What is Mental Health? How Do We Create it?

What is Mental Health? How Do We Create it?

The Social Therapy Group
on Jan 19, 2014

As mental health practitioners and part of a national network of independent therapy and life coaching centers in New York City, Atlanta, Philadelphia, Boston and San Francisco, we are inviting you to join an international conversation on mental health. As community therapists and coaches we are concerned about the impact of living in a world that is in crisis. In order to help people create the conditions for their well-being, we are organizing a dialogue with progressive therapists and their clients to create a conversation that will explore how we understand and respond to the mental health needs of our communities in such uncertain times. What is mental health? How do we create it within our communities? We look forward to hearing from people with a wide range of viewpoints and experience as practitioners, patients and people from all walks of life. Please join the conversation and pass this invitation on to others you know who may be interested.

Conversation Starter

Hello, everyone, and welcome to this online conversation on mental health. I'm Hugh Polk, a psychiatrist and social therapist at the Social Therapy Group in NYC. My STG colleagues – Christine La Cerva (NYC), Jenn Bullock (Philadelphia) and Murray Dabby (Atlanta) – and I will take turns hosting the conversation, with me kicking off the first week.

A word or two by way of introduction: I'm a traditionally trained psychiatrist. Early on in my career – this was back in the ’70s – I experienced the limitations of psychiatry in helping people who were in emotional pain and started looking for what else was out there. A friend introduced me to the late Fred Newman, a philosopher who had begun practicing a new, non-diagnostic, group-based, development-focused therapeutic approach that grew out of the radical cultural perspective of the ’60s. Along with Christine, Jenn, Murray and our colleagues and clients throughout the U.S. and abroad, I have been learning/practicing/teaching this approach, called “social therapy,” for the past 30+ years. We’re among the growing number of practitioners who are creating/practicing highly effective approaches that are focused on health and growth rather than illness and symptom control. 

But enough about me! I’m eager to hear from you – practitioners, therapy clients and others who want to share their concerns about the state of mental health. We may find the conversation awkward at first, in part because it’s not often that people who “do” therapy and people who are “in” it get to talk to one another about this or anything else outside of office hours. In some circles, as you know, doing so is actually a no-no. But I think we have a lot to talk to each other about.

To start with, I’d like to know what in particular you’re concerned about regarding mental health. The avalanche of drugs being prescribed for ADHD? The seemingly contradictory fact that so many youngsters, as well as adults, aren’t getting quality help with their emotional problems and pain? The indiscriminate labeling of people as mentally ill and/or cognitively impaired? The rampant bullying among children and teens? Psychiatrists controlling the diagnostic process? What else?

And what about the unspoken (and often unexamined) assumptions of Psychology? What do we mean by the terms “mental health” and “mental illness”? Is the medical model the best way to understand and treat emotional pain? Is diagnosis a necessary or helpful component of helping people?

Along with your concerns, tell us what’s working. What are you discovering about how to live an emotionally healthy life?

I’m eager to hear what you’re thinking about…let’s talk!

Looking forward, Hugh Polk

Moderators (1)

What do you think?

Anonymous
on 2017-08-21T04:32:33+00:00
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Recent Activity

