Tag Archives: Self-esteem

The Hostility of Mental Health Stigma

Mental Health Stigma (MHS) is the hostile expression of the abject undesirability of a human being who has a mental illness. It is the instrument that brands the mentally dysfunctional (victim) defective due to stereotypes. MHS is purposed to protect the general population from unpredictable and dangerous behaviors by any means necessary. MHS is fomented by prejudice, ignorance, and discrimination. The stigmatized are devalued in the eyes of others and subsequently in their self-image as well.

Between 50 and 65 million U.S. adults and adolescents have a mental illness; 90% of those will be impacted by mental health stigma, a presence that elicits unsupportable levels of shame and jeopardizes the emotional and societal wellbeing of the victim.

Origins and Evolution

The Signaling Event. MHS is triggered by a set of signals or signaling event, i.e., an occasion, experience, news story, encounter where the visibility of behaviors and mannerisms associated with mental illness elicit a reaction.

The Label. Labeling defines the signaling event and distinguishes it from other labels. ‘Woman’ is a label; it is specific, restrictive to gender, and says certain things that distinguish it from other labels. A successful label elicits a strong public reaction. The defining characteristics of the label become the stereotype. Labeling is subject to the labeler’s belief system and, like stereotype and stigma, is reliably inaccurate because of implied expectations of behavior. 

The Stereotype. Labeling gives the signal a moniker for identification; the stereotype defines it and gives it meaning. Stereotyping is a cognitive differentiation of something that piques one’s interest; everyone stereotypes. Mental health stereotyping is distinguishable by pathographic overtone that identifies the victim as unpredictable, potentially violent, and undesirable. 

Ironically, 14th century asylums in Spain and Egypt were built to protect the mentally afflicted from the dangerous and violent members of society.

Mental health labeling and stereotypes support and collaborate with preconceived notions of mental illness, generated by the natural aversion to weakness and difference. This is supported by an ignorant and prejudicial belief system and, on occasion, personal experience. Labels and stereotypes are unbound by truth or evidence; believability is the ultimate criterion.  

Stigma. A stigma is a brand or mark that negatively impacts a person or group by distinguishing and separating that person or group from others. The branding concept originated with the ancient Greek custom of identifying criminals, slaves, or traitors by carving or burning a mark into their skin. Stigma is identified by three types: (1) abominations of the body, (2) moral character stigmas, and (3) tribal stigmas. The first refers to physical deformity or disease; tribal stigmas describe membership in devalued races, ethnicities, or religions; and moral character stigma refers to persons perceived as weak, immoral, duplicitous, dishonest, e.g., criminals, substance addicts, cigarette smokers, and the mentally ill. 

Mental Health Stigma. The objective of a MHSisto protect the general population from the unpredictable and dangerous behaviors associated with mental illness by any means necessary, including deception, misinformation, and fear-baiting. Its ultimate goal is to negatively impact the social reintegration of the victim. 

  • Anticipatory stigma is the expectation of a stigma due to behavior or diagnosis, and subsequent adverse social reaction. This causes a resistance by the potential victim to disclose any physiological aberration.  
  • Stigma-avoidance identifies those who avoid or postpone treatment fearing the associated stigma will discredit them and negatively impact their quality of life. Studies indicate almost one third of the potential victims resist disclosure, impacting the potential for recovery.
  • Family-stigmatization occurs when family members reject a child or sibling because of their mental illness. Throughout history, it was commonly accepted that mental illness was hereditary or the consequence of poor parenting. A 2008 study found 25% to 50% of family members believe disclosure will bring shame to the family. (Courtesy-stigma denotes a supportive family member.)

An active stigma is a parasitic one. If it finds enough suitable hosts, the parasitosis can spread rapidly by traditional means. Studies show the aversion to mental illness is prosocially hard-wired which provides an abundance of hosts.  

