Category Archives: ReChanneling

Social Anxiety Disorder: General Overview

Social anxiety disorder onsets at adolescence. The afflicted are not responsible for their dysfunction.

Social anxiety disorder (SAD) is one of the most common mental disorders, affecting the emotional and mental wellbeing of millions of U.S. adults and adolescents who find themselves caught up in a densely interconnected network of fear and avoidance of social situations. SAD is the second most diagnosed form of anxiety in the United States. Statistics estimate 40 million U.S. adults will experience SAD. The National Institute of Mental Health estimates 9.1% of adolescents (ages 10 to 19) currently experience symptoms, and 1.3% have severe impairment. Statistics are imperfect for LGBTQ+ persons; the Anxiety and Depression Association of America estimates their susceptibility is 1.5-2.5 times higher than that of their straight or gender-conforming counterparts. All statistics are fluid, however; a high percentage of persons who experience SAD refuse treatment, fail to disclose it, or remain ignorant of its symptoms. 

SAD is arguably the most underrated and misunderstood psychological dysfunction. Debilitating and chronic, SAD attacks on all fronts, negatively affecting the entire body complex. It manifests in mental confusion, emotional instability, physical dysfunction, and spiritual malaise. Emotionally, persons experiencing SAD are depressed and lonely. In social situations, they are physically subject to unwarranted sweating and trembling, hyperventilation, nausea, cramps, dizziness, and muscle spasms. Mentally, thoughts are discordant and irrational. Spiritually, they define themselves as inadequate and insignificant. 

The commitment-to-remedy rate for those experiencing SAD in the first year is less than 6%. This statistic is reflective of symptoms that manifest perceptions of worthlessness and futility. SAD also has lower recovery-remission rates because many of the afflicted are unable to afford treatment due to symptom-induced employment instability. Over 70% of SAD persons are in the lowest economic group.

Social anxiety disorder is a pathological form of everyday anxiety. Feeling anxious or apprehensive in certain situations is normal; most individuals are nervous speaking in front of a group and anxious when visiting their dentist. The typical individual recognizes the normalcy of a situation and accords it appropriate attention. The SAD person anticipates it, personalizes it, dramatizes it, and obsesses on its negative implications. The clinical term “disorder” identifies extreme or excessive impairment that negatively affects functionality.

The generic symptom of SAD is intense apprehension—the fear of being judged, negatively evaluated and ridiculed. There is persistent anxiety and fear of social situations such as dating, interviewing for a position, answering a question in class, or dealing with authority. Often, mere functionality in perfunctory situations―eating in front of others, riding a bus, using a public restroom—can be unduly stressful. 

The fear that manifests in social situations is so fierce that many SAD persons believe it is beyond their control, which manifests in perceptions of incompetence and hopelessness. Negative self-evaluation interferes with the desire to pursue a goal, attend school, or do anything that might trigger anxiety. Often, the subject worries about things for weeks before they happen. Subsequentially, they will avoid places, events, or situations where there is the potential for embarrassment or ridicule.

The overriding fear of being found wanting manifests in self-perspectives of inferiority and unattractiveness. SAD persons are unduly concerned they will say something that will reveal their ignorance, real or otherwise. They walk on eggshells, supremely conscious of their awkwardness, surrendering to the GAZE―the anxious state of mind that comes with the maladaptive self-belief they are the uncomfortable center of attention. Their social interactions can appear hesitant and awkward, small talk clumsy, attempts at humor embarrassing–every situation reactive to negative self-evaluation. 

‘Maladaptive’ is a term created by Aaron Beck, the ‘father’ of cognitive-behavioral therapy. Although maladaptive self-beliefs can occur with many psychological dysfunctions, they are most common to SAD. A maladaptive self-belief is a negative self-perspective unsupported by reality. SAD persons can find themselves in a supportive and approving environment, but they tell themselves they are unwelcome and the subject of ridicule and contempt. They ‘adapt’ negatively to a positive situation.

SAD persons are often concerned about the visibility of their anxiety and are preoccupied with performance or arousal. SAD persons frequently generate images of themselves performing poorly in feared social situations, and their anticipation of repudiation motivates them to dismiss overtures to offset any possibility of rejection. The SAD subject meticulously avoids situations that might trigger discomfort. The maladaptive perceptions of inferiority and incompetence can generate profound and debilitating guilt and shame.  

SAD is repressive and intractable, imposing irrational thoughts and behavior. 

The key to SAD’s hold on its victims is its uncanny ability to sense vulnerability in the child/adolescent. SAD is like the person who comes to dinner and stays indefinitely. It feeds off its host’s irrationality. It crashes on the couch, surrounded by beer cans drained of hope and potential. It monopolizes the bathroom, creating missed opportunities. It becomes the predominant fixture in the house. After a while, its host not only grows accustomed to having it around but forms a subordinate dependency.

SAD persons crave the companionship but shun social situations for fear of being found out as unlikeable, stupid, or annoying. Accordingly, they avoid speaking in public, expressing opinions, or even fraternizing with peers. People with SAD are prone to low self-esteem and high self-criticism due to the dysfunction itself, and its causal disruption in natural human development. SEE Healthy Philautia and Self-Esteem.

SAD onset occurs during adolescence and can linger in the system for years or even decades before asserting itself. Any number of situations or events trigger the infection. The SAD person could have been subject to bullying or a broken home. Perhaps parents were overprotective, controlling, or unable to provide emotional validation. In some cases, its cause is perceptual. A child whose parental quality time is interrupted by a phone call can sense abandonment. The SAD person is not accountable for their dysfunction; there is the likelihood no one is intentionally responsible. 

SAD is routinely comorbid with depression and substance abuse. Symptom are similar to those of avoidant personality disorder, panic disorder, generalized anxiety disorder, depression, substance abuse, eating disorders, OCD, and schizophrenia. Coupled with the discrepancies and disparity in its definition, epidemiology, assessment, and treatment, SAD is usually misdiagnosed. SEE Misdiagnosis

For over 50 years, cognitive-behavioral therapy has been the go-to treatment for SAD. Only recently have experts determined that CBT can be ineffectual unless combined with a broader approach to account for SAD’s complexity and the individual personality. A SAD subject subsisting on paranoia sustained by negative self-evaluation is better served by multiple approaches, including those defined as new (third) wave (generation) therapies, developed through client trust, cultural assimilation, and therapeutic innovation. CBT, positive psychology, and neural restructuring might serve as the foundational platform for integration. SEE One-Size-Fits-All 

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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.

The Neglected Significance of Forgiveness in Recovery

The inability or unwillingness to forgive is self-defeating.

Science supports the cliché that by not forgiving, we allow the transgressor to occupy valuable space in our brain. We are so inundated from childhood with the concept of forgiveness, we tend to disregard its power and significance. The role of forgiveness is ridding ourselves of the unresolved antagonisms of hate, resentment, shame, and guilt. These are negatively valanced emotions, which means they are destructive to our physiological wellbeing. They are irrational in that they are harmful to the self. The fact that we get pleasure or satisfaction from our righteous indignation only means our neural network, not knowing any better, has become accustomed to this negativity and transmits the hormones that sustain and give us pleasure (serotonin). 

Recovery from our dysfunction or discomfort requires restructuring our neural network by feeding it positive stimuli to counter the years of harmful, negative input. But there is little room in our brain for healthy thoughts and behaviors unless we evict the bad tenants by forgiving them. That new vacancy allows us to access our character strengths and virtues that generate the motivation, persistence, and perseverance to recover.

We hold onto anger and resentment because we persuade ourselves it impacts those who transgressed against us. The irony is, they are (1) unaware they injured us, (2) have forgotten it, or (3) take no responsibility for it. The only person affected is us, the injured party.

We amplify the harm inflicted upon us by our irrational compulsion to hold onto our anger and resentment. The bile accumulates and festers until there is no room for things constructive to our recovery. To paraphrase Buddha, holding onto anger is holding onto a hot coal with the intent of throwing it at someone else; you’re the one who gets burned. The inability or unwillingness to forgive is self-defeating.

Recovery requires letting go of our negative self-perspectives, expectations, and beliefs, opening our minds to new ideas and concepts. 

When we hold onto hate and resentment, we remain imprisoned in the past. Forgiveness opens us to new possibilities and offers hope for the future. 

Allowing our transgressors to dominate our thoughts makes us victims. Forgiving takes away their power. 

The drive for vengeance can be formidable, our baser instinct cries out for retribution. Forgiving is not easy. It takes enormous courage. That’s why it is so powerful

Forgiveness does not condone or excuse the transgressor; it takes their power away. 

We don’t forgive to make our transgressors feel better; they’re not important. We forgive to promote change within our self. 

There are three types of transgression: Those inflicted on us by another, those we inflict on another, and those we inflict on ourselves. We are both victim and abuser. We are victimized by the transgression against us. We abuse ourselves with our resentment and hate. When we transgress, we abuse the other, and our shame for the act victimizes us. Transgression against our self is both self-abuse and victimization. Abuser and victim. This is important to understand and accept. That is the role of mindfulness, a requisite for recovery.

Forgiving those who have harmed us. It is important to recognize that forgiveness is not forgetting or condoning. Our noble self forgives, our pragmatic self remembers. The actions of another may seem indefensible, but forgiving is for our wellbeing, not theirs. 

L. was in a group for social anxiety disorder. He claimed he couldn’t forgive his parents; their injustice was so severe. “If you knew what they’d done to me you wouldn’t ask me to forgive them.” L was unwilling to relinquish his parents’ negative hold on his psyche, much like a cancer victim refusing chemotherapy. Unlike many, he was mindful of the physiological ramifications of holding onto his nixtamalization, which mitigated the negative impact on his recovery, but it will remain an obstacle to recovery until L is willing to forgive and let it go.

Forgiving ourselves for harming another is accepting and releasing the guilt and shame for our actions. It’s important to recognize, transgression against another is a transgression against ourselves. The act of self-forgiveness accepts and embraces our imperfections and evidences our humanness.

Forgiving ourselves for harming ourselves. Transgression against the self is self-deprecation. It is telling ourselves we are worthless by belittling, undervaluing, or disparaging ourselves. Self-pity, self-contempt, and other hyphenated forms of self-abuse. devalue our inherent character strengths and virtues. Forgiving ourselves is challenging because our self-harm is generated by our deficit of self-esteem.

