Category Archives: Wellness Model

ONLINE GROUP: STRATEGIZING YOUR PSYCHOLOGICAL DYSFUNCTION

I invite you to join our online family. If you are committed to alleviating those symptoms of neuroses (disorders) that impact your emotional wellbeing and quality of life, contact me. This is a no-fee discussion and support group. 

I have studied, researched, and written about psychological dysfunctions for well over a decade. I have facilitated groups, workshops, and practicums for various dysfunctions. I utilize the Wellness Model of mental healthcare, which focuses on the character strengths and attributes that generate the motivation, persistence, and perseverance that enable recovery. 

My work with individuals and groups emphasizes communication and empathy. As someone who has been dealing with my own dysfunction (social anxiety disorder) for decades, I understand what you are going through on a personal level, and I know how the mental healthcare community functions. 

While each of the 31 dysfunctions listed in the Diagnostic and Statistical Manual of Mental Disorders has its characteristics and symptoms, they are similar in how they affect your emotional wellbeing, affect your self-esteem, image, and self-beliefs. These similarities are how we can relate to and support each other.

Your confidentiality is paramount to this group. Your email is shared only with your permission. We are on a first-name basis during our sessions, and you may choose an alias if that makes you comfortable. 

We want these sessions to be relaxed and joyful experiences where you can share your stories and concerns with others. 

Once you contact us, I will open a channel of dialogue so that I can get to know your needs and concerns before any online participation. That will allow you to get to know me better before you decide to participate.

You are not alone, it is not your fault, and you deserve to be treated with dignity and respect.

Dr. Mullen

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Index to Article Posts here.

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.

There Is No Shame in Mental Illness

Others may attempt to shame you; it is up to you whether you chose to be shamed.

What is shame? The painful feeling of humiliation or distress that comes from the sense of being or doing a dishonorable, ridiculous, or immodest thing; the feeling that you are less than, unbefitting, or undesirable. 

What causes shame of a mental dysfunction. History, culture, the disease model of mental healthcare, and mental health stigma (MHS).

Why you should not be ashamed. History is crude and inconsistent, culture is misinformed, the disease model is exploitive and archaic, and MHS is generated and sustained by prejudice, ignorance, and discrimination based on disinformation.

The most famous definition of shame is “feeling ridiculous, embarrassed, humiliated, chagrined, mortified, shy, reticent, painfully self-conscious, inferior, and inadequate.”[i] There are many aspects and degrees of shame; volumes have been written about shame’s types and complexities. Here is what some of the experts write. “Shame is painful, [ii] incapacitating,[iii] and uncontrollable.[iv] Shame makes you feel powerless,[v] inferior, and worthless.[vi] “To feel shame is to feel seen, acutely diminished.[vii]

Shame makes you want to escape, to become invisible. It elicits self-defensive reactions that can make you feel inadequate or become hostile and aggressive. Shame is inescapable, embracing every aspect of the human experience.[viii] 

Shame is not all bad. Shame alerts you to wrongness. You have done something wrong (you are bad), someone has wronged you (they are bad), or you feel wrong (you are inadequate). Shame can be revealing, cathartic and motivational, promoting change, growth, and broadened self-awareness. 

Right now, I am only concerned about the shame you feel because of your mental dysfunction. Everyone has some degree of psychological disturbance. It is a universal and undiscriminating condition; it infects during childhood rendering you unaccountable. So why do you feel shame? Because mental illness is historically denigrating and culturally feared and scorned – beliefs perpetuated by the disease model of mental health and reinforced by MHS claims that you are disgusting, distressing, frightening, and undesirable. 

The disease model of mental health focuses on what is wrong with you. It labels you by your diagnosis, and you cease to be a person. You are then lumped in with others similarly diagnosed and labeled as schizophrenics, paranoiacs, depressive persons, persons with anxiety. You are then stereotyped by the most descriptive symptoms and characteristics of your dysfunction using terms utilized by the Diagnostic and Statistical Manual of Mental Disorders (e.g., incapable, deceitful, unempathetic, manipulative, irresponsible). Then and ignorant (misinformed) and prejudiced (fearful) society stigmatizes or brands you as personifications of that stereotype.

Labels, stereotypes, and stigma are inaccurate representations because of the “implied expectations of how people with mental health problems may behave.” [ix] You may share or resemble symptoms or characteristics of a dysfunction (who doesn’t), but the sum of the label and stereotype is not the sum of the person. You are not your dysfunction.

Mental Health Stigma is the hostile expression of the abject undesirability of a human being who has a mental illness. Stereotypes of mental illness “often include an exaggerated sense of dangerousness.” [i] (Ironically, the early asylums in Spain and Egypt were built to protect the mentally ill from the dangerous and violent members of society.)[ii] The stigma or branding does not need to be true or accurate; it just has to be believed. Its only purpose is to separate you from the rest of society, which assumes they are normal, and you are not. 

What are the factors or attributes in MHS? Mental health stigma is formed facilitated by ignorance (misinformation), prejudice (fear), and discrimination (false superiority). Stigma supports and is supported by public opinion, media misrepresentation, the mental healthcare industry, and the disease model of mental health. 

First of all, studies show that the aversion to mental illness is socially hard-wired. Society considers you dangerous, unpredictable, and socially undesirable. Society wants to distance themselves and isolate you because of their deep-rooted fear and realization of their own susceptibility. 

The media stereotypes anyone with a dysfunction as an unpredictable, hysterical, and dangerous schizophrenic. Half of news stories on ‘mental’ illness allude to violence. A person with a mental illness is either a homicidal maniac, autistic, or a rebellious, hair-brained, free spirit. 

