Making peace of life’s troubles
Re: Is life itself a sickness in need of a cure?, Feb. 20. I am writing in response to Robert Sibley’s column concerning new inclusions in the most recent edition of the Diagnostic and Statistical Manual and psychotherapy’s response to what he considers normal life events.
First and foremost, the DSM and the psychotherapy industry are not in cahoots trying to drum up business for therapists or pharmaceutical companies. The role of the DSM is to provide diagnostic criteria to help mental-health professionals understand the highly complicated and often confounding symptoms that people come to therapy seeking help for.
Having practised the craft of psychotherapy for over a decade, I have never engaged in anything which strives to find an “untroubled life” for my clients. I don’t believe any such thing exists. What I have to offer my clients is much more a validation of their feelings and support in helping them find ways of coping with them. As a psychotherapist rather than a psychiatrist I do not prescribe medication, although I know that in some circumstances psychopharmacology is an important piece of the puzzle in recovering from emotional disability.
It is normal to feel grief, worry and anxiety in response to difficult life events. Most times individuals present themselves for help because they are having trouble coping in their usual ways, don’t like it and don’t know what to do about it. Our society promotes notions of perfection to such an extent that many people feel shame and isolate themselves rather than reveal to those around them that they are struggling. Sometimes, the very act of social isolation tips the balance from normal feelings to mental illness. My response, as a psychotherapist, is not to tell people that they fit a certain diagnostic criteria, but to help them figure out why they feel the way they do, make peace with the tragic, heart-wrenching realities of life and to find ways to cope with them.
The DSM is useful in helping us understand what symptoms point to what problems, just as there are medical criteria for all other illnesses and disorders. Depression has a list of symptoms that can occur for no immediately recognizable reason, or following a challenging life event. A depression that seems largely chemical in nature is often best treated with a combination of medication and psychotherapy. A depression that is connected to a challenging life event may also be helped with medication but is often best treated with therapy to help the individual work through his or her feelings, trauma or altered life view. Just because the pain they are experiencing makes sense doesn’t mean that they can or should just get over it or toughen up.
The mental-health industry is not promoting the idea that “stress, grief, sadness and even fear can be or should be eliminated from the repertoire of human experience” as Sibley suggests. Mental-health professionals and the forces behind the DSM are striving to bring some clarity to human difficulties that are largely invisible, highly complicated and often shameful for the afflicted.
Psychotherapists help clients make peace with themselves and the life stresses they are experiencing. We offer support, guidance and normalization that what they are going through is part of the human experience. We journey with them as they find more effective ways of responding to life’s challenges.
JUDY KIAR, Individual, couple and family therapist, Ottawa