Imagine you're in a tiny, sterile, white cubicle awaiting a doctor to read you the results from a series of tests. You remain optimistic with just a tinge of nervousness in the back of your mind- after all, nothing to get upset about yet. The doctor arrives. He shuffles some papers, or perhaps scans coldly through a series of databases on his laptop. The news- not good. You are ill...By ill, the doctor means that he has confirmed through a series of scientific tests that you have a disease. Suddenly, you are stricken with panic. Your thoughts race. Your knees feel weak. Your heart rate speeds up and you feel as if you're free falling in the pit of your stomach. You've come face to face with not only a new "disease", but also with your body's own vulnerability- perhaps even mortality.
Now, the term "disease" is defined vaguely at best in the dictionary. I encourage you to look it up yourself, but I assure you that it is broad in it's definition. However, the meaning that it conjures in the mind is that someone has been "stricken" with something- some sort of outer pathogen has entered the body and produced a sickness. Concretely speaking, if you're afflicted with a disease, you are considered ill. If you have cancer, this means your cells have begun to replicate and mutate. You did not directly cause this to happen, although perhaps some lifestyle choices you have made contributed to this, but you assuredly are sick and will remain so until a treatment is administered. If you have diabetes, then your body is unable to produce a necessary chemical and without taking it into your body, you'll likely remain sick. Take a moment and imagine that the doctor has told you that the disease you have is depression.
Advertisers and mental health professionals have spent countless amounts of time and money advocating that depression is indeed an illness. I suppose from a marketing standpoint, making depression the new treatable scourge makes perfect sense for pharmaceutical companies. I have less patience for mental health professionals advocating this type of labeling. Countless psychological research has indicated that we act as we are labeled. If you are labeled as sick or ill, guess what you have a tendency to act like? On a more philosophical level, we are faced with the anxiety of choice. With freedom to choose comes the responsibility of choice- an idea that is so terrifying we will do almost anything to escape it. The thing I believe we've done to escape our own choices is to attempt to medicalize them away. We are no longer in charge of our depression or our anxiety. We are, in fact, victims of our own brain chemistry. This type of medicinal approach has it's own benefits, namely the placebo effect and some small change in the absorption of serotonin. However, the risks are numerous, and socially they are catching up with us.
Feelings...nothing more than feelings. If I asked you to tell me one phrase that is associated with counselors, I'm betting 99% of you would say something close to "How does that make you FEEL". Feelings have become the stereotyped confessions inherent in therapy. I argue that feelings have become the focus of most therapy and most media information about mental "illness". The strange irony of this type of advertising is that feelings are really our least effective "agents of change" (hate that phrase but nothing else fits). We really have very little control of our feelings and therefore talking about them does very little to alleviate them. I would argue that talking about feelings and the catharsis that comes with this at first is at least better than attempting to mask them with medication. So much attention is paid to feelings because they are what we want to change. We don't want to FEEL depressed or anxious, so if we can talk through our feelings of depression and anxiety we will be ok, right? Well, if I talked about wanting to lose weight everyday of my life from now on, but never changed my eating habits or exercise habits, I'm assured to not lose weight. I won't lose weight because I haven't considered DOING anything different. Now, here is where I believe treatments for depression and anxiety get tough.
Anyone who has ever been depressed, or even seriously tired, for any amount of time knows that you don't FEEL like DOING much of anything. Serious depression robs us of our motivation, which in turns robs us of acting in ways that would help us. Motivation is a unique word because it is often used both as a feeling and as a behavior. For instance, you might say "I don't feel motivated" or you might say "I can't get motivated". In this case, it is much easier to "get motivated" rather than "feel motivated". I think both Frankl and Glasser would argue that in the process of getting motivated, meaning in the process of attempting new actions or just simply doing repetitively healthy behaviors, one has a better chance of eventually having the feeling of motivation. Simply put, if you FEEL depressed, DO un-depressing things even if you aren't up to it.
Doing implies that you have control over yourself. You don't have control over illness. Illness implies that something or someone else must make you better. This type of thinking and wording is doing more to harm people than anything else in the field of mental health. If you give up your control, then you are at the mercy of others but if you give up your control you may think they are at the mercy of you. Unfortunately, the idea that you can give your problems to someone else is untrue and, worse, dangerous. To believe that others are in charge of your care is to believe that unhappiness is akin to physical sickness- it's not. For now though, it would be nice to just do away with the word "illness" in any form related to counseling.
