It is recommended that you read this letter after the first three essays on this website, and hopefully also my thoughts on psychiatric medications or you will not have the context that will best make sense of what I have written here.
I Love Psychology
I really love reading the books. I especially loved reading the social psychology experiments when I was at Uni. I think it was Zimbardo and the prisons, and Milgram with the experiments around authority, ordering volunteers to administer electric shocks….. They were powerful studies.
They were about INFLUENCE. That is what psychology is about, in my view. We learn about people and what effects what. And we use that to influence people and systems.
Along with the above studies, the idea of self-fulfilling prophecies was a HUGE revelation to me. That is why it features early in my first essay, where among other things I wrote about labelling and diagnosing.
I think psychology may have wanted to aid research in the mental health field by trying to make diagnostic categories systematic, but the disadvantages of these categories outweigh any advantage.
What has resulted is the idea that people ‘are’ their label – they are Schizophrenics, they are OCDs, or Borderlines – staff refer to them in casual conversations every day. The clients sometimes refer to themselves like this. But worse is that they (and staff and families) think they have some limitation inside of them because of this use of language.
Those who surpass their labels, or who quickly exceed our predictions, should make us question our forecasting abilities. Yet we continue to diagnose; and our diagnoses often carry a lifetime prediction of difficulty
– We are INFLUENCING their future. Should we do it in this way?
It seems to me that psychologists are best placed to critique the practices of labelling and diagnosing our clients – historically you uncovered and explored these ideas. Yet this issue is rarely mentioned in mental health services today.
What do you recommend, given the significant harm that arises from negative and limiting thinking?
We all know that people frequently exceed predictions in – how can we foster this in our clients? Is this compatible with telling them they have an ‘illness’ (with inherent limitations?)
Do you think it is possible to have staff remember clients are not their labels, while they go ahead and use them on a daily basis? I don’t.
With the client who is in front of you, can you do your utmost to find that person’s successes and capabilities, when simultaneously you feel a need to diagnose them and consequently search for information about their difficulties, the variety of them, the worst level they have reached in their life (recently and historically?)
Is reminiscing about those experiences even necessary to assist the person to develop the skills they need to reach their goals? Solution-focussed practitioners suggest it makes it more difficult to focus on their successes and capabilities.
Despite medications, people are often left with significant symptoms that they must learn to cope with….and they do. People have great capacity to cope with symptoms and make improvements in their lives.
The idea that medication be given to people with psychological symptoms is just an idea that has arisen out of bad science and bad medicine. I think that psychological interventions have more to offer than medications. Much of the research supports this.
I heard once of an experimental ward that used almost purely psychological treatment; the results were favourable compared to a psychiatric ward run in the traditional way. However, the experimental ward was nonetheless closed down! (Ref – see below.)
I hold great hope for your profession to be more helpful to the clients of mental health services. Certain ideas get in the way, and the idea about ‘mental illness’ is one key concept that needs close examination. It leads on to the practice of labelling and creating limitations.
Call to Action
For the benefit of clients for decades ahead, the Psychology profession can place itself to have major role in this field. The idea of ‘mental illness’ is a limiting and untherapeutic construct that holds back clients and professionals in achieving great outcomes.
What can you do today to begin creating change?
1. Deikman AJ, Whitaker LC (1979). “Humanising a psychiatric ward: Changing from drugs to psychotherapy.” Psychotherapy: Theory, Research, and Practice; 16(2):204-14.