By withholding forgiveness, we deny ourselves the ability to function optimally. Our resentment and hatred are divisive to our emotional wellbeing and disharmonious to our true nature. Inner harmony is impossible unless we heal the anger within ourselves. Forgiving is the only way we expel the hostility. We cannot hope to function optimally without absolving both our self and others whose actions contributed to our negative thoughts and behavior. This courageous willingness to forgive is indispensable to recovery. 

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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.

Healthy Philautia and Self-Esteem

Healthy philautia serves as a focused revitalization tool for self-esteem.

Healthy philautia is an integrative platform specifically designed to address the deficit of self-esteem caused by our dysfunction or discomfort, and the disruption in human development.

It achieves this through an integration of historically and clinically practical approaches that serve as focused revitalization tools for self-esteem by recognizing and replacing negative self-perspective and behavior. 

Self-esteem. Self-esteem is the self-recognition of our value; value is the accumulation of positive self-qualities that generate our character strengths and virtues. Positive self-qualities (e.g., self-compassion, -love, -regard, -respect, -value, -worth, and other intrinsic wholesome attributes) determine our relationship to self, others, and the world. They provide the evidence we are competent, consequential, and worthy of love.

Psychological dysfunction and discomfort. Both conditions impact our emotional wellbeing and quality of life and can interfere with or limit one or more major life activities. Both are addressed through the same basic processes. The primary distinction is severity. A psychological dysfunction is defined as a mental, behavioral, or emotional disorder of sufficient duration to meet diagnosable criteria. Both are dysfunctions.

How dysfunction impacts self-esteem. The vast majority of dysfunctional onset (or susceptibility to onset) happens during childhood/adolescence, negatively impacting the development of self-esteem. This is best illustrated by Maslow’s hierarchy of needs which reveals how childhood physical, emotional, or sexual disturbance disrupts natural human development. The perception of detachment, exploitation, or neglect disenables the child’s safety and security as well as the sense of belonging and being loved, which impacts the acquisition of self-esteem. The adult symptoms and characteristics of the dysfunction continue or augment that deficit. 

Childhood physical, emotional, or sexual disturbance disrupts natural human development.

Why Healthy Philautia? The Greeks categorized love by its object. For philia, the object is comradeship, eros is sexuality, storge is familiar affection, and so on. Philautia is the dichotomy of self-love: the love of oneself (narcissism), and the love that is within oneself (self-esteem). 

Narcissism is a psychological condition in which people function with an inflated and irrational sense of their importance, often expressed by haughtiness or arrogance. It is the need for excessive attention and admiration, masking an unconscious sense of inferiority and inadequacy. 

Healthy philautia is the recognition of our value and potential, the realization that we are necessary to this life and of incomprehensible worth. To feel joy and fulfillment at being you is the experience of healthy philautia,and such feelings cannot be boundAccepting and embracing our self-worth compels us to share it with others and the world, to love and be loved. 

The deprivation of our fundamental needs caused by our dysfunction detrimentally impacts our acquisition of self-esteem. It is not lost but hidden, undeveloped, subverted by our negative self-perspectives. The rediscovery and rejuvenation of self-esteem is an essential component of recovery. ReChanneling advocates and utilizes a Wellness Model over the etiology-driven disease or medical model of mental healthcare. The Wellness Model emphasizes the character strengths and virtues that generate the motivation, persistence, and perseverance to function optimally through the substantial alleviation of the symptoms of dysfunction. 

Among the integrative approaches utilized in the reacquisition of self-esteem are:

  • Positive affirmations and CBT. Positive affirmations and the cognitive aspect of cognitive-behavioral therapy are deliberate, repetitious inputs of positive thoughts and behaviors to replace the negative, unhealthy ones habituated by our dysfunction. Practicing repetitive positive affirmations increases activity in the self-processing systems of the cortex, which counteracts the negative input that threatens self-esteem. The behavioral component of CBT involves activities that reinforce the process.
  • Neural restructuring. Our neural network automatically responds to stimuli by transmitting the hormones that sustain and provide us comfort and pleasure. Deliberate repetitious stimuli compel neurons to fire repeatedly causing them to wire together. The more positive input, the more our brain responds. The more repetitions, the quicker and stronger the new connection. Hormonal rewards of comfort and pleasure motivate us to continue the repetitive practice which, in time, reconstruct our brain’s neural pathways. 
  • Mindfulness. The dual components of Mindfulness–awareness and acceptance–identify the occasions and situations we fear and in which we lack confidence, impacting our self-esteem. Clinically proven questionnaires and surveys assist in discovery, and mindfulness exercises and techniques are examined. Practicum activities assiduously address these fears, while introspection and meditation are vigorously recommended for the home environment. 
  • Abhidharma is the ultimate checklist of our relationship to self, others, and the world. The Buddhist psychology of the eightfold path is a profile of the requisites for rational living. Right views, intention, speech, action, livelihood, effort, mindfulness, and concentration have an additional implicit component, that of right choice. Evidence suggests we experience a physiological reaction when choosing to do something irrational or self-detrimental because it conflicts with our inherent awareness of what is beneficial to self and community. Through mindfulness, we learn to recognize this physiological reaction and its impact on our self-esteem. 
  • Positive autobiography helps us focus on our life experiences of achievement, triumphs, and other prideful events and occasions. Our dysfunction sustains itself through irrationality, so we devalue these experiences by disallowing our conscious mind to entertain them. Mindfulness and the Recovered-memory process are especially helpful in unlocking this information. 
  • Positive psychology can be defined as the science of optimal functioning. Its objective is to identify the character strengths and virtues that generate our motivation, persistence, and perseverance to recover. Mindfulness of our attributes generates the psychological, physical, and social wellbeing that buffer against dysfunction. The objective is to achieve our potentials and becoming the best that we can be. Research shows that positive psychology interventions improve overall wellbeing and decrease psychological distress in persons with anxiety, mood, and depressive disorders. Studies support the utilization of positive psychological constructs, theories, and interventions for enhanced understanding of and recovery from our dysfunction. 
  • Recovered memory process is utilized to recall hidden memories and the emotions they embrace. Our dysfunction sustains itself on our irrationality and negative self-perceptions. It encourages us to repress feelings, thoughts, and desires unacceptable to our conscious mind, storing them in the archives of our memory. It is useful to retrieve and address the emotions hidden in these repressed memories. The prideful ones fulfill our Positive autobiography and support Neural restructuring. The unhealthy ones allow us to view them from the multiple perspectives of emotion, decreasing the power of their negativity. Stanislavski developed a method for authentic stage-acting that retrieves and deconstructs our volatile memories and emotions. 

The rediscovery and revitalization of self-esteem is an essential part of recovery and cannot be second-tiered. Due to our dysfunction and subsequent disruption in natural human development, we are subject to significantly lower implicit and explicit self-esteem relative to healthy controls. One-size-fits-all methods are inadequate to a multiple pronged approach. Our recovery practicum incorporates activities such as roleplay, interactive exercises, and games. Clinically proven self-esteem exercises, questionnaires, and scales are utilized. Immersion therapy is ideally practiced in a public environment setting but currently remains in-practicum, postponing public immersion for the duration of the pandemic. Utilizing the platform of methods outlined, we collaboratively create a blueprint that emphasizes our inherent strengths, virtues, and attributes to implement the crucial reacquisition of self-esteem and its positive self-qualities.

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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.

Neural Restructuring, CBT, and Positive Affirmations

When we restructure our neural pathways, there is a correlated change in our behavior and perspective.
  • Our brain contains hundreds-of-billions of nerve cells (neurons) arranged in networks.
  • When neural pathways reshape, there is a correlated change in behavior and perspective.
  • Our brain is not a moral adjudicator, but a mechanical reciprocator. It adapts and correlates to stimuli.
  • Anything destructive to our well-being is irrational and unhealthy.
  • Our brain does differentiate between rational and irrational. Its job is to provide the chemical and electrical maintenance that maintain our vital functions: heartbeat, nervous system, and blood–flow. It tells us when to breathe. It generates our mood, controls our weight and digestion, and so on.
  • A stimulus occurs at every experience: a muscle twitch, a decision, a memory, emotion, reaction, noise, the prick of a needle.
  • Every stimulus causes the receptive neuron to fire, transmitting a message, passed from neuron to neuron until it reaches its destination.
  • Plasticity is the brain’s capacity to change with learning. Learning is a component of everything that happens to a person; it is comprised of infinitesimal moments of experience. Studies in brain plasticity evidence the brain’s ability to change at any age.
  • Our psychological dysfunction or discomfort generates and is sustained by our irrational thoughts and behaviors, impelling us to feed our brain unhealthy stimuli.
  • Our brain is always learning at an accelerated rate. What has been learned can be unlearned. Unhealthy beliefs and behaviors are unlearned, as our brain learns new beliefs and behaviors.
  • The function of cognitive-behavioral restructuring is to supplant irrational thoughts and actions with rational ones. This causes the neural network to restructure. Over time and through repetition, these new thoughts and behaviors become habitual and spontaneous.
  • Deliberate repetitious stimuli compel neurons to fire repeatedly causing them to wire together. The more repetitions the quicker and stronger the new connection.

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The Science of Positive Affirmations. 90% of treatment programs feature cognitive-behavioral therapy. The cognitive aspect is positive affirmations. Practicing repetitive positive affirmations increases activity in the self-processing systems of the cortex, which counteract the negative input that threatens self-esteem. The brain automatically responds by transmitting the hormones that sustain us and provide comfort and pleasure. The more input of positive affirmations, the more our brain responds. These constant feelings of comfort and pleasure then motivate us to continue the repetitive practice of self-affirmations. Positive affirmations must be rational, reasonable, possible, and first-person present time.

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Our brains consist of hundreds-of-billions of nerve cells (neurons) arranged in pathways or networks. Inside each of these neurons, there is electrical activity. Neurons are the core components of our brain and our central nervous system. Our functionality is facilitated by a hugely complex system of synapses, axons, and dendrites working in collaboration with our nerve cells.

Every stimulus we experience causes a 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. Because of our dysfunction, our brain has structured itself around unhealthy feelings, thoughts, and behaviors. It sustains this irrationality by naturally releasing pleasurable chemicals (serotonin, dopamine, norepinephrine). It does not know any better; it responds to our input. 

Science confirms our neural pathways are constantly realigning. Since its onset (adolescence), our dysfunction or discomfort has been feeding our brain irrational thoughts and behaviors. What is irrational? Irrational is anything detrimental to our emotional wellbeing and quality of life. Simply put, it is irrational to hurt ourselves. 

