“Mental health” is so all-encompassing in its breadth (It’s basically our entire subjective experience with the world) but at the same time, it’s actually quite limiting in the solutions it implies, as if there’s specific ailments or exercises or medications.
Are you saying that mental health is too limiting in terms of its solutions, because the real world is not involved? For example, I might come to a doctor saying that my child is restless. The child might be prescribed with medicine for an ADHD diagnosis, whereas the root cause is a flaky parent.
I agree with this point.
We’re miserable because our world is bad. The mental health crisis is probably better understood as all of us being sad as we collectively and simultaneously burn the world and fill it with trash, seemingly on purpose, and we’re not even having fun.
How is this not an over-simplification? People are miserable for all kinds of reasons. Of course the problem and the solution is always some combination of the world and how we interpret the world, but sometimes the problem lies more in the interpretation than in the world, right? It may have nothing or nearly nothing to do with climate change or the state of the world at large.
The mental health framework, by converting our anger, loneliness, grief, and sadness into medicalized pathologies, stops us from understanding these feelings as valid and actionable. It leads us to seek clinical or technical fixes, like whether we should limit smart phones or whatever.
Which may be valid under some circumstances, but sometimes a clinical fix as you call it might be in order. Sometimes people are just extremely unkind to themselves due to conditionings of the past, which are not relevant anymore today.
I would agree that solutions to mental health problems need to be examined in a biopsychosocial context, but whereas you say that just looking at the person and not the world is too limiting, I think just looking at the state of the world is too limiting.
Perhaps. I am not an expert. It was an example of a problem where the diagnosis depends more on the social context than on the biological context.
My wife is a family systems therapist and she told me once of a case, where one group of therapist had a child diagnosed with autism and another group found that the parents were the problem and that the child was only behaving in a certain way as a reaction to the parents’ behavior. They had a meeting on the topic and after re-evaluation they decided that the child was not autistic after all.
How is this not an over-simplification? People are miserable for all kinds of reasons. Of course the problem and the solution is always some combination of the world and how we interpret the world, but sometimes the problem lies more in the interpretation than in the world, right? It may have nothing or nearly nothing to do with climate change or the state of the world at large
Maybe it is, but is it useful? Right now, our currently accepted model for dealing with our widespread sadness is to go to doctors. Biden administration recently announced it wants to start screening every American over a certain age for anxiety.
I propose we consider that maybe people are more sad because the world is actually getting worse in a variety of ways. Sure, it’s simple, but I think it’s a great starting point. This way of thinking won’t help us understand every single so-called mental health problem, but isn’t it a reasonable starting point, rather than screening every American for anxiety.
would agree that solutions to mental health problems need to be examined in a biopsychosocial context, but whereas you say that just looking at the person and not the world is too limiting, I think just looking at the state of the world is too limiting.
Sure. That’s fine. I even agree. Multiple models and theories can coexist and have utility, even if they’re conflicting. My main point is that we’re seemingly stuck on one. There will never be one theory that explains anything perfectly, and I think the one we’re using now is particularly harmful for the reasons that I have set out.
My main point is that we’re seemingly stuck on one.
Yeah, and my point was that you’re just shifting it from this one (mental health) to that one (the state of the world).
It seems we both acknowledge that mental health issues are complex. Sometimes you really do need to get out of a toxic relationship or find a new career path or move to another city. But nevertheless people need to learn to take responsibility for their mental health. Usually when people do that they also then see that they need to make a change in their circumstances. Even if the state of the world makes you sad, it is still up to you whether you are going to mope all day, do something about it and/or learn to live your best life regardless of that fact.
The good news is that your basic point is largely being acknowledged by the mental health community. My wife is a systems therapist and has been reporting an increased understanding, in the mental health community, of the fact that issues do not live in isolation in someone’s brain as some kind of hormonal imbalance that can be fixed with some pills. Where I am from systems therapy gets covered by basic insurance and family systems therapy even gets funded by the government. We might be a bit ahead of the curve over here, but there are a lot of signs the mental health community is maturing.