Healthcare professionals are often undertrained and inflexible. You know how your disorder impacts your emotional wellbeing and quality of life far better than your doctor. Clinicians deal with 31 similar and comorbid disorders, over 400 schools of psychotherapy, multiple treatment programs, and an ever-increasing plethora of medications. 

The mental healthcare community is drowning in pessimism. There is evidence to indicate the problem is endemic in the medical health community and universally systemic, which means that it impacts you personally, and the current model of healthcare is the culprit. 

Clients report instances where staff members are rude or dismissive. Complaints include coercive measures, excessive wait-times, paternalistic or demeaning attitudes, one-size-fits-all treatment programs, medications with undesirable side-effects, and stigmatizing language. 

The ‘defective’ or disease emphasis has been the overriding psychiatric perspective for over a century. By the 1952 publication of the first DSM, the focus had drifted from pathology (the science of the causes and effects of your dysfunction) to pathography (the breakdown of your psychological shortfalls, categorizing them to facilitate diagnosis). Pathography focuses on a deficit, disease model of human behavior. Which disorder poses the most threat? What behaviors contribute to the disorder? Are you contagious? What sort of person has a mental illness? It is these attributions that form public opinion, stigma, and your self-beliefs and image. 

The disease model and the DSM’s diagnostic system is under increasing scrutiny for its misdiagnosis, constant criteria revisions, symptom comorbidity, one-size-fits-all recovery programs, and general negativity. The Wellness Model of mental health focuses on your character strengths and virtues that generate the motivation, persistence, and perseverance to recover. A battle is not won by focusing on incompetence and weakness; it is won by knowing and utilizing your strengths and attributes. That is how you recover―with pride and self-reliance and determination―with the awareness of what you are capable. 

Why you should not be ashamed   

(History is crude and inconsistent, culture is misinformed, the disease model is exploitive and archaic, and MHS is generated and sustained by prejudice, ignorance, and discrimination based on disinformation.)

Recognizing that shame is a fundamental part of human nature allows you to confront it and realize, while others may attempt to shame you, it is up to you whether you chose to be shamed. No one can make you feel shame; it is entirely of your own volition. What is there to be ashamed of? Mental illness is universal and undiscriminating. Everyone is dysfunctional in one way or another. You are not responsible for being infected. You did not deal yourself the cards. You should only feel shame if your dysfunction negatively impacts your emotional wellbeing and quality of life, and you refuse to do something about it.

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

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i Goldberg C. (1991). Understanding shame. New Jersey/London: Jason Aronson.

ii Benda, J., Kadleĉík, P., Loskotová, M. (2018). Differences in self-compassion and shame in patients with anxiety disorders, patients with depressive disorders and healthy controls. Československá psychologie / ročník LXII (6), 520-541.

iii Keen, N., George, D., Scragg, P., Peters, E. (2017). The role of shame in people with a diagnosis of schizophrenia. British Journal of Clinical Psychology 56, 115–129 (2017). doi:10.1111/bjc.12125.

iv Camp, A.R. (2018). Pursuing Accountability for Perpetrators of Intimate Partner Violence: The Peril (and Utility?) of shame. Boston University Law Review, 98: 1677-1736.

v  Vanderheiden, E., & Mayer, C.-H. (2017). An introduction to the value of shame―Exploring a health resource in cultural contexts.  In E. Vanderheiden, C-H. Mayer (Eds.) The Value of Shame. Exploring a Health Resource in Cultural Contexts (pp, 1-42). New York City: Springer Publishing. doi:10.1007/978-3-319-53100-7

vi Murphy, S.A., & Kiffin-Petersen, S. (2017). The Exposed Self: A Multilevel Model of Shame and Ethical Behavior. Journal of Business Ethics, 141, 657–675 (2017). doi:10.1007/s10551-016-3185-8.

vii Miceli, M., & Castelfranchi, C. (2018). Reconsidering the Differences Between Shame and Guilt. Europe’s Journal of Psychology, 14(3), 710-733 (2018). doi:10.5964/ejop.v14i3.1564.

viii Okano, K. (1994). Shame and Social Phobia: A Transcultural Viewpoint. Bulletin of the Menninger Clinic, 58(3), .http://enlight.lib.ntu.edu.tw/FULLTEXT/JR-MDL/oka.htm

ix Huggett, C., Birtel, M.D., Awenat, Y.F., Fleming, P., Wilkes, S., Williams, S., Haddock, G. (2018). A qualitative study: experiences of stigma by people with mental health problems. Psychology and Psychotherapy: Theory, Research and Practice, 91, 380–397 (2018). doi:10.1111/papt.12167

x Pryor, J.B., Reeder, G.D., Monroe, A.E., Patel, A. (2009). Stigmas and Prosocial Behavior Are People Reluctant to Help Stigmatized Persons in S. Stürner, M. Snyder (Eds.) The Psychology of Prosocial Behavior, (pp.59-80). New York City: John Wiley and Sons.  doi:10.1002/9781444307948.ch3

xi Stuart, H., & Arboleda-Flórez, J. (2012). A Public Health Perspective on the Stigmatization of Mental Illnesses. Public Health Reviews, 34: Epub ahead of print.

You Deserve to Be Treated with Dignity and Respect.

You’re not abnormal and it’s not your fault

This is a personal message to those of you whose emotional wellbeing and quality of life are impacted by a ‘mental’ disorder. I write as someone who knows what you are going through, and who understands the system. I have dealt with social anxiety disorder throughout my life. I have spent the last 16 years researching and developing methods to alleviate the impact of mental dysfunctions. I know the disease model of mental health has been ineffective and demeaning, and I emphasize the importance of adopting a Wellness Model that treats you with dignity and appreciation for your abilities and potential. 