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

Neural restructuring is our brain’s capacity to change with learn­ing; functions performed by our neurotransmitters are learning functions. Our neurons don’t act by themselves but through neural circuits. These circuits strengthen or weaken their connections based on chemical and electrical activity. 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. The purpose of neural restructuring is to replace irrational thoughts and behaviors with healthy ones. Our beliefs and concepts, thoughts, and actions have been learned and practiced from early on. We are conditioned to them. As our brain reciprocates our positive input, our neural network restructures itself accordingly. Over time, through deliberate repetition, healthy, rational thoughts and behaviors become habitual and spontaneous. Why the repetition? When our neurons fire repeatedly, they wire together. The more repetitions. the quicker and stronger the new connection.

fAn essential element in subverting our dysfunction or discomfort is the deliberate restructuring of our neural network.

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Why is your support essential? ReChanneling is dedicated to research and development of methods to mitigate 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.

Video: Social Anxiety Disorder & Relationships

YouTube

This YouTube Video is a brief PowerPoint presentation of social anxiety disorder and its impact on the individual’s emotional wellbeing and quality of life. One of the characteristics of social anxiety disorder, or its appropriate acronym, SAD, is the difficulty in establishing interpersonal relationships. SAD persons find it hard to establish close, personal connections. The avoidance of social activities and fear of rejection limits the potential for comradeship, and the inability to interact rationally and productively makes long-term, healthy relationships difficult.

Social anxiety disorder is arguably the most underrated and misunderstood psychological dysfunction. A debilitating and chronic affliction, SAD affects the perceptual, cognitive, personality, and social activities of the afflicted. It wreaks havoc on the person ‘s emotional wellbeing and quality of life. Almost one out of every three persons in the U. S. experiences some anxiety disorder at some point in their lives; 30 million are impacted by social anxiety disorder.

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Why is your support essential? ReChanneling is dedicated to research and development of methods to mitigate 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.

Embrace Your Dysfunction

We share an intimate and unhealthy relationship with our dysfunction or discomfort that manifests in many ways. Let’s take a look at the most obvious ones non-conducive to recovery.

The tolerant relationship. Simply put, we recognize our condition is detrimental to a healthy and productive lifestyle, but we are too lazy, scared, or lack the moral determination to do anything about it. 

The resigned relationship is borne by our expectation or acceptance of failure. Not only do we accept the problem, but we wish we could something about it. Because we don’t value our worth or ability (often a component of our dysfunction), we convince ourselves any attempt at recovery is futile. We have given up.

The self-pitying relationship is sadder, still. We welcome our unhappiness because we believe we have suffered more than is fair or reasonable. We wallow in our misery because it comforts us and confirms our victimization.

The assimilate relationship. We have become so acclimated to our condition, we adapt to it and absorb the poison into our system. This is the one relationship where we truly become one with our dysfunction.

The denial relationship. Refusing to acknowledge the problem in the irrational hope it doesn’t exist or will go away is a common escape mechanism. Our lie becomes so pervasive we begin to believe it. This drives the truth into our subconscious where it metastasizes, like unchecked cancer. 

The guilt relationship. Guilt is a moral emotion that manifests in response to self-disappointment. It is self-consciously evaluated, meaning no matter the severity of the offense, explicit or otherwise, it is our personal assessment that matters. Until we forgive ourselves, we cannot expect to recover. Forgiveness rids us of the self-indulgent bile of guilt and opens us to possibility. 

The cognitive distorting relationship. Cognitive distortions – common to anxiety, depression, and their comorbidities – are tendencies or patterns that twist our thinking. They are irrational perceptions that influence our emotions and behavior. We are all subject to cognitive distortions but, in their more extreme forms, they are a hindrance to recovery. These are a few of many:

  • Magnification and minimization. Believing our accomplishments are inconsequential, or our mistakes excessively important.
  • Overgeneralization. I made a mistake; therefore, I am a stupid person.
  • Personalization. Taking responsibility for something that is out of our control. It’s my fault my lover drinks excessively.
  • Disqualifying the positive. Dwelling on the negative aspects of a situation and ignoring the positive.
  • Absolutism such as “always,” “never,” or “every.” I never do anything right. Everything I try, fails.

Those are just a few unhelpful and detrimental relationships. Of course, the healthy way to address our dysfunction or discomfort is to do something about it, but how we approach this is important. Most processes ask that we accept it, educate ourselves on its symptoms and impact, then challenge or confront it. Here’s why this is not the most productive approach. 

The confrontation or challenge relationship is not a positive one, but one of hostility and retaliation. Confrontation is, by definition, an act of hostility, sowing discord. When we confront something, we oppose it, assault it, attack it, and threaten it. Our current condition is part of who we are, a component of our current being. In essence, we are expressing hostility against self. 

According to the Diagnostic and Statistical Manual of Mental Disorders, we are deceitful, unempathetic, manipulative, irresponsible, and incompetent. The American Psychological Association labels our condition distressing, irrational, obsessive, compulsive, dissociative, depressive, and exaggerated. 

Fundamental moralists and the ignorant assume we are dishonorable or lack moral fiber. The public view our behavior as bizarre and illogical. The urban dictionary calls us silly and stupid. Adolescents derisively assign the term mental to the unpopular, different, and socially inept. 

No wonder we feel we have to confront it with guns blazing. These negative and hostile aspersions on our character are supported by public opinion, media misrepresentation, and the disease model of mental healthcare. The general perception of the psychologically dysfunctional is a dangerous and unpredictable individual who should be isolated from society. So, our emotions tell us, the only way to fight it is to confront it head-on, a person possessed. 

Our primary objective in recovery is the restructuring of our neural network. Every stimulus we input causes a receptive neuron to fire, transmitting a message from neuron to neuron until it generates a reaction. Our brain is an organic reciprocator. It doesn’t understand our motivation. Maybe we want to confront our dysfunction in order to mitigate its symptoms. Our neural network only gleans the unhealthy input of confrontation. Restructuring requires positive input to compensate for the years of negation. Hostility defeats the purpose. Only a conscious input of healthy thought and behavior reverses the trend. 

By embracing our dysfunction or discomfort, we embrace ourselves. It is an act of love. Love is linked to positive mental and physical health outcomes. Love motivates change far better than hostility. What is there to be ashamed of? A dysfunction or discomfort is a natural component of human development. Think of it as an emotional virus. It is evidence of our humanness. After all, that’s who we are: a human being with a dysfunction. Embracing it does not mean we don’t want to transform to a healthy and more productive environment. It encourages transformation. Self-love is a fundamental component of self-esteem and the value of self-esteem in recovery is immeasurable. 

Embracing is not acquiescence, resignation, or condoning. Acquiescence is accepting our condition and doing nothing to change it. Condoning is accepting it and allowing it to fester. Resignation is defeatism. Embracing is logically accepting ourselves for who we are, which is a person currently dysfunctional or discomforted, but one abounding in ability and potential. Embracing is recognizing our character strengths, virtues, and attributes that facilitate the motivation, persistence, and perseverance to recover. We can never meet our potential until we truly learn to love ourselves. 

Embrace you, know you, love you, then transform you.

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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.

Video: Psychological Dysfunction and Discomfort: Myths and Misinformation

Dr. Mullen discusses the myths and misinformation about mental health supported by the pathographic focus of the disease model of mental healthcare, which is responsible for negative public opinion, media misrepresentation, misdiagnoses, stigma, and overall pessimism of the industry as a whole. The video illustrates the benefits of transitioning to the wellness model, which emphasizes the character strengths and virtues that generate the motivation, persistence, and perseverance to endure and recover.

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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.

Deconstructing ReChanneling

a paradigmatic approach to historically and clinically practical methods

ReChanneling is dedicated to researching methods to alleviate symptoms of psychological dysfunctions (neuroses) and discomfort that impact our emotional wellbeing and quality of life. It does this by targeting the personality through empathy, collaboration, and program integration. ReChanneling is a system of common-sense solutions, evident in their simplicity. It is a paradigmatic approach to historically and clinically practical methods. 

ITS ORIGINS

Affected with social anxiety disorder, ReChanneling’s director spent his developing years assuming his emotional and behavioral problems were due to some moral inadequacy, a diagnosis supported by family, clergy, and even health professionals. Years later, study for his degree revealed social anxiety disorder. Armed with that knowledge, Mullen set forward to develop methods to alleviate the symptoms of dysfunctions and discomforts, beginning with colleagues also afflicted with social anxiety disorder. These efforts developed into workshops and practicums for over 400 individuals in the San Francisco bay area. Recognizing the similarities among psychological dysfunctions, Mullen broadened his research to include the multiple forms of anxiety and depression and their comorbidities, e.g., PTSD, OC-D, substance abuse, self-esteem issues, etc. ReChanneling is the culmination of those efforts. 

Dr. Mullen facilitates seminars and practicums on ReChanneling, Strategizing Your Psychological Dysfunction, and Memory Retrieval and Emotional Recall, as well as workshops focused on specific mental disorders. A published worldwide academic author, he is a philosophy graduate of California Institute of Integral Studies; his dissertation focused on advanced human potential―the capacity to harness the intrinsic aptitude for extraordinary living and the potential to lift the human spirit. Mullen’s academic disciplines include contemporary behavior, modified psychobiography, and method psychology. A former director and teacher of method acting, Mullen incorporates Stanislavski’s emotional retrieval and retention into his programs. 

Psychological dysfunctions and discomforts. Both conditionscan result in functional impairment which interferes with or limits one or more major life activities. Both impact our emotional wellbeing and quality of life. Both are addressed through the same basic processes. The primary distinction between the two is severity. A psychological dysfunction is defined as a mental, behavioral, or emotional disorder of sufficient duration to meet diagnosable criteria. However, the Diagnostic and Statistical Manual of Mental Disorders is prone to rampant misdiagnoses and substantial discrepancies and variations in definition, epidemiology, assessment, and treatment. ReChanneling advocates and supports the Wellness Model over the etiology-driven disease or medical model of mental healthcare. The Wellness Model emphasizes the character strengths and virtues that generate the motivation, persistence, and perseverance to function optimally through the substantial mitigation of symptoms of psychological dysfunction and discomfort. 

While we recognize the value of trauma-based and regression therapies, our focus is on the here-and-now, advocating the Wellness Model’s emphasis on solution over the problem-oriented disease model.

