Money will not fix mental-health crisis
If you have had trauma, being told to think happy thoughts can be like sticking a band-aid on a gaping wound
As I write this, I feel too hot, too sweaty, too fat, a little dumb, but, strangely, quite cheerful.
I water my plants. I make my bed. I feed the cat. My “good things log” records that this week: made vegetarian lasagne, de-nitted kids, took back library books. I am weirdly excited that I have finally organised a tradie to clean my gutters. Pizza, friends, music and water blasting. These are not remarkable things. But they are special for me.
Because I wouldn’t be like this if I hadn’t had therapy that worked. I may not even be here at all.
Imagine you have snagged your coat on a nail. You cannot go forward without going back to unhook it. Just carrying on pulling harder rips your coat. And creates more distress.
And with the highest level of youth suicide in the developed world, it seems a lot of us are stuck.
The Government has recognised that and announced a wide-ranging review of mental health. Commentators who wouldn’t normally agree on a whole lot (Mike Hosking, meet the Association of Social Workers) have chorused in unison that what it is all about is: money and needing more of it.
Of course, funding matters. But at the same time, it may not be the most important thing. Putting more money into telling people to pull harder on their coat is not going to get them unstuck.
As management guru Peter Drucker said: “There is nothing so useless as doing efficiently that which should not be done at all.”
Currently, the kind of help which tends to be offered to anyone suffering with mentalhealth issues is a short course of cognitive behaviour therapy (CBT), a type of talking cure which attempts to address “distorted” thinking by replacing it with “rational” thinking. I know, me neither.
CBT is considered the “gold standard” of therapy because it’s (relatively) cheap, gratifyingly superficial and there are double-blind studies supporting its efficacy. Never mind that since 2011 the whole enterprise of psychological research has been challenged as statistically unsound. In an age of data, it is not popular to point out that not everything that can be counted counts, and not everything that counts can be counted. Did I mention it’s (relatively) cheap?
CBT does work for some. But if you have suffered trauma, being told to think happy thoughts can be like sticking a band-aid on a gaping wound.
I tried CBT with three therapists over a period of years. But since thinking had got me stuck in the first place, more thinking did not unstick me, it kept me trapped. But I kept getting told by experts this was the proven method which would help. When all it did was give me something else to suck at.
Sometimes problems are not even the problem. Coping is the problem. And if you’re coping in a way that creates more pain, trying harder doesn’t help, it just hurts more.
The truth is that a person becomes a person through other people. So the kind of therapy that worked for me was not about fixing myself, but about learning to connect (a therapeutic alliance, in the jargon). I learned I could be accepted as I am, despite being too intense, too much, stinky, imperfect, flawed, crazy. My therapist did this for me, while I learned how to do it for myself.
Bit of a shame I couldn’t have learned this earlier. And that’s the thing. Dealing with the underlying social dislocation that isolates us and foments distress and mental illness is so much harder isn’t it? If only we can just make it a little easier for people to feel they can be themselves and still be accepted. (Our mainstream education system is still brutal for anyone who doesn’t fit in).
It is acceptance and gentleness that heals. Whether that is a relationship with a “proper” therapist or a connection with another human being, it brings us back to that “good enough” place, where we can clean our gutters and pay library fines.
Many people who become mentally ill, like me, feel they don’t fit in to mainstream social norms. We develop an idea that we are “wrong” in some ill-defined but deeply flawed way. But I started to heal when I realised I wasn’t actually broken. Sometimes you don’t need to be fixed, you just need to be accepted.
I know it is not feasible for everyone to have the kind of therapy I had, but let’s at least tell the truth. Quick fixes are not going to work for everyone, and rather than telling individuals to change, maybe we all need to change too. After Harvey Weinstein we have seen that social norms around gender can move dramatically within months. So when is the #metoo revolution coming for mental illness?