You are not alone.

  • 1 in 5 adults and 1 in 6 children (ages 6-17) have a diagnosable mental illness.
  • 20 million adults and 5 million adolescents experience mild to major depression.
  • Anxiety disorders impact 45 million adults and 13 million adolescents .
  • 60% of those have both anxiety and depression. Substance abuse is often comorbid.
  • The estimated rate of infection for minorities is 1.5-2.5 times higher.
  • Anxiety and depression are the primary causes of the 56% increase in adolescent suicide over the last decade.
  • Sexual and gender-based adolescents are almost five times more likely to attempt suicide.

There are four essential facts I want you to recognize.

Number 1: You are not abnormal. A disorder, or what they used to call a neurosis, is a common part of natural human development. Mental health professionals have a saying. Question: Why do 26% of American adults have a diagnosable mental disorder? Answer: Because the other 74% haven’t been tested.  Scientific American speculates that mental disorders are so common, almost everyone will develop at least one diagnosable disorder at some point in their life. It is, simply, a condition that negatively impacts your emotional wellbeing and quality of life. 

Number 2: It is not your fault. You were infected, most likely, during your childhood. In the rare event onset happened later in life, the susceptibility originated in your childhood. The infection is a consequence of some physical, emotional, or sexual disturbance. It could be hereditary, environmental, or the result of trauma. Any number of things could have caused it. Perhaps your parents were controlling or did not provide emotional validation. Perhaps you were bullied, or you are from a broken home. It is never your fault and it may be no one’s fault.

Number 3: Forget what you have been told. You have been negatively informed by the disease model of mental health, and influenced by mental health stigma. The disease model focuses on diagnosis, deficit, and denigration. Through its diagnostic process, you cease to be an individual and become your disorder. The Wellness Model emphasizes your character strengths and virtues that generate the motivation, persistence, and perseverance to recover.

You are not ‘mental.’ Not only is the description inaccurate, it promotes hostile perceptions of incompetence, unworthiness, and undesirability. It is the dominant source of stigma, shame, and self-loathing. It feeds the pervasive public stereotype of the dangerous and unpredictable, deranged person who should be isolated in an institution. 

They once thought mental illness was demonic possession. They blamed it on the moon, sorcery, witchcraft, and bodily fluids. In the early 20th century, it was your cellular structure. The biological approach says it is in your brain; the pharmacological approach pushes drugs to balance your chemistry and hormones. The fact is that simultaneous mutual interaction of your human system components is required for sustainability of life and your disorder.

Your dysfunction is not ‘mental,’ biologic, hygienic, neurochemical, or psychogenic, but all of these things facilitated by all your human system components – your mind, body, spirit, and emotions working in concert. 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. So, we have to change the common perception of the word. The Wellness Model’s primary objective is the reformation of language, power structure, and perspective throughout the mental healthcare community and beyond.

And finally, number 4: You deserve better ― from the ‘mental’ healthcare industry, your doctor, family, peers, media, and community. ‘Mental’ illness is a stigma, formed by ignorance, prejudice, and discrimination. It is supported by public opinion, family rejection, a misinformed community, media misrepresentation, and the disease model of mental health. No wonder so many avoid treatment, reject diagnosis, or refuse to disclose their condition.

General public opinion considers you dangerous, unpredictable, and socially undesirable.

37% of family members hide their relationship with their child or sibling in order to avoid bringing shame to the family. Many disordered are family undesirable, a devaluation more life-limiting, and disabling than the illness itself.

The media stereotypes you as a hysterical, unpredictable, and dangerous schizophrenic. Half of news stories on ‘mental’ illness allude to violence. You are either a homicidal maniac, an emotionally challenged childlike prodigy, or a rebellious, hair-brained, free spirit.

Healthcare professionals are often undertrained, misinformed, and inflexible. You know how your disorder impacts your emotional wellbeing and quality of life far better than your doctor. Clinicians deal with 31 similar and comorbid disorders, over 400 schools of psychotherapy, multiple treatment programs, and a constantly evolving plethora of medications, but they do not know the personal impact of your disorder.

The mental healthcare community is drowning in pessimism. There is evidence to indicate the problem is endemic in the medical health community, and universally systematic, which means that it impacts you personally, and the disease model is the culprit. Clients report instances where staff members are inordinately rude or dismissive. Complaints include coercive measures, excessive wait-times, paternalistic or demeaning attitudes, one-size-fits-all treatment programs, medications with undesirable side-effects, stigmatizing language, and general therapeutic pessimism.

The etiology-driven, disease model defines you as incapable, deceitful, unempathetic, manipulative, difficult, irresponsible, and incompetent. These descriptions are straight from the manual. This ‘defective’ emphasis has been the overriding psychiatric perspective for over a century. By the 1952 publication of the first DSM, the focus had drifted from pathology (the science of the causes and effects of diseases) to pathography (the breakdown of an individual’s problems, categorizing them to facilitate diagnosis). Pathography focuses on a deficit, disease model of human behavior, Which disorder poses the most threat? What behaviors contribute to the disorder? Are you contagious? What sort of person has a mental illness? It is these attributions that form your self-beliefs and image.

To iterate, the current Diagnostic and Statistical Manual of Mental Disorders describes 31 dysfunctions. Most share symptomatology and are comorbid. Estimates show that 60% of those with anxiety also have symptoms of depression, and both are comorbid with substance-abuse. The following are closely related to or comorbid with social anxiety: major depression, panic disorder, alcohol abuse, PTSD, avoidant personality disorder, generalized anxiety disorder, substance abuse, eating disorders, schizophrenia, ADHD, and agoraphobia.

