Overcoming mental illness may be started best by no longer thinking of it as “mental illness.” Or “disease,” or a “sickness.” In the world of marriage and parenting, it’s important to think how you will deal with certain problems. If your spouse or child seems to “have” a mental illness, then please read on.
So why do I say that you shouldn’t think of it as mental illness, disease, or sickness?
There are three reasons why I’m putting it in these terms.
- The Concept is Made Up; They Only Describe; They Can’t Ascribe
If we look back in history, people who heard voices were thought of as prophets at one time. In a different era, they were considered possessed by the devil. At present, if you compare the European diagnostic code with ours, you learn that the Europeans have fewer categories and ever since World War II are really, really hesitant to put labels on people.
In the psychology world today, diagnostics are considered a “construct.” This means that we made up the idea because it seems useful to have it. We constructed it.
Unfortunately, putting people into the “correct” diagnostic category is impossible because there is no objective measure of what the correct category would be. Yes, there are many rules as to what sorts of behaviors we are looking for but people don’t actually fall within the neat rules that the panel that composes the series of books on it have arbitrarily created.
Unlike diagnosing a broken arm (which takes place with the help of an X-ray) or whether a person hit a D# (which takes place with the help of an ear that has perfect pitch or a tuning fork), diagnostic categories cannot be backed up by a pure example of each case in nature.
The absolute worst part of this is that people have begun to think of diagnoses as explanatory. But diagnoses are merely descriptive names of groupings of behavior or feelings. They don’t explain why the person has that behavior. Yet, people have come to think they do. They are not causes.
As an example, if Mary shows the behavior of anxiety, where did the anxiety come from? It could not possibly come because she had an “Anxiety Disorder.” All “Anxiety Disorder” does is describe the symptoms she has. It cannot tell where she got them from. To do so would be ascribing those symptoms to some mysterious root cause in “having” the disorder, but that is circular reasoning.
Research has shown again and again that there is no biological cause of such behaviors and feelings. At the most, science has been able to say that in certain families, there is a proclivity or propensity toward certain behavior.
Now, that makes perfect sense. Let’s say a child is genetically endowed with a “sensitive” nature. Put that child in a rough family, one where he is, perhaps, mistreated, and I could see where he might be more likely to develop anxiety. This is logical, right? But it doesn’t mean that his genetics “caused” the anxiety.
If that were true, then everyone with that genetic makeup would have anxiety and obviously they don’t. Plenty of sensitive people are not anxious.
So, if the concept is made up to begin with, why think of it as “sick” at all? I will get back to this answer shortly.
- It Is Not Helpful
Time and again, these categories are used to justify people receiving financial benefits which they would not receive otherwise. Therefore, having a diagnosis ends up rewarding a person for being “sick.”
To the extent that the financial gain is indeed helpful, we could say, in a backwards kind of way, that the label is helpful. But to the extent that having the label helps a person overcome it, it is counterproductive. The proof that I have just given — that it rewards people for holding onto their symptoms — is not the only one.
As a Marriage & Family Therapist, I see a fair number of people who, because they have been given a label of one sort or another, use that label to shirk the effort needed to create a warm, happy, loving home.
Says one person, “I’m emotionally handicapped. That’s what my Doctor told me. So if I can’t show you love, it’s not my fault.”
In other words, not only do people use the label to remain within the label because of financial gain but also because of psychological gain: They don’t have to make any changes to their way of interacting with their spouse or children.
I will mention that upon occasion, I have heard from people that their label was a comfort because now they knew that the symptoms they were suffering from had a name and that they were not alone in as much as other people had them too. This is fine provided the information is presented to the client the right way.
Saying, “You have Anxiety Disorder” would be a bad way of breaking the news. The person doesn’t “have” anything: we’ve just explained that diagnoses are merely a psychological construct used for the purpose of describing behavior, not for ascribing a cause.
A more productive way of explaining things would be for the therapist to say, “You seem anxious. What do you do to handle it?”
- Alternative Ways Of Seeing Symptoms Are More Helpful
What inspired me to write on this topic was an old article that I came across by Stephen Gilligan in the Psychotherapy Networker a number of years ago.
Gilligan learned under Milton Erickson, a world-famous hypnotherapist of the earlier 20th Century. Erickson’s education was medicine; he was a practicing psychiatrist. However, in his youth he had polio and used his time in bed imagining himself walking. Eventually, he literally re-trained his muscles to a large extent through self-hypnosis.
Erickson did not think of symptoms as some pesky problem that needs banishment. Rather, the very fact that the person wishes to banish them — yet nevertheless has them — shows that the symptoms are in some way “telling” us something important that we need to know.
Gilligan suggests we think of people as poems with some symbolism that we can express when words fail to capture feelings.
To clients, their symptoms feel “like an alien presence” and they want therapist to help get rid of them. Erickson believed in the wholeness of people. Their symptoms were not alien at all but parts of themselves that they had trouble dealing with and so cut them off.
Therapists — who also have parts of themselves cut off from awareness — are unnerved by their client’s symptoms because they remind them of their own cut off parts. So, Gilligan explains, “we intellectualize it, turn it into a ‘syndrome,’ a diagnosis, a sickness somehow separate and apart from the ‘real’ self of the client” (p. 26).
If we understand our symptoms to originate from parts of ourselves that were punished or frowned upon growing up, then we can learn to embrace those parts of ourselves. Erickson and Gilligan feel that we should accept and embrace all of ourselves. Once we do, then we not only understand where and why the symptom originated, but more importantly, we don’t need it anymore.
Let’s take the example of a person who feels depressed all the time. Let’s make up someone named Sherry. Sherry could not recall getting compliments from her parents on her schoolwork as a child. Her parents were hard-working people who didn’t have much time for the emotional niceties.
As a result, Sherry was never sure whether she was doing things “right” or not. No matter what she did, she never got the feedback so necessary for a person to develop a sense of their own competencies. She gave up.
In therapy, it turned out that she really couldn’t recall a time when she was not feeling blue. Following Erickson and Gilligan, her therapist did not label her with “Depression.” Rather, the therapist asked her if she could remember a time in her childhood that she was happy and she could not.
“Poor little girl,” the therapist said softly.
But at this, Sherry brusquely waved off the kind words. This gesture is an indication of Sherry rejecting her younger self — with all of the pain, rejection, and humiliation that that part of herself carried.
This gave her therapist the clue that her depressed feelings came from how Sherry learned to cope as a child: “If I give up hope for getting feedback about who I am and how I’m doing, then I won’t be disappointed.” Depression was the solution to a problem, not the problem.
That is, although giving up hope is bad and sad, having hope dashed is even worse.
When her therapist looked at it that way, she did not try to “treat” the depression. Rather, she praised Sherry for having learned something as a child that would help her cope. Her depression was a smart move!
Seen this way, Sherry could begin to embrace that clever part of herself that figured out a way to cope with a bad situation so many years ago. As she re-connected to herself, she also was surprised to find that she did not feel depressed any more.
This makes sense. She no long had the “need” to cut off the part of herself that carried the pain because that part was now being shown to her in a brand new — and positive — light. She could feel empathic for her younger self for what she had to go through without having to hold onto the bad feelings associated with that part of her life.
This way of looking at people is more empowering, don’t you think?