It's possible (in fact I think it personally very likely) that the very reason why we're not making any improvements in the way our society functions is because of the damage living in it causes to our mental health. Addressing that damage may well be a step toward removing the conditions of its cause. — Isaac

Yes I agree. I think the trauma model is sound and that there is potential value in treatment and prevention both.

it's too easy to diagnose an illness as the result of a failure to function according to some societal norm rather than a failure to function according the person's own preferences. That is gradually changing (although third world backwaters like America are very slow to progress). — Isaac

Again we largely agree, though I think you are more optimistic. The use of Ritalin, for example, to treat an overly rigid curriculum and un-engaging teaching seems more to be spreading than retreating. Psychiatry as substitute for corporal punishment - the chemical cosh returns.

The use of Ritalin, for example, to treat an overly rigid curriculum and un-engaging teaching seems more to be spreading than retreating. Psychiatry as substitute for corporal punishment - the chemical cosh returns. — unenlightened

Yes, that's true, actually - the progress (where it's being made) seems to be confined to adults at the moment. I don't think we're going to see a return to the bad old days of asylums for the 'sexually deviant' etc, but as usual we treat children as second class citizens and any progress made in the adult world may trickle down in fifty years (or not).

I think the treatment of children in schools (and in the homes sometimes) is tantamount to abuse and those psychiatrists, teachers, and parents who support it should be criminalised. For some reason, baffling to me, children's rights (something I've campaigned for all my professional life) is not an issue either side of the political spectrum cares much about - I guess if you don't vote you don't count.

Your point about therapy approaches which don't pathologise but see it as necessary for life issues is important. However, part of the problem comes down to funding. In England, most but not all therapy is costly, whereas you can access it without payment through for free through the NHS system although there are often long waiting lists.However, getting referred for therapy is complex and mostly comes through mental health teams, so that is where the use of diagnosis comes in.
Also, the need for therapy is often seen as based on the severity of the mental health problems. I knew a woman who was fairly pleased when she got diagnosed with borderline personality disorder because she realised on that basis she would be able to access forms of therapy which would have been otherwise not available for her.

Many private therapists work as self-employed and in their own homes. Often, the way they make their living is through giving therapy to trainee therapists. These people are the ones willing to pay because it is mandatory for most trainee therapists to be in therapy while training and many qualified therapists may continue to be in therapy. This means that psychotherapy and art therapy can become almost a closed circle. Also, the person pursuing a career a career in art therapy is also taking the path of personal therapy, and knowing oneself.

I have known people diagnosed with mental health problems who have found great meaning in the antipsychiatry movement. When I did my mental health nurse training, I don't think that the approach even got any mention at all. The main way I knew of the antipsychiatry was because I studied the sociology of mental illness as part of sociology 'A' level, meaning that I studied it prior to any formal study of psychiatric disorders. I was really impressed by Laing's book, 'The Divided Self' for his whole critique of the way in which contradictions in messages in socialisation in the family give contradictions messages. I think that this is an important idea which is worth holding on to and should be embraced within psychiatry more.

There is an inherent tension within psychiatry between trying to adjust people to fitting in to the norms of society and of enabling them to find ways of fulfilling their own aspirations. The people who are seen as more outside the norm may be viewed as more unwell. I am sure this varies according to social contexts. Within psychiatry in England, I think that there has been a positive move towards recovery based models of care, which are aimed at people identifying their own goals to work towards. There are even recovery colleges, which run courses for working on specific issues. Another move is the existence of crisis telephone helpline, so I would say that things may be going in a positive direction.

Your point 'despair is a mental health problem' is interesting, but it is a very debatable one. That is because on, one hand, it can be a cognitive state resulting from brain chemistry. Some people who are in a state of extreme despair, notice an immense relief due to antidepressants, whereas others don't notice much at all. Of course, it can be about adjusting the dose or of finding a different one which works. However, the opposing arguments against despair as a mental health problem is the one in which despair can be seen as a response to horrible life conditions.

One book about and despair is 'Suicide and the Soul' by James Hillman, which looks at the whole meaning of despair and what it means to live without hope. Hillman looks at the whole way in which suicidal thoughts and feelings exist for people. He also looks at the way in which the whole meaning of despair needs to be faced in its profound depths. He suggests that the suicidal ideas may exist like a whole wish for some kind of symbolic rebirth within life.

I do agree that suffering is part of life and it doesn't necessarily call for medication or therapy, but I do think it is variable. One factor is that some have family or close friends to turn to and others don't. It would be ideal if we all had people to turn to when we going through really unpleasant experiences, and could be equally supportive in listening to others. Perhaps this ideal is not stressed enough in Western culture.

I think that you make a very good point in saying about the way in which will is important and in most of the literature on depression which I have read this does not seem to be really explored. I do believe that it is possible for a person's sense of will to be broken. I am sure that will plays a major factor in biochemistry, with potential implications for depression and physical illness. It may be that is the whole will which may have to be repaired or healed within therapy.