A PARADIGMATIC APPROACH 

The Wellness Model. One of the disadvantages of the etiological perspective is that you focus on the dysfunction over the individual; traditional psychology has abandoned studying the entire human experience in favor of focusing on diagnosis. Evidence suggests that conventional psychiatric diagnoses have outlived their usefulness. The National Institute of Mental Health, for example, is replacing diagnoses with easily understandable descriptions of the issues based on the emerging research data, not on the current symptom-based categories. 

The disease model of mental health focuses on the problem. We become our diagnosis. The Wellness Model emphasizes the solution. A battle is not won by focusing on incompetence and weakness; it is won by knowing and utilizing our strengths, and attributes. That is how we positively function―with pride and self-reliance and determination―with the awareness of what we are capable. 

One-size-fits-all. The single solution approach perpetuated by the disease model of mental health and the American Psychiatric Association is insubstantial. (Almost 90 percent of recovery programs pursue cognitive-behavioral treatments.) One-size-fits-all approaches’ ineffectiveness is evident in their singular focus, which cannot sufficiently address the complexities of human thought and behavior generated by the individual human systems which help determine personality. Personality is how we embrace and express the sum of experiences.

Complementarity is the inherent cooperation of our human system components in maintaining physiological equilibrium. Sustainability-of-life and sustainability of a psychological dysfunction require simultaneous mutual interaction. Recognizing the constant collaboration of our mind, body, spirit, and emotions is crucial to emotional and behavioral oversight. 

A TARGETED APPROACH

Addressing the complexity of the personality demands integrating multiple traditional and non-traditional approaches, developed through client trust, cultural assimilation, and therapeutic innovation. There is no one right way to do or experience growth or recovery. Any evaluation and treatment program must be innovative, fluid, and targeted. Culture, environment, history, and associations in conjunction with social, creative, and intellectual needs and aspirations are necessary components of any successful strategy. Consideration of each determines our value and the efficacy of the program.

A WORKING PLATFORM showing encouraging results for most psychological dysfunctions and discomforts is an integration of positive psychology’s optimum human functioning with CBT’s behavior modification, neuroscience’s network restructuring, and other targeted approaches.

Positive Psychology. The Wellness Model’s chief facilitator is positive psychology, which originated with Maslow’s (1943) seminal text on humanism. Positive psychology focuses on virtues and strengths that help you transform and flourish. Until recently, the focus on optimal functioning’s positive aspects ignored the individual’s holism by neglecting their negative aspects. Positive Psychology 2.0 emphasizes the positive while managing and processing the negative to increase wellbeing. Although it functions best in conjunction with other programs, PP’s mental health interventions have proved successful in mitigating the symptoms of depression, anxiety, and other disorders. Growing research suggests that PP not only improves life outcomes but improves overall health. PP interventions produced significant improvements in emotional wellbeing while also decreasing symptoms of anxiety and depression.

CBT.  Cognitive theory assumes that our dysfunction results from negative, irrational thinking and behavior caused by our ingrained reactions to situations and conditions. CBT trains us to recognize these irrational thoughts and beliefs that sustain our discomfort or dysfunction and replace them with healthy ones until they become automatic and permanent.

The behavioral component of CBT involves activities that reinforce the process. Despite recent criticism, when utilized in concert with other programs, CBT has been proven effective in addressing depression, anxiety, substance abuse, and other disorders. CBT is structured, goal-oriented, and focused on the present and the solution. The repetitive behavioral exercises of CBT and positive affirmations are beneficial in the reconstruction of our brain patterns. 

We acclimate to our condition, and our neural network transmits chemicals and hormones to support it, so it is often difficult to envision a light at the end of the tunnel. 

Neural Restructuring.Science confirms our neural pathways are continually realigning. Our brains do not think or analyze; they are organic reciprocators. The irrational thoughts and behaviors that we feed our brain are neuro-transmitted back to us in the chemicals and hormones that sustain us, creating an unhealthy cycle that affects our entire outlook on life. A conscious input of healthy thought patterns reshapes our neural network to a structure supported by neurotransmitters conducive to dramatically altering our outlook on life. However, it does not happen overnight, which is why we begin the process on day one of recovery. 

SPIRIT

Spirit is defined as those qualities that form the definitive or typical elements in a person’s character. The strength of your spirit corresponds to the depth of your self-esteem, which administrates our self-qualities, i.e., self -compassion, -love, -regard, -respect, -worth, and other wholesome attributes. 

Healthy Philautia. The loss of self-esteem is due to the disruption in our natural human development caused by childhood physical, emotional, or sexual disturbance. This disturbance impacts satisfaction of three basic human needs: physiological, safety, and belongingness and love. That lacuna hinders the development of our self-qualities essential to our emotional and physiological development. Healthy philautia is the polar opposite of narcissism–the self-appreciation that recognizes we are consequential and worthy of love. Healthy philautia serves as a focused revitalization tool for self-esteem. 

Abhidharma is mindfulnessofthe eightfold path that leads to emotional wellbeing and quality of life. Essential to that is the implicit ninth path, which supersedes the others: making the right choice when our humanness leads us to behaviors that aggravate our discomfort and dysfunction. Challenging this irrationality is essential to reinvigoration and recovery. 

EMOTIONS 

Emotions are associated with mood, temperament, personality, disposition, and motivation. Do they dictate our behavior, or are we able to manage their volatility? Rather than succumbing to emotional instability, awareness of the origins of emotional instability prevents reactionary outbursts and inconsistency due to lack of foresight, empathy, and perspective. 

Recovered-memory process is the umbrella term for methods or techniques utilized in recalling memories. We repress certain feelings, thoughts, and desires unacceptable to the conscious mind and store them in the archives of our memory. It is helpful to retrieve and address the emotions felt in those repressed memories that once flashed by like a meteor. Stanislavski developed a method for authentic stage-acting that addresses our volatile emotions to deconstruct and better understand them. 

Affective Emotion Management. Emotions are not solitary and exclusive but fluid and mutually interconnected, although we allow one to dominate the others. Love and hate are indistinct and interchangeable extremes of the same instinct as are laughter and tears, resentment and acceptance, and so on. The ability of the film actor to project an emotion when script and scheduling demands it, demonstrates they are controllable. Any situation can be experienced though laughter, tears, pride, or anger. We choose the one that suits a psychological need, which exposes its transience and manipulability. Utilizing Stanislavski’s method of emotional management, we assume control of our emotions, rather than allowing them to control us,

PRACTICUM VERSUS THERAPY

ReChanneling is practicum over therapy. A practicum is designed for self-reliance. While therapy often incurs a subordinacy to or dependency on the counselor, a practicum is a program developed in collaboration with the individual that targets her or his unique condition. We design a blueprint and provide the recovery methods, but the responsibility for achieving the goal rests on the individual, who controls the progress with the facilitator’s guidance.

SIMPLE CONCEPTS, CHALLENGING EXECUTION. 

The solutions are common-sense and evident in their simplicity. ReChanneling is not a new concept; it is a paradigmatic approach to historically or clinically effective methods. Its holistic advancement is in targeting the personality through empathy, collaboration, and program integration. Developing the methodology is the easy part. The challenge is in its execution. While progress is exponential, goals are not met overnight. Human development is an ongoing process. For example, neural network restructuring begins immediately, but estimates suggest it may take up to a year for significant rebuilding restructure significantly. That may seem like a long time but remember, your dysfunction has likely impacted you since childhood. Recovery is a lifelong work-in-progress.

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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.

Dysfunction is Evidence of Our Humanness.

Simultaneous mutual interaction of all human system components is required for sustainability of life and sustainability of dysfunction or discomfort.

There is a joke that circulates among mental health professionals. Why do only 26% of people have a diagnosable mental disorder? . . . Because the other 74% haven’t been diagnosed yet.

We are all psychologically dysfunctional in some way. “Mental illnesses are so common that almost everyone will develop at least one diagnosable mental disorder at some point in their life” (Scientific American). 

Why do we treat the mentally ill with contempt, trepidation, and ridicule? We are hard-wired to fear and isolate mental illness, and we have been misinformed by history and the disease model of mental health. There are four common misconceptions about psychological dysfunctions. They are (1) abnormal and selective, (2) a consequence of behavior, (3) solely mental, and (4) psychotic. 

Let us deconstruct these misconceptions, beginning with the latter.

A dysfunctional person is psychotic.

There are two degrees of mental disorder: neuroses and psychoses. When someone sees, hears, or responds to things that are not actual, they are having a psychotic episode. While few persons experience psychosis, everyone has moderate-and-above levels of anxiety, stress, and depression. We are universally neurotic. Since the overwhelming majority of mental disorders are neuroses, we are all dysfunctional to some extent.

A dysfunction is abnormal or selective. 

A neurosis is a condition that negatively impacts our emotional wellbeing and quality of life but does not necessarily impair or interfere with normal day-to-day functions. It is a standard part of natural human development. One-in-four individuals have a diagnosable neurosis. According to the World Health Organization, nearly two-thirds of people who have a neurosis reject or refuse to disclose their condition. Include those who dispute or chose to remain oblivious to their dysfunction, we can conclude that mental disorders are common, undiscriminating, and impact us all in some fashion or another. Many of us have more than one disorder; depression and anxiety are commonly comorbid, often accompanied by substance abuse. 

A dysfunction is the consequence of a person’s behavior. 

Combined statistics prove that 89% of neuroses onset at adolescence or earlier. In the rare event conditions like PTSD or clinical narcissism begin later in life, the susceptibility originates in childhood. Most psychologists agree that a neurosis is a consequence of childhood physical, emotional, or sexual disturbance. Any number of things can cause this. Perhaps parents are controlling or do not provide emotional validation. Maybe the child is subjected to bullying or from a broken home. Behaviors later in life may impact the severity but are not responsible for the neurosis itself. It is never the child’s fault, nor reflective of their behavior. There is the likelihood no one is intentionally responsible. This disputes moral models that we are to blame for our disorder, or it is God’s punishment for sin.  

A dysfunction is solely mental.

To early civilizations, mental illness was the domain of supernatural forces and demonic possession. Hippocrates and diagnosticians of the 19th century looked at the relative proportions of bodily fluids. Lunar influence, sorcery, and witchcraft are timeless culprits. In the early 20th century, it was somatogenic. The biological approach argues that neuroses are related to the brain’s physical functioning, while pharmacology promotes it as chemical or hormonal imbalance. However, the simultaneous mutual interaction of all human system components—mind, body, spirit, and emotions—is required for sustainability and recovery.

