally under the oversight of the church. They were in better, more compassionate, hands then. But not all of mental health people were devoted to Freud’s teachings. And that included Carl Jung who took us out into the world at large in a variety of ways. I won’t try to explore him. Take a look yourself.

What’s the Point?

It seems we are lost in a forest of exploration. There are those who believe in specific diagnoses for mental illness and in some case it yields helpful intervention. But there are others of us who believe it is far more complex than that. Sometimes diagnoses lead us down narrow corridors and sometimes it is more effective to shy away from an illness model and take the path to looking for functional factors and something I will call life management.

In This Age

Isn’t it interesting that as we rush forward into the future we are still mired in definitions and differing camps of adherents when it comes to what we call health care. At least we have latched onto prevention and a variety of preventive procedures. Those continue to need exploration and so do our responses to things happening to us that deserve attention.

That’s enough of the meshing of philosophical exploration with the real world. In future posts I’ll move deeper into the world of what we call mental illness and alternative forms of response which includes what I call self management.

What are your biggest concerns about health care?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt