Monthly Archives: June 2020

What is a Disorder?

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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 Illness (1952) was produced to address the influx of veteran shell shock (PTSD) and 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 3rd Diagnostic and Statistical Manual of Mental Disorders 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. 

U.S. government agencies 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 delineation of a person’s psychological disorders, 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 behaviour,” 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. 

Carl Roger’s study of homeodynamics, or the cooperation of human system components to maintain physiological equilibrium, produced the word ‘complementarity’ to define simultaneous mutual interaction. All human system components must work in concert; they cannot function alone. Integrality describes the inter-cooperation of the human system and the environment and social fields. A disorder is not biologic, hygienic, neurochemic, or psychogenic, but a collaboration of these and other approaches administered by the mind, body, spirit, and emotions (MBSE) 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 all have disorders. They come in different intensities and affect each of us individually. 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. We designed this Blog for those of us whose lives are negatively impacted by their disorder. 

Research shows that the onset of disorders 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?

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.

How Our Disorder Impacts Our Quality of Life.

Seventy-five million adults and adolescents have diagnosable anxiety and depression.

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A disorder that interferes with our emotional wellbeing and quality of life was once called a neurosis. Neurosis was the term used to describe abnormal psychological processes. Our complications are not abnormal or odd, but part of everyday life. Due to its medical starkness, neurosis implied something off-putting or dangerous. The words are ostracizing. Many who have a disorder cannot admit to it nor seek help because of the perceived shame and stigma implied by the phrase, mental illness.  

Neuroses are now diagnosed as depressive or anxiety disorders. They are disorders involving symptoms of stress evidenced by depression, anxiety, or obsessive behavior.

Seventy-five million adults and adolescents have diagnosable anxiety and depression. More than half of go without treatment. OCD impacts 2.2 million. Millions of us have issues of self-esteem or lack motivation. Sometimes it is not easy to get out of bed in the morning.

The number of adolescents with depression and anxiety has doubled in the last decade. They are a primary cause of the 56% increase in adolescent suicide. The LGBTQ community is 1.5 to 2.5 times as susceptible to social anxiety disorder than that of their straight or gender-conforming counterparts. The numbers are staggering. 

For many of us, these debilitating and chromic issues wreak havoc on our daily lives. They attack all fronts, negatively affecting the entire body complex. We are subject to mental confusion, emotional instability, physical dysfunction, and spiritual malaise.

Why are we subject to these disorders? Where did they originate? Any number of things might have caused it, but we were likely infected during our childhood or adolescence. It may or may not have been a significant event; you probably do not remember it.

The only higher power you need already resides within you

It could be hereditary, environmental, or the result of some traumatic experience. Some might cite emotional distress as the cause; another attribute it to being bullied; a third to over permissive parenting. It often lays dormant until manifesting during times of emotional crisis or when life offers more than we think we can handle. 

We may be depressed for long periods, have panic attacks, be compulsive, or unmotivated. We may be self-abusing with food, alcohol, or pharmaceuticals. We may feel incompetent or worthless. Depression, anxiety, low self-esteem, lack of motivation, and other disorders subsist by our emotional reactions to events, situations, and circumstances. The subject who understands her or his disorder, and recognizes the power to heal comes from within, is likely to recover. 

This BLOG provides the blueprint; you construct the edifice. We do not counsel you; this is a practicum. In counseling, we depend upon another for relief; a practicum teaches us how to heal yourself. We are in control of the transformation

Before recovery, our disorder controls our thoughts and behaviors. That is unnatural; that is not our inheritance. Reverse the process. This BLOG is committed to teaching you how to take control of your disorder to live a more healthy, productive, and satisfying life.

Why One-Size-Fits-All Approaches Fail

Recovery programs must reflect our unique and individual personalities.

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Personal recovery 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. Recovery programs must learn to appreciate the individuality of their subjects. The insularity of cognitive-behavioral therapy, positive psychology, and other approaches cannot address the dynamic complexities of our personality.

It is arrogant of recovery programs to lump us into a single niche. Stereotyping is what people do when they are not interested in getting to know the individual. Judging by public opinion, a person with a Malfunction would be stereotyped as an unpredictable, potentially violent, and undesirable individual―a claim supported by the stigma triad of ignorance, prejudice, and discrimination. We are unique individuals with unique personalities who happen to be impacted by a disorder. 


Your program of recovery should be one specifically designed for your unique needs.

Programs that boast of a specialized combination of other programs are also ineffectual unless they adapt their approach to fit the individual. Recovery programs complain that it is unproductive, time-consuming, and challenging. If that is the case, they have no business working with people who seek their advice. 

Let us use the example of cognitive-behavioral therapy. It is the most highly utilized program of recovery in the world. It is usually the first question asked at a counseling session. Are you familiar with cognitive behavioral therapy? Almost 90 percent of the approaches empirically supported by the American Psychological Association involve cognitive-behavioral treatments. Six years minimum of specialized education, and that is their opening gambit? Would you be comfortable with a general practitioner who only treats clients for the mumps?