jennifer bullock
on Mar 04, 2014
"Thank you Murray.  and I look forward to continuing the dialogue in these other forums with..."
Murray Dabby
on Mar 03, 2014
"I noticed that some of the links did not work so I am submitting them again.  Thank You ..."
Murray Dabby
on Mar 03, 2014
"I would like to thank everyone for participating in this important dialogue. We have now come to..."
Murray Dabby
on Mar 03, 2014
"Thanks Cecelia, for all your thoughtful words. I completely agree about the confusion of..."
Cecilia Alcocer
on Mar 03, 2014
"Thanks for the opportunity to share some ideas and advocate for myself and my peers. My main..."
Baylah Wolfe
on Feb 28, 2014
"  Jenn, I am grappling with how to respond to your question about the relationship between the..."
Noel T
on Feb 28, 2014
"Hi Elizabeth, Hugh and Jennifer Personally I had found being labeled and categorised as bipolar..."
Baylah Wolfe
on Feb 27, 2014
"Leah, I love your post about rejecting the ‘against-ness’ in the anti-labeling movement.  When..."
Leah  Schneider
on Feb 25, 2014
"Thank you for the sharing the blog piece on your group Hugh - what an excellent example of..."
Leah  Schneider
on Feb 25, 2014
"Hi Murray -  I appreciate your thoughtful reply and the opportunity to look at my approach to..."
Hugh Polk
on Feb 25, 2014
"Leah, I think your pointing to the need for us as creators of new emotional ways of being to..."
Murray Dabby
on Feb 25, 2014
"Yes Leah. What you are saying makes sense...certainly to me. I like your example using the..."
jennifer bullock
on Feb 25, 2014
"This is such an important converstation.  As a long time advocate for youth in the state/foster..."
Leah  Schneider
on Feb 25, 2014
"It seems to me that historically, the field of mental health has taken a medical approach to..."
Murray Dabby
on Feb 25, 2014
"Yup Lauren.  You are speaking to the ongoing contradictions of the healthcare and mental health..."
Hugh Polk
on Feb 24, 2014
"  Dear Elizabeth and Noel, Thank you for honest comments.  I’m a psychiatrist practicing a..."
Elizabeth Bautista
on Feb 24, 2014
"For those struggling with a mental illness, it's bad enough for them to deal with normal everyday..."
Lauren Feiner
on Feb 24, 2014
"While I think mental health should be about healthcare, I don't think it really can be dealt with..."
Murray Dabby
on Feb 24, 2014
"Yes Yuki. While Western medicine has made huge contributions, there is also so much more. Just..."
Yuki Nakamura
on Feb 24, 2014
"No one doubts the contributions of science and medicine to the people and society. Yet, there is..."
jennifer bullock
on Feb 24, 2014
"Thanks for sharing your story Noel.  I too see such a value in  being in tune with how we are..."
Noel T
on Feb 24, 2014
"I am bipolar and have recently been labeled schizo affective. To me that's all they are; just..."
Aaron Feinstein
on Feb 23, 2014
"not to say that disabilities aren't stigmatized as well....but many are accomodated for, and it's..."
Aaron Feinstein
on Feb 23, 2014
"I perosnally would like to see a disability/accomodations based system over a mental "illness"..."
Marian  Rich
on Feb 23, 2014
"I love that you turn to writing, Diana.  It is a very healing activity and I agree that it is..."
Marian  Rich
on Feb 23, 2014
"Thanks so much for your heartfelt responses Jennifer, Murray and Randy.  How fortunate we are to..."
Randy Wilson
on Feb 23, 2014
"living socially embracing our humanity and loving you"
Murray Dabby
on Feb 21, 2014
"Hello everyone.  While it has been quiet for a few days, there has been some interesting and..."
Murray Dabby
on Feb 21, 2014
"  Thank you Marion. Such a touching moment for you to share about the experience in your family..."
Murray Dabby
on Feb 21, 2014
"  Thanks for your thoughts here, Diana. I thought you so poetically wrote about what works for..."
Murray Dabby
From the Moderator: Murray Dabby
on Mar 03, 2014 - 5:29 pm

I would like to thank everyone for participating in this important dialogue. We have now come to the end of the exploration. We (Christine, Hugh, Jennifer and myself) were excited and privileged to participate in this important conversation. We wanted to create an opportunity for people from all backgrounds who are concerned about mental health to have an opportunity to talk and learn from each other, and create something. We covered the gamut, from very personal ways in which we struggle with the mental health system as it exists and what we do about it, to conversations about the conflicts of labeling and diagnosis in the mental health process, to the social, cultural and political context of creating mental health that make it challenging and critical to engage.  You gave us a wealth of compelling ideas in these dialogues as to how we can create mental health. Congratulations to us all!

We will be continuing this dialogue in a number of different forums.  First, Jenn Bullock leads a vibrant social therapy center in Philadelphia; Christine LaCerva heads up the social therapy center in New York and I lead the Atlanta Social Therapy Center.  Please contact us at those centers to join a social therapy group or to participate in the many workshops, forums, conversations with practitioners and other activities that we create as part of the community-building, relational therapeutic activity we’re engaged in.  Also, read Jenn’s blog at www.letsdevelopphilly.com/Blog/30/.  Please also read Christine’s blog at communitytherapist.com and my blog at www.atlantasocialtherapy.com. 