The disease model focuses on the history of deficit behavior. The American Psychiatric Association’s (APA) brief definition of neurosis contains the following words: distressing, irrational, obsessive, compulsive, dissociative, depressive, exaggerated, unconscious, and conflicts. The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the APA, uses words like incapable, deceitful, unempathetic, manipulative, difficult, irresponsible, and incompetent. 

This ‘defective’ emphasis has been the overriding psychiatric perspective for over a century. The disease model is the chief proponent of the notion that the mentally ill are dangerous and unpredictable. We distance ourselves and deem them socially undesirable. We stigmatize them. The irony is, we are them. 

  • Over one-third of family members hide their relationship with their dysfunctional child or sibling to avoid bringing shame to the family. They are considered family undesirable, a devaluation potentially more life-limiting and disabling than the neurosis itself. 
  • The media stereotypes neurotics as homicidal schizophrenics, impassive childlike prodigies, or hair-brained free-spirits. One study evidenced over half of U.S. news stories involving the dysfunctional allude to violence. 
  • Psychologists argue that more persons would seek treatment if psychiatric services were less stigmatizing. There are complaints of rude or dismissive staff, coercive measures, excessive wait times, paternalistic or demeaning attitudes, pointless treatment programs, drugs with undesirable side-effects, stigmatizing language, and general therapeutic pessimism. 
  • The disease model supports doctor-patient power dominance. Clinicians deal with 31 similar and comorbid disorders, 400 plus schools of psychotherapy, multiple treatment programs, and an evolving plethora of medications. They cannot grasp the personal impact of a neurosis because they are too focused on the diagnosis. 

A recent study of 289 clients in 67 clinics found that 76.4% were misdiagnosed. An anxiety clinic reported over 90% of clients with generalized anxiety were incorrectly diagnosed. Experts cite the difficulty in distinguishing different disorders or identifying specific etiological risk factors due to the DSM’s failing reliability statistics. Even mainstream medical authorities have begun to criticize the validity and humanity of conventional psychiatric diagnoses. The National Institute of Mental Health believes traditional psychiatric diagnoses have outlived their usefulness and suggests replacing them with easily understandable descriptions of the issues. 

Because of the disease model’s emphasis on diagnosis, we focus on the dysfunction rather than the individual. Which disorder do we find most annoying or repulsive? What behaviors contribute to the condition? How progressive is it, and how effective are treatments? Is it contagious? We derisively label the obvious dysfunctional ‘a mental case.’

Realistically, we cannot eliminate the word ‘mental’ from the culture. Unfortunately, its negative perspectives and implications promulgate perceptions of incompetence, ineptitude, and unlovability. Stigma, the hostile expression of someone’s undesirability, is pervasive and destructive. Stigmatization is deliberate, proactive, and distinguishable by pathographic overtones intended to shame and isolate. 90% of persons diagnosed with a mental disorder claim they have been impacted by mental health stigma. Disclosure jeopardizes livelihoods, relationships, social standing, housing, and quality of life. 

The disease model assumes that emotional distress is merely symptomatic of biological illness. The Wellness Model focuses on the positive aspects of human functioning that promote our wellbeing and recognize our essential and shared humanity. The Wellness Model emphasizes what is right with us, innately powerful within us, our potential, and determination. Recovery is not achieved by focusing on incompetence and weakness; it is achieved by embracing and utilizing our inherent strengths and abilities. 

Benefits of the Wellness Model

  • Revising negative and hostile language will encourage new positive perspectives
  • The self-denigrating aspects of shame will dissipate, and stigma becomes less threatening. 
  • A doctor-client knowledge exchange will value the individual over the diagnosis.
  • Realizing neurosis is a natural part of human development will generate social acceptance and accommodation. 
  • Recognizing that they bear no responsibility for onset will revise public opinion that  people deserve their neurosis because it is the result of their behavior. 
  • Emphasizing character strengths and virtues will positively impact self-beliefs and image, leading to more disclosure, discussion, and recovery-remission. 
  • Realizing proximity and susceptibility will address the desire to distance and isolate. 
  • Emphasis on value and potential will encourage accountability and foster self-reliance.

The impact of a neurosis begins at childhood; recovery is a long-term commitment. The Wellness Model creates the blueprint and then guides, teaches, and supports throughout the recovery process by emphasizing our intrinsic character strengths and attributes that generate the motivation, persistence, and perseverance to recover. 

The adage, treat others as you want to be treated, takes on added relevance when we accept that we all experience mental disorder. In fact, dysfunction is evidence of our humanness.

A referenced copy of this article is available: rechanneling@yahoo.com.

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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.

Dysfunction in the LGBTQ Community

The LBGTQ+ community is 1.5-2.5 times more likely to have anxiety and depression

Establishing a Wellness Model for LGBTQ+ Persons with a Psychological Dysfunction

Abstract. Firmly establishing wellness models in mental health requires nothing less than a reformation of language, power structure, and perspective throughout the mental healthcare community and beyond. 

65 million U.S. adults and 18.5 million adolescents have major depression and anxiety. Estimates show that 60% of those with anxiety also have depression symptoms, and both are comorbid with substance abuse. The LBGTQ+ community is 1.5-2.5 times more likely to have anxiety and depression than their straight or gender-conforming counterparts. Similar numbers hold for LGBTQ+ persons with other mental and emotional disorders. Anxiety and depression are primary causes of the 56% increase in adolescent suicide over the last decade. High school LGBTQ+ students are almost five times as likely to attempt suicide than their heterosexual peers, and 40% of transgender adults have attempted suicide in their lifetime.

Wellness must become the central focus of mental health because the disease model has provided grossly unsatisfactory results. Rather than obsessing on disease and deficits, wellness models emphasize the character strengths and virtues that generate motivation, persistence, and perseverance essential to recovery. Psychological science is there, but it needs positive implementation through program integration, positive evaluation, transparency, and information management. Empathy and communication must supersede etiology and misdiagnosis. 

Wellness impacts more than mental health; it is a paradigmatic perspective that seeks to promote a state of complete physical, mental, and social well-being. This paper will show how the wellness model’s sociological emphasis on character strengths and attributes not only positively impacts the self-beliefs and image of a mentally ill person but resonates in sexual and gender-based identities and portends well, the recovery-remission of an LGBTQ+ person with a mental illness.  

Introduction

To illustrate the wellness model’s potential impact, this paper focuses on LGBTQ+ persons with anxiety and depression disorders, which comprise 42% of diagnosable dysfunctions in the current Diagnostic and Statistical Manual of Mental Disorders (DSM). It posits what is learned can be applied to the remaining 58% of mental disorders that impact an LGBTQ+ person’s emotional wellbeing and quality of life. “There is an urgent need to develop and disseminate tailored evidence-based interventions that improve the health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. (Wilkerson et al., 2016, p. 358). 

Depression and anxiety are the two most common forms of mental dysfunction impacting millions of U.S. adults who find themselves caught up in a densely interconnected network of fear and avoidance of social situations. Johns Hopkins (2020) reports that around 25 million U.S. adults have a depressive illness, and 45 million, anxiety. Adolescent numbers fluctuate between 8 and 18 million (CDC, 2020; NIMH, 2017); the actual number indeterminate. Statistics are even less reliable for the LGBTQ+ community because large-scale mental health studies rarely include sexual and gender identity (NAMI, 2020b). “Federally funded surveys only recently have begun to identify sexual minorities in their data collections” (Medley et al., 2020, p. 1). Experts estimate the infection rate in the LBGTQ+ community is 1.5 to 2.5 times higher “than that of their straight or gender-conforming counterparts” (Brenner, 2019, p. 1).

Depressive illnesses tend to co-occur with anxiety and substance abuse (Johns Hopkins, 2020). “Some estimates show that 60% of those with anxiety will also have symptoms of depression, and the numbers are similar for those with depression also experiencing anxiety” (Salcedo, 2018, p. 1). Anxiety and depression are primary causes of the 56% increase in adolescent suicide over the last decade (Curtin & Heron, 2019). “High school students who identify as lesbian, gay or bisexual are almost five times as likely to attempt suicide compared to their heterosexual peers,” and “40% of transgender adults have attempted suicide in their lifetime” (NAMI, 2020b, p. 1). 

Anxiety is the most common mental dysfunctions, impacting the emotional wellbeing and quality of life of adults and children who find themselves caught up in a densely interconnected network of fear, worry, and apprehension. The psychological and sociological toll can be overwhelming. Physically, anxiety can cause sweating, trembling, fatigue, and rapid heartbeat, lower the immune system and increase the risk of heart disease risk. Persons with depression may experience a lack of interest and enjoyment of daily activities, significant weight fluctuation, insomnia or excessive sleeping, enervation, inability to concentrate, feelings of worthlessness, guilt, and recurrent thoughts of death or suicide. Anxious and depressed persons frequently generate images of themselves performing poorly in social situations (Hirsch & Clark, 2004; Hulme et al., 2012) for fear of being found out as unlikeable, stupid, or annoying. Accordingly, they avoid speaking in public, expressing opinions, or even fraternizing with peers. Symptoms can be repressive and intractable, imposing irrational thought and behavior (Richards, 2014; Zimmerman et al., 2010) that govern perspectives of personal attractiveness, intelligence, and competence (Ades & Dias, 2013). Over time, these self-beliefs become automatic negative thoughts (Amen, 1998) that determine initial reactions to situations or circumstances. 

Mental Health and LGBTQ+ Culture

Halloran and Kashima (2006) define culture as “an interrelated set of values, tools, and practices that is shared among a group of people who possess a common social identity” (p. 140). Culture impacts,

how mental illness is perceived or diagnosed, how services are organized and how they’re funded. It also affects how patients express their symptoms…and how they cope in the range of their community and family supports. (Daw, 2001, p. 1)

Studies and research indicate that mental health culture is underscored by the same interrelated attributions to mental health stigma: public opinion, media representation, family rejection, distancing, and the diagnosis itself. These attributions are similarly LGBTQ+ cultural influences along with heterosexualism and victimization. Both are impacted by history, while the disease model remains the primary contributor to mental health culture.   

