Monthly Archives: June 2020

What are Physiological Dysfunctions and Discomforts?

Physiological dysfunction and discomfort are common elements of natural human development.

http://ReChanneling.org

What are physiological dysfunctions and discomforts and how do they differ? Both are conditions that can result in functional impairment which interferes with or limits one or more major life activities, both are neuroses that impact the simultaneous mutual interaction of mind, body, spirt, and emotions, and both are correctible through the same basic processes. It’s a matter of severity. A discomfort is a condition that impacts our quality of life, a dysfunction is a diagnosable condition that impacts our quality of life. The disease model of mental healthcare labels the latter a mental illness or disorder.

To the early civilizations, ‘mental illnesses’ were the domain of supernatural forces and demonic possession. Hippocrates and diagnosticians of the 19th century favored the humours. Lunar influence and sorcery and witchcraft are timeless culprits. In the early 20th century, it was somatogenic.[i] The biological approach argues that “mental disorders are related to the brain’s physical structure and functioning.” [ii] The pharmacological approach promotes it as an imbalance in brain chemistry. The 1st Diagnostic and Statistical Manual of Mental Disorders (DSM) was produced in 1952 to address the influx of veteran shell shock (PTSD). It leaned heavily on environmental and biological causes. 

One only needs the American Psychological Association’s [iii] definition of neurosis to comprehend the mental health community’s pathographic focus. The 90-word overview contains the following words: distressing, irrational, obsessive, compulsive, dissociative, depressive, exaggerated, unconscious, conflicts, anxiety, disorders. The 3rd 

The DSM-3 abandoned the word ‘neurosis’ in 1980, but it remains the go-to term in the mental health community. Its etymology is the Greek neuron (nerve) and the modern Latin osis (abnormal condition). Coined by a Scottish physician in 1776, neurosis was then defined as functional derangement arising from disorders of the nervous system. 

Experts define mental illness as a “diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria” that can “result in functional impairment which substantially interferes with or limits one or more major life activities.” [iv] This ‘defective’ emphasis has been the overriding psychiatric perspective for over a century. By the 1952 publication of DSM-1, the focus had drifted from pathology (the science of the causes and effects of diseases) to pathography (the breakdown of an individual’s problems, categorizing them to facilitate diagnosis). ‘Pathos’ is the Greek word for ‘suffering’ and the root of pathetic, and ‘graphy’ is its biographic rendering. Pathography is the history of an individual’s suffering, aka, a morbid biography. Pathography focuses “on a deficit, disease model of human behavior,” whereas the wellness model focuses “on positive aspects of human functioning.” [v]

Realistically, most terms for mental illness cannot be eliminated from the culture. Unfortunately, the negative implications of the term and its derivatives promulgate perceptions of incompetence, ineptitude, and undesirability. It is the dominant source of stigma, shame, and self-denigration. In deference to a wellness paradigm, we choose the word ‘disorder’―defined as a correctable inability to function healthily or satisfactorily―over historical terms of pathographic influence.

There are four stages to any illness: susceptibility, onset, gestation, and manifestation. A disorder onsets (client is infected) and manifests (client is affected)―there can be no disagreement about that. Childhood/adolescent exploitation creates the susceptibility to the onset of a disorder, and the holism of the host―mind, body, spirit, and emotions―nurtures it. 

The fact is that simultaneous mutual interaction of all our human system components is required for sustainability-of-life and sustainability of a physiological dysfunction, which is not ‘mental,’ biologic, hygienic, neurochemical, or psychogenic, but all of these things facilitated by all our human system components – mind, body, spirit, and emotions – working in concert. 

There is no legitimate argument against mind-body collaboration in disease and wellness. Emotions are reactive to the mind and body; spirit’s participation merits explanation. First, spirit is not ‘super,’ but it is a natural component of human development. While some suggest spirit as the seat of emotions and character, the three are distinct entities. Spirit forms the definitive or typical elements in the character of a person. Emotions are the expressions of those qualities, responsive to the mind and body.[vi] 

We are all dysfunctional to some extent. Physiological dysfunction and discomfort are common elements of natural human development. Scientific American speculates neuroses are so common almost everyone will develop at least one diagnosable disorder at some point in their life. Dysfunction and discomfort are, simply, conditions that negatively impact our emotional wellbeing and quality of life and there is nothing abnormal or unusual about them. 

There are at least nine clinical types of depression, five significant forms of anxiety, and four types of obsessive-compulsive disorder; their impacts can be mild, moderate, or severe. Some people adapt quite nicely and get on with their lives. Others incorporate it into their personalities―the cranky boss, clinging partner, temperamental neighbor.