With regard to the Biden’s anxiety proposal. I don’t think it is necessarily bad to screen people for anxiety. Anxiety is really out of control since covid and that affects the happiness of a lot of people. It depends what you do with the diagnosis. If that means that people are going to be prescribed mindfulness practices, which will be covered by insurance, then it might be a good thing. Even though America is the land of Xanax, it is also home to people like Dr. Jud Brewer whose book “Unwinding Anxiety” offers a very healthy approach to anxiety. And if people learn to rid themselves from anxiety based on mindfulness practices, there is a much higher likely hood that they will do something about the state of the world then if they are going to be stuck in endless anxiety loops.
There is another point that I’d like to raise. While you point out that the state of the world is pretty bad, I’d like to point out that the average mental health of people is pretty bad too. The two go hand in hand, for sure, but they are also independent to a large part. It is amazing how few tools people have to deal with their own psychological issues. People go to therapists to deal with stuff that they could trivially deal with themselves if they were somewhat better equipped to understand their own mind. From my vantage point most people could really benefit from going into some kind of therapy, meditation retreats, journalling, gratitude practice, solo hikes, etc. but people are super reluctant to do these things. Instead, most people who have mental health issues are not using their time effectively to deal with their issues, but instead complain about the state of the world and blame everybody but themselves. And usually it is also these very same people that fuck up the world. If people can not take responsibility for their own mind, then how can they take responsibility for the world?
Yeah again we don’t really disagree very much. I think you’re misinterpreting what I’m saying. I definitely don’t think I did this:
Yeah, and my point was that you’re just shifting it from this one (mental health) to that one (the state of the world).
As I said before, I don’t want to shift to any one new way, but rather to critique everything being always understood in the context of “mental health,” as per this article. The framing of this article is ridiculous, but also completely normal. I was just proposing that as a counterpoint to the prevailing narrative, not as a replacement. I think I already explained that in the follow-ups.
The good news is that your basic point is largely being acknowledged by the mental health community.
I unfortunately have extensive personal experience with the mental health community, and this has not been my experience at all, but I live in that land of Xanax, the USA, and our mental health community fucking sucks. Our psychiatric hospitals are barbaric. It is still perfectly normal to throw a psych patient into a room with nothing but a bed, a fluorescent light, and a camera, not provide them with food and water, lock the door from the outside, and leave them there for hours.
the fact that issues do not live in isolation in someone’s brain as some kind of hormonal imbalance that can be fixed with some pills.
This is awesome. The “chemical imbalance” theory of mental illness is scientifically debunked, but here in the US, it’s absolutely still taught in school and told to patients. It’s what my doctors have told me. If you tell people they have a chemical imbalance in their brain, that tells them that they have an innate medical problem, and that it must be overcome with medication. It’s almost like the drug companies come up with the theory 🙃.
Are you familiar with the book “Mad in America?” There’s also a sequel, “Anatomy of an Epidemic,” and a website. Maybe to an outsider from the US, this is just what the normal mental health community is like, but to me, discovering their work really helped me understand the barbarity of my own experiences.
Oh yeah, I live in the Netherlands and it is very different here. It seems big pharma is running the show in the US. Although I’ve heard that these kinds of things happen in the Netherlands to some extent as well, the scale of it is not comparable. We don’t have ads for medicine and doctors don’t reap rewards for writing certain kinds of prescriptions. These kinds of things just seem like insanity to me.
Omg lol those commercials are perfect. You’re making fun of them, but have you considered that that approach to healthcare maximizes GDP 🫠. Big pharma, big companies in general, really does run the show here. Send help, please.
I’d say it’s getting worse here, and more worryingly, it’s getting worse faster. My doctor friends are very clear about this: Our healthcare system has already collapsed, but you only know about it if you’re in it in some way.
Every year, my health insurance goes up in cost some ridiculous amount. This year, my partner and I had to spend some 4000 USD for our annual premium (that is in addition to what her employer is already paying for “employer provided” healthcare [itself a scam]), plus our deductible, or the total amount we have to spend before our insurance covers virtually anything, is 8000 USD. After that, there’s “co-insurance,” which I’m pretty sure didn’t exist 10 years ago and is a concept I don’t fully understand, but it’s some cost sharing arrangement with insurance companies before you finally hit your “max out of pocket.” I don’t even know what my max out of pocket is anymore.
The billing is similarly insane. Every time I interact with any healthcare system, I don’t just receive a single bill, but instead I receive a stream of confusing letters, each with differing amounts, and they trickle in for months and months.