Contributing Factors to MHS. The stigma triad of ignorance, prejudice, and discrimination is generated and supported by preconceived notions, general obliviousness, a lack of education, and society’s deep-rooted fear of its susceptibility. The primary attributions to MHS are public opinion, media misrepresentation, visibility, diagnosis, and the disease or pathographic model of mental healthcare. 

How MHS Affects the Victim 

MHS impacts the victim through a series of stigma experiences:

  • Felt stigma. The anticipated or implied threat of a stigma.  
  • Enacted stigma. The activated stigma. 
  • External stigma. Victim holds the perpetrator responsible for the stigma. 
  • Internalized stigma. Victim assumes behavioral responsibility for the stigma.
  • Experienced stigma. Victim’s reaction to the stigma.

The victim anticipates their mannerisms, behaviors or diagnosis will generate a stigma (felt stigma). When the stigma is realized it becomes an enacted stigma. The victim blames the person who originated the stigma (external stigma) or assumes responsibility due to behavior (internalized stigma). When the stigma impacts the victim’s wellbeing, it becomes an experienced stigma

MHS Impact. Mental health stigma can negatively affect the victim’s emotional wellbeing and quality of life by jeopardizing their:

(mind, body, spirit, and emotions)

  • Livelihood
  • Housing
  • Social status
  • Relationships

Solution

Mental health stigma will not be mitigated or eliminated until the mental healthcare community embraces the wellness model over the disease of mental health. The disease model of mental health focuses on the problem; creating a harmful symbiosis of individual and diagnosis. The wellness model https://robertfmullen.com/2020/07/21/the-disease-model-versus-the-wellness-model-of-recovery/

emphasizes the solution. A battle is not won by focusing on incompetence and weakness but 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. 

Establishing new parameters of wellness calls for a reformation of thought and concept. In 2004, the World Health Organization began promoting the advantages of the wellness over disease perspective, defining health as a state of physical, mental and social well-being and not merely the absence of disease or infirmity. The World Psychiatric Association has aligned with the wellness model and it has become a central focus of international policy. Evolving psychological approaches have become bellwethers for the research and study of the positive character strengths that facilitate the motivation, persistence, and perseverance helpful to recovery. Wellness must become the central focus of mental health for the simple reason that the disease model has provided grossly insufficient results.

A WORKING PLATFORM showing encouraging results for most physiological dysfunctions and discomforts is an integration of positive psychology’s optimum human functioning with CBT’s behavior modification, neuroscience’s network restructuring, and other positivity targeted approaches. including affirmations, autobiography, and methods to regenerate self-esteem and motivation.

This new wellness paradigm, however, should not be a dissolution of medical model approaches but an intense review of their efficacy, and repudiation of the one-size-fits-all stance within the mental health community. 

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

Recovery and The Willful Pursuit of Ignorance

Ignoring it does not make it go away.

The resistance to fully acknowledge our physiological dysfunction (neurosis) is a major impediment to our recovery. Many deliberately choose to remain ignorant of the destructive capability of their dysfunction. We go to enormous lengths to remain oblivious to its symptoms, characteristics, and traits as if, by ignoring them, they don’t exist or will somehow go away. Despite these efforts, the aura of undesirability cannot be muted.

Emphasis must be placed on the importance of fully recognizing and accepting our dysfunctional idiosyncrasies and how they impact our emotional wellbeing and quality of life—mentally, physically, emotionally, and spiritually (MBSE). Deliberate ignorance is tantamount to fixing a malfunctioning computer by ignoring the manual. This resistance, arguably justified by multiple attributions, is meant to protect us from our irrational self-beliefs, but the shield is unsustainable and counterproductive.

The attributions to resistance are correlated internal and external components. The former is implemented by the dysfunction, diagnosis, and the disruption in natural human development. External resistance is generated by the stigma triad of ignorance, prejudice, and discrimination. 