LGBTQ+ culture is defined by its sexual and gender identity as distinct from the heterosexual and cisgender community (NAMI, 2020b). Subcultures within the community comprise “a diverse set of groups, including distinct groups based on sexual orientation and gender identity” (Lewis et al., 2017, p. 861), each struggling to develop their recognition. LGBTQ+’s social identity is shaped by oppression and its role in overcoming it. The community faces “numerous challenges and instances of heterosexism and homophobia in their daily lives” (UW-Madison, 2020, p. 1), including “discrimination, prejudice, denial of civil and human rights, harassment, and family rejection” (NAMI, 2020b, p. 1). The contrast in social culture is underscored by 26 countries with legalized same-sex marriage versus 73 countries where homosexual activity between consenting adults is illegal (Equaldex, 2020) and 8 countries where it is punishable by death (ILGA, 2019). LGBTQ+ people worldwide are confronted by “violence, arbitrary arrest, imprisonment, torture, and execution, according to Amnesty International” (WEF, 2018, p. 1). Because of this cultural disparity, this paper limits its focus to LGBTQ+ mental health issues in the United States. 

Transition

Working within a wellness model of mental health has become a central focus of international policy (Slade, 2010). As psychologist Kinderman (2014) writes, “we need wholesale and radical change, not only in how we understand mental health problems but also in how we design and commission mental health services” (p. 1). Decades of pathographic focus in psychological research and studies, negative diagnostic attributions, stereotyping and stigma, public and institution resistance, and a doctor-client power dominance factor in the need to transition to a wellness paradigm.

Firmly establishing wellness models in mental health requires nothing less than a reformation of language, power structure, and perspective throughout the mental healthcare community and beyond. Rather than obsessing on disease and deficits, wellness models emphasize the character strengths and virtues that generate motivation, persistence, and perseverance to recovery. Psychological science is there but needs implementation through program integration, positive evaluation, transparency, and information management. Empathy and communication must supersede etiology. This paper does not endorse a total dissolution of medical model approaches, but a review of their efficacy and the psychological effectiveness of their pathographic dominance is highly warranted. 

Redefining Mental Health

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” (Salzer et al., 2018, p. 3). This ‘defective’ emphasis has been the overriding psychiatric perspective for centuries. 

The pathographic or disease perspective of diagnosis and recovery focuses on the history of an individual’s suffering to facilitate diagnosis. Schioldann (2003, p. 303) defines pathography as a

historical biography from a medical, psychological, and psychiatric viewpoint. It analyses a single individual’s biological heredity, development, personality, life history and mental and physical pathology, within the socio-cultural context of his/her time, in order to evaluate the impact of these factors upon his/her decision-making, performance and achievements. (Kőváry, 2011, p. 742)

One only needs the American Psychological Association’s (APA, 2020) 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. DSM-3 abandoned the word ‘neurosis’ in 1980, but it remains the go-to term in the mental health community. Coined by a Scottish physician in 1776, neurosis defined itself as functional derangement of the nervous system. Pathography focuses “on a deficit, disease model of human behaviour,” whereas the wellness model focuses “on positive aspects of human functioning” (Mayer & May, 2019, p. 159). 

Studies and researchportray the mental healthcare community drowning in pessimism (Henderson et al., 2014; Khesht-Masjedi et al., 2017; Pryor et al., 2009). “There is evidence to indicate the problem may be endemic in the medical health community” (Gray, 2002, p. 3), and universally systemic (Knaak et al., 2017). Noted psychologist Alison Gray (2002) argues that more disordered persons would seek treatment if psychiatric services were less stigmatized and stigmatizing. Patients commonly report instances where a staff member was inordinately rude or dismissive. They cite coercive measures, excessive wait times, paternalistic or demeaning attitudes, treatment programs revolving around drugs with undesirable side-effects, stigmatizing language, and general therapeutic pessimism (Henderson et al., 2014; Huggett et al., 2018). Clients with more severe complications or illnesses are often deemed “difficult, manipulative, and less deserving of care” (Knaak et al., 2017, p. 2). Nurses and clinicians cite a lack of collegial support, insufficient knowledge and training, and the fear of client self-harm (Henderson et al., 2014), leading them to over-diagnose and over-prescribe (Huggett et al., 2018).

Transitioning from the disease model’s pathographic language to the optimistic and encouraging language of wellness models is everyone’s responsibility in the mental health community―its institutions, associations, practitioners, researchers, media, and clients. In the growing opinion of clinical psychologists, empathy and communication must take precedence over etiology. 

We must move away from the disease model, which assumes that emotional distress is merely symptomatic of biological illness, and instead embrace a model of mental health and well-being that recognizes our essential and shared humanity. Our mental health is largely dependent on our understanding of the world and our thoughts about ourselves, other people, the future and the world. (Kinderman, 2014, p. 3

Language and Perspective

Language generates and supports perspective, and linguists agree that the relationship between language and power is mutual (Ng & Deng, 2017). Language influences thought and action. Terms like incapacity, deceit, unempathetic, manipulative, and irresponsible describe DSM-5 traits for various disorders. The argument is not that these descriptions are invalid; they are overwhelmingly negative and perceptually hostile. Judging by public opinion, media representation, and mental health stereotype and stigma, these words help frame the perception of a person with a mental disorder (DeMare, 2016; Pinfold et al., 2005; Pryor et al., 2009).

Realistically, we cannot eliminate the word ‘mental’ from the culture. The disease model’s guide for 70 years is called the Diagnostic and Statistical Manual of Mental Disorders. Unfortunately, the word ‘mental’ is a limited description of a disorder, and its negative implications support perceptions of incompetence, unworthiness, and undesirability. It is the dominant source of stigma, shame, and self-denigration. Psychologically, the word mental defines a person or their behavior as somehow extreme or illogical. Adolescents derisively assign the term to the unpopular, different, and socially inept. The urban dictionary defines mental as someone silly or stupid. 

Hostile and demeaning language is pervasive throughout mental healthcare promulgated by the disease or medical model’s pathographic undercurrent. This perspective influences public opinion, study and research, media representation, the doctor-patient power structure, community interrelationships, and client self-beliefs and image. Transitioning from the disease model to wellness models requires constructing a more reasonable mental health perspective by addressing misunderstanding, misinformation, and the overriding focus of the disease model on diagnosis, disorder, deficit, and denigration. 

Misinformation is generated by the psychological community’s difficulty finding agreement due to changing criteria, “substantial discrepancies and variation in definition, epidemiology, assessment, and treatment” (Nagata et al., 2015, p. 724), and the intractability of the American Psychiatric Association. There are four common misconceptions about mental disorders. They are (1) abnormal and selective, (2) a consequence of behavior, (3) solely mental, and (4) psychotic. These are corrected by the universality, age of onset, and complementarity of mental illness and clearly differentiating psychosis from neurosis. 

Universality. 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” (Reuben & Schaefer, 2017, p. 1). It is a standard part of natural human development. One-in-four individuals have a diagnosable mental disorder. According to the World Health Organization, nearly two-thirds of people who believe they have a mental disorder reject or refuse to disclose their condition. Include those who dispute or chose to remain oblivious to their dysfunction, and we can conclude that mental disorders are common, undiscriminating, and universally impacting. 

Age of Onset. The onset of a disorder is a consequence of early psychophysiological disturbance, according to Mayoclinic (2019). Perhaps parental behaviors are overprotective or controlling or do not provide emotional validation (Cuncic, 2018). The receptive juvenile might be the product of bullying, abuse, or a broken home. “LGBT youths experience greater stressors from childhood into early adulthood, such as child abuse and unstable housing, that exacerbate mental health problems” (Mustanski et al., 2016, p. 527). LGBTQ+ youth experience disproportionately high rates of verbal and physical harassment and other types of peer victimization (Berlan et al., 2010; Reisner et al., 2015). “Gender minority youth had approximately four-fold higher odds of experiencing any bullying or harassment in the past year” (Reisner et al., 2015, pp. 35-36).

Childhood/adolescent exploitation or abuse are generic terms to describe a broad spectrum of experiences that interfere with a youth’s optimal physical, cognitive, emotional, and social development (Steele, 1995). Any number of situations or events can trigger the susceptibility to onset; it could be hereditary, environmental, or some traumatic experience (Mayoclinic, 2019; NIH, 2019). Statistically, the LGBTQ+ community is at “a higher risk than their heterosexual counterparts for traumatic life experiences such as childhood physical, psychological, and sexual abuse” (Bandermann, 2014, p. 3).

Despite the implication of intentionality in the words’ abuse’ and ‘exploitation,’ a toddler might sense abandonment and develop emotional issues when a parent is preoccupied (Lancer, 2019). The child/adolescent is not accountable for their dysfunction; there is the likelihood no one is intentionally responsible. Similarly, with the scientific affirmation that, while sexual and gender-based identities may have a genetic or biological basis, they are not chosen, and the LGBTQ+ person is not accountable; unlike mental illness, there is no implicit or explicit responsible party.

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” (Corrigan 2006, p. 53), and sexual and gender-based orientation is a choice.

Complementarity. To early civilizations, mental illness was the domain of supernatural forces and demonic possession. Hippocrates and diagnosticians of the 19th century looked at the relative proportions of bodily fluids. Lunar influence, sorcery, and witchcraft are timeless culprits. In the early 20th century, it was somatogenic. The biological approach argues that neuroses are related to the brain’s physical functioning (McLeod, 2018), while pharmacology promotes it as chemical or hormonal imbalance. Carl Roger’s study of 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. The simultaneous mutual interaction of all human system components—mind, body, spirit, and emotions—is required to sustain and recover from a mental dysfunction. The same mutual interaction is evident in sexual and gender-based identities as it is in all persons.

Psychosis and Neurosis. There are two degrees of mental disorder: neuroses and psychoses. When someone sees, hears, or responds to things that are not actual, they are having a psychotic episode. While few persons experience psychosis, everyone has moderate-and-above levels of anxiety, stress, and depression. A neurosis is a condition that negatively impacts our emotional wellbeing and quality of life but does not necessarily impair or interfere with normal day-to-day functions. Since the overwhelming majority of mental disorders are neuroses, humans are all dysfunctional to some extent. 

“Language reveals power, reflects power, maintains existing dominance, unites and divides . . . and creates influence.” (Ng & Deng, 2017, p. 15). The similar impact of the wellness model on the mentally ill and the LGBTQ+ person is evident. Revising negative and hostile language to embrace a positive dialogue of encouragement and appreciation generates new perspectives that positively contribute to self-beliefs and image, leading to more disclosure, discussion, and, in the case of mental illness, recovery-remission. The self-denigrating aspects of shame should dissipate; stigma becomes less threatening. 