There are at least 65 psychology programs and types of therapy. A program is never static but develops through client trust, cultural assimilation, and therapeutic innovation. Our cultural environment, heritage, background, and associations reflect our wants, choices, and aspirations. If they are not given consideration, then we are not valued.

We are better served by an 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. Do not settle for someone else’s recovery program; demand one specifically designed for your unique needs.

Restructuring Our Neural Network

When we restructure our neural pathways, there is a correlated change in our behavior and perspective.

Science confirms our neural pathways are constantly realigning. Our disorder has been feeding our brain irrational thoughts and concepts since its onset. What is irrational? Irrational is anything detrimental to our emotional wellbeing and quality of life. Simply put, it is irrational to hurt yourself.

Our brain cannot differentiate between rational and irrational. It does not think; it provides the means for us to think. Our brain is an organic reciprocator. Its job is to provide the chemical and electrical neurotransmitters and hormones that maintain our heartbeat, nervous system, and blood–flow. They tell us when to breathe. They stimulate thirst, control our weight and digestion. They establish and affect our behavior, moods, memories, and so on. 

Hundreds-of-billions of nerve cells (neurons) arranged in pathways or networks make up our brains. Inside each of these neurons, there is electrical activity. Every stimulus we experience causes its receptive neuron to fire, transmitting a message from neuron to neuron until it generates a reaction. A stimulus occurs at every experience―a muscle movement, a decision, a memory, emotion, reaction, noise, the prick of a needle, a twitch―every part of our living being. Because of our disorder, we have structured our brain around unhealthy feelings, thoughts, and behaviors. Our brain sustains this irrationality by naturally releasing pleasurable chemicals (serotonin, dopamine, norepinephrine). It does not know any better; it just works off our input. 

Neural restructuring is our brain’s capacity to change with learn­ing; functions performed by our neurotransmitters are learning functions. This process is called Hebbian learning, and this is important. Our brain learns at an incredibly accelerated rate, and what has been learned can be unlearned. A conscious input of healthy thought patterns reverses the trend. As our brain reciprocates our positive activities, our neural network restructures itself accordingly. We unlearn our unhealthy beliefs and behaviors and replace them with healthy ones. Over time, through deliberate repetition, healthy, rational thoughts and behaviors become habitual and spontaneous. 

An essential element in subverting our disorder is the deliberate restructuring of our neural network.

Neural restructuring is science, not hyperbole. The power of our words, thoughts, and actions is life-altering. We all can change the direction of our lives through Hebbian relearning, but the restructuring does not happen overnight, which is it must begin on day one of our commitment to recovery. 

How Did It Happen?

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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 disorder. 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.

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. 

Overcoming Our Resistance

Resistance is our deliberate or unconscious attempt to prevent something from happening.

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Our resistance is the first hurdle to recovery, and it is a formidable one. Resistance comes in many forms, and it has multiple attributions. We are usually unaware of it or refuse to admit it. There are seven legitimate causes of our resistance that need to be recognized and overcome. 

CHANGE. We are hard-wired to dislike change. Our bodies and brains are structured to resist anything that disrupts our equilibrium. Our body monitors our metabolism, temperature, weight, and other survival functions to balance and perform properly. A new diet or exercise regimen, for example, produces physiological changes in our heart rate, metabolism, and respiration, which impact these functions. Inertia senses these changes and resists them by making it difficult for us to maintain them. Our brain’s basal ganglia resists any change in our patterns of behavior. Therefore, habits like smoking or gambling are hard to break, and new undertakings challenging to maintain.

PERSONAL BAGGAGE: The various disorders affect us differently, and our personalities are unique; while there are similarities, no two situations are identical. A person with anxiety may be uncomfortable contributing to the classroom, while those with issues of self-esteem have difficulty establishing healthy relationships. Many of us make self-destructive decisions like substance abuse or emotional blackmail to feel viable or to numb us to the pain of our inadequacy. We may feel angry, incompetent, resentful, or worthless. This personal baggage makes commitment difficult; we have beaten ourselves so often we resist anything new, especially something of personal benefit. 

PUBLIC OPINION. Public aversion to mental illness is hard-wired. What is perceived as repugnant or weak in mind or body has suffered since the dawning of man. Having a diksorder is not a sign of weakness or strength. It is an intrinsic part of nature. Much of society views it differently because they see our disorder in themselves, and it frightens them. That fear is reinforced by prejudice, ignorance, and discrimination. One would hope that negative public opinion would evolve, but studies indicate it has fluctuated since World War II but remains steadfast. 