The overarching attributions to internal resistance are personal baggage, mental health stigma, and the natural physiological aversion to change. External attributions fall within the following categories, each informing the others:

  • Public opinion
  • Media misrepresentation
  • Visibility
  • Distancing
  • Diagnosis
  • Mental health stigma

Physiological Aversion. We are hard-wired to dislike change. Our bodies and brains are structured to resist anything that disrupts our equilibrium. Our nervous system monitors our metabolism, temperature, weight, and other survival functions. A new diet or exercise regimen produces physiological changes in our heart rate, metabolism, and respiration, which impact these functions. Inertia senses and resists these changes, making them difficult to maintain. Our brain’s basal ganglia resist any modification in patterns of behavior. Thus, habits like smoking or gambling are hard to break, and new undertakings (e.g., recovery), challenging to maintain.

Personal Baggage. Every physiological dysfunction and discomfort generates an emotional and behavioral identity due to childhood disturbance, and the corresponding disruption in natural human development. Most are more correlational than dissimilar and commonly comorbid. Their impact Is variable and distinguishable by human complexity. Many induce self-destructive decisions like substance abuse or emotional blackmail. Self-perceptions of incompetence, unattractiveness, and worthlessness are buttressed by guilt, blame, and shame. 

Public Opinion. Public aversion to mental illness is hard-wired. Individuals perceived as repugnant or weak in mind or body have suffered since the dawning of humankind. Psychological dysfunction and discomfort are components of natural human development. Scientific American speculates they are so common almost everyone will develop at least one diagnosable disorder at some point in their life. However, much of society views them differently because they see dysfunction in themselves, and it frightens them. That fear generates and is generated by prejudice, ignorance, and discrimination. 

Media Misrepresentation. TV, books, and films exaggerate the symptoms and traits of dysfunction, stereotyping the dysfunctional as annoying, dramatic, and peculiar. Portrayals suggest all persons impacted 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. The media is powerful. Studies show homicide rates go up after televised heavyweight fights, and suicide increases after on-screen portrayals. 

Visibility is the public display of behaviors associated with dysfunctions. Not only are the recipients uneasy or repulsed by such behaviors, but the afflicted are vividly conscious of being observed, whether actual or imagined, and surrender to the GAZE―what psychoanalyst Lacan defines as the anxious state of mind that comes with scrutiny and unwanted attention.

Distancing is the public expression of contempt for the behaviors associated with dysfunction. Social distance varies, obviously, by diagnosis, but also by region, race and ethnicity, political persuasion, educational attainment, and economics. 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 correlates to the level of discriminatory behavior. 

Mental Health Stigma is the hostile expression of the abject undesirability of a human being who has a mental illness. It is theinstrument that brands the dysfunctional as socially undesirable due to stereotype. The stigmatized are devalued in the eyes of others and thus in their own self-image as well. MHS is purposed to protect the general population from ‘unpredictable and dangerous’ behaviors by any means necessary. MHS is fomented by prejudice, ignorance, and discrimination. 

Diagnosis. impacted by the DSM, the disease model of mental healthcare, ignorance or ineptitude of mental health professionals, and misdiagnoses.  Diagnosis drives mental health stereotypes. Which dysfunction is the most repulsive, and which poses the most threat? People are concerned about the severity of the dysfunction, whether it is contagious, or whether the dysfunction was caused by certain behaviors. Will the symptoms worsen? Is the dysfunction punishment for sin, implying the more dangerous the symptoms, the worse the offense? Diagnosis is facilitated by the deficit disease model of mental healthcare via the Diagnostic and Statistical Manual of Mental Disorder which focuses on the history of harmful behavior.

The disease model assumes that emotional distress is merely symptomatic of biological illness. The Wellness Model of mental healthcare focuses on the positive aspects of human functioning that promote our wellbeing and recognize our essential and shared humanity. Positive psychologies and the Wellness Model emphasize what is right with us, innately powerful within us, our potential, and determination. Rather than disease and deficit, they emphasize our character strengths, virtues, and attributes. 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. 
  • The 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.

Resistance closes the door to possibility. Nothing comes in, nothing goes out. Nonresistance is a prerequisite for recovery. We cannot recover if we do not consider our options. Nonresistance opens our minds and broadens our perspective. Consideration of new possibilities is rewarding and productive; resistance is counterintuitive to recovery.