Diagnostic criteria change dramatically from one edition to the next. Causes and symptoms are added, removed, and rewritten without evidence that the new approach is better than the prior one. Researchers cite substantial discrepancies and variation in definition, epidemiology, assessment, and treatment. One clinic reports that 8.2% of their clients had generalized anxiety; 0.5% were correctly diagnosed. A study of 67 clinics reported that 76.4% of social anxiety clients were improperly diagnosed.

That is why the Wellness Model focuses on the individual over the diagnosis. The disease model focuses on the diagnosis. The Wellness Model emphasis your character strengths and attributes that generate the motivation, persistence, and perseverance to recover. A battle is not won by focusing on incompetence and weakness; it is won by knowing and utilizing our strengths, and attributes. That is how we recover―with pride and self-reliance and determination―with the awareness of what we are capable.

Recoveryis an individual process. There is no one right way to do or experience recovery. You are not toasters, mass-produced in a factory. You have unique DNA. There has never been a single human being with your sensibilities, memories, and abilities. Your personality is comprised of distinct phenomena generated by everything experienced in your lifetime. It formed itself by core-beliefs and developed through social, cultural, and environmental experiences. It is your current being and the expression of that being―your inimitable way of thinking, feeling, and behaving.

One-size-fits-all approaches have never been able to address the complexity of your individual personality. Any evaluation and treatment program must comprehensively address your individual complexity. Recovery programs must be innovative, fluid, and targeted.

Clinicians must assimilate your culture and earn your trust. They do not have to become you; they must attempt to understand your culture in order to relate to you. An LGBTQ+ person will not be served well by a fundamentalist Baptist psychotherapist. Any clinician or program must consider your environment, history, and autobiography in conjunction with your wants, needs, and aspirations.

Your dysfunction has impacted your life since childhood; recovery is a long-term commitment. The Wellness Model creates the blueprint then guides teaches and supports you throughout the process of recovery, but you must do the work. The Wellness Model helps you reengage your intrinsic character strengths and attributes that generate the motivation and persistence and perseverance to recover.

Any suggestion of undesirability is a devaluation more life-limiting and disabling than the illness itself. You deserve to be treated with dignity and appreciation. 

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.

Positive Psychology and the Wellness Model

The disease or medical model of ‘mental’ health focuses “on a deficit, disease model of human behavior.” The wellness model focuses “on positive aspects of human functioning.”[i] This disease model ‘defective’ emphasis has been the overriding psychiatric perspective for well over a century.

We must move 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.[ii]

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.”[iii] The World Psychiatric Association agrees, stating, “the promotion of well-being is among the goals of the mental health system.”[iv] As positive psychologists point out, “psychological wellbeing is viewed as not only the absence of mental disorder but also the presence of positive psychological resources.”[v]

The wellness model’s chief facilitator is positive psychology (PP), which originated with Maslow’s[vi] seminal texts on humanism, and was legitimated by Seligman as American Psychological Association president in 1998. The focus of positive psychology and other optimistic approaches, is on virtues and strengths “not only to endure and survive, but also to flourish.”[vii]  PP describes 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.”[viii]

Positive psychology is a relatively new field (since 1998) that ostensibly complements and supports rather than replaces traditional psychology. “Positive psychology serves as an umbrella term to accommodate research investigating positive emotions and other positive aspects such as creativity, optimism, resilience, empathy, compassion, humor, and life satisfaction.”[ix]

PP has been defined as the science of optimal functioning, its objective “to study, identify and amplify the strengths and capacities that individuals, families and society need to thrive.”[x] Cultural psychologist Levesque[xi] describes optimal functioning as the study of how individuals attempt to achieve their personal potentials and become the best that they can be.

Research has shown that positive psychology interventions “improved well-being and decreased psychological distress in mildly depressed individuals, in patients with mood and depressive disorders, [and] in patients with psychotic disorders.”[xii] Studies supports the utilization of positive psychological constructs, theories, and interventions for enhanced understanding and improvement of ‘mental’ health. “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.”[xiii]

A range of approaches promoting wellbeing have been tested in intervention research.  A recent study found positive psychology interventions showed “significant improvements in mental well-being (from non-flourishing to flourishing mental health) while also decreasing both anxiety and depressive symptom severity.”[xiv] Continuing research suggests that a positive psychological outlook not only improves life outcomes but enhances health directly.[xv] A meta-analysis of 51 studies with 4,266 individuals utilizing therapies focusing on mindfulness, autobiography, positive writing, gratitude, forgiveness, or kindness, found PPIs “significantly enhance well-being . . . and decrease depressive symptoms.“[xvi]  

The academic discipline of positive psychology continues to develop evidence-based interventions that focus on eliciting positive feelings, cognitions or behaviors.[xvii] Independent research shows PPIs “decreased psychological distress [in individuals] with mood and depressive disorders [and] patients with psychotic disorders . . . improving quality of life and well-being.”[xviii] 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.”[xix]

Disease (Medical) Model

  • Pathography/etiology
  • DSM intractability
  • Systemic pessimism
  • Disease, deficit and denigration
  • One-size-fits-all recovery programs
  • Doctor-client power relationship
  • Rampant Misdiagnosis

Wellness Model

  • Communication
  • Optimal functioning
  • Emerging research data
  • Positive language, perspective
  • Client strengths and abilities
  • Program integration
  • Individual dynamics

