- Mental Health
Healthy Interventions for Overall Mental Wellness
The Medication Pandemic
The pharmaceutical industrial complex would have us believe that a more satisfying life replete with love, success, and morality for ourselves and our children is only a prescription away. The financial collusion between the APA, research institutes, drug manufacturers, and the media not only reinforces this untenable view in the face of massifs of anecdotal and empirical evidence to the contrary but seeks to make psychopharmacological intervention the gold standard in care for not only those who are truly sick but also for any and every one dealing with the disappointments and vicissitudes of typical life. What then is a viable alternative; one that draws from a holistic, wellness oriented framework with underpinnings in the ubiquitously resilient human spirit? Many possible alternatives might help in the fundamental effort to lift the human condition but there are center tenets that will likely be common to all efficacious interventions.
A Shift in Perspective
One characteristic of any such counseling intervention must be that it not be based upon the medical model of disease. This model is stifling to the human alacrity toward progress and gratification rather than relevant in treating mental health conditions. The language endemic to this perspective such as disorder, pathology, imbalance is undermining to the positive strength based approach that precipitates real transformation. What’s more the science it is derived from is at best unproven conjecture with little known about long term medical pharmaceutical interventions that interrupt the functional mind. The research we have been exposed to in this course argues for at best short-term symptom amelioration with damaging lasting consequences as a result of these interventions.
And so first and for most a therapeutic approach that treats the complex affective, cognitive, and behavior reactions to life that we all employ as individuals that is fundamentally different from interventions in other areas of physical medicine is essential. We are treating at the core here; the human spirit, individual mental foibles, and the capacity for resilience. This is not the case when treating diseases rooted in true organic disruptions such as cancer, diabetes, or heart disease.
A Strength Based Approach
The model of these interventions must not tell us, or our clients, that we are disordered or diseased thus excusing us from the indomitable will we may choose to exercise towards wellness. This capacity is in us all but may be rendered inert by the medical model and the practice of psychopharmacology. This model, in essence places, the lack of wellness squarely on the shoulders of poorly understood neuroscience rather than in the empowered hands of the client.
Sweeney and Myer wrote of the ‘Indivisible Self” Model of wellness. This is based on five factors encompassing 17 different wellness dimensions. The creative factor includes cognition, emotion, control, work, and humor. The physical factor pertains to exercise and nutrition. The coping factor encapsulates belief, stress management, self-worth, and leisure. The social factor has to do with friendships and love and the Essential factor includes spirituality, self-care, gender identity, and cultural identity.
Most individuals that need help in transcending the guilt, shame, and anxiety endemic to our species or more fully realizing something akin to Maslow’s self-realization do not have a biological issue but rather an intra-physic psychosocial concern that can be best addressed through examining which are these wellness factors are either absent, insufficient, or suffering as of result of their learned cognitions, affects, and behaviors. Within this, “Indivisible Self,” model a lack of satisfaction in one area will necessarily cause dissatisfaction in other areas. This makes wellness not only pernicious when it falls to a low level but also easily ameliorated. Just as a negative change in one area can undermine other areas, a positive change will unavoidably cause improvements in other areas.
Affect, Cognition, and Behavior Gone Awry
Even the, “healthiest,” of us can develop patterns of cognition, affect, or behavior that may develop of their own accord due to our temperament or perhaps our inconsistent childhood experiences. They may also emerge suddenly in response to a particularly stressful precipitating event.
Karen Horney, coined the term, “The Tyranny of the Shoulds,” an idea that closely relates to Ellis’s Rational Emotive Behavioral Therapy. This cognitive behavioral modality is so useful because it highlights the negative messages that humans ubiquitously tell themselves. Cognitive distortions concerning what should be or must be so are engendered in an inner dialogue that we all confront from time to time. These unreasonable cognitions, often absolutist in nature, lead us to unproductive emotions such as self-pity, anxiety, and shame. These self-defeating affective states insidiously feed upon themselves until we have been paralyzed by our own self-deprecation and resulting emotions. In turn, our emotional distress provokes destructive behaviors that fulfill our unreasonable, undisputed, prophetic beliefs.
All effective interventions should address this model of human epistemological and behavioral phenomenology. It is not until we learn to talk honestly with ourselves in a self-affirming way, based on the evidence of our past successes that we can break this cycle of self-defeating illogic.
Where and How To Intervene
Although clients often have a multitude of pressing concerns when presenting for treatment a hierarchy of concerns with a specific point of focused change is usually identifiable. Beginning here will not only address the most pressing concern but begin to mollify ancillary concerns.
For instance if a client is suffering from low self-esteem due to a poor body image; either increasing the wellness of the physical self through better eating habits and exercise or examining the destructive cognitions that accompany these feelings along with how they affect the client’s sense of personal worth present a couple of places where an a strength-based intervention can begin. We know that exercise bolsters the mood more effectively and healthily than any drug and so obtaining a commitment from the client to pursue a leisure interest of a physical nature may begin to improve affect, and in turn, cognition, and self-esteem.
For a socially disconnected individual encouraging an activity of interest that will allow them to make meaningful social connections based on common interests might be recommended. Such activity and connection will lend more meaning to their daily routine, will likely increase their ability to cope with stressors, and will foster a sense of personal mastery and accomplishment.
A client who presents as unhappy in his work, with the proper career counseling and self-exploration, may find a much more fulfilling career thus encouraging more fulfilled leisure activities, better self-management, and increased satisfaction in social relationships.
For a client in an existential crisis or major phase of life transition it would be helpful to explore their spiritual beliefs and the intrinsic values that promote their need for fulfillment and self-transcendence. Encouraging activities that allow them to exercise these values and foster a spiritual sense of connection will in turn greatly affect their self-care, identity, and sense of higher purpose.
The interconnected nature of wellness demonstrates that the vicissitudes of life whether derived from childhood trauma, adjustment to the seasons of life, or an unexpected loss can wreak havoc on a life that is most fully lived with love, empathy, and self-fulfillment. These qualities can be fostered and remediated when impinged upon by trial and tribulation.
If we have done our job as mental health professionals then the interventions we enact and the cognitive restructuring we engage in with clients should leave the client in an increasingly well-fostered, strength based problem solving approach to the inevitable pains and disappointments that are yet to come after they stop seeing us. Hopefully we have empowered them to dig deep into their human spirit to claim for themselves what they need to feel well and this strength will remain with them, now occupying the places where doubt, trepidation, and self-limitation once lurked.
Without this state of self-realization as a primary goal of a therapeutic intervention; without a secure sense emanating from us as counselors and therapists that our clients possess tremendous ability and are capable of handling further difficulty, we will undermine them as self-empowered individuals. This disservice will keep them chained to the perceived personal limitations that brought them to us originally.
We will further take the gift of lifelong growth from them. Life if hard and full of challenges and pitfalls; the best any of us can do when faced with this truism is show the will to live creatively, develop a mature sense of self-efficacy, and learn from the inevitable mistakes that we will make along the way. If we can pass this message along to our children then we might see fewer adults in need of our assistance during times of duress.