For some reason, baffling to me, children's rights (something I've campaigned for all my professional life) is not an issue either side of the political spectrum cares much about - I guess if you don't vote you don't count. — Isaac

I believe the biggest change in Western countries since WWII has been the de-prioritization of children and their needs along with the prolongation of adolescence well into adulthood (the proliferation of adult-children).

By the way the left wing Gestapo came for Dr. Seuss today, and I am in despair. The Cat in the Hat was my very first book, and I take this personally. — fishfry

The article you yourself linked to does not indicate that "the left" had anything to do with this. It was simply a business decision made by the publishing company unprompted by external political influences.

From the article:

"The decision to cease publication and sales of the books was made last year after months of discussion, the company, which was founded by Seuss’ family"

"Random House Children Books, Dr. Seuss’ publisher, issued a brief statement Tuesday: 'We respect the decision of Dr. Seuss Enterprises (DSE) and the work of the panel that reviewed this content last year, and their recommendation.”

The article also says that The Cat in the Hat will continue to be published. Sounds like your reading skills haven't progressed beyond that.

Within two weeks two different children's companies made internal business decisions for their own products. Hasbro dropped the Mr. moniker for their Potato Head brand (they are keeping the Mr. Potato Head character), and Dr. Seuss Enterprises are ceasing publications of children's books that contain racist caricatures as they stated "ceasing sales of these books is only part of our commitment and our broader plan to ensure Dr. Seuss Enterprises’s catalog represents and supports all communities and families." Simply a long term business decision to protect the brand, and ensure continued audience appeal.

unprompted by external political influences. — Maw

LOL. No. Nor does some corporate press release constitute evidence.

You speak of, 'Psychiatry as a substitute for corporal punishment_ the chemical cohosh returns'. I think that it is a far better idea to address behavioral disturbances in children through medication and therapy rather than simply punishing it. I am thinking of particular difficulties identified, such as ADHD and autistic disorders. There is a definite area of research correlating autistic spectrum disorders with genetics. One particular form of therapy which can be helpful for this is art therapy because it seems to enable communication without speech being necessary. Art therapy is often found to be a helpful way for working with other difficulties in children, including trauma. One helpful way of seeing trauma is offered by Rebecca Marks, in 'Understanding and Healing Trauma'. She says,
'Trauma causes a build up of physical anxiety, and our physical responses become the new enemy. Our biggest fear becomes fear itself.'

I do believe that trauma in children and adults needs to be worked with. It may be the underlying cause of many problems people have in life beyond childhood too.

I am thinking of particular difficulties identified, such as ADHD and autistic disorders. — Jack Cummins

I was talking about ADHD. It is hard not to notice how ADHD diagnosis and Ritalin and function as the social control of children. Even more disturbing, there are reports of isolation amounting to sensory deprivation being used in schools on a regular basis, that inflicted on adults would be classed as torture.

Autism is very different, and usually doesn't get a drug treatment precisely because it is a real condition of the psyche, a matter of what used to be called 'character' rather than a 'mental illness'. One does not 'cure' autism any more than one cures Down's syndrome, one adapts.

I don't have any experience of working in schools or mental health services for children, so I am not aware of any practices of sensory deprivation. It sounds very worrying.

I do believe that there is some relationships between ADHD and autistic spectrum disorders. That is because I am aware of many individuals who have been diagnosed as being on the autistic spectrum, and often diagnosed as having Asperger's syndrome, having been diagnosed as ADHD in childhood. One particular area of adjustment which is viewed in the research on Asperger's syndrome is the whole way in which these people seem to lack a theory of mind. They are often seen as lacking in empathy and this is connected to lack of ability to read other people's emotions and thoughts.

I have come across suggestions that some of the most creative thinkers, including Kant may have been on the autistic spectrum, but, of course, this is pure speculation. Would we say that Kant needed therapy? It is all a matter of perspective. Beyond the issue of autism, we could also ask what would have happened if other creative thinkers, such as Van Gogh and William Blake been seen from the standpoint of present day psychiatry. Perhaps they would have been prescribed antipsychotics and mood stabilizers, which are being combined commonly more recently. They might have experienced calmer lives, but would they have produced their greatest creative works?

I am not aware of any practices of sensory deprivation. It sounds very worrying. — Jack Cummins

Here's an oldish mention.

I had no idea this was happening and it seems as though it is within England, where I am. I did hear one woman saying that her son was put in seclusion and never really knew what she meant. I am familiar with the idea of seclusion in psychiatry and that is about someone being put into a padded area for safety to self and others, but only after an event of severe aggression. The idea in psychiatry is about managing violence and aggression safely, until medication works, and is not about punishment.