Resistance v. Repression

RESISTANCE is the 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 the conscious mind refuses to accept from entering it. It is the ‘stuff’ that permeates our brain that we cannot address because we have compartmentalized it and misplaced the key. 

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

Utilizing Complementarity for Social Anxiety (and other physiological dysfunctions)

Complementarity is the inherent cooperation of our human system components in maintaining physiological equilibrium. Sustainability-of-life and sustainability of our dysfunction require simultaneous mutual interaction.

How is this physiologically supported? 

Every thought and behavior generates a realignment of our neural network which produces a correlated change in our thought and behavior. Our neural network transmits the chemical and electrical maintenance that maintains our vital functions: heartbeat, nervous system, and blood–flow. It tells us when to breathe. It generates our mood, controls our weight and digestion. It provides acetylcholine for learningnoradrenaline for concentration, glutamate for memory (Mind), adrenaline for muscles, endorphins to relax (Body), dopamine for motivation, GABA for anxiety (Spirit), and serotonin for mood stabilization (Emotions).

Examples of Complementarity (Simultaneous Mutual Interaction).

  • The freeway fender bender: I could have died (mind), I’m sweating, my heart is pounding (body), I’m angry, and frustrated (emotions), and suddenly conscious of my mortality (spirit).
  • The social gathering: are they looking at me (mind), I’m shaking and sweating (body), I’m afraid I’ll say or do something stupid (emotions), and they probably won’t like me, anyway (spirit).

Mindfulness of Complementarity.

Recognizing that the “Self’ is not a single entity but a complex collective of four major components: mind, body, spirit, and emotions (“MBSE”); accepting that these components react simultaneously and work in concert. One component will seem to dominate, depending on the situation. 

How is this relevant to social anxiety?

The symptoms of social anxiety attack our self-image. Because this causes us to build up defense mechanisms, our reactions are often irrational (self-destructive). This is especially pertinent in situations where our anxiety and depression generate self-denigrating or unhealthy responses: the social event, job performance review, the interview, the classroom.

The clinical term ‘disorder’ identifies extreme or excessive impairment that negatively affects functionality. Feeling anxious or apprehensive in certain situations is normal; most individuals are nervous speaking in front of a group and anxious when pulled over on the freeway. The typical individual recognizes the ordinariness of a situation and accords it appropriate attention. The socially anxious person anticipates it, takes it personally, dramatizes it, and obsesses on its negative implications. 

Let’s look at an example applicable to social anxiety disorder: We find ourselves in a social situation where our apprehensions and fears overwhelm us. We feel incompetent and unattractive. Our dysfunction persuades us we are being judged, criticized, or held in contempt. We either feel we are the center of attention or invisible. Our deflated spirit and fraught emotions fight for dominance. 

How do we alleviate our fears and associated symptoms? We engage a well thought out and prepared diversion from our emotional/spiritual malaise by utilizing our supporting components, e.g., our mind and body. To divert is “to change course or turn from one direction to another.”  When ‘A’ is overwhelming, we engage ‘B’ or ‘C’ to mitigate “A.” (We instinctively divert readily. We go for a walk to calm our emotions, pray when anguished, vent frustration by bellowing or breaking something.) There are numerous ways to divert as we will discover; here are a few examples

Engage your body. Place a small item in your shoe, snap the rubber band around your wrist, or carry a distracting item in your pocket like a pushpin. Your slight physical discomfort diverts from your emotional and spiritual woes.

Engage your mind. Find three items in the room: the blue couch, red vase, cuckoo clock, and focus on them in moments of stress. Prepare event-focused PAs, repeating them the week before and mentally at the event. Learn the lyrics to an empowering song and mentally sing it.

Engaging Mind and Body. Subtly mimic a fearless or confident character from a film or book. Paul Newman created the walk to establish the character. 