MEDIA REPRESENTATION. TV, books, and films exaggerate dysfunction, stereotyping us as annoying, dramatic, and peculiar. More extreme portrayals suggest we are unpredictable and dangerous. A 2011 comparative study revealed that nearly half of U.S. stories on mental illness explicitly mention or allude to violence. Half of the disordered surveyed by Mind, a London organization, focused on improving mental healthcare standards, said media coverage had a negative effect on their mental health. The media is powerful. Studies show homicide rates go up after televised heavyweight fights, and suicide rates increase after on-screen portrayals. Television content leads to an inflated estimate of adultery and crime rates and negative self-appraisal. 

VISIBILITY is the public display of behaviors associated with disorders. Not only is the public uneasy or repulsed by such behaviors, but we also are conscious of being watched, whether it is real or imagined, and often surrender to the GAZE―what psychoanalyst Lacan defines as the anxious state of mind that comes with scrutiny and unwanted attention.

UNDESIRABILITY.  Distancing is the public’s psychological expression of aversion and contempt for the behaviors associated with our disorder. Social distance varies by diagnosis. In a 2000 study, 38–47% of respondents supported a desire for social distancing from individuals with depression. The range was most significant for those with drug abuse disorders, followed by alcohol abuse, and depression. Distancing reflects the feelings a prejudiced group has towards another group; it is the affirmation of undesirability. In stigma research, the extent of social distance loosely corresponds to the level of discriminatory behavior. E

DIAGNOSIS. Diagnosis drives mental health stereotypes. Which disorder is the most repulsive, and which poses the most threat? People are concerned about the severity of our disorder, whether it is contagious, or whether our behaviors caused the disorder. Will the symptoms worsen? Is our disorder punishment for our sins, implying the more dangerous the symptoms, the worse the offense. Do not believe everything you read on the internet, chose your friends wisely, and take what your relatives have to say with a grain of salt.

Resistance v. Repression

RESISTANCE is our deliberate or unconscious attempt to prevent something from happening for any reason whatsoever. REPRESSION is a defense mechanism that prevents certain events, feelings, thoughts, and desires that our conscious mind refuses to accept from entering it. It is more of that stuff that clogs our brain and impacts our thoughts and behaviors, but we cannot address it because we don’t know it’s there. We have compartmentalized it and misplaced the key. 

There is Nothing to Be Ashamed of.

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A recent article in Scientific American speculates that mental illnesses are so common that almost everyone will develop at least one diagnosable mental disorder at some point in their life. A disorder that interferes with our quality of life and emotional wellbeing can generate irrational behavior and negative self-image. We feel less than. Our perceptions of incompetence, substantiated by perceptions of inadequacy and ineptitude, create feelings of hopelessness and worthlessness. We have no value. We believe we are undeserving of the prosperity and happiness that is our universal entitlement. We are ashamed of our perceived inadequacy.

Shame is distressing and incapacitating. Shame makes us feel powerless, inferior, and worthless. To feel shame is to feel acutely diminished in our own eyes and the eyes of others. Shame makes us want to hide or self-harm. 

Hiding from it aggravates our shame. Recognizing that shame is a fundamental part of personal evolution allows us to confront it and realize it is purely self-motivated. No one can make us feel shame; it is entirely of our own volition. What do we have to be ashamed of―being human? We should not be ashamed of our condition. We are not accountable for its onset. We didn’t deal the cards. We should only feel shame if our disorder negatively impacts our quality of life and emotional wellbeing, and we refuse to do something about it.

Extraordinariness

Each of us is unlike every other being in the history of the world. We are one of a kind.

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We are our body, mind, spirit, and emotions. For us to be healthy, the four components must work in concert to achieve homeostasis. Each is involved in every activity, although we favor one over the others. How do we know this? Imagine narrowly avoiding a collision on the freeway. As you sit safely on the shoulder, your hands become clammy, and you hyperventilate. You think of your family and ponder your mortality. You express anger at the driver who caused the incident and frustration at the delay while you thank god you survived.

Knowing these four components are integral and cooperative is helpful. When we have a mental block, physical exercise rejuvenates us. When our spirit is deflated, our mind takes us to a place that encourages us, or we dig up a memory of something that gives us joy or strength. When we are emotionally distraught, we engage in mental activities like balancing our checkbook or playing a board game. Or we turn to the physical and go to the gym, or jog, or swim. Or we meditate, pray, or practice yoga. In other words, when one component impacts us negatively, we turn to another one to compensate. This cooperation does not happen by accident; we control their functionality.

We are children of the Universe

Remember, we are children of the universe, entitled to everything the universe has to offer. It is the implicit theory of positive psychology, humanism, and their mentor Abraham Maslow that all individuals are extraordinary by their humanness, and each has the potential for significant personal achievement.

Each of us is unlike every other being in the history of the world. We are one of a kind and inimitable; there will never be another one like us. We are special. We belong. We are an essential part of everything, and without us, the world would not exist. The Philosophy of Organism states that every actual entity is present in every other actual entity. The Principle of Process determines we are in a constant process of becoming because we are creativity.  We are significant and necessary.