Hugh Polk will be writing an article in the next few weeks summarizing and quoting from this online conversation and posting it on DxSummit.org, a website where progressive professionals share their work in developing creative new non-diagnostic approaches for mental health.

Finally, please check out Lois Holzman’s website loisholzman.org.

Lois is the Director of the East Side Institute for Group and Short Term Psychotherapy and a brilliant thinker and creator of a new developmental psychology. She is writing a very powerful book, the Overweight Brain, on social therapeutic methodology and is encouraging people to offer input on her blog that she is using to develop the book. Please contribute.

Again thanks so much for being part of this! On behalf of Christine, Hugh, Jennifer and myself, we appreciate getting to know you all! 

 

Responses(2)

Murray Dabby
on Mar 03, 2014

I noticed that some of the links did not work so I am submitting them again.  Thank You

http://www.DXsummit.org

 

www.Loisholzman.org

 

http://thecommunitytherapist.com

 
jennifer bullock
on Mar 04, 2014

Thank you Murray.  and I look forward to continuing the dialogue in these other forums with everyone.

 
Expand This Thread
Cecilia Alcocer
on Mar 03, 2014 - 4:38 am

Thanks for the opportunity to share some ideas and advocate for myself and my peers.

My main concern with this topic is the terminology and the implications of it.

Some use Mental Health while others use Mental Illness.

The medical model and goverment institutions name it Mental Health "Departments" but they focus on mental illness, they label the patient and push medication as the "solution" to the "problem".

Organizations that promote peer support and provide support to family and friends; and are pro-recovery, talk about manage the condition, etc. have the name of National Alliance for the Mentally Ill. They are focused in health and wellbeing but present themselves as the association for illness.

This are just two simple examples of how confused we are and how much we confuse the public and those who are looking for help.

Language matters and until we do a reengineering in the language we use I don't think we can go anywhere.

When someone experiences emotional distress or have behavioral problems is refered to a professional in the mental health field and what he/she gets is a label of illness that has a terrible stigma attached to it. After that the person becomes part of a different category of beings, if you are a good listener you might have heard more than one person say this and if you haven't or you forgot  just ask again.

Of course, that person can always reach out for support, which I find extraordinarily helpful, but guess what, this wonderful support could in the form of a membership at the National Alliance for the Mentally Ill. Honestly, I wouldn't like to carry that membership in my wallet, I wouldn't be proud to belong there, I wouldn't tell anyone, would you?

Consequences of using that LANGUAGE:

- People are not seeking help

- People are not getting help

- Those who are seeking/getting help are not getting quality help

 

In my experience both as a consumer and as a peer professional I can say:

- There is no one model that fits everyone, there is no one theory or approach that works for all. But the medical model is definately failing us, it needs to be fix in every way.

- Professionals that deal with human beings need a deeper understanding of the complexity, connection and all the dimensions of the person. We are one but we have body, mind, emotions; and even for those who have difficulty accepting it we have soul/spirit -or let's find an ecumenical name for it- but it's something totally misterious and intangible that plays a great role in the persona and personality of all of us, it's undeniable.

- Persons who have to deal with mental and emotional challenges need a comprehensive, compassionate CARE.

- Please, no person who seeks professional help likes to be consider a CLIENT = $$$

 

What I would like to promote is new way to communicate about this topic applying some reengineering in the language. As a consequence of this I expect a shift in the professional and the consumer view as well as the public in general.

Forget about mental health or mental illness instead of that let's say:

Personal Wellness. 

A person with a medical/emotional condition.

Someone who is experiencing mental/emotional challenges.

Someone who needs support.

Patient with symptoms that need medical attention.

The symptoms that this person experiences require such and such medication.

Patient who has such and such symptoms and might benefit from therapy. 

It has to be about finding a positive, hopeful different way to see how chemical, genetic, environmental, sociological factors affects us and our behaviors. And bring together more and better ways to deal with them.

What is working? Good news, there are many options that work for different people.

Alternative medicine: homeopathy, accupuncture, supplements.

Breathing techniques.

Movement in all posibilities: walk, jog, exercise machines, sports.

Mind-body practices: yoga, ba-duan-jin, qui-gong, etc.

Reiki.

Art in all the possibilities.

Socialization: human contact, friends and support groups.