With Positive Autobiography and positive psychologies, we retrieve those extraordinary moments of our lives resisted or repressed by the negative self-image generated by our dysfunction. Reflecting on these just before and during the event challenges our irrational perceptions of incompetence and worthlessness. 

Through mindfulness, practice, and the simultaneous restructuring of our neural network, these distractions or diversions will eventually become less important. 

Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of physiological dysfunction and discomfort (neuroses/disorders). 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 groups, workshops, and practicums.

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.

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.

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 

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

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. 

Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of physiological dysfunction and discomfort (neuroses/disorders). 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.

Self-esteem is mindfulness (recognition and acceptance) of our value to our self, society, and the world. Self-esteem can be further understood as a complex interrelationship between how we think about ourselves, how we think others perceive us, and how we process or present that information.

Self-esteem deficits are the consequence of disapproval, criticism, and apathy of influential others—family, colleagues, ministers, teachers. Any number of factors impact self-esteem including our environment, sexual orientation, race and ethnicity, and education.

  • Our negative self-image is generated by our deficit of self-esteem.
  • Self-esteem administers and is determined by our self-properties. Positive self-properties: self -reliant, -compassionate, -confidant, -worth, etc. Negative self-properties: self -destructive, -loathing, -denigrating, etc.
  • Our positive self-properties tell us we are of value, consequential, and desirable. 
  • Our intrinsic self-esteem is never fully depleted or lost; however, underutilized self-properties can be dormant like the unexercised muscle in our arm or leg.
  • Self-esteem impacts our mind, body, spirit, and emotions separately and in concert. Mindfulness of this complementarity is important to emotional and behavioral control as we learn utilize each component.
  • We rediscover and reinvigorate our self-esteem through exercises designed to help us become mindful of our inherent strengths, virtues, and attributes. 

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. 

Physiological 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 physiological 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. 

Maslow’s Hierarchy of Needs

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 is a state of active, open recognition and acceptance of present realities. It is the act of embracing our flaws as well as our inherent character strengths, virtues, and attributes. Mindfulness is the key to reengaging our positive self-properties that constitute healthy 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 physiological 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.

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

Neural Restructuring, CBT, and Positive Affirmations

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

Neural Plasticity

  • 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 an organic 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.

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.

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. 

It’s estimated that humans have up to 60,000 thoughts a day. Whenever you provide negative input, your brain releases chemicals that make you feel bad. Conversely, every time you provide positive input, your brain releases chemicals that make you feel good.

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.

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.

Dysfunction in the LGBTQ+ Community

Establishing a Wellness Model for LGBTQ+ Persons with Anxiety and Depression and Other Physiological Dysfunctions

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 ahistorical 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 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). 

Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of physiological dysfunction and discomfort (neurosis/disorder). 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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Perkins R., & Repper, J. (2003). Social Inclusion and Recovery. London: Baillière Tindall.

Pescosolido, B. A. (2013). The Public Stigma of Mental Illness. What Do We Think; What Do We Know; What Can We Prove? Journal of Health and Social Behavior 54(1): 1-21 (2013), doi: 10.1177/0022146512471197

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Pinfold, V., Thornicroft, G., Huxley, P., Farmer, P. (2005). Active ingredients in anti-stigma programmes in mental health. International Review of Psychiatry, 17(2): 123–131 (2005). doi: 10.1080/09540260500073638

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

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,8: (Vol. 8, pp. 153–176). Dordrecht, Netherlands: Springer.

Reisner, S. L., Greytak, E. A., Parsons, J. T., & Ybarra, M. (2015).  Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity. Journal of Adolescent Health, 56(3): 243-256 (2015).  doi: 10.1016/j.jadohealth.2014.10.275

Reuben, A., & Schaefer, J. (2017). \Mental Illness Is Far More Common Than We Knew. [Online.] Scientific American. Retrieved from https://blogs.scientificamerican.com/observations/mental-illness-is-far-more-common-than-we-knew/

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

Richards, T. A. (2019). What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis. (Online.) The Social Anxiety Institute, Inc. https://socialphobia.org/social-anxiety-disorder-definition-symptoms-treatment-therapy-medications-insight-prognosis.

