I have never been disillusioned by the idea that anyone but me was responsible for my problems and I have carried that same ideology into my practice. Perhaps it is because I was raised by parents who did their best to instill a sense of personal responsibility for everything I did. I was certainly influenced by two extremely effective therapists prior to my decision to enter the field. Both of whom reiterated that belief throughout my time with them. So it is refreshing to see the field that I love so much and have seen benefit many people begin to come back around to the idea that most people do not have a “mental illness”. The field has a long way to go and certainly a lot of resistance in an era of entitlement, microwave healthcare, and desire to blame everyone and everything else for our personal problems, but it is getting there.
I cannot think of anything more disempowering than telling someone that they are depressed or anxious (or a host of other mental issues) because of genetic factors or some other biological defect they have no control over. Many psychiatrists have made a fortune, often supported by therapists, pushing this idea. I understand it. They were taught a biological model in medical school where everything is a disease to be treated with medication. Sure the responsible physicians also require therapy as an adjunct to medication but it is often viewed as a way to help the patient learn ways to “cope” with the disease instead of a way to eliminate something the patient has control over. Fortunately for the public the tide is very slowly beginning to shift as people are recognizing that medication is not working and in many, if not most cases, creating additional side effects that are worse than the original problem - raise your hand if you are a male that enjoys the side effects of ejaculatory delay and decreased sex drive caused by your SSRI! I didn’t think so.
I was recently reading an article on the site Mad In America that discussed the failure of the genome project to find ANY genetic determinant for psychiatric issues. Dr. E. Fuller Torrey, associate director for research at the Stanley Medical Research Institute, stated in an article in the Dallas Morning News that in the cases of depression and schizophrenia “...genetic research has produced virtually nothing of clinical value”. I have written elsewhere in my blog about the unfounded idea of the chemical imbalance theory so widely used to market psychopharmacology. So if a large number of the mental health issues people suffer from are (as far as we know currently) not caused by genetic defects and drugs do not cure these conditions, what is the answer? The answer is your ability to choose.
I get that most people are not “choosing” depression, anxiety, and bi-polar disorders but helping someone to realize that the way they are choosing to relate to others may be contributing to unhealthy emotions is extremely beneficial and in most cases the answer to the problem. Most people who come to therapy are there because a relationship is suffering. The reason they make the appointment may be labeled depression or anxiety but when you dig far enough you realize that somewhere there is a relational issue. When I live in a supportive environment, have healthy relationships at work, involved in social activities, especially those that meet the needs of other people, I find it difficult to worry and depress. That’s not to say we don’t address limiting beliefs and other concerns if they arise but more often than not relationships are a primary issue.
So where does the idea of choice fit into this? It is simple. A couple of theories, including Choice Theory developed by William Glasser, state that everything we do is motivated by a genetic drive to fulfill our psychological needs. I have written about psychological needs in greater depth elsewhere. Choice Theory lists these needs as survival, love and belonging, power, freedom and fun. Cloe Madanes lists the psychological needs as Certainty, Uncertainty/Variety, Significance, Connection/Love, Growth, and Contribution. I prefer Madanes’ list but I believe both communicate the same thing. This means that whether our behavior is healthy or unhealthy we are engaging in the behavior to meet at least one of our needs. If the theories are correct, and decades of successful outcomes suggest they are, then recognizing why we engage in the behaviors we choose allows us to make a different choice. This seems very simple on the surface, and it is, but putting it into practice is another issue. It is often much easier for us to continue to engage in the negative, unhealthy behaviors we have become accustomed to that reliably meet our needs, than it is to change. Change is difficult. It is scary and creates a lot of uncertainty that is not always comfortable to some people. This is where a therapist or coach that understands these concepts can play a valuable role.
I have dedicated my practice to helping others overcome barriers to their mental, physical, personal, and relational success by effectively supporting them in recognizing these needs and creating healthy ways to meet them.
Resources noted in my post above can be found using the links below.
www.madinamerica.com/2019/11/chronicles-gene-worshiping/ https://www.dallasnews.com/opinion/commentary/2019/10/13/was-the-human-genomeproject- a-dud/ https://cloemadanes.com/2016/10/12/the-6-human-needs-for-fulfillment/