I and many of my friends no longer pay our medical bills. I really just ignore them. When a healthcare debt collector call, I inform them that they are the most vile bottom-feeders and absolute scum of the earth, and that my payment plan is the revolution. So far, that hasn’t been a problem for me, which is only because I live in Vermont, and we do have some laws regulating healthcare debt, plus all our hospitals are not-for-profits. In much of the US, most hospitals are for-profit, and not paying your bills means you end up in a bad legal situation really quickly.
To add to all that, somehow, hospitals are perpetually low on funds, and wait times to see a new doctor are easily a year.
The situation is plainly unsustainable. We tolerate it because we are a stupid, pathetic, illiterate, and completely dominated population, terrified of each other and of change, but also too afraid to admit to ourselves that our pride at being the world’s most special country is a lie, because it’s the only thing we have left as the rest collapses around us.
Oh my god, I knew it was bad, but this sounds god aweful. Why is the US so broken in so many ways? Is it all to due with the 2 party political system? That would be my best guess for a root cause.
I’m not sure. I think the two party system is itself a symptom of a citizenry with very little political education, because ultimately we could exert power collectively if we had the consciousness to do so. There’s a small but very active leftist population in the US, but for whatever reason, we struggle to organize and break into mainstream.
The average American thinks Karl Marx is almost literally a demon from hell, socialism is when free stuff, communism is when government owns everything, and anarchism is when bombs.
Our state legislators, at least here in Vermont, and I’ve interacted with many of these, are generally landlords, and they themselves have little background or even interest in political theory. Our news rarely even covers other countries. As a result, we don’t even have the vocabulary for how things could be different.
I’m actually a dual citizen. I’m currently in Spain visiting my family, and it’s just shocking to me how much better things are here. I come about once a year, and by comparison, the US is just uncivilized. I don’t know how else to put it. It’s a huge comfort to me that I have a place with family and whee I speak the language to escape if/when things finally end in the increasingly inevitable violence that is coming.
I’d venture to say the political system is what made the citizenry. Genetically people in the US aren’t so different. My guess is that somehow your political system got fucked and that fucked the rest. I’d be interesting to know how it got to that point.
In terms of socialism, yeah I know people over there are totally brainwashed to vote against their own interest. It was just amazing to see how much people rallied against Obama when he tried to introduce some type of universal health care. “Health care for everyone? How dare you!!”. Lordy lord. People are so dumb. Not just americans though, it depends so much on the system.
Here in the Netherlands we have a surplus of PhDs. Not that we are genetically superior. We just have affordable universities and a culture that stimulates learning.
Ok, let me see if I get you.
Are you saying that mental health is too limiting in terms of its solutions, because the real world is not involved? For example, I might come to a doctor saying that my child is restless. The child might be prescribed with medicine for an ADHD diagnosis, whereas the root cause is a flaky parent.
I agree with this point.
How is this not an over-simplification? People are miserable for all kinds of reasons. Of course the problem and the solution is always some combination of the world and how we interpret the world, but sometimes the problem lies more in the interpretation than in the world, right? It may have nothing or nearly nothing to do with climate change or the state of the world at large.
Which may be valid under some circumstances, but sometimes a clinical fix as you call it might be in order. Sometimes people are just extremely unkind to themselves due to conditionings of the past, which are not relevant anymore today.
I would agree that solutions to mental health problems need to be examined in a biopsychosocial context, but whereas you say that just looking at the person and not the world is too limiting, I think just looking at the state of the world is too limiting.
I’d just like to say that this does not tend to be the issue in ADHD diagnoses, and is framing the issue of ADHD in a very incorrect way.
Perhaps. I am not an expert. It was an example of a problem where the diagnosis depends more on the social context than on the biological context.
My wife is a family systems therapist and she told me once of a case, where one group of therapist had a child diagnosed with autism and another group found that the parents were the problem and that the child was only behaving in a certain way as a reaction to the parents’ behavior. They had a meeting on the topic and after re-evaluation they decided that the child was not autistic after all.
I understand that singular cases do happen, it’s just a fairly irresponsible framing to use as an example imo.
👍
Maybe it is, but is it useful? Right now, our currently accepted model for dealing with our widespread sadness is to go to doctors. Biden administration recently announced it wants to start screening every American over a certain age for anxiety.