Spirituality: prayer, meditation, organized religion or just personal relationship with a higher power.

Healthy life: free of addictions, balanced diet, sleep higiene.

Self-care and self-knoledge.

Self-education/Research.

Perseverance, persistance, resilence.

LOVE

 

 

 

 

Responses(1)

Murray Dabby
on Mar 03, 2014

Thanks Cecelia, for all your thoughtful words. I completely agree about the confusion of language, particularly when it comes to mental health.  And I find that so true in so many areas of our culture. The 'mental health' establishment has do so much to focus on deficits, disorders and diagnosis. To me the focus need to be on possiblity, process, play, performance...what we can do as a people to grow, to develop.

I like all the options you have put forth...and i am sure we could collective develop many more that focus on our growth, rather than thinking we need to 'fix' what is wrong with us.

I am going to putting closing words to this over all conversation and glad you joined in.  I will be putting links up where this and other related conversations can be continued. Hope you can join us!  

 
Expand This Thread
Leah  Schneider
on Feb 25, 2014 - 11:20 am

It seems to me that historically, the field of mental health has taken a medical approach to understanding such abstract and complicated phenomena as our mental processes. Of course this approach does not work because we cannot trace pathogens (as we can in medicine) to the cause of mental illness. 

One similar example in how the medical field tries to tackle something so complex and dynamic is the "obesity epidemic." There is no pathogen for obesity (although there is a genetic component to being overweight - which is a different issue than the obesity epidemic) yet medicine tries to address it with a medical model, but often fails to look at the socio-cultural aspects of the "disease." 

I hope this is making sense, but for me, it's like we are approaching mental health as the medical field approaches something as complex as obesity.

 

To me, creating mental health seems to be about working within the system that we have and making changes from within, little by little. I think things are already going that way. Humans want to understand such seemingly intense and scary things as "mental illness" so it makes sense that as humans, we try to label and create categories. I think understanding this human side of the way we try to make sense of things may allow us as "creators" to "start where the people are at" and work from there. 

 

Responses(5)

Murray Dabby
on Feb 25, 2014

Yes Leah. What you are saying makes sense...certainly to me. I like your example using the obesity epidemic. I agree...how could one seriously treat such a epidemic from a medical frame? It is such a challenge just to work at living healthfully, given the social frame many of us live with. It is such a profoundly cultural phenomenon influenced by so many factors.  

I appreciate what you said about working to make incremental changes within the existing framework.  However I wonder if the existing framework is limiting the kinds of questions and ways of looking at the problem, and that may always be. Kind of like reforming the education system, when schools are maintaining the framework of teaching young people as individual learners, when a strong case can be made that support the whole group to learn would be more effective.

I was wondering what you thought about continuing to work within the framework that we have to improvement, while we simultaneously build outside of that, to create new frameworks that create success and brand new ways of looking at the problem?  I think there are many examples of that going on, - for example looking at mental health as having to do with creating new culture rather than new medical approaches - that is influencing the very conversations we are all trying to have. What are your thoughts about that?

Thanks so much for your thoughts and the work you do!

 
Hugh Polk
on Feb 25, 2014

Leah,

I think your pointing to the need for us as creators of new emotional ways of being to “start where the people are at and work from there” is very important and necessary.  As a social therapist leading groups every week, I try to help group members do that.  I recently led a group where people were having a hard time accepting what someone was saying, how hard her life is—they (understandably) wanted her to just get better.  I asked them why they were having a hard time accepting her and people spoke about how painful it is to accept our pain, hardships, difficulties.  They thought it was the same as being passive.  I said I thought it was critically important to radically accept where we’re at in order to begin to be able to create something new.  Our pain, difficulty, failures, humiliation—this is (among other things) what we have to build with.  I asked if they would work with me to engage our pain.  They said yes.  I was touched.  I wrote about this in more depth on Christine LaCerva’s blog—she's the Director of the Social Therapy Group.  The blog is at http://thecommunitytherapist.com.  The piece was written on Feb 19, 2013.  It’s an abbreviated transcript of this group session called “Radical Acceptance.”  I’d love to hear yours and others’ comments.  Thanks for your thoughts.

 
Leah  Schneider
on Feb 25, 2014

Hi Murray - 

I appreciate your thoughtful reply and the opportunity to look at my approach to therapy from different angles. 

