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I think the problem is not with the medications themselves that are used to treat mental illness, but the framework in which they are utilized. The medical model, indeed, often sees intervention as being the only and best way in which to alleviate stresses to the body. This myopic understanding of health, mental and otherwise, is of great detriment to the patient and physician alike. Physicians are trained in specialization of the body, not its connectedness, as evidenced by the growing number of clinical sub-specialities. It is this view of health and the body that makes medication an obvious choice in cases of mental distress. Cause and effect in disease and mental health are not always so linear as to make a “magic-bullet” the ideal “solution” to complicated, multi-faceted problems. This can be a problem with talk-therapy, too, when the symptoms as they manifest to an outside observer or are reported by the patient reign supreme over the “whys” of the scenario, over the individual experience of the patient of that “illness.” Treating symptoms is the hallmark of modern medicine, but overlooks the context in which illness takes place, the individual who is experiencing the illness. And what is that individual’s experience of the illness itself? This may well not be as formulaic as medicine would like to think. When medication can be utilized to enable a person to be more available, emotionally, physically, etc. to engage in re-shaping their story, I think it is important, perhaps necessary. As was raised in class, a valid and important issue of which to be mindful is the potential for the medicine to mask the underlying problems and to become, yes, a “fix” to the problem, but sometimes one that is not sustainable without medication. I’m not sure this is a desirable end. If mental health can be viewed as the possibility of continually refining and reshaping out ability to tell stories that maximize choices (free will?), medication alone may not enable us to do that in the long-term, though it may allow us to be open to the possibility of revision of our stories. Psychiatrist Peter Breggin, writes :

“Children become diagnosed with ADHD when they are in conflict with the expectations or demands of parents and/or teachers. The ADHD diagnosis is simply a list of the behaviors that most commonly cause conflict or disturbance in classrooms, especially those that require a high degree of conformity.

By diagnosing the child with ADHD, blame for the conflict is placed on the child. Instead of examining the context of the child's life why the child is restless or disobedient in the classroom or home - the problem is attributed to the child's faulty brain.”


I think this raises an interesting issue, one of which to be wary. By pathologizing to a greater and greater extent, behaviors that are in some way non-conformist, the context of those behaviors is overlooked and the underpinnings of mental distress may fade into obscurity. Medication tends to give us license to ignore the “real” problems by treating the symptoms. The issue of whether medication or therapy or both are useful ways to treat mental illness cannot themselves be removed from the contexts in which they are used. In my mind, over-utilizing therapy is not at issue here, in terms of straining the system. Many people do not have mental health coverage that adequately ensure they receive the best care, so end up cycling in and out of hospitals or taking numerous expensive medications, rather than being able to engage in meaningful long-term therapy that may enable them to break the cycle. I’m not sure how mental health parity  will in real terms affect the quality of care, but hopefully it will make access to care less of an issue. I'm not sure that more money will, in and of itself, enhance understanding or awareness about mental health, but perhaps it can be seen as a step in the right direction... 

I think a general sense of interpersonal disconnection is very much a theme of modernity. As such, therapy enable an interpersonal connection that people may not be encouraged to foster in daily life. It is not the only or best connection, but a unique and important one for many people. 

On group therapy… I really enjoyed the exercise we did in class with Sarah. For me, it was a novel way to enact the working of tacit knowledge. Prior to the exercise, I did not have a working knowledge that I may have certain intution about people. The exercise brought to light some of those unconscious understandings and crafting a story after being drawn to a particular person pushed me to examine and understand my intuition in a way that I likely would not have done otherwise.

In certain contexts, I think group therapy has the potential to be incredibly constructive in serving as a source of new understandings, alternate stories that may prove more useful for the individual. My friend attends Alcholics Anonymous and, for him, this form of therapy is useful. He is open to and actively seeking a new story and interacting with people who have had similar experiences is helping him to create a new story. I think victims of trauma and abuse, may well, also, be served by group work, where shared experience may help to diminish grief, shame, etc. and translate those feelings into a story that is less paralyzing and more conducive to health. This is all very individual, as with anything else, and, of course, not everyone is open to this kind of forum or desirous of sharing their personal experiences with a group.

On the other hand, there are contexts in which I think group therapy may not be constructive and may, in fact, be deleterious. If there is no awareness of an alternative story, the possibility of an alternative story, the story teller may well take any incoming information and translate it in such a way so as to confirm and re-confirm the existing story. In group contexts in which a number of people are dealing with the same issues, the group dynamic may serve to reinforce the existing story. Until there is awareness of and openness to another possibility, I think group work may not be constructive.

I found the notion that blogging can be considered a modern form of group therapy an interesting one  For many, blogging can be a way to share a story and receive feedback in order to create new meaning by weaving together the others’ stories and sorting out what may or may not be useful/constructive for one’s own story.