I see. A more interpersonal and semantic approach on therapy is great, though I suppose there are certain circumstances that no matter how you look at it, something's meaninglessly wrong. Insomnia, in some cases, is ridiculous. The insomniac is victimized by their stressors or physiological problems. CBT-I is the popular treatment and all, but for someone who experiences insomnia because of a lack of exposure to certain external stimuli needed to get the body clock working properly because of their hikikomori working environment and lifestyle, it's just some meaningless suffering, a sort of side-effect of the technological advancements of our time and the economic and vocational needs of those flowing with this trend. It's somewhere along the lines of "Some forms of treatments are good and I'm glad to have access to them but I find it irritating that I have to go through this at all." I am referring to myself here and it's with great distaste that I receive this experience.

I agree that therapy is important but only insofar as it is used as a tool for life-affirmation. There's a sort of life-denial when people think that anyone who suffers needs therapy. I suppose there's a line between suffering that needs therapy and suffering that doesn't. I think it is problematic how (in some countries) the view is like this: therapy/medication=disease/disorder=inferior/incompetent=repugnant=should be avoided/scorned. It makes it hard for those who need therapy to reach out in fear of social discrimination, which in some cases actually makes their situation worse.

I do see your view of how people can begin seeking therapy, get labelled and end going down a whole chain of being seen as lesser and end up getting scorned and rejected. It is a sad reality which often makes people wish to avoid seeking therapy when they are feeling really desperate.Of course, this is in contrast to the way in which it is seen as necessary for all forms of suffering. So, it is hard for people to know at what point to ask for help. Some may be advised to do so by others, but even then, the advice may not always be the best. Perhaps, misconceptions about therapy are part of the problem and a whole demystification of the therapy process is needed.

On the other hand, I have known people who become so dependent on therapy. Perhaps this is a result of having someone who listens to their suffering. I think that the idea which I have seen in some CBT interventions, of trying to enable the person to become his or her and therapist is particularly helpful is one of the best. Also, I think that now, there are more self-help books which can make it possible to learn useful knowledge for working on personal problems without having to go down the official pathway of accessing therapy. Also, there are books which teach techniques of mindfulness meditation in other useful ones.

In one of my initial posts, I said that I thought on-line CBT therapy may be inadequate, but that probably applies to the point where people have got too unwell for this to be sufficient. However, for some people who are struggling mildly, such support available on-line may be worthwhile. I would say that it is when the person really feels that they are struggling beyond that which they can cope with that the need for professional help comes in. Hopefully, there will be more accessible therapies available and I think that this does vary depending on country and location.

One way to look at it is the emphasis upon diagnosis. One has to define it to support treatment. That approach makes sense from many points of view. It is difficult to imagine another way to provide help as an institution.
On the other hand, the institutions get it wrong many times. Or only partially right; for any variety of reasons.
The entire industry of mental health is....

Do you think that the reason why people have such an extended adolescence is because they never reach adulthood? Also, we could ask what does adulthood mean, and is about being independent responsibility?

I believe that much of it has to do with their parents (baby-boomers) who have turned out to be the worst parents of all-time, coddling and spoiling their kids, then turning them over to corporate America and the university system which took weak, dependent children and apparently destroyed what was left of them. I think a new name for these folks might be in order, maybe something like human phone or cell (mobile) being or some such thing.

I know that there's a great deal of research on-going in the social sciences attempting to figure out what happened to these folks, but I am sure that they are truly going to live up to their nickname as the "lost generation." Many of them would just assume never move away from their parents. That's a serious problem in and of itself.

Just the fact that so many have gone along with this entire woke religion thing will set them back ten to fifteen years at the minimum. Imagine believing that an entire race of people (and the one you happen to belong to) is racist? Would you hire somebody who thought like this?

I do think that our problems probably stem from our parents. Certainly, when I have been in therapy I have felt that I was dealing with a whole spectrum of problems in my own parents' thinking and philosophy. I have worked on these issues, but as it is, most of our parents still remain oblivious, and perhaps the views and thinking of our parents and past generations impact on our lives so much. I am not saying that we are in the position of supreme truth, but we are left to try to pick up the pieces, in deconstructing pictures of reality and demystifying ethical and social values.

I am a baby-boomer (65) and have four daughters and a step daughter and a step son. It would take me a month and a half to tell my story but many of the people I know in their 20's and 30's (and I have gotten to know many over the years as I am a practicing physician) are ten years behind where we were growing up. It's just amazing. They are so weak. It really is a tragedy.

What do you think happened? Parents are one thing, but there must be a bunch of factors.

I think that social conditions are also important. Personally, I live with about 10 to 12 people in one house, in London, so that all the rules of social distancing are absurd. There are so many people living in the house in which I am renting, and I don't even know all of their names. I do think that social and sociological questions are an underlying factor. I also think that we are living in such a way that we are almost considered as mere numbers and it is so difficult to find any cohesive sense of personal identity as we become part of the mass. Perhaps, my biggest sense of identity is having a voice on this site because in the world at large, I feel that I count for absolutely nothing.

