Let’s embrace our differences and learn to be tolerant to them

Some say that mental health is the last taboo. Well, yes and no. Depression and anxiety seem to have become a rights of passage these days, and are so common, that I’d be inclined to say they are almost the norm.

But some aspects still are. Suicide and self harm certainly are although I do not actually see these as mental health issues in a strict definition. Many people attempt or complete suicide, or self harm, with no other official mental health problem. I think that people might understand them more if they could be simplified as a mental health disorder. It is because they are not easily categorised or pigeonholed, or easily understood even by experts, that makes me think these may be some of the last taboos.

Borderline personality disorder is probably another one, for very similar reasons. People just don’t understand it. And the shrinks have been washing their hands of these clients for years letting the psychologists mop up the mess.

I do wonder though whether we even need these kinds of labels, especially seen as labels and the biological explanations out forward about them actually increase stigma. If you have a disease then the public assume you’ll never recover, that you’re unreliable, and in some cases, dangerous.

And, if we go with the biomedical account, that there is a pathological disease process at work, it makes moral judgments about what is acceptable and unacceptable behaviour in society. These are moral judgments, not medical ones, and psychiatrists are not qualified to make such judgments.

Is there even such a thing as “abnormal” behaviour? A lot of what would be classed as a biologically driven mental disorder are just natural reactions and adaptations to adversive environments and life events. They are normal and justified reactions.

It is too easy to consign someone to the dustbin of life by saying that they are crazy. It justified us in treating them different because they are perceived to be different.

We could ditch the labels if we all just learned to tolerate differences. We don’t need terms like ‘abnormal’ or ‘psychopathology’. ‘Normal’ and ‘abnormal’ are all behaviours, it’s just that some are more unique, more unusual, and more confrontational to our values and beliefs.

But, shouldn’t we celebrate the differences? Wouldn’t it be a dull world if everyone was identical? Shouldn’t we try and help those with less mainstream behaviour and thoughts find their niche in life where they can thrive, instead of doping them up on meds or locking them away in a padded cell?

The power of emotional avoidance

Yesterday, I was reading in The Psychologist Archives, about “workaholics” and whether you can be addicted to work. It suggests that if you are doing it to avoid other things in your life then it would qualify as an addiction.

Given that addiction is assumed to have a physical basis, that it is a “disease”, I am neither convinced that being a workaholic, or any other addiction, meets this criteria.

Rather than suggesting that there is some kind of unknown disease process at work, is it not more parsimonious to assume that they are all just examples of emotional avoidance?

So many “psychological disorders” are assumed to be due to a disease process, despite the scant evidence to support it and the masses of evidence showing that life circumstances, trauma and social factors are big contributors to these disorders.

Most of them have emotional avoidance at their centre.

This is important for applied reasons. If an unknown disease process is at work, we are no closer to having a remedy. If it is emotional avoidance at work, then we have numerous effective psychological therapies, such as the third wave therapies, to address this.

But not the dreadful CBT. The cognitive “restructuring” involved is, in itself, a form of emotional avoidance and, from a learning theory point of view, doesn’t make any sense. Surely, the “bad” thoughts re-emerge due to extinction?

And, CBT makes the mistake of assuming that thoughts or emotions can be “good” or “bad”. They are neither. They just are. If you want good mental and physical health, they are not to be avoided but experienced. The idea that you can live your life without “bad” thoughts or emotions is a fallacy that CBT continues to peddle.

Given the complicated nature of addiction and ALL psychological “disorders” is it likely that there will EVER be a magic bullet? Is this not in itself delusional thinking? At the very least, overly simplistic and parochial? Can human nature be reduced to this neurotransmitter, this area of the brain, this gene? Is this search not, in of itself, a form of avoidance?