to wonder if we have all become mentally ill?

[Alameda]

(and for slightly stalking this blogger)

but can 1 in 2 Americans really have a mental illness? have slightly vested interest in this because would quite like my own mental disorder to be somehow integral to society rather than there actually be something wrong with me

psychopathology of american life

going away to have a look at those recommendations, thanks

have you noticed that when someone is ill with a health problem it's deemed they have a health problem; but if it is a mental health problem it is deemed a mental health problem. It's all health, why the differentiation?

(I know why but that's besides the point)

edit button please

try again: when someone has a physical health problem it's called a 'health problem'; when someone has a mental health problem it's called a 'mental health problem'

The counselling stuff fascinates me - how we got to a stage where someone 'going thought a bad patch' or 'behaving erratically' should see a counsellor. These sorts of things, in the past, we're dealt with by family, friends, the church. How did they get professionalised and now only expected to be handled by 'qualified' counsellors - what is a qualified counsellor anyway? Why do you need qualifications?

In my other thread about this it emerged that the supply of counsellors vastly outstrips the need. Simon Wesley makes the point about 'trained counsellors' or 'qualified counsellors', we don't say that of any other profession which implies anyone can do it anyway. We don't say 'your trained pilot will be flying this plane' or 'yoir qualified surgeon will be excavating your liver'.

Life transitions and crises are not mental health problems in themselves are they?

springydaffs your 11.52 post made me smile. I feel like this often.

Well I'm going through a bad patch in my life right now and various people have told me I may be depressed and need to speak to a doctor. I personally don't think I'm depressed, I'm having a tough time dealing with a particular event in my life (a miscarriage :(), but it was only a couple of months ago and I already feel better than I did. When my mum went through the same thing 35 years ago nobody suggested she was depressed or that she should see a counsellor, she was allowed time to greive and be sad then she just got one with things.

Alameda Tue 29-May-12 21:02:05
"The counselling stuff fascinates me - how we got to a stage where someone 'going thought a bad patch' or 'behaving erratically' should see a counsellor. These sorts of things, in the past, we're dealt with by family, friends, the church. How did they get professionalised and now only expected to be handled by 'qualified' counsellors - what is a qualified counsellor anyway? Why do you need qualifications?"

So what is the advantage of a 13yo having to prop her mum up through her depression when an adult with proper training could be doing it instead? Have you any idea how draining that sort of thing is? And how many things have to be unspoken because you simply cannot confide them to somebody close to you?

The advantage with the professional outsider is that you can tell them how you actually feel without worrying about gossip in the community or risking breaking up your marriage or burdening your young children with things that frankly they shouldn't have to be thinking about.

As for the church filling this role in the past, what were they then if not professionals? Even in the Middle Ages, priests were trained in dealing with these situations, there were handbooks. Not really that different from trained therapists.

Both have two great advantages: they are not part of the family so will not be hurt or take your feelings as a reflection on them, and they are bound by confidentiality.

I don't think anyone is suggesting that everybody who is going through a bad patch should see a mental health professional. Any more than most people think that everybody who cuts their foot or bangs their head should see a doctor. But a cut that doesn't heal or a head bang that gives rise to severe or prolonged symptoms might need attention. Same with "feeling bad" some people just need the time to grieve, others end up in a place where they can't get any further, some are vulnerable and even small events will throw them because they are not well in themselves.

but that's sort of what is happening, isn't it, it is constantly expanding to the point where we feel burdened or unable to cope with the kind of crises that families would have weathered - the mental health industry is eroding the wider social supports that would have buffered a 13 year old you generations ago against isolation, not going through it alone etc

yes, it does put it to one side doesn't it: 'over there', not in the mainstream; unseamly.

I do very much believe there is a place for therapy though. It's either therapy or cultural norms... and what are they? We're all after - and led to believe it is our right to have - perfection in every area, including our psyche; and won't put up with things that aren't tip-top. Cultural norms - apart from the individualistic, entitled 'you are worth it' - are rejected: we are all (supposedly) carving out our futures and have total control over how they will look.