At this point in my life and career, I have found that it is most useful to deal with the reality that exists and find ways to transfrom it from within. I agree, the direction the field of mental health has taken has been damaging to people, yet, it has provided some foundation from which to work. Many of the traditional ideas of psychotherapy and psychoanalysis have been refuted, especially in the field of social work. I was drawn to how social workers are encouraged to look at the various layers and interactions of the individual/family/environment, etc. and how self-disclosure can be helpful to clients. Furhtermore, i was drawn to how social workers are encouraged to look within ourselves, and to consider how we may be encouraging or derailing change. 

I believe change starts with ourselves. I believe I do the best work by helping my clients create change within themselves without denying them the reality they are in. Some therapists may always use labels, that's not a good thing, but by being against labels I think we give them too much power. I say, don't use the label, your effectiveness will show, and people will want to know more about it. 

 
Leah  Schneider
on Feb 25, 2014

Thank you for the sharing the blog piece on your group Hugh - what an excellent example of "starting where we are at." 

I also really liked your approach, that you helped the group members see and understand that they were avoiding the dismal reality of their situations and that this was preventing them from doing the work. 

Thank you again for sharing! It's always nice to see examples. 

 
Baylah Wolfe
on Feb 27, 2014

Leah, I love your post about rejecting the ‘against-ness’ in the anti-labeling movement.  When your radically accept your client, when you create growthful conversations with clients without putting them in a box, the person may sees new possibilities for their lives; they may be curious and like you said “they will want to know more”. That’s collaboration in the creating of your therapeutic relationship.

 

 

 

 

 

 

 

 
Expand This Thread
Lauren Feiner
on Feb 24, 2014 - 1:01 pm

While I think mental health should be about healthcare, I don't think it really can be dealt with in the usual healthcare manner given how healthcare is currently organzed.   Current healthcare is about treatment and (hopefully) cure.  Mental health, when related to in the same way, just becomes failure.  Most mental health issues are continuous battles...while some involve typical healthcare routines such as medication, most are not fully treated/curable, and can't achieve a clear ending to the condition.  And because of this, there is often no measurement for the success of the treatment/cure.  Many people cannot afford such an open ended financial commitment to mental health, and insurance companies rarely agree to pay for such a commitment.   Also, if someone can be treated with meds, insurance companies might wonder why they should reimburse for therapy.  Why is therapy needed if the meds work?  And it the meds don't work well enough that the person still needs/wants therapy, why pay for the meds in addition to therapy?

 

Responses(1)

Murray Dabby
on Feb 25, 2014

Yup Lauren.  You are speaking to the ongoing contradictions of the healthcare and mental health system. I liked your statement that most mental health issues are ongoing struggles. Unlike the medical model which requires the notion of the presence or absence of illness, symptoms, behavior, etc., doesn't it seem that an approach to creating mental health need to be about how we live and create our lives? 

 
Expand This Thread
Yuki Nakamura
on Feb 24, 2014 - 11:45 am

No one doubts the contributions of science and medicine to the people and society. Yet, there is a difference between something that can be bad and something that can be dangerous. The categorizations that science and medicine does about what is and who is mentally ill, can be dangerous depending on the way it is used and applied. It may make people think that they have "problems". It can make people around them to think that as well. It is in these cases that each and everyone of us has to think of a way to escape these processes.

 

Responses(1)

Murray Dabby
on Feb 24, 2014

Yes Yuki. While Western medicine has made huge contributions, there is also so much more. Just the advent and understanding of non-western practices have demonstrated to me how much western practice is so shaped by a dualistic method that limit looking at the entire life practice of human beings in taking care of health.

I do agree with what sounds like a concern about the danger of this kind of practice when it comes to defining who we are as human beings, via mental illness diagnosis.. Afterall, as simple as a label can seem, that is what is happening...defining or redefining us as human beings. This label saddles us and our culture with a new understanding of human as reduced to certain traits, personailities, abilities and deficits.  Not only that, we had no part in the decision or creating of the label! Now what if we did, that we had a say in the kind and character of the label that we are comfortable or happy with, or what might be useful to us? Is it possible to create our mental health as well as the conditions for when labels can be useful and what they even can be.

 
Expand This Thread