Ritter, V., Ertel, C., Beil, K., Steffens, M. C., & Stangier, U. (2013). In the Presence of Social Threat: Implicit and Explicit Self-Esteem in Social Anxiety Disorder. Cognitive Therapy & Research, 37(6): 1101-1109 (2013)doi: 10.1007/s10608-013-9553-0.  

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 

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

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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: 1-11 (2018). https://doi.org/10.1186/s12888-018-1825-5

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).

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

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)

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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

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Positive Psychology and the Wellness Model of Mental Health

The Disease Model focuses on the problem; the Wellness Model emphasizes the solution.

Clinical psychologists posit the need for wholesale and radical change, not only in how we understand mental health problems but in how we communicate positivity and collaboration with the client. This radical change, however, should not be a dissolution of approaches but an intense review of their efficacy, and repudiation of the one-size-fits-all stance within the mental health community. 

Certain fundamentals like language, perspective, and diagnosis demand drastic adjustment. The Diagnostic and Statistical Manual of Mental Disorders (DSM) abandoned the word neurosis in 1980 but it remains the go-to term in the mental health community. One only needs the American Psychological Association (APA, 2020) definition of neurosis to comprehend the pathographic focus of the disease model. Neurosis is

any one of a variety of mental disorders characterized by significant anxiety or other distressing emotional symptoms, such as persistent and irrational fears, obsessive thoughts, compulsive acts, dissociative states, and somatic and depressive reactions. The symptoms do not involve gross personality disorganization, total lack of insight, or loss of contact with reality (compare psychosis). In psychoanalysis, neuroses are generally viewed as exaggerated, unconscious methods of coping with internal conflicts and the anxiety they produce. Most of the disorders that used to be called neuroses are now classified as anxiety disorders.

Establishing new parameters of wellness calls for a reformation of thought and concept. In 2004, the World Health Organization began promoting the advantages of the wellness over disease perspective, defining health as a state of physical, mental, and social well-being and not merely the absence of disease or infirmity. The World Psychiatric Association has aligned with the wellness model and it has become a central focus of international policy.  Evolving psychological approaches have become bellwethers for the research and study of the positive character strengths that facilitate the motivation, persistence, and perseverance helpful to recovery. 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.” Wellness must become the central focus of mental health for the simple reason that the disease model has provided grossly insufficient results

Health experts define mental illness as a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria that can produce functional impairment which substantially interferes with or limits one or more major life activities. Any disorder that results in 30 or more days of role impairment at work, home, or in social relationships seriously impacts one’s emotional wellbeing and quality of life. 

The pathographic or disease model of mental healthcare has been the modus operandi for centuries and it has been the overriding psychological perspective for over a century, with an insular focus on biological and neurological origins of mental illness. In Scientific American, psychologist Kinderman argues, 

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.

Positive Psychology

The wellness model’s chief facilitator is positive psychology (PP), which originated with Maslow’s  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.” 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.” 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.” 

PP has been defined as the science of optimal functioning, its objective to identify the inherent strengths, virtues, and attributes individuals and society need to live a productive life. Cultural psychologist Levesque describes optimal functioning as the study of how individuals attempt to achieve their 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.” Studies support the utilization of positive psychological constructs, theories, and interventions for enhanced understanding and improvement of ‘mental health. 

A range of approaches promoting wellbeing has 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.” Continuing research suggests that a positive psychological outlook not only improves life outcomes but enhances health directly. 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.“

The academic discipline of positive psychology continues to develop evidence-based interventions that focus on eliciting positive feelings, cognitions, or behaviors. 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.” 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.” 

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, incorporating both positive and negative aspects of the holistic individual. As one critical psychologist wrote, “people are not just pessimists or optimists. They have complex personality structures.” 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.” 

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. Positive psychology aims “to emphasize the positive while managing and transforming the negative to increase well-being.”

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.” 


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

[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.”

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.

‘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.

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

[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