Accepting that mental illness and sexual and gender-based identities are ubiquitous and non-discriminating should make it easier to embrace the subject within the family structure. Realizing their proximity and general susceptibility should mitigate the desire to distance and isolate. Accepting their social pervasiveness should alleviate the prejudice, ignorance, and discrimination attached to mental illness (Khesht-Masjedi et al., 2017; Pescosolido, 2013; Pinfold et al., 2005; Wood & Irons, 2017), as well as sexual and gender-based identities (Adamczyk & Liao, 2018; Dodge et al., 2016; Lewis et al., 2017). Recognizing that neither the mentally ill nor the LGBTQ+ person is accountable disputes the belief that they are weak or amoral and their condition a reflection of behavior. (Condition is herein defined as the state of something with regard to its quality.)

Resistance to Recovery-Remission

The term stigma-avoidance defines those who fear that public disclosure could, potentially, stigmatize and discredit them. Statistics from the National Bureau of Economic Research “find that survey respondents under-report mental health conditions 36% of the time when asked about diagnosis” (Bharadwaj et al., 2017, p. 3). A recent study by Salzer et al. (2018) reveals that only one-third of disordered persons were in recovery-remission in 2017. The lower recovery-remission rates may be partly due to the inability to afford treatment due to anxiety-induced financial and employment instability (Gregory et al., 2018). More than 70% of social anxiety disorder patients, for example, are in the lowest economic group (Nardi, 2003).

The LGBTQ+ community’s resistance to disclose a mental disorder, seek treatment, or accept diagnosis is due to the same attributions that underscore general reticence: stigmatization, victimization, public opinion, media representation, family rejection, and the diagnosis itself. 

Stigmatization 

Mental health stigma is the hostile expression of the abject undesirability of the afflicted. 90% of survey respondents with a mental disorder claim they have been impacted by mental health stigma (NAMI 2020a). Stigmatization is deliberate and proactive, distinguishable by pathographic overtones intended to shame and isolate (Pryor et al., 2009). Disclosure of a mental disorder jeopardizes livelihoods, relationships, social standing, housing, and quality of life (Huggett et al., 2018; Pinfold et al., 2005; Sowislo et al., 2016; Wood & Irons, 2017). “The deleterious effects of stigma and prejudice on the health of sexual minority individuals have been well-documented across both physiological and psychological domains” (Dodge et al., 2016, p. 1). 

For LGBTQ youth, the minority stress theory posits that their health is affected by the degree to which their social environment stigmatizes sexual and gender minorities and the extent to which LGBTQ+ youth in these environments are expected to hide their nonconformity. (Wilkerson et al., 2016, p. 359)

Mental health stigma is expressed within three categories:

  • Tribal stigma devalues.
  • Moral character stigma implies amorality and weakness.
  • Abominations of the body stigma refers to physical deformity or disease (Pryor et al., 2009).

Mental disorder occupies the last two categories. Ignorance equates a mental disorder with weakness or contributing behavior, while the medical model focuses on the disease and deformity aspect. LGBTQ+ persons share the added onus that their sexual and gender-based identity is socially and culturally tribal.

Victimization

“Community-based samples of LGBT youths have shown that as many as 30% may experience psychological distress at clinically significant levels” (Mustanski et al., 2016, p. 527). A study of the effects of cumulative victimization on LGBTQ+ youth’s mental health found that they “experience greater mental health problems, such as depression, anxiety, suicide attempts, and posttraumatic stress disorder (PTSD) . . . than do heterosexual and cisgender individuals” (Mustanski et al., 2016, p. 527). Contributors include internalized homophobia, stigma consciousness, identity concealment, and experiences of heterosexism and victimization. (Heterosexism is the sociological term for discrimination or prejudice against gay people by heterosexuals who assume heterosexuality is the normal sexual orientation). Sexual and gender-identity minorities are disproportionally subject to bullying, harassment, and other peer victimization (Berlan et al., 2010; Reisner et al., 2015). The LGBTQ+ community is “one of the most targeted communities by perpetrators of hate crimes in the country” (NAMI, 2020b, p. 1). 

Because of the greater risk of victimization in LGBT individuals compared with heterosexuals starting as early as adolescence, research is needed that examines how trajectories of sexual orientation-based victimization across development influence the risk for mental health problems for LGBT people. (Mustanski et al., 2016, p. 528)

Public Opinion 

Although recognition, attributions, and service use may reflect prejudice associated with mental illness, the heart of stigma lies in social acceptance” (Pescosolido, 2013, p. 8). The image of the dangerous, unpredictable, mentally ill person is still widely endorsed by the public (Corrigan & Watson, 2002; Pinfold et al., 2005). Stuart and Arboleda-Flórez (2012) analysis of two surveys (1990/2006) on public perception found, “between 80-100 percent of respondents . . . favoured involuntary hospitalization for that disorder when they thought that violence was an issue” (p. 7). 

Attitudes toward sexual and gender-based identity became substantially more accepting between the 1970s, the most significant shift among 18- to 29-year-olds (Adamczyk & Liao, 2018; Dodge et al., 2016). “It is clear that Americans have become more accepting of same-sex sexual behavior and relationships, but it is unclear how universal those changes are and whether they are due to age, time period, or cohort” (Twenge et al., 2016, p. 10).

Persons tend to be more supportive, in part, “because gay men and lesbians are then seen as less responsible for their orientation” (Adamczyk & Liao, 2018, p. 4). An overwhelming share (92%) of the U.S. LGBTQ+ community believe “society has become more accepting of them in the past decade and expect it to grow even more accepting in the decade ahead” (Pew, 2020, p 1). However, many rights and benefits afforded to LGBTQ+ individuals depend on region, race and ethnicity, political persuasion, educational attainment, economics, and religiosity (Adamczyk & Liao, 2018; Dodge et al., 2016; UW-Madison, 2020). Religion is strongly associated with negative beliefs about the justifiability of LGBTQ+ “sexual behavior and marriage” (Twenge et al., 2016, p. 8). The degree of intolerance is denominational and subject to frequency of attendance. Jews and moderate-to-liberal protestants are more tolerant than Baptists, fundamentalists, and Catholics (Adamczyk & Liao, 2018; Schnabel, 2016). The Pew (2020) study shows that 29% of LGBTQ+ persons have felt unwelcome in a place of worship;

Heterosexual women consistently demonstrate more positive attitudes toward sexual and gender minority groups than heterosexual men who are “traditionally expected to more rigidly conform to gender explicitly heteronormative norms and stereotypes” (Dodge et al., 2016, p. 4). Attitudes toward lesbians and gay men are significantly more positive than attitudes toward transgender people (Adamcyzk & Liao, 2018; Lewis et al., 2017), whereas “bisexual individuals commonly report experiencing stigma, prejudice, and discrimination from both heterosexual and gay/lesbian individuals” (Dodge et al., 2016, p. 1).

Education and interpersonal contact mitigate prejudicial attitudes and behaviors towards both the mentally disordered and LGBTQ+ individuals. Contact-based education has emerged as the most influential factor in public attitude and behavior towards people with mental health problems (Pinfold et al., 2005; Corrigan, 2006). “Multiple studies have found that knowing someone who is LGBTQ+ is associated with more supportive attitudes” (Adamczyk & Liao, 2018, p. 10), and “may increase knowledge, reduce anxiety, and increase empathy” (Lewis et al., 2017, p. 862). This benefit has not crossed over to transgender people, likely, because “personal contact is relatively small” (Lewis et al., 2017 p. 871).

According to the Pew Research Center (Pew, 2020), 30% of the LGBTQ+ community reported they have been threatened or physically attacked, 21% treated unfairly by an employer, and 58% the target of slurs or jokes. Heterosexism inflicts itself on individual, familial, institutional, employment, political, and cultural levels, and openly occurs in educational, career, religious, and social settings (Bandermann, 2014; Lewis et al., 2017). 

While public opinion has drastically improved for the LGBTQ+ community, the perception of the dangerous and unpredictable mentally disordered person who should be isolated has not changed substantially in decades (Stuart & Arboleta-Flórez, 2012). A primary goal of wellness models is mitigating mental health stigma by changing the public perspective. 

Media Representation 

A 2011 study revealed that nearly half of U.S. media stories on mental illness mention or allude to violence (Pescosolido, 2013). News and social media, propelled by far-right politics, fundamentalism, and other fringe organizations, contribute to discrimination and prejudice. Analysis of film, television, and tabloid presentations identify three common misconceptions: people with mental illness are homicidal maniacs, they have childlike perceptions of the world that should be marveled, or they are rebellious, free spirits (Corrigan, 2006). Portrayals of sexual and gender-based identity in the latter half of the 20th century were, generally, stereotypical exaggerations. “Beginning in the 1990s, some highly likable gay and lesbian television and media characters began to appear in the media” (Adamczyk & Liao, 2018, p. 10). Still, there is an abundance of gay-themed portrayals designed to arouse feelings of shock, betrayal, and titillation. Media coverage commonly promotes images that negatively impact the self-beliefs and image of LGBTQ+ and mentally ill persons. 

Family Rejection

Family-stigmatization is the rejection of an LGBTQ+ or mentally dysfunctional child or sibling. A 2008 literature review found around 38% of family members “attempt to hide their relationship in order to avoid bringing shame to the family” (Stuart a& Arboleda-Flórez, 2012, p. 8). Another study showed that 34% of LGBTQ+ persons reported rejection by family members, 49% reported unfair treatment, and “52% were subject to anti-gay remarks from family members” (Bandermann, 2014, p. 3). The implication of familial undesirability impacts a mentally disordered and LGBTQ+ person’s sense of positive self, a devaluation more potentially “life limiting, and disabling than the illness itself” (Stuart & Arboleda-Flórez, 2012, p. 3). “The difficulties of living with psychiatric distress are magnified by the experience of rejection” (Gray, 2002), which can lead to psychological and physiological health issues, substance abuse, and addiction.

Etiology and Misdiagnoses 

Etiology and diagnosis drive the disease model. Which disorder do people find most repulsive, and which poses the most threat? What behaviors contribute to the disorder? How progressive is the disorder, and how effective are treatments? (Corrigan, 2006). It is essential to recognize how these attributions affect public perception, treatment options, and client self-beliefs and image. 