Positive Psychology

  • Optimal human functioning
  • Support and enhance traditional psychology
  • Emphasize character strengths & attributes
  • Evidence-based interventions
  • Balanced, holistic perspective

Positive Psychology 2.0.  One of the early challenges of positive psychology was its inattention to the negative aspects of the individual. Recognizing this imbalance, psychologists advocated a more holistic approach to embrace the dialectical opposition of human experience. Positive Psychology 2.0 (PP 2.0) evolved as a correction to this singular focus on optimism so that it could “move forward in a more inclusive and balanced matter,[xx] incorporating both positive and negative aspects of the holistic individual. As one psychologist put it, “people are not just pessimists or optimists. They have complex personality structures.”[xxi] PP 2.0 recognizes the individual achieves optimal human functioning by living a meaningful life that comes through full engagement. PP 2.0 is a balanced approach, one that “equally considers positive emotions and strengths and negative symptoms and disorders.”[xxii]

The positive psychology perspective maintains that individuals with a ‘mental’ disorder can live satisfying and fulfilling lives regardless of symptoms or impairments associated with the diagnosis.[xxiii] Positive psychology aims “to emphasize the positive while managing and transforming the negative to increase well-being.”[xxiv] 

Positive psychology focuses on enhancing wellbeing and optimal functioning rather than ameliorating symptoms. By emphasizing wellness rather than dysfunction, the positive-psychology movement aims to destigmatize ‘mental’ illness. Positive psychologists believe “the constructive use of positive psychology perspective is generally needed in contemporary research to complement the long tradition of pathogen orientation.”[xxv]

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

[ii] Kinderman, P. (2014). Why We Need to Abandon the Disease-Model of Mental Health Care. (Online.) Scientific American. https://blogs.scientificamerican.com/mind-guest-blog/why-we-need-to-abandon-the-disease-model-of-mental-health-care/ 

[iii] Slade, M. (2010). Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Service Research 10 (26), 1-17 (2010). https://doi.org/10.1186/1472-6963-10-26 10(26)

[iv] Schrank, B., Brownell, T., Tylee, A., & Slade, M. (2014). Psychology: An Approach to Supporting Recovery in Mental Illness. East Asian Arch Psychiatry, 24, 95-103 (2014).

[v] Sin, N. L., & Lyubomirsky, S. (2009). Enhancing Well-Being and Alleviating Depressive Symptoms with Positive Psychology Interventions: A Practice-Friendly Meta-Analysis. Journal of Clinical Psychology: In Session, 65(5), 467–487 (2009). doi:10.1002/jclp.20593

[vi] Maslow, A.H. (1943). A theory of human motivation. Psychological Review, 50(4): 370-396 (1943). doi.org/10.1037/h0054346; Maslow, A. (1954). Motivations and Personality.  New York City: Harper & Brothers; Early edition.

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

[viii] Schrank, B., Brownell, T., Tylee, A., & Slade, M. (2014). Psychology: An Approach to Supporting Recovery in Mental Illness. East Asian Arch Psychiatry, 24, 95-103 (2014).

[ix] Ibid.

[x] Carruthers, C., & Hood, C. D. (2005).  The Power of Positive Psychology. Parks and Recreation.  .file:///C:/Users/rober/ OneDrive/ Pending/New%20Psychobiography/carruthers%20x.pdf 

[xi] Levesque, R. J. R. (2011). Optimal Functioning. In Levesque R. J. R. (eds) Encyclopedia of Adolescence. New York City: Springer. doi:https://doi.org/10.1007/978-1-4419-1695-2

[xii] Chakhssi, F., Kraiss, J. T., Sommers-Spijkerman, M., & Bohlmeijer, E.T. (2018). The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: a systematic review and metaanalysis. BMC Psychiatry 18:211, 1-17 (2018). https://doi.org/10.1186/s12888-018-1739-2.

[xiii] Carruthers, C., & Hood, C. D. (2005).  The Power of Positive Psychology. Parks and Recreation.  .file:///C:/Users/rober/ OneDrive/ Pending/New%20Psychobiography/carruthers%20x.pdf 

[xiv] Schotanus-Dijkstra, M., Drossaert, C. H. C., Pieterse, M. E., Walburg, J. A., Bohlmeijer, E. T., & Smit, F. (2018).  Towards sustainable mental health promotion: trial-based health-economic evaluation of a positive psychology intervention versus usual care. BMC Psychiatry 18:265, pp. 1-11 (2018). https://doi.org/10.1186/s12888-018-1825-5

[xv] Easterbrook, G. (2001). Psychology discovers happiness. I’m OK, You’re OK. The New Republic, Article 27,  6

[xvi] Sin, N. L., & Lyubomirsky, S. (2009). Enhancing Well-Being and Alleviating Depressive Symptoms with Positive Psychology Interventions: A Practice-Friendly Meta-Analysis. Journal of Clinical Psychology: In Session, 65(5), 467–487 (2009). doi:10.1002/jclp.20593

[xvii]  Schotanus-Dijkstra, M., Drossaert, C. H. C., Pieterse, M. E., Walburg, J. A., Bohlmeijer, E. T., & Smit, F. (2018).  Towards sustainable mental health promotion: trial-based health-economic evaluation of a positive psychology intervention versus usual care. BMC Psychiatry 18:265, pp. 1-11 (2018). https://doi.org/10.1186/s12888-018-1825-5

[xviii] Chakhssi, F., Kraiss, J. T., Sommers-Spijkerman, M., & Bohlmeijer, E.T. (2018). The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: a systematic review and metaanalysis. BMC Psychiatry 18:211, 1-17 (2018). https://doi.org/10.1186/s12888-018-1739-2.

