Tuesday 16 October 2007

(Late for) World Mental Health Day

It was last week. How time races on. Anyway, I'm never sure if the idea of a World Mental Health Day, like days for women, peace, the eradication of poverty or disease, is a good idea, a 'can't hurt', or an insult.

Although never diagnosed with anything in particular, I've always thought of myself as someone with fragile mental health. When I was 6 or 7, my parents took me to a doctor to ask if I perhaps was mad. I wasn't very happy and responded to discipline by yelling a lot. The doctor said no: maddening perhaps, but not mad. But the question had been planted and didn't leave.

Recent weeks have brought some difficult states of mind - intense, bleak disappointment in myself for... well, for being me. Sad realisations from which - as always with the toughest stuff, be it self-inflicted or inflicted by another or by fate - there is no escape, for which there is no comfort except: "well, it hasn't killed you." or "well, this is not all there is."

If you tend to be depressive, this kind of experience is always a reminder of... how to express it? a reminder that the default state is paralysis and that motivation for living is something that has constantly to be cultivated. It breaks the habitual rhythms, the chugging along, hopefully without too much self-questioning. The power of habit is huge - as huge, I think, as the power of deeply internalised beliefs, and mental health is inextricably tied up with both.

Sadly this seems not to be the prevailing view in these parts, where WMHD was marked by a proud UK governmental announcement of new funds for the training of Cognitive Behavioural Therapists. Everyone who goes to their doctor feeling depressed or behaving oddly is to be offered a few sessions of CBT, and Bob's your uncle! It's cheaper in the long term than drugs and just as effective, research is claimed to show.

Excuse me, er, we're all the same, then? You have human nature cracked? This is going to work for everyone? Mental illness has nothing to do ever with life experiences, past or present, or with heredity in all its nature-nurture complexity? Gee.

This initiative has been in the pipeline for a while. Ms Melancholy, on her blog Confessions of a Psychotherapist, wrote informatively and movingly about it here, here and here, while blog-friend Stray contributed with equal knowledge and eloquence from the client's viewpoint.

One sentence of Stray's, I think, strikes to the heart of therapeutic wisdom and why neither CBT nor anything else is a quick fix: "There is no 'solution' - simply a (very) slow growth in tolerance of emotional discomfort."

That slow - slow, slow, tiny, tiny, but oh-so-signficant - growth of tolerance has certainly been my experience. So I find this book, and the kind of practice - now slowly finding its way into the mainstream health service - of which it is part,
though emphatically not a panacea and not claiming to be one, a more hopeful sign in a climate scarily typified by the blanket CBT initiative.


Anonymous said...

What a wonderful post, thank you so much. And extremely absorbing links. Yes, I agree with you about MBSR/MBCT. The one-size fits all approach of the government towards mental health provision is appalling, as is so much else of its attitude to people with mental illnesses. Sigh.

Anonymous said...

It goes without saying that people with MH issues want/need to discuss their problems with somebody but you are absolutely right , the Government and the major MH charities have completely misrepresented this desire/need for basic human contact , communication and empathy as a demand for CBT .

Its simply a modern £170 million Snake Oil pitch with the Government providing the CBT and wagon and the more unscrupulous MH charities pushing this miraculous product, oops, I mean treatment and cure, for their own ends.

Mad planet

Zhoen said...

Having cared for folks with what seems to me to be obvious brain dysfunction, damage, thoughts and emotions so disordered no simple behavioural explanation would make any sense, I want to shout in frustration.

On the other hand, garden variety insanity, chaotic lives and self destructive habits, probably are best served by intensive retraining. I have also heard that definitions of insanity are very culture bound.

When it comes to mental diagnoses, I think we are still on the leeches and patent medicine, amulets and blood letting stage.

Anonymous said...

What a refreshing post, despite the problems you are addressing. It is so rare that I hear real compassion for those struggling with mental health issues. I think much of my part of the world (US), though they may not like to admit it, still consider these issues a moral lack on the part of the sufferer. Thanks for the links - I'm off to investigate them.

leslee said...

"slow growth in tolerance of emotional discomfort"

Oh, does that ring true. Though I suppose that, too, doesn't fit all. I've known people with serious brain chemistry problems who were only helped by medication. They would not have survived long enough for slow growth of tolerance. But yes, for the rest of us with just complex emotional issues maybe combined with high sensitivity, learning to live with it - and learning we can live with it - seems to be the right path.

Anonymous said...

Depression is a commonplace event in modern times, taking on many different forms, including physical, sexual, emotional, and verbal abuse, occurring in many different contexts.


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