Research shows that the onset of dysfunction happens, ostensibly, to adolescents or younger who have experienced detachment, exploitation, and or neglect. Childhood/adolescent susceptibility to all disorders is plausible because, statistically, 89% of onset happens during adolescence.[vii] However, because symptoms can remain dormant until they manifest in the adult, statistics are indeterminate. This paper posits that childhood/adolescent-onset or susceptibility to onset is total. Claims or ‘evidence’ that onsets occur later in life do not impact the argument that susceptibility to onset originates during childhood/adolescence. 

Anything that interferes with a child’s social development is detrimental to adolescent and adult emotional health. Childhood/adolescent exploitation or abuse is a generic term to describe a broad spectrum of experiences that interfere with their optimal physical, cognitive, emotional, and social development.[viii] Any number of situations or events can trigger the susceptibility to onset; it could be hereditary, environmental, or some traumatic experience.[ix] Inheritability is rare and susceptible to other factors, and traumatic experience is environmental.

The cumulative evidence that childhood and adolescent occasions and events are the primary causal factor in lifetime emotional instability has been well-established. This exploitation interferes with the optimal physical, cognitive, emotional, and social development of the child. Most importantly, it affects our self-esteem, which administrates all our positive self-qualities (self-respect, -reliance, -compassion, -worth, and so on). These are the intangible qualities that make up our character, our goodness, our spirit. Our self-esteem is reactive to―and, in turn, impacts―our body, mind, and emotions. They all work together in concert. If one is affected, all are affected. 

Despite the implication of intentionality in the words’ abuse.’ and ‘exploitation,’ much can be perceptual. A toddler who senses abandonment when a parent is preoccupied could develop emotional issues[x] Onset or susceptibility to onset should never be considered the child/adolescent’s fault and may be no one’s fault.

Undoubtedly, this sociological model conflicts with moral models that claim, “mental illness is onset controllable, and persons with mental illness are to blame for their symptoms,” [xi] or that mental illness is God’s punishment for sin or amoral behavior. Again, it is crucial to recognize we are not responsible for our disorder. Quite possibly, no one is at fault. Playing the blame game only distracts from the solution: What are we going to do about it?

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Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of physiological dysfunction and discomfort. Our vision is to reshape the current pathographic emphasis on diagnoses over individual, which fosters a deficit, disease model of human behavior. Treatment programs must disavow ineffective, one-size-fits-all approaches and target the individual personality through communication, empathy, collaboration, and an integration of historically and clinically practical methods. All donations support scholarships for workshops and practicums.

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References

[i] Bertolote, J. (2008). The roots of the concept of mental health. World Psychiatry, 7(2): 113-116 (2008). doi:10.1002/j.2051-5545.2008.tb00172.x; Farreras, I. G. (2020). History of mental illness. In R. Biswas-Diener & E. Diener (Eds), Noba textbook series: Psychology. Champaign, IL: DEF publishers. http://noba.to/65w3s7ex

[ii] McLeod, S. (2018). The Medical Model. (Online.) Simply Psychology. https://www.simplypsychology.org/medical-model.html

[iii] APA. (2020). Neurosis. (Online definition.) Dictionary of Psychology. American Psychological Association. Washington, DC: American Psychological Association.  https://dictionary.apa.org/neurosis  Accessed 05 April 2020.

[iv] Salzer, M. S., Brusilovskiy, E., & Townley, G. (2018). National Estimates of Recovery-Remission from Serious Mental Illness. Psychiatric Services, 69(5) 523-528 (2018). https://doi.org/10.1176/appi.ps.201700401; SAMSHA. (2017).  2017 National Survey on Drug Use and Health (NSDUH) by the Substance Abuse and Mental Health Services Administration.  (Rockville, MD: SAMHSA. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#:~:text=Serious%20 mental%20illness%20(SMI)%20is,or%20more%20major%20life%20activities.

[v] Mayer, C.-H., & May, M. (2019). The Positive Psychology Movement. PP1.0 and PP2.0. In C-H Mayer and Z. Kőváry (Eds.), New Trends in Psychobiography (pp. 155-172). Springer Nature Switzerland. https://doi.org/10.1007/978-3-030-916953-4_9.