[xix] Schrank, B., Brownell, T., Tylee, A., & Slade, M. (2014). Psychology: An Approach to Supporting Recovery in Mental Illness. East Asian Arch Psychiatry, 24, 95-103 (2014).

[xx] Wong, P. T. P., & Roy, S. (2017). Critique of positive psychology and positive interventions. In N. J. L. Brown, T. Lomas, & F. J. Eiroa-Orosa (eds.), The Routledge International Handbook of Critical Positive Psychology, pp 142-160. London, UK: Routledge.

[xxi]  Miller, A. (2008). A Critique of Positive Psychology— or ‘The New Science of Happiness.’ Journal of Philosophy of Education, 42(3-4), 591-608 (2008).  

[xxii] Rashid, T., Anjum, A., Chu, R., Stevanovski, S., Zanjani, A., & Lennox, C. (2014). Strength based resilience: Integrating risk and resources towards holistic well-being. In G. A. Fava & C. Ruini (eds.), Increasing psychological well-being in clinical and educational settings (Vol. 8, pp. 153–176). Dordrecht, Netherlands: Springer.

[xxiii]  Slade, M. (2010). Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Service Research 10 (26), 1-17 (2010). https://doi.org/10.1186/1472-6963-10-26 10(26)

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

[xxv] Ibid.

Why We Should Avoid the Term ‘Mental.’

“Everyone will develop at least one diagnosable disorder in their lifetime.”

‘Mental’ Disorder

  • Condition that negatively impacts your emotional wellbeing and quality of life.
  • Called a neurosis by DSM prior to 1980.
  • Facilitated by mind, body, spirit, and emotions working in concert.
  • Source of shame, stigma, and self-denigration.
  • Correctible inability to function in a ‘normal’ or satisfactory manner.
  • A normal facet of human development.

Language generates and supports perspective. Language influences thought and action. Not only is the word ‘mental’ inaccurate in describing a disorder, but its negative perspectives and implications promulgate perceptions of incompetence, unworthiness, and undesirability. It is the dominant source of stigma, shame, and self-denigration. Realistically, we cannot eliminate the word ‘mental’ from models of healthcare. Still, we should utilize it sparingly, and only to differentiate a disorder from a physical injury or ailment.

The first descriptions that come to mind when one utilizes the word ‘mental’ are crazy and insane. A person with a disorder is not crazy or insane. She or he is someone who has a common malfunction that negatively impacts their emotional wellbeing and quality of life. Scientific American speculates that ‘mental’ disorders are so common that almost everyone will develop at least one diagnosable disorder at some point in their life.[i] A disorder is a normal facet of human development that infects at adolescence or earlier. A person cannot be held accountable for their disorder. They did not make it happen; it happened to them. 

In political correctness, the word ‘mental’ defines a person or their behavior as extreme or illogical somehow. During our schooldays, anyone unpopular or different was derisively called ‘mental’ or ‘mental’ retard. The urban dictionary defines mental as someone silly or stupid. The word was used for attention, involving nonsensical references and actions, usually involving violent or divisive behavior, resulting in the general amusement and hilarity of onlookers. Add the words illness or disorder onto the adjective, ‘mental,’ and we have the public stereotype of dangerous and unpredictable, deranged persons who cannot fend for themselves, necessitating isolation in an institution. 

Dictionary definitions of the adjective ‘mental’ are: (1) of or relating to the mind or (2) of, relating to, or affected by a disorder of the mind. A disorder is not mental. It is administered and facilitated by the mind, body, spirit, and emotions working in concert.

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

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. Integrality describes the inter-cooperation of the human system and the environment and social fields. A disorder is not biologic, hygienic, neurochemical, or psychogenic. It is a collaboration of these, and other approaches administered by the simultaneous collaboration of the mind, body, spirit, and emotions.

There is no legitimate argument against mind-body collaboration in disease and wellness. We know that emotions are reactive to the mind and body and vice versa. Spirit is not ethereal or otherworldly, but a natural component of human development. While some suggest spirit as the seat of emotions and character, the three are distinct entities. Spirit forms the definitive or typical elements in the character of a person. Emotions are the expressions of those qualities, responsive to the mind and boy.[vi] 

In deference to a wellness paradigm, focusing on the word disorder (a correctable inability to function healthily or satisfactorily) and avoiding the mental description will help alleviate the healthcare system’s negativity. Changing negative and hostile language to embrace a positive dialogue of encouragement and appreciation will open the floodgates to new perspectives and positively affect the disordered person’s self-beliefs and image, leading to more disclosure, discussion, and recovery-remission. The self-denigrating aspects of shame will dissipate; mental health stigma become less threatening. The concentration on character strengths and virtues, propagated by humanism, PP2.0, and other wellness-focused alliances, will encourage client accountability and foster self-reliance, leading to a confident and energized social identity. 

Transitioning from the disease model’s pathographic language to the optimistic and encouraging perspective of wellness models is everyone’s responsibility in the mental health community―its institutions, associations, practitioners, researchers, media, and clients. When ‘mental’ is essential for focus or differentiation, we recommend utilizing quotation marks (‘mental’) to diffuse its negative and harmful perspectives.

We are not accountable for the hand we have been dealt. We are responsible for how we play the cards.

___________________

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.

____________________

[i] Henderson, C., Noblett, J., Parke,  H., Clement, S., Caffrey, A., Gale-Grant,  O., Schulze,  B., Druss,  B., & Thornicroft, G. (2014).     Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry,  1(6), 467-482 (2014). doi:10.1016/S2215-0366(14)00023-6.

