Posts Tagged ‘mental health’

I attended a conference the other day: “Widening the Lens: Combining Science and Compassion in Treating Addiction and Mental Illness” presented by Gabor Mate, sponsored by William Osler Health Centre.

In order to understand an illness, we must understand the whole person. This theme was central to Gabor’s presentation, known as the biopsychosocial perspective, which acknowledges and explores the connections between the mind, body and environment in influencing and affecting an individual. (Although I completely agree with this idea, there is a lot of merit for the short-term approach of providing immediate assistance and support to clients who are not in the right space to delve into trauma counselling. For some clients, all they need are practical tips and suggestions for how to get more sleep, how to stop sleep walking, etc., which does not require counsellors to obtain a full understanding of the person to provide compassionate support). Without compassion in counselling and medical treatment, we are not considering the individual as existing outside of their symptoms/illness.

Addiction is the continued involvement with a substance or activity despite the negative consequences associated with it, where pleasure or enjoyment are also gained. We view addiction in 2 ways: as a choice, and as a disease. Regardless of whether addiction is the result of choice or disease, we have a tendency to focus on what the addiction is doing TO the person, and not FOR the person. Oftentimes people develop addictive habits out of necessity, as a coping mechanism when stress levels are high or where trauma has occurred. We expect people to stop their negative addictive behaviours, but what are we really asking of them? We’re asking them to stop something that makes them feel good, loved and connected (if only momentarily). Who would want to give up feeling this way?

An example: During the Vietnam war, 1 in 5 American soldiers were using regularly using (or were addicted to) heroin. When the war was over, 1 in 20 remained addicted. What does this mean? It means that the drug itself is not independently addictive, but that soldiers were temporarily susceptible to drugs because of the situation of war. Gabor argued then, that the soldiers who remained addicted to heroin had childhood issues of trauma.

Gabor did not deny that genes set the potential for addiction to develop, but insisted that our genetic makeup does not define us, but that if addiction develops, it is in conjunction with social and environmental factors.

Another example: Gabor was born in Hungary during the outbreak of World War II to Jewish parents. As an infant, Gabor was very upset and was crying all the time. When his mother called a doctor to inquire the causes, the doctor replied that all the Jewish babies were crying. Gabor concluded this was a result of the stress of his parents were feeling from the fear and threat of death and war. Children are attached and attune to their parents’ emotions and state of being much more than we might know.

At this point Gabor paused for a music break, playing the songs ‘Mother’ and ‘I Call Your Name’, both written by John Lennon, which portrayed John’s struggle with addiction and the rejection he faced in childhood.

However, in recent years, we have seen a shift of the attachment of children and youth from their parents to their peers. Peer-attachment is much more common today, and is facilitated by the developments in technology, where youth can communicate and bond with one another through text messages, Facebook, Twitter, and so forth. Peer-attachment is also more prevalent due to the hectic lives and stresses of parents, who do not see their children all day, and then at night are irritated or working second jobs. It is no wonder then, that children and youth seek attachments to their peers when they cannot get what they need from their parents. Gabor warns however, that so-called ‘normal’ development requires a hierarchy of attachment, where children attach to and learn from adults, and that peer-to-peer attachment will result in greater risk of youth for addiction. Looking at the situation of First Nations peoples in Canada, where addiction is highly prevalent, we have to go only as far as the violently imposed residential school system to see Gabor’s point.

The approach Gabor takes, centers on harm reduction and practices that bridge the mind-body-community gaps, such as spirituality, yoga, meditation, and non-Westernized practices, particularly those practiced by First Nations cultures, such as sweat-lodges and consciousness-raising experiences.

While I think the arguments presented here by Gabor Mate raised some very important concerns and issues, it needs further exploration. Also, the practicality of how to work with individuals in a way that addresses the biopsychosocial model is something I would question.

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The Western medical system has a long history of power abuse, oppression and discrimination. The Western medical model is premised on the notion that doctors and other medical professionals are in justified positions of authority, and hence are able to make health decisions for the purported benefits of patients. This necessarily implies an imbalanced relationship in terms of who has power and authority and who does not. Medical professionals of the Western world are given the power to control the bodies of patients, deciding what drugs they need to be taking, what surgeries they have access to, and even what bodies are permitted freedom in society and what bodies must be kept locked away in mental health institutions. Sometimes these doctors are correct, and the outcomes of their decisions benefit their patients. Other times they do not.

In my placement, I find myself struggling with the issue of the diagnosis of mental imbalances for women who have experienced violence. One client, H, is a woman who frequents the Centre on a regular basis. My supervisor, who is H’s counsellor, has told me that H has experienced sexual violence, and that it is likely that H suffers from a few mental health imbalances, as the paranoia and delusions that H experiences are vast. Just recently, my supervisor approached me and asked that I assist H at the Centre in booking a flight to leave that same day. Both my supervisor and I were wary of H leaving the province, but H was very adament that she needed to go away. As I was booking the plane ticket with H, she was literally unable to proceed with the process without constantly describing her assaults and the effects of these on her life. I tried to intervene and focus her on the task at hand, but her traumas combined with undiagnosed mental imbalances seem to have frozen her in a space where she is constantly consumed with the trauma. We booked H a 4:30 pm flight, but H continuously got sidetracked, and did not end up getting into a taxi to head to the airport until less than an hour before her flight. I spent the rest of the weekend thinking about if she made it to her destination safely, what she would do when she got there, and even where she would stay (she does not know anyone out there anymore, so I sent her with contact phone numbers and addresses for shelters, hospitals, etc).

So I have a very difficult time when contemplating the pros and cons of mental health diagnoses. On the one hand, I want to respect the rights and choice of my female clients in their decision to seek treatment (medicinal or alternative) for their mental health imbalances or not to seek treatment. Yet on the other hand, I feel myself wanting to refer some women to seek treatment, particularly the women who clearly have mental health imbalances but do not realize it (client H), as going untreated/undiagnosed could be extremely detrimental to their safety, health and overall quality of life.

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