↪Nagel
I do agree that suffering is part of life and it doesn't necessarily call for medication or therapy, but I do think it is variable. One factor is that some have family or close friends to turn to and others don't. It would be ideal if we all had people to turn to when we going through really unpleasant experiences, and could be equally supportive in listening to others. Perhaps this ideal is not stressed enough in Western culture.

I think that you make a very good point in saying about the way in which will is important and in most of the literature on depression which I have read this does not seem to be really explored. I do believe that it is possible for a person's sense of will to be broken. I am sure that will plays a major factor in biochemistry, with potential implications for depression and physical illness. It may be that is the whole will which may have to be repaired or healed within therapy. — Jack Cummins

I've been a working musician and done my share of piano bars while enjoying some of the humor that goes with the right people. I've avoided drugs but known others who have become alcoholics and had to take friends to AA meetings. I found it helped in ways therapy was incapable of duplicating.

Then one day when reading on Simone Weil I began to see why AA works. It helps a person to hit bottom rather than avoiding it. Since our suffering rules our lives it doesn't want to die and lose control. When we hit bottom we no longer defend our suffering and ask for help from the deepest part of our essence. I understood the importance of hitting bottom to attain freedom from needless defensive suffering which is often dominant in our lives

"Grace fills empty spaces, but it can only enter where there is a void to receive it We must continually suspend the work of the imagination in filling the void within ourselves."
"In no matter what circumstances, if the imagination is stopped from pouring itself out, we have a void (the poor in spirit). In no matter what circumstances... imagination can fill the void. This is why the average human beings can become prisoners, slaves, prostitutes, and pass thru no matter what suffering without being purified."

"That is why we fly from the inner void, since God might steal into it. It is not the pursuit of pleasure and the aversion for effort which causes sin, but fear of God. We know that we cannot see him face to face without dying, and we do not want to die."
-- Gravity and Grace

The response to the pandemic has been historically poor on many fronts. Almost all politicians are idiots (so it seems). Those are tough conditions to live under but difficult times makes for your best teacher. It will be a benefit of you in the future.

Jack, what's real is on the inside. Don't worry about everybody else. Feeling alienated in an alienating culture is actually healthy. The key is in building up your internal strength (physically and mentally) so what's going on outside doesn't affect you nearly as much.

The folks who are really in trouble are those who keep acclimating to all the bizarre things going on. Much of this will pass, so you want to have your head together when better times arrive (and they will). This shit storm has been brewing for decades and will probably take another 10 years or so to play out, but much better times lie and the other side.

I do hold onto what's inside, and I do keep in touch with friends, even though I have not been able to meet up with people for a year. I do wonder how some people are coping. I have experience of working in mental health care before the pandemic started, and I do wonder how some of the people who were the service users are coping.

I think that this is a critical time for many, but perhaps it was an inevitable consequence of the way society was heading. I probably can cope with time alone more than many others can. It is a challenge for myself, and I cannot even begin to imagine how much of a challenge this can be for some who are not used to being alone at all. So, we might be speaking about the whole therapy of knowing oneself, as isolated individuals and perhaps that is the quest we must face. It is the time of knowing oneself as an individual being, in the full existential sense.

.

Health-wise (and particularly mental health-wise), I believe the entire lock-down scenario will go down as one of the worst public policy decisions of the past century. This is why you give people in government the least amount of power possible.

There will be tens of millions of people who will develop all kinds of assorted issues, but as I am a great believer in the "equal amount of good and bad in everything" school of thought, there will also be a great deal of good to come out if it, as well. The next couple of years are not going to easy for many, many people, no doubt about that.

As much as we are social beings, you must get your individual act together before you will be of much good to anybody else. So many people are looking for others to save them and its just not going to happen. This is why taking care of yourself physically, mentally/emotionally, and spiritually is critical. Once you make so progress down this path, then you can see that you are truly in control of your life and others can only have a limited impact.

As you have stated, the time has come to discover who you are, what you are about, and what it is you are going to do. Unfortunately, this is the job to which few wish to apply.

I think that part of the problem is that many people have not been socialised to see the importance of getting an act together as an individual task. For many, ideas of how one can achieve a fulfilled life is connected to belonging and being immersed in a family or group. It is such a strong idea perpetuate in religion and education. Being a loner is often seen as odd, whereas now many have no choice to follow that path. Personally, I grew up as an only child, so I was always used to my own company but for people who have always been with others at most times, if they are forced to spend so much time in lockdown alone it is likely to be an extreme challenge. I have definitely heard that telephone support lines have been almost bombarded and, I am not surprised.