[ii]  Khesht-Masjedi, M.F., Shokrgozar, S.,  Abdollahi, E.,  Golshahi, M., & Sharif-Ghaziani, Z. (2017). Exploring Social Factors of Mental Illness Stigmatization in Adolescents with Mental Disorders. Journal of Clinical and Diagnostic Research, 11(11) (2017). doi: 10.7860/JCDR/2017/27906.1083.

[iii] Pryor, J.B., Reeder, G.D., Monroe, A.E., & Patel, A. (2009). Stigmas and Prosocial Behavior Are People Reluctant to Help Stigmatized Persons in S. Stürner, M. Snyder (Eds.) The Psychology of Prosocial Behavior, (pp.59-80). New York City: John Wiley and Sons.  doi:10.1002/9781444307948.ch3

[iv] Gray, A.J. (2002). Stigma in Psychiatry. Journal of the Royal Society of Medicine, 95(2): (2002). doi:10.1258/jrsm.95.2.72

[v] Knaak, S., Mantler, E., Szeto, A. (2017). Mental illness-related stigma in healthcare. Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2), 111-116 (2017). doi:10.1177/0840470416679413

[vi] Mullen, R. F. (2018). Social Anxiety Disorder. (Online.). https://rechanneling.org/page-20.html

Diagnosing Your Disorder. (It’s likely you’ve been misdiagnosed)

It is difficult to get a proper diagnosis even from a knowledgeable and caring clinician

One reason why it is crucial for us to understand the causes and symptoms of our disorder is the likelihood of misdiagnoses. It is time to recognize: we know more about the impact of our condition than our doctors. Psychiatrists may have extensive knowledge of medication, and psychologists, treatment programs, but that expertise is useless if the client is misdiagnosed and mismanaged. Mental health misdiagnosis is a cautionary phenomenon. Even mainstream medical authorities have begun to “criticize the poor reliability, validity, utility and humanity of conventional psychiatric diagnosis.” [i] A recent Canadian study reported, of 289 participants in 67 clinics meeting DSM-IV criteria for social anxiety disorder, 76.4% were improperly diagnosed.[ii] The Anxiety Institute in Phoenix reports an estimated 8.2% of clients had generalized anxiety, but just 0.5% were correctly diagnosed.[iii] Experts cite the mental health community’s difficulty distinguishing different disorders or identifying specific etiological risk factors due to the DSM’s failing reliability statistics. This failure in psychological diagnosis is like being hospitalized for strep throat and losing a leg. 

The DSM changes drastically from one edition to the next, even though the APA swears by its credibility. One study[iv] cites therapist Zimmerman’s[v] concern that criteria are “added, removed, and rewritten, without evidence that the new approach is better than the prior one.” [vi] A recent study points out that DSM-IV listed nine possible symptoms or traits for narcissistic personality disorder; DSM-V contains only two.[vii]  

The massive number of revisions, substitutions, and changes from one DSM to the next is never universally accepted. Psychiatrists, psychologists, and researchers who specialize or survive by funding are justifiably protective of their territory. Even under the best circumstance with a knowledgeable and caring clinician, it is difficult to get a proper diagnosis. Currently there are eight or nine types of depression, four or five different anxiety disorders, five types of stress response (three of them are PTSD), nine forms of obsessive-compulsive disorders, and ten personality disorders.

Bipolar personality disorder, a psychosis, shares characteristics and symptoms with avoidant, social anxiety, obsessive-compulsive, and post-traumatic stress disorders (neuroses). Psychologists cite the “substantial discrepancies and variation in definition, epidemiology, assessment, and treatment” of social anxiety.[viii] A researcher for this BLOG paper received three different depression diagnoses (including bipolar) and ADHD. Social anxiety was never considered, although he met nine of ten criteria for the disorder.

Adding to misdiagnosis is the prevalence of disorder comorbidity, which is especially concerning if the first diagnosis is inaccurate. The Anxiety and Depression Association of America [ix] reports many disorders are related to social anxiety, including major depression, panic disorder, alcohol abuse, PTSD,[x] avoidant personality disorder, generalized anxiety disorder, substance abuse, eating disorders,[xi] schizophrenia,[xii] ADHD, and agoraphobia.[xiii] Anxiety and depression are commonly comorbid. “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.” [xiv] Three types or clusters categorize 10 personality disorders: 3 focus on the bizarre and eccentric, 4 on the dramatic; and 3 on the anxious and fearful; each cluster shares traits and symptoms. The diagnostic criteria for one disorder are common to others. For example, dependent personality has characteristics and symptoms mirroring social anxiety, avoidant personality, and histrionic personality disorders.[xv] One misdiagnosis is bad enough, not to mention two, resulting in “in worse treatment outcomes.” [xvi]

Thomas Insel,[xvii] director of the National Institute of Mental Health, has been “re-orienting [the organization’s] research away from DSM categories,” declaring that traditional psychiatric diagnoses have outlived their usefulness,  A program of recovery cannot be entertained if the problem is misdiagnosed. A recent article in Scientific American[xviii] 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. However, this BLOG balks at throwing out the baby with the bathwater, positing that the DSM could be utilized as a part of a more thorough analysis focusing on the character strengths that generate motivation and persistence/perseverance towards recovery-remission. 