“Until the 1950s, most homosexual persons studied by psychologists and others were prisoners or mental patients, so it was easy to conclude that these were linked” (McFarland, 2018, p. 1). In 1973, the APA announced homosexuality was no longer an illness. DSM diagnostic criteria change dramatically from one edition to the next. Lynam and Vachon (2012) cite therapists’ concern that criteria are “added, removed, and rewritten, without evidence that the new approach is better than the prior one” (p. 483). The social fears described in the DSM-II in 1968 became social phobia in the DSM-III (1980), and social anxiety disorder in 1994’s DSM-IV, resulting in the nickname, the ‘neglected anxiety disorder.’

Revisions, substitutions, and contradictions between DSM’s are never universally accepted. Even under the best circumstance with a knowledgeable and caring clinician, it is difficult to obtain a proper mental disorder diagnosis. In addition to the nine types of depression, four anxieties, and eight obsessive-compulsive disorders, the current DSM lists five types of stress response and ten personality disorders, each sharing similar traits and symptomatology with varying degrees of impact. Bipolar personality disorder, for example, shares characteristics and symptoms with generalized anxiety disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, and panic disorder (Sagman & Tohen, 2009). The most common comorbidities associated with anxiety are major depression, panic disorder, posttraumatic stress disorder, and alcohol abuse/dependence. For example, social anxiety disorder is often comorbid with avoidant personality disorder, eating disorders, schizophrenia (Cuncic, 2018; Vrbova et al., 2017), ADHD, and agoraphobia (Koyuncu et al., 2019).

The Social Anxiety Institute (Richards, 2019) reports that an estimated 8.2% of patients had generalized anxiety, but just 0.5% were correctly diagnosed. A recent Canadian study by Chapdelaine et al. (2018) reported, of 289 participants in 67 clinics meeting DSM-4 criteria for social anxiety disorder, 76.4% were improperly diagnosed. 

Self-Esteem

Maslow’s (1943/1954) hierarchy of needs reveals how childhood disturbance can disrupt natural human development. Healthy growth requires satisfying fundamental physiological and psychological needs. The experience of detachment, exploitation, or neglect may disenable the subject from satisfying their physiological and safety needs and or the need to belong and experience love, which can impact the acquisition of self-esteem

If the child is criticized, overly controlled, or not given the opportunity to assert itself, it begins to feel insecure in its ability to survive, and may then become overly dependent on others, develop low self-esteem, and experience a sense of shame or doubt in its own abilities. (Vanderheiden & Mayer, 2017, p. 15)

Research on persons with depression and anxiety reveals how the disease model “diminishes hope, self-esteem, self-efficacy, empowerment, and quality of life.” (Garg and Raj, 2019, p. 124). LGBTQ+ youth rejected because of their identity have much lower self-esteem, are more isolated, and have less support than those accepted by their families (House, 2018). 

Self-esteem determines one’s relation to self, to others, and the world. Self-esteem is the umbrella for all the positive self-qualities that structure optimal functioning, e.g., self -respect -resilience, -efficacy, -reliance, -compassion, -value, -worth, and other intrinsic wholesome attributes. Self-esteem provides the recognition that one is consequential and worthy of love. A grassroots poll by Unite UK (2016) found that 62% of LGBTQ+ persons believe they have low self-esteem. Exposure to historical alienation, ambiguous public opinion, adolescent bullying, heterosexualism, and other harmful elements, in time, will have an impact on an LGBTQ+ person’s self-beliefs and image (Unite UK, 2016). 

Recovery

Recovery is an individual process. Humans have unique DNA and disparate sensibilities, memories, and abilities. One-size-fits-all approaches are inadequate to fully address the personality’s dynamic complexity and its owner’s uniqueness. Mental illness is ubiquitous and non-discriminating; dysfunction embraces every walk of life. As well, “the LGBTQ+ community encompasses a wide range of individuals with separate and overlapping challenges regarding their mental health” (NAMI, 2020b, p. 1). 

Recovery is “about seeing people beyond their problems – their abilities, possibilities, interests, and dreams – and recovering the social roles and relationships that give life value and meaning” (Slade, 2010, p. 2). Recovery programs must be fluid, integrating multiple traditional and non-traditional approaches developed through client trust, cultural assimilation, and therapeutic innovation. Any analysis must consider the subject’s environment, hermeneutics, history, and autobiography in conjunction with their wants, beliefs, and aspirations. Otherwise, the personality complexity is not valued, and the treatment inadequate.

Positive Psychology and the Wellness Model

In 2004, the World Health Organization began promoting the advantages of the wellness perspective, declaring health “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (Slade, 2010, p. 1). The World Psychiatric Association states, “the promotion of well-being is among the mental health system” (Schrank et al., 2014, p. 98). As psychologists point out, “psychological well-being is viewed as not only the absence of mental disorder but also the presence of positive psychological resources” (Sin & Lyubomirsky, 2009, p. 468). 

The wellness model’s chief facilitator is positive psychology (PP), which originated with Maslow’s (1943/1954) seminal texts on humanism; APA president Seligman legitimized it in 1998. Positive psychology and other optimistic approaches focus on the inherent ability, “not only to endure and survive, but also to flourish” (Mayer & May 2019, p. 160). 

Positive psychology is a relatively new field (since 1998) that, ostensibly, complements rather than replaces traditional psychology. Defined as the science of optimal functioning, PP’s objective is “to study, identify and amplify the strengths and capacities that individuals, families, and society need to thrive” (Carruthers & Hood, 2004, p. 30). Cultural psychologist Levesque (2011) describes optimal functioning as the study of how individuals attempt to achieve their potentials and become the best that they can be. 

Studies support the utilization of positive psychological constructs, theories, and interventions for enhanced understanding and improvement of mental health. PP interventions have “improved wellbeing and decreased psychological distress in mildly depressed individuals, in patients with mood and depressive disorders, [and] in patients with psychotic disorders” (Chakhssi et al., 2018, p. 16). As Carruthers and Hood (2004) point out, “The things that allow people to experience deep happiness, wisdom, and psychological, physical and social wellbeing are the same strengths that buffer against stress and physical and mental illness” (p. 30).

The academic discipline of positive psychology continues to develop evidence-based interventions that focus on eliciting positive feelings, cognitions, or behaviors (Schotanus-Dijkstra et al., 2018). Positive psychology offers promising interventions “to support recovery in people with common mental illness, and preliminary evidence suggests it can also be helpful for people with more severe mental illness” (Schrank et al., 2014, p. 99). 

Positive Psychology 2.0.  

One of the early challenges of positive psychology was its inattention to the negative aspects of character. Recognizing this, psychologists advocated a more holistic approach to embrace the dialectical opposition of human experience. As one psychologist put it, “people are not just pessimists or optimists. They have complex personality structures” (Miller, 2008, p. 598). Positive Psychology 2.0 (PP 2.0) evolved as a correction to the singular focus on optimism to embrace a more inclusive and balanced perspective (Rashid et al., 2014). 

The disease model of mental health bases recovery on the remission of symptoms or the suspension of substantial interference or limitation (ADAMHA, 2012; Salzer et al., 2018). The wellness model maintains that individuals with a mental disorder can live satisfying and fulfilling lives regardless of symptoms or impairments associated with the diagnosis (Slade, 2010). Schrank et al. (2014) describe recovery as people “(re-) engaging in their life on the basis of their own goals and strengths, and finding meaning and purpose through constructing and reclaiming a valued identity and valued social roles” (p. 98). By emphasizing wellness over dysfunction, the positive psychology movement aims to destigmatize mental illness by emphasizing “the positive while managing and transforming the negative to increase wellbeing” (Mayer & May, 2019, p. 163). Perkins and Repper (2003, p. 3) write: 

People with mental illness who are in recovery are those who are actively engaged in working away from Floundering (through hope-supporting relationships) and Languishing (by developing a positive identity), and towards Struggling (through Framing and self-managing the mental illness) and Flourishing (by developing valued social roles).  

Concluding Thoughts

Thomas Insel (2013), director of the National Institute of Mental Health, is “re-orienting its research away from DSM categories” (p. 2), declaring that traditional psychiatric diagnoses have outlived their usefulness (Kinderman, 2014). NIMH is transforming diagnosis based on emerging research data and a doctor-patient communication dynamic rather than on the current symptom-based categories. Kinderman (2014) suggests replacing traditional diagnoses with easily understandable descriptions of the issues.

A simple list of people’s problems (properly defined) would have greater scientific validity and would be more than sufficient as a basis for individual care planning and the design and planning of services. (1)

In mental health, recovery-remission is a realized, long-term mitigation of symptoms. Wellness impacts more than mental health; it is a paradigmatic perspective that seeks to promote a state of complete physical, mental, and social well-being. Its sociological emphasis on optimal human functioning, designed to counter the pathographic focus of other models, not only positively impacts the self-beliefs and image of a mentally ill person but resonates in sexual and gender-based identities and portends well, the recovery-remission of an LGBTQ+ person with a mental illness. 

There are many approaches to recovery. Psychology textbook author, Farreras (2020) cites 400 different schools of psychotherapy. Mayer and May (2019) characterize current positive psychology as “a balanced, interactive, meaning-centred and cross-cultural perspective” (p. 156) that considers equally “positive emotions and strengths and negative symptoms and disorders” (Rashid et al., 2014, p. 162). Positive psychology works best in conjunction with other programs (CBT, for example), and its mental health interventions have proved successful in mitigating symptoms of depression, anxiety, and other disorders. “Growing research suggests that a positive psychological outlook not only improves ‘life outcomes’ but enhances health directly” (Easterbrook, 2001, p. 23).

Training in prosocial behavior and emotional literacy might be useful supplements to specific interventions. Behavioral exercises enhance the execution of resilient and generous social skills. Positive affirmations have enormous subjective value as well. Data supports mindfulness and acceptance-based interventions to re-engage and regenerate positive thoughts, feelings, and memories. Castella et al. (2014) suggest motivational enhancement strategies to help clients overcome resistance. Ritter et al. (2013) tout the benefits of positive autobiography to counter destructive thoughts and behaviors. The importance of considering the nuanced and unique dynamics inherent in the relationships among emotional expression, intimacy, and overall relationship satisfaction for dysfunctional individuals and LGBTQ+ persons, should be thoroughly investigated (Montesi et al., 2013).

However, this paper balks at throwing out the baby with the bathwater, positing that the current diagnostic system should be utilized as a part of a more thorough analysis that embraces communication and emphasizes the character strengths that generate motivation, persistence, and perseverance towards recovery-remission. All “patients with mental disorders deserve better” (Insel, 2013, p. 2). 

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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.

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