[vi] Mullen, R.F. (2018). ‘Mental’ Disorders. ReChanneling.org. http://www.rechanneling.org/page-12.html 

[vii] Baron, M., Gruen, R., Asnis, l., Kane, J. (1983). Age-of-onset in schizophrenia and schizotypal disorders.Clinical and genetic implications. Neuropsychobiology,10(4):199-204 (1983). doi:10.1159/000118011; Kessler, R. C., Berglund, P., Demler, O., Jin,  R., Merikangas,  K. R., & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry62(6):593–602 (2005). doi:10.1001/archpsyc.62.6.593; Jones, P. (2013). Adult mental health disorders and their age at onset. British Journal of Psychiatry, 202(S54), S5-S10. doi:10.1192/bjp.bp.112.119164

[viii] Steele, B.F. (1995). The Psychology of Child Abuse. Family Advocate, 17 (3). Washington, DC: American Bar Association.

[ix] Mayoclinic. (2019). Mental Illness. (Online.) Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968; NIH. (2019).Child and Adolescent Mental Health. (Online.) National Institute of Health. https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/index.shtml

[x] Lancer, D. (2019). What is Self-Esteem? (Online.) PsychCentral. https://psychcentral.com/lib/what-is-self-esteem/  Accessed 19 November 2019.

[xi] Corrigan, P. (2006). Mental Health Stigma as Social Attribution: Implications for Research Methods and Attitude Change. Clinical Psychology Science and Practice, 7(1), 48-67 (2006). Doi:10.1093/clipsy.7.1.48.

Why One-Size-Fits-All Approaches Fail

Recovery programs must reflect individual over diagnosis.

Personal recovery from psychological dysfunction and discomfort is an individual process. Just as there is no one right way to do or experience recovery, so also what helps us at one time in our life may not help us at another. It is myopic of recovery programs to lump us into a single niche. Recovery programs must address the complexities of the individual personality. The insularity of cognitive-behavioral therapy, positive psychology, interpersonal therapy, and other approaches cannot address the dynamic complexities of our personality.

It is myopic of recovery programs to lump us into a single niche. Stereotyping is what people do in lieu of getting to know the individual. Judging by public opinion, a person with a psychological dysfunction is unpredictable, potentially violent, and undesirable individual―a claim supported by the stigma triad of ignorance, prejudice, and discrimination.

We are not toasters, mass-produced in a factory. We have individual personalities generated by everything and anything experienced in our lifetime. Every teaching, opinion, belief, and influence facilitates personality development. It is our current being and the expression of that being. It forms itself by core-beliefs and is developed by social, cultural, and environmental experiences. It is constant yet fluid, singular yet multiple. It is our inimitable way of thinking, feeling, and behaving. It is who we are, who we think we are, and who we are destined to become. Any evaluation and treatment program must comprehensively address the complexity of the individual personality.

In the disease model of mental healthcare, we are treated as the diagnosis rather than the individual with concerns and issues. Unfortunately, the traits, characteristics, and symptoms defined by diagnosis are subject to substantial deviations in definition, epidemiology, and treatment. Mental health experts maneuver among eight or nine types of depression, several anxiety disorders, nine obsessive-compulsive disorders, five types of stress response, and ten personality disorders sharing similar traits and symptomatology with varying degrees of impact. 

The disease model of mental health focuses on what is wrong with us. It is based on the history of our negative behavior. The Wellness Model of mental health focuses on our character strengths and virtues that generate the motivation, persistence, and perseverance to recover. A battle is not won by focusing on incompetence and weakness; it is won by knowing and utilizing inherent strengths and attributes. That is how we successfully recover―with pride and self-reliance and determination―with the awareness of what we are capable of. 

All treatment programs are flawed to some extent; integration into a platform of approaches can compensate for that ineffectiveness. Let us use the example of cognitive-behavioral therapy. Almost 90 percent of the approaches to recovery involve cognitive-behavioral treatments. Critical studies dispute CBT’s efficacy, claiming it fares no better than non-CBT programs. They claim its effectiveness has deteriorated since its introduction, concluding it is no more successful than mindfulness-based therapy for depression and anxiety.

Despite these criticisms, the program of thought and behavior modification pioneered by Beck in the 1960s is still useful in modifying the irrational thoughts and behaviors that sustain a disorder when used in concert with other approaches.

One such integration is utilizing positive psychology in the cognitive behavioral therapy model: CBT would modify automatic negative self-beliefs, thoughts, and behaviors, and positive psychology would emphasize positive replacement. The Wellness Model’s chief facilitator, positive psychology focuses on our virtues and strengths that help us transform and flourish, but the approach has its critics, too. They claim positive psychology is still in its formative stage and, despite recent scientific attention to the positive spectrum of human potential, has yet to be integrated into mainstream theory, assessment, and treatment options.