I propose we consider that maybe people are more sad because the world is actually getting worse in a variety of ways. Sure, it’s simple, but I think it’s a great starting point. This way of thinking won’t help us understand every single so-called mental health problem, but isn’t it a reasonable starting point, rather than screening every American for anxiety.
Sure. That’s fine. I even agree. Multiple models and theories can coexist and have utility, even if they’re conflicting. My main point is that we’re seemingly stuck on one. There will never be one theory that explains anything perfectly, and I think the one we’re using now is particularly harmful for the reasons that I have set out.
Yeah, and my point was that you’re just shifting it from this one (mental health) to that one (the state of the world).
It seems we both acknowledge that mental health issues are complex. Sometimes you really do need to get out of a toxic relationship or find a new career path or move to another city. But nevertheless people need to learn to take responsibility for their mental health. Usually when people do that they also then see that they need to make a change in their circumstances. Even if the state of the world makes you sad, it is still up to you whether you are going to mope all day, do something about it and/or learn to live your best life regardless of that fact.
The good news is that your basic point is largely being acknowledged by the mental health community. My wife is a systems therapist and has been reporting an increased understanding, in the mental health community, of the fact that issues do not live in isolation in someone’s brain as some kind of hormonal imbalance that can be fixed with some pills. Where I am from systems therapy gets covered by basic insurance and family systems therapy even gets funded by the government. We might be a bit ahead of the curve over here, but there are a lot of signs the mental health community is maturing.
With regard to the Biden’s anxiety proposal. I don’t think it is necessarily bad to screen people for anxiety. Anxiety is really out of control since covid and that affects the happiness of a lot of people. It depends what you do with the diagnosis. If that means that people are going to be prescribed mindfulness practices, which will be covered by insurance, then it might be a good thing. Even though America is the land of Xanax, it is also home to people like Dr. Jud Brewer whose book “Unwinding Anxiety” offers a very healthy approach to anxiety. And if people learn to rid themselves from anxiety based on mindfulness practices, there is a much higher likely hood that they will do something about the state of the world then if they are going to be stuck in endless anxiety loops.
There is another point that I’d like to raise. While you point out that the state of the world is pretty bad, I’d like to point out that the average mental health of people is pretty bad too. The two go hand in hand, for sure, but they are also independent to a large part. It is amazing how few tools people have to deal with their own psychological issues. People go to therapists to deal with stuff that they could trivially deal with themselves if they were somewhat better equipped to understand their own mind. From my vantage point most people could really benefit from going into some kind of therapy, meditation retreats, journalling, gratitude practice, solo hikes, etc. but people are super reluctant to do these things. Instead, most people who have mental health issues are not using their time effectively to deal with their issues, but instead complain about the state of the world and blame everybody but themselves. And usually it is also these very same people that fuck up the world. If people can not take responsibility for their own mind, then how can they take responsibility for the world?
Yeah again we don’t really disagree very much. I think you’re misinterpreting what I’m saying. I definitely don’t think I did this:
As I said before, I don’t want to shift to any one new way, but rather to critique everything being always understood in the context of “mental health,” as per this article. The framing of this article is ridiculous, but also completely normal. I was just proposing that as a counterpoint to the prevailing narrative, not as a replacement. I think I already explained that in the follow-ups.
I unfortunately have extensive personal experience with the mental health community, and this has not been my experience at all, but I live in that land of Xanax, the USA, and our mental health community fucking sucks. Our psychiatric hospitals are barbaric. It is still perfectly normal to throw a psych patient into a room with nothing but a bed, a fluorescent light, and a camera, not provide them with food and water, lock the door from the outside, and leave them there for hours.
This is awesome. The “chemical imbalance” theory of mental illness is scientifically debunked, but here in the US, it’s absolutely still taught in school and told to patients. It’s what my doctors have told me. If you tell people they have a chemical imbalance in their brain, that tells them that they have an innate medical problem, and that it must be overcome with medication. It’s almost like the drug companies come up with the theory 🙃.
Are you familiar with the book “Mad in America?” There’s also a sequel, “Anatomy of an Epidemic,” and a website. Maybe to an outsider from the US, this is just what the normal mental health community is like, but to me, discovering their work really helped me understand the barbarity of my own experiences.