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 it? How effective are treatments? It is important to recognize how these attributions affect public perception, treatment options, and self-belief and image. Imagine being treated for the wrong condition. Not only does it defeat the purpose of the treatment, but it is also potentially dangerous. Firsthand, we know the impact of our disorder on our emotional wellbeing and quality of life far better than the clinician, whose relationship is one of power over communication. Self-diagnosis is a slippery slope, but a client armed with the knowledge of the traits and characteristics of their disorder, and its impact would have a far better possibility of appropriate diagnosis and treatment. Equally important is recognizing the extent of our strengths and abilities to counter and defeat the symptoms of our disorder. The disease model of mental health tells us the problem; the wellness model emphasizes the solution.

____________________

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.

____________________


[i] Kinderman, P. (2014). Why We Need to Abandon the Disease-Model of Mental Health Care. [Online.] Scientific American. https://blogs.scientificamerican.com/mind-guest-blog/why-we-need-to-abandon-the-disease-model-of-mental-health-care/  .

[ii] Chapdelaine A., Carrier J-D., Fournier L., Duhoux A. Roberge P. (2018) Treatment adequacy for social anxiety disorder in primary care patients. PLoS ONE 13(11) (2018). doi.org/ 10.1371/journal.pone.0206357.

[iii] Richards, T.A. (2014). Overcoming Social Anxiety Disorder: Step by Step. [Online.] Phoenix, AZ: The Social Anxiety Institute Press.

[iv] Lynam, D. R. & Vachon, D. D. (2012). Antisocial Personality Disorder in DSM-5: Missteps and Missed Opportunities. Personality Disorders: Theory, Research, and Treatment, 3(4) 483– 495 (2012). doi:10.1037/per0000006

[v] Zimmerman, M. (2011). Is there adequate empirical justification for radically revising the personality disorders section for DSM-5? Personality Disorders: Theory, Research, and Treatment. Advance online publication. doi:10.1037/a0022108

[vi] Stein, D. J., Fineberg, N. A., Bienvenu, O. J., Denys, D., Lochner, C., Nestadt, G., Leckman, J. F., Rauch, S. L., & Phillips, K. A. (2010). Should OCD be classified as an anxiety disorder in DSM-V? Depression and Anxiety, 6:495-506 (2010). doi:10.1002/da.20699.

[vii] Lynam, D. R. & Vachon, D. D. (2012). Antisocial Personality Disorder in DSM-5: Missteps and Missed Opportunities. Personality Disorders: Theory, Research, and Treatment, 3(4) 483– 495 (2012). doi:10.1037/per0000006

[viii] Nagata, T., Suzuki, F., Teo, A.R. (2015).Generalized Social Anxiety Disorder: A still‐neglected anxiety disorder 3 decades since Liebowitz’s review. Psychiatry and Clinical Neurosciences, 69(12): 724-740 (2015).  doi.org/10.1111/pcn.12327

[ix] ADAA (Anxiety and Depression Association of America). (2019). [Online.] Facts and Statistics. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/understanding-anxiety-and-depression-lgbtq.

[x] Koyuncu, A., İnce, E. , Ertekin, E., & Tükel R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in Context 2019, 8. doi:10.7573/dic.212573; Lyliard, R. B. (2001). Social anxiety disorder: comorbidity and its implications. Journal of Clinical Psychiatry, 62(Suppl1): 17-24 (2001).

[xi] Cuncic, A. (2018). How Social Anxiety Affects Dating and Intimate Relationships. [Online.] verywellmind. https://www.verywellmind.com/adaa-survey-results-romantic-relationships-3024769; Koyuncu, A., İnce, E. , Ertekin, E., & Tükel R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in Context 2019, 8. doi:10.7573/dic.212573

[xii] Cuncic, A. (2018). How Social Anxiety Affects Dating and Intimate Relationships. [Online,] verywellmind. https://www.verywellmind.com/adaa survey-results-romantic-relationships-3024769; Vrbova, K., Prasko, J., Ociskova, M., & Holubova, M. (2017). Comorbidity of schizophrenia and social phobia – impact on quality of life, hope, and personality traits: a cross sectional study. Neuropsychiatric Disease and Treatment, 13: 2073-2083. doi: 10.2147/NDT.S141749

[xiii] Koyuncu, A., İnce, E. , Ertekin, E., & Tükel R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in Context 2019, 8. doi:10.7573/dic.212573

[xiv] Salcedo, B. (2018). The Comorbidity of Anxiety and Depression. (Online). National Alliance on Mental Illness.  https://www.nami.org/Blogs/NAMI-Blog/January-2018/The-Comorbidity-of-Anxiety-and-Depression 

[xv] DPD. (2007). Dependent personality disorder.  [Online.] Harvard Health Online.

[xvi] Koyuncu, A., İnce, E. , Ertekin, E., & Tükel R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in Context 2019, 8. doi:10.7573/dic.212573

[xvii]  Insel, T. (2013). Post by Former NIMH Director Thomas Insel: Transforming Diagnosis. [Online.] Washington, DC: National Institute of Mental Health. https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

[xviii] Kinderman, P. (2014). Why We Need to Abandon the Disease-Model of Mental Health Care. [Online] Scientific American. https://blogs.scientificamerican.com/mind-guest-blog/why-we-need-to-abandon-the-disease-model-of-mental-health-care/ 

What are Psychological Dysfunctions and Discomforts?

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

http://ReChanneling.org

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

____________________

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.

____________________

References

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

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

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

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

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

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

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

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

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

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

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

Why One-Size-Fits-All Approaches Fail

Recovery programs must reflect individual over diagnosis.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How Did It Happen?

Healthy human development requires satisfying fundamental human needs.

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

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

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

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

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

Overcoming Our Resistance

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

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

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

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

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

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

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

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

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

Resistance v. Repression

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

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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.