Did you know that if you embrace your truth you are allowing those around you to embrace their truth too? (no? get with the times!) You are doing humanity a favour, apparently. We are also quite a therapised culture now, which imo is a good and a bad thing re it's good to have eg boundaries but a lot of shit has wormed its way into our culture that is imo inappropriate: half-baked concepts that are touted as one-size-fits-all, and variables are not tolerated. For example, the concept of a 'victim' is a dirty word in our culture, which insists we are in control of our destiny, horrified at the idea we could be a victim of anything. Yet there is such a thing as a bona fide victim which has nothing to do with whether the victim invited or allowed the abuse (and to suggest so makes the victim a double victim, to blame for what happened to them). We are exhorted to be 'strong', applauded for it, when it is not always appropriate or available to us to be 'strong'.

We can - and do - pick and choose now, rejecting 'cultural norms' eg the wisdom and experience of those who have gone before us: in fact, despise age, the older, believing they are were idiots and we know better, things are different now, we won't put up with the shit our mothers did. yy it's always been the case that the young despise the [wisdom and experience of] those who have gone before; but imo this has bled into the whole of our culture, has become a 'cultural norm'.

rambling here

I think it is more than the mental health industry affecting social/family support systems and that is a more general societal shift.

I agree with the posters who are aligning mental and physical health. We need to look at health more holistically and stop dividing off mental health. I agree with Cory that mental health applies to us all as much as physical health and the analogy between not everyone who is going through a bad patch needs a MH professional and not everyone who cuts their foot/bangs their head needs to see a doctor.

Individuals need to take as much responsibility for maintaining personal mental health as physical health. Mental illness is not only the big MH diagnoses like schizophrenia, Bipolar etc in the same way that physical health is not just about the big physical diagnoses such as cancer and cardiac.

I still don't understand why a trained professional priest in the past is seen as a social support network that is being eroded whereas a trained professional therapist today is somehow part of an expanding industry eroding our ability to cope. Surely they are both trained professionals with the role of providing support that the family for various reasons cannot?

And I think you overestimate how much support people were able to ask from their families in the past. The problem with families is that they are emotionally bound up in whatever is troubling you.

I cannot ask my mother to support me with my feelings about dd's genetic disorder because I know she can't cope with the idea that she has passed this on and for some reason it has such disastrous results for dd.

My friend who had been sexually abused by a family member couldn't ask the family to support her over that one either- because they already felt awful about not having been able to protect her.

My mum who was depressed and unhappy partly because she hated the place she lived in couldn't ask for support from her neighbours who loved the place and would have seen her feelings as a criticism of themselves and their home.

As far as I am aware, all societies have had professionals or semi-professionals whose job it has been to deal with feelings and emotional health issues that is beyond the individual and his immediate family. Sometimes they are called schamans, sometimes priests, sometimes therapists- but that's just the name: the whole point is that they take over when a problem becomes too much of a burden.

And I have spent far too much time studying medieval history to believe that everybody weathered their crises in an orderly fashion in the olden days.

In many ways I believe the generation that had it hardest was my parents, living at a time when priests were no longer the source of support but there was nothing to replace them.

Which of course negates my previous post about all societies. All societies except at times of rapid transition, I should have said.

cory I completely agree with you that on the whole the professionalisation of counselling is a good thing - families, for all their wonderfulness, are not impartial 'wailing walls'.

Friends can be, but it is immensely draining. I function as wailing wall for a good friend and for my cousin, both of whom have genuine 'shit life syndrome' type problems and the only reason I keep going is because I see the positive effect it has.

And I'm widely considered strong and patient (I don't always think I am) but that's just because my life is not shit. Not everyone has someone like that available, nor would everyone want to risk their family bonds and friendships by exposing themselves like that.