Oh yeah, I live in the Netherlands and it is very different here. It seems big pharma is running the show in the US. Although I’ve heard that these kinds of things happen in the Netherlands to some extent as well, the scale of it is not comparable. We don’t have ads for medicine and doctors don’t reap rewards for writing certain kinds of prescriptions. These kinds of things just seem like insanity to me.
Have you seen this: https://www.youtube.com/watch?v=h_jX2KT7AMY ? :)
Would you say that the situation is getting worse, staying the same or (if ever so slightly) getting better in the US?
I am not familiar with that book. Sounds interesting.
Omg lol those commercials are perfect. You’re making fun of them, but have you considered that that approach to healthcare maximizes GDP 🫠. Big pharma, big companies in general, really does run the show here. Send help, please.
I’d say it’s getting worse here, and more worryingly, it’s getting worse faster. My doctor friends are very clear about this: Our healthcare system has already collapsed, but you only know about it if you’re in it in some way.
Every year, my health insurance goes up in cost some ridiculous amount. This year, my partner and I had to spend some 4000 USD for our annual premium (that is in addition to what her employer is already paying for “employer provided” healthcare [itself a scam]), plus our deductible, or the total amount we have to spend before our insurance covers virtually anything, is 8000 USD. After that, there’s “co-insurance,” which I’m pretty sure didn’t exist 10 years ago and is a concept I don’t fully understand, but it’s some cost sharing arrangement with insurance companies before you finally hit your “max out of pocket.” I don’t even know what my max out of pocket is anymore.
The billing is similarly insane. Every time I interact with any healthcare system, I don’t just receive a single bill, but instead I receive a stream of confusing letters, each with differing amounts, and they trickle in for months and months.
I and many of my friends no longer pay our medical bills. I really just ignore them. When a healthcare debt collector call, I inform them that they are the most vile bottom-feeders and absolute scum of the earth, and that my payment plan is the revolution. So far, that hasn’t been a problem for me, which is only because I live in Vermont, and we do have some laws regulating healthcare debt, plus all our hospitals are not-for-profits. In much of the US, most hospitals are for-profit, and not paying your bills means you end up in a bad legal situation really quickly.
To add to all that, somehow, hospitals are perpetually low on funds, and wait times to see a new doctor are easily a year.
The situation is plainly unsustainable. We tolerate it because we are a stupid, pathetic, illiterate, and completely dominated population, terrified of each other and of change, but also too afraid to admit to ourselves that our pride at being the world’s most special country is a lie, because it’s the only thing we have left as the rest collapses around us.
Oh my god, I knew it was bad, but this sounds god aweful. Why is the US so broken in so many ways? Is it all to due with the 2 party political system? That would be my best guess for a root cause.
I’m not sure. I think the two party system is itself a symptom of a citizenry with very little political education, because ultimately we could exert power collectively if we had the consciousness to do so. There’s a small but very active leftist population in the US, but for whatever reason, we struggle to organize and break into mainstream.
The average American thinks Karl Marx is almost literally a demon from hell, socialism is when free stuff, communism is when government owns everything, and anarchism is when bombs.
Our state legislators, at least here in Vermont, and I’ve interacted with many of these, are generally landlords, and they themselves have little background or even interest in political theory. Our news rarely even covers other countries. As a result, we don’t even have the vocabulary for how things could be different.
I’m actually a dual citizen. I’m currently in Spain visiting my family, and it’s just shocking to me how much better things are here. I come about once a year, and by comparison, the US is just uncivilized. I don’t know how else to put it. It’s a huge comfort to me that I have a place with family and whee I speak the language to escape if/when things finally end in the increasingly inevitable violence that is coming.
I’d venture to say the political system is what made the citizenry. Genetically people in the US aren’t so different. My guess is that somehow your political system got fucked and that fucked the rest. I’d be interesting to know how it got to that point.
In terms of socialism, yeah I know people over there are totally brainwashed to vote against their own interest. It was just amazing to see how much people rallied against Obama when he tried to introduce some type of universal health care. “Health care for everyone? How dare you!!”. Lordy lord. People are so dumb. Not just americans though, it depends so much on the system.
Here in the Netherlands we have a surplus of PhDs. Not that we are genetically superior. We just have affordable universities and a culture that stimulates learning.