Response to “Thinking About Our Work: What Do We Mean by ‘Mental Health’?”

Abstract

Response to “Thinking About Our Work: What Do We Mean by ‘Mental Health’?” Robert Pepper1 issn 0362-4021 © 2017 Eastern Group Psychotherapy Society group, Vol. 41, No. 2, Summer 2017 159 1 Director of Training, Long Island Institute of Mental Health, Rego Park, New York. Correspondence should be addressed to Robert Pepper, PhD, CGP, 110-50 71st Road, #1E, Forest Hills, NY 11375. E-mail: DrRobertSPepper@aol.com. In the immortal words of William Jefferson Clinton, “I feel your pain.” As a sociologist and psychotherapist, I tend to see the problem from a larger culture perspective. The perception of human unhappiness as an illness is a reflection of society’s dehumanized value system. We view each other as objects and treat each other accordingly. I, too, have cringe-worthy moments when I see in print (or hear spoken) terms like evidence-based or mindfulness-based group psychotherapy. These seemingly polar opposites are actually opposite sides of the same coin—the tendency to reduce complicated human emotions to simplistic formulations. Not everything that can be counted counts, and not everything that counts can be counted. And remember—don’t forget to breathe. It seems to me that no major change in a person’s life can occur without the person going through a period of despair, a mourning period for the illusion that a person can maximize all the good things in life—so much for the “change your brain” brand of therapy. The medicalization of psychotherapy has also led to the bastardization of medication. In our society of finding quick-fix solutions to complicated life problems, we tend to treat ourselves as objects, too. I’m reminded of the New Yorker cartoon in which a fellow, lying on his analyst’s couch, says, “Doc, I think it’s time to up the meds. I still have feelings.” We’ve become a nation of pill takers. Have you ever scratched your head in befuddlement watching a TV ad for some psychotropic medication whose side effects are worse than the condition it is supposedly treating? Some medications require the patient to take another medication to counter the ill effects of the first. Question: 160 pepper Who would take this stuff knowing the adverse effects? Answer: Plenty of people. The only legitimate use of psychotropic drugs is to facilitate functioning. Some group members actually have complained that they can’t understand why, even after taking medication, they are still unhappy. Instead of taking a pill, sometimes the best way to resolve anxiety and depression is to make a significant change in life. Here’s an analogy: Upon hearing the smoke alarm go off in the middle of the night, would you get up, turn it off, and go back to bed without determining why it went off in the first place? In some primitive societies, the witch doctors are only paid when their patients are well. In the West, we subsidize illness. Can you manage the radical shift in the priority of preventive treatment if we were to adopt the alternative model? But short of that, all is not lost. Here’s where group therapy comes in. To paraphrase Harry Stack Sullivan, relationships can drive us mad, and relationships can heal us. And R. D. Laing said that schizophrenia is a sane response to a crazy environment. He said that attempting to evaluate the emotional well-being of an identified patient in isolation from his or her social network is like trying to understand a football game by watching only the quarterback. We live in an ecological world in which others induce feelings in us and, in turn, we induce feelings in them. As group therapists, we facilitate the exchange of the most authentic currency of human experience—interpersonal feelings. We are in the unique position of being able to disregard the prevailing fragmented and fragmenting value system of the larger society and provide our group members with the opportunity to reconnect with their own emotional selves, in the context of progressive emotional communication with others. ...