Tuesday, 19 August 2014

A Common Conversation


He said: I want to be normal again
I said: What’s normal?
He said: Like I was before
I said: What would that have been?
He said: Happy
I said: What makes you think you should be happy?
He said: Because I was.
I said: And now?
He said: I’m not happy.
I said: That’s tough then.
He said: Yeah. It is.
I said: And it shouldn’t be tough?
He said: No. Not this tough.
I said: And it is this tough.
He said: Yes. It is.
I said: Are you sure?
He said: Yes. I am.
I said: Good. Now we know where to start

Sunday, 17 August 2014

Your MENTAL Health? Really?

MENTAL Health. 

The Oxford Dictionary definition of Mental
relating to the mind
 mental phenomena
mental faculties 



done by or occurring in the mind:a quick mental calculation, she made a mental note to ring him later

of or relating to disorders of the mind: a mental hospital

[predic.
informal mad; insane:I think he was a little worried that I might be mental

Origin: late Middle English: from late Latin mentalis, from Latin mensment-'mind'
The use of mental in compounds such as mental hospital andmental patient was the normal accepted term in the first half of the 20th century. It is now, however, regarded as old-fashioned, sometimes even offensive, and has been largely replaced by the term psychiatric in both general and official use.
How often have you heard  - "well, we all have mental health issues", "I'm worried about my mental health"? What do we really mean when we say this? What are we really trying to identify?

It has become a term so ubiquitous it is now very much part of the zeitgeist. We talk about 'mental health' as if we all understand what that means; a term swallowed whole without being chewed over, digested or appreciated, and this lack of awareness is having serious repercussions for those identified as having a 'mental health' problem or 'disorder'.

In my practice I frequently meet people who have either identified themselves, or been identified, perhaps by a GP, psychiatrist, or indeed a friend, as having a mental health disorder, problem or issue; they have 'depression', 'anxiety', 'bipolar disorder',  'social anxiety disorder', 'obsessive compulsive disorder'. These labels strike fear into most of us because they are de-contextualised from our individual lives and perspectives, identify us as a member of a sub-group and thus incomprehensible. "How come I've got this (illness)?" The subtext will often be - "I am (mentally) ill" or simply "I am mental", "there must be something wrong with my brain", "I'm mad"etc.

No doubt you will have noticed my italicised emphasis - mental. As you read these words, notice how you react, how the word locates the field of the problem; in the head and probably more specifically in the brain or the mind. The Oxford Dictionary definition above clearly locates this as the field.

My gripe with this is not semantic, far from it, for quite clearly we need our mental faculties; we need our intellect, cognition, and our abilities to conceptualise, perceive, theorise, think etc. However, this is to seriously overlook and ignore the complexities of our lived experience. To locate the problem in the mental field alone is to ignore the significance and impact of our felt world; e.g I feel depressed or I am depressed, I feel anxious or I am anxious, I feel scared or I am scared,  - in short, I feel or I am. We don't say, I think scared, I think anxious, I think depressed; it is a felt experience.

Those I have worked with who have been in the 'mental health system', have all experienced a focus on their problem or disorder and not on them as individuals, an experience which can be very invalidating and dismissive, as if the journey they made to the point where they sought help is both irrelevant and unimportant; i.e. the problem is 'the mental health problem/disorder', nothing to do with how they found themself at this point in their life.

Each of us has a unique story. How can we expect our clients to feel they are being taken seriously if we ignore their story and their experience of that story.