Until recently, the focus on optimal functioning’s positive aspects ignored the individual’s holism by neglecting their negative aspects. The emergence of PP2.0 rectified the lacuna. Positive psychology now emphasizes the positive while managing and processing the negative to increase wellbeing, but this is still innovative and not thoroughly tested. This is no t to disparage evidenced-based solutions but to show how an evolving customized platform is the better option. 

Focusing on the individual personality would compensate for the statistical failures of diagnosis based on the disease model’s reliance on DSM criteria. Even mainstream medical authorities have begun to recognize the unreliability of conventional psychiatric diagnosis. A recent Canadian study reported, of 289 participants in 67 clinics meeting DSM-IV criteria for social anxiety disorder, 76.4% were improperly diagnosed. The Anxiety Institute in Phoenix reports an estimated 8.2% of clients had generalized anxiety, but just 0.5% were correctly diagnosed. Experts cite the mental health community’s difficulty distinguishing different disorders or identifying specific etiological risk factors due to the fluidity and ambiguity of the Diagnostic and Statistical Manual of Mental Disorders. . 

The massive number of revisions, substitutions, and changes from one DSM to the next is never universally accepted. Psychiatrists, psychologists, and researchers who specialize or survive by funding are justifiably protective of their territory. Even under the best circumstance with a knowledgeable and caring clinician, it is difficult to get a proper diagnosis. What is lacking is communication and collaboration between subject and clinician. 

We are better served by the integration of multiple traditional and non-traditional approaches, including those defined as new (third) wave (generation) therapies, developed through client trust, cultural assimilation, and therapeutic innovation. Our environment, heritage, background, and associations reflect our wants, choices, and aspirations. If they are not given consideration, then we are not valued.

We must emphasize individual over diagnosis and create individual-based solutions. Training in prosocial behavior and emotional literacy might be useful supplements to typical interventions. Behavioral exercises can be used to practice the execution of considerate and generous social skills. Positive affirmations have enormous subjective value as well. Data provide evidence for mindfulness and acceptance-based interventions. Motivational enhancement strategies could help clients overcome their resistance to new ideas and concepts. Many therapists tout the benefits of positive autobiography to focus on our positive life experiences. Evidence-based solutions must address issues of self-esteem.

The best solution is to establish an integrated platform of approaches as a general solution , then further customize as determined by effectiveness. Diagnosis must be vigorously challenged by individual concerns and experiences, and treatment programs must reflect this dynamic.

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Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of psychological dysfunction and discomfort. Our vision is to reshape the current pathographic emphasis on diagnoses over individual, which fosters a deficit, disease model of human behavior. Treatment programs must disavow ineffective, one-size-fits-all approaches and target the individual personality through communication, empathy, collaboration, and an integration of historically and clinically practical methods. All donations support scholarships for workshops and practicums.

How Did It Happen?

Healthy human development requires satisfying fundamental human needs.

The cumulative evidence that childhood and adolescent exploitation is a primary causal factor in lifetime emotional instability has been well-established. This is likely the cause of our dysfunction or discomfort. Detachment, exploitation, and abandonment in our formative years can manifest in chronic depression, and feelings of helplessness, hopelessness, and unworthiness. We may be prone to repetitive patterns of shallow relationships. We may have difficulty trusting others;  we may be afraid of intimacy and commitment.  Add to these, debilitating anxiety, codependence, feelings of insecurity, isolation, and the loss of control over life.

In Maslow’s hierarchy theory, the orderly flow of social and emotional development requires satisfying specific fundamental human needs. The adolescent experiencing detachment, exploitation, or neglect, is disenabled from fulfilling his or her physiological and safety needs and the need to belong and experience love.

Maslow’s hierarchy illustrates how childhood abuse can impact natural human development

Child psychologist B.F. Steele maintains “abuse” includes events that interfere with the optimal physical, cognitive, emotional, and social development of the child. The term is subdivided into physical, sexual, and emotional abuse and various forms of neglect, all of which can occur alone or in combination. Maslow’s hierarchy is not a purely linear exercise, and it is not absolute that one level of needs must be satisfied to get to the next level. The list of individuals who have been deprived of fundamental needs yet achieved greatness is long and inspirational. But disruptions in our natural human development makes it more difficult. We did not make it happen; it happened to us as a child/adolescent. It is not our fault, but it is our responsibility to do something about it. 

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Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of psychological dysfunction and discomfort. Our vision is to reshape the current pathographic emphasis on diagnoses over individual, which fosters a deficit, disease model of human behavior. Treatment programs must disavow ineffective, one-size-fits-all approaches and target the individual personality through communication, empathy, collaboration, and an integration of historically and clinically practical methods. All donations support scholarships for workshops and practicums.