I see the rise of professional counsellors as a replacement for the confessional, only (I hope) without the bloody guilt trip and atonement afterwards.

am not the biggest fan of the institution of the family because it's where most horrible things happen anyway - when I think about social support I mean friends, neighbours etc too

maybe there isn't much difference between the pastoral counselling of the past and today's therapist but whilst the church were not meant to replace those other social supports but enhance them our current cultural script erodes them by reframing our support as the 'toxic famiy' that makes us ill - which am sure lots of us can relate to

at least with the religious structures there was a narrative of fortitude and resilience but counselling encourages us to see ourselves as damaged, unwell and unable to manage without professional support

which reminds me again of the chemical imbalance thing - the encouragement to see ourselves as biologically inept, there is a sort of tension between what the counsellors are promoting and the whole SSRI thing. The biological model and the talking therapies compete but all aiming at the same thing, to make us believe we are sick and to create a need for their services?

sorry am rambling too

with the confessional though, don't people want absolution? Except we call it closure now

so you agree I was rambling then Alameda!

"the church were not meant to replace those other social supports but enhance them our current cultural script erodes them by reframing our support as the 'toxic famiy' that makes us ill - which am sure lots of us can relate to"

I've never known a therapist to do that either. That was one of the great advantages of seeing a therapist to me; they didn't take sides for me, either.

"at least with the religious structures there was a narrative of fortitude and resilience but counselling encourages us to see ourselves as damaged, unwell and unable to manage without professional support"

All the counsellors I have seen (both on my own behalf and for dd) have concentrated heavily on helping us to locate resources within ourselves and developing our own strategies for dealing with difficult things.

"The biological model and the talking therapies compete but all aiming at the same thing, to make us believe we are sick and to create a need for their services?"

Surely all Christian preaching is aimed at making us believe that we are damaged and unable to cope on our own? Isn't that the whole point of the redemption? Or have I missed something?

no no no springy, just meant in thinking aloud sense

I agree with you Cory, therapy is the new religion but where the old one idealised the family to horrifying extents therapy does tend to denigrate it

I'm not sure everyone wanted absolution, Alameda, given that a lot of people 'confessed' things that were completely trivial and required no more than a handful of Hail Marys. I think the power of an uninvolved listener is enormous.

I'm not even sure everyone is after closure - a lot of people recognise that closure is not always possible.

As far as the medical model vs the societal model of mental illness is concerned - this is fascinating stuff, and mental health research is in a phase of finding out a lot about how the brain works. Functional Magnetic Resonance Imaging (fMRI) is a rapidly expanding field of research and is throwing up some very interesting slants on the old 'nature vs nurture' debate. Right now I would not rule anything out, nor would I rule anything in. The research is in a state of flux not seen for decades, it's a really interesting time to be involved (can you tell I'm in the field? )

Last post before going to bed!

I actually think we're very fortunate that nowadays we have access to counselling, therapy, etc, even if it might be slightly overdone in some parts of the world (I used to live in NYC and every man and his handbag dog seemed to be in therapy).

I know my parents' generation were encouraged to take the stiff upper lip approach and going to a priest for advice would typically just be met with "it's part of God's plan" or something equally enlightening. Is fortitude and resilience really better than being able to admit we need help? But then the line must be drawn somewhere - see my last paragraph!

Re your last point - I see mental health problems that can be solved by talking cure and biological problems that require chemical intervention (in the form of medication) as being slightly different; though the two forms of therapy can complement each other, and you should probably not have the latter without the former, many, many issues (including some of pp) have been greatly helped by the former but would have no need of the latter.

Not sure if I'm making sense any more at this point so...sleep.

"therapy does tend to denigrate it"

hasn't been my experience

I think I just have an axe to grind because of never being allowed any sort of talking treatment - the saying 'nobody is too well to benefit from therapy', they always tell me am too ill :(