Time for something rather different, yet very related! Here is the Forward of a book written by Perth Clinical Psychologist Bill Saunders, What Happened? What Mental Health is Really About. This is a really important book, essential reading for anyone interested in mental health or psychological wellbeing. I agree with all of Bill’s statements below about mental health.
‘On most mornings when writing this book I’d get up at first light and go for a ‘clear the head run.’ Running is a great way to think; especially about writing. I’d begin the run ‘thinking’ about how to address an issue and then somewhere in the run I would start ‘having thoughts’ that brought clarity.
One day, wending my way back to the beachside house that I was using as a writer’s retreat, I saw the following statement written on a blackboard that normally advertised the local golf club’s menu specials.
“The standard you walk past is the standard you accept.”
I guiltily knew that the message applied to me. I knew that for many years, I had kept quiet about troubling things. I knew that I had, for a couple of decades at least, had a growing disquiet about how we manage mental health. But, I had remained silent. I went back that morning and I wrote with increased vigour. I toughened the book up.
The current mental health modus operandi is to consider any exhibition of emotional distress as aberrant, as a mental health disorder. Thus, we diagnose emotional pain as though it is physical pain. In classic medical model paradigm we consider what is wrong; what are the symptoms? We then apply a label, one of the currently available 250 plus mental illnesses, and medication is administered; a pill to moderate the aberrant distress.
Nowhere in this process is there any acceptance that emotions, of whatever type, from calm to catatonic or frenzied to furious, are valid emotions. The existing zeitgeist is that if you are distressed (or even worse distressing others), then the remedy is to apply a psychopharmacological response that deadens and masks your feelings. Nowhere in this paradigm is there space to acknowledge a universal psychological truth.
Which is that: all emotions are valid.
You cannot have a wrong feeling. Our feelings are never logical, and yes, you may have over reacted, or been triggered, you may even feel ‘crazy,’ but nonetheless such feelings are valid. You cannot have a ‘wrong’ feeling.
So, instead of focusing on how we assist distressed people to understand that the core of every so-called mental illness is valid emotional dysregulation (that can be managed), we tell dysregulated people that the voices they hear, the anxiety they feel, the depression they experience, are aberrant and are ‘wrong.’
But what if, just for the moment, we were to see the voices, the fear and the depression as ‘right.’ As being the obvious, valid, real consequence of something else; with that something else being either developmental, or adulthood acquired, trauma.
It is contended in this book that in order to keep the ‘your feelings are wrong’ mental illness model going, psychiatry has to perpetuate four great hoaxes.
The first, is that there really are 250 plus mental illnesses that exist. In this book the contention is that they are all merely epiphenomena of trauma.
The second great hoax is that psychiatrists can reliably diagnose the 250 or so mental illnesses. Unfortunately, in psychiatry every diagnosis is nothing other than an opinion. And because opinions always vary, inter-rater reliability in the diagnosis of ‘mental illness’ is no better than chance.
If you see one psychiatrist, you will get one diagnosis. If you see two, the probability, at about sixty percent, is that you will get two diagnoses. But if you see three psychiatrists, you will definitely get two different diagnoses, possibly three.
Such is this variation in opinions that psychiatrists cannot reliably distinguish between schizophrenia (the purported major mental illness) and so-called personality disorders that are deemed not mental illnesses at all.
The third great hoax is that the existing two hundred and fifty plus mental illnesses have a biological base. They don’t. Despite some seventy years of looking, and after billions of dollars have been spent searching for malfeasant alleles or aberrant neuro-transmitters, not a skerrick of biological evidence has been found.
So, in modern day psychiatry, the causes of all the mental illnesses, bar one, remain unknown. That one is Post Traumatic Stress Disorder (PTSD).
In modern day psychiatry there is not a single blood test, not one hard biologic endpoint, to either diagnose these biologic illnesses or sustain the claim that all mental illnesses have a biological base.
The fourth great hoax is that the 250 mental illnesses, with their purported (but yet to be discovered) biologic aetiology, can be treated effectively and efficaciously with psychopharmacology.
A psychopharmacology that was developed without any knowledge or understanding whatsoever of any underlying biological malfunction, because such malfunctions are, of course, yet to be discovered.
Thus, so-called ‘anti-depressants’ are not ‘anti-depressants’ at all, ‘anti-psychotics’ aren’t ‘anti-psychotics’ and the so-called ‘mood stabilizers’ are either ‘anti-epilepsy’ drugs or ‘anti-psychotics,’ that aren’t of course ‘anti-psychotics,’ because we still don’t know the biologic aetiology of psychosis; though we do know that psychosis is a consequence of trauma.
The compelling evidence is that all psychopharmacology changes your brain chemistry, even though there’s absolutely no evidence that your brain chemistry is in any way aberrant. Thus, you will get nasty side effects, develop tolerance, and if you cease using ‘psych meds,’ you will have nasty withdrawals (oops, sorry, ‘discontinuation syndrome.’)
And the accumulating evidence is that they don’t work; but more about that in the book.
As I ran past the sign that morning, I knew that I had walked past a too low standard of care for people with mental health disorders (emotional dysregulation) for too long. Hence this book.
It was time to stand up and promulgate a different discourse, which, in a nutshell, is “What Happened To You?” rather than the false psychiatric rhetoric of “What Is Wrong With You?”
And the acceptance of a style of care, trauma-informed psychotherapy, that directly addresses the absolute aetiology of mental health; one’s capacity to regulate one’s emotions. Bill Saunders, Trigg, March 2021.‘
As some of you will know, I was a neuroscientist for 24 years, having trained with a Noel Laureate (Arvid Carlsson) and directed my own neuroscience research laboratory in two UK universities for 14 years.
I walked away from the field in 2000 because I did not believe that neuroscientists were helping people overcome addiction. I soon lost belief in the biomedical model of mental health. Today, I believe that long-term administration of psychiatric drugs causes more harm than good.