In the middle of a rainy Swedish summer, I am reading articles and blogs connected to the subject which is defined as “mental health,” and so I find myself feeling a bit “tired.” What is very obvious, when reading and pondering about mental health issues, is the psycho-individual perspective. For many years I have been aware of the increasing individual and psychological perspective in the Western world; still it makes me unhappy to notice this limited and to some extent narrowing focus described in articles, blogs, and also at conferences taking place all over the world.
Many researchers, practitioners and people with “lived experience” describe phenomena related to individuals, and most often related to psycho-individual ideas and “solutions.” In traditional psychiatry this perspective is very dominant, and Robert Whitaker describes in his books the increasing number of psychiatric diagnoses relating to individual symptoms and behavior, and the enormous increase of psychiatric drugs. He points out that an epidemic has taken place in the last decades.
The sad—and to some extent more concerning—thing, though, is that a kind of epidemic is occurring in the field of psychotherapy and psychology, with its increasing use of disparate approaches, methods, manual-based formulas and different theoretical schools, each having their own understanding and different treatments. Psychotherapy has come to mean everything and at the same time nothing.
The increase of psychological ideas, assumptions, theories and approaches based on an individual perspective is spread not just in therapeutic contexts, but also within social services, schools, and among people in common. Far too often social, political and economic perspectives are left out, as for example the harm caused by poverty, war, and injustice in society—as illustrated by huge differences between standards regarding schools, hospitals and housing.
Instead of focusing on these issues, no matter which “category” we belong to, we tend to examine and describe from an individual perspective. More organizations connected to people with lived experience are created and finally getting a place on the official stage. This is altogether great; people who have not been heard before are taking, and to some extent being given, space for their important experiences to be acknowledged and heard.
BUT, my fear is that if those of us, no matter if we are defined as professional helpers, clients or their families, miss the point, and instead of together trying to create a world built on equality, and justice we separate from each other by focusing on “our own idea”. For many years many of us have noticed the “fight” between different therapeutic approaches and how this fight rather has created a split than a strong movement.
For example, systemic family therapy was created as a reaction to the individual perspective some 50 years ago. Unfortunately nowadays in systemic practice and research you may often find people being described in terms of individual diagnoses. Individual-based methods and manuals are used no matter which theoretic understanding is presented.
It is high time for those of us working as professional “helpers” to find a way to not focus so much on our own specific approaches, theories and ideas, but instead focus on finding agreement on larger concerns. As much as each of us are influenced by our own history and context, we are also part of a large social and political context. These social and political issues have to be more acknowledged, and to be more taken into consideration.
The Family Care Foundation began with a vision to create a place that would be good for people, whether they be clients, their families, professional helpers or family homes. In other words; our vision wasn’t to create a method of treatment or produce a new theory. It was about something else; something that had to do with the conditions of people’s lives, our dreams, hopes and chances of creating meaning in our lives. It was about something that would give people the courage to live, and to promote the living part of ourselves. Our vision was built on the idea that we all contribute in different ways and that these contributions form a whole where each part is vital. Solidarity and each and everyone´s participation were essential from the very beginning.
Our practice has developed from people’s joint efforts, feelings, thoughts and deeds. There have been both moments and longer periods of deep anguish and uncertainty concerning the shared work, and our ability to survive as an organization. We’ve been questioned — and questioned ourselves — about what we’re doing. Is it really possible that so-called ordinary people can do what both psychiatry and social service “have failed at”? We’ve come to understand over the years how doubt and periods of self-examination are important. We’ve found a way to use this doubt and anxiety in practice, to listen to it and see it as an opportunity to comprehend something vital, something that creates meaning.
Still, today, the idea that we could create a living organization which consists of very different people coming from wildly diverse backgrounds is an amazing experience, which has affected my whole life. Influenced by a strong embodied feeling, we made the important decision when we started in 1987 that we would never do something we couldn’t stand for. No matter what happened we wouldn’t do it. We would rather shut down our operations. What brought us to this decision? The answer has to be that it felt so right, that intuitively we knew it was crucial. One of the most important decisions was to abolish psychiatric diagnosis and to support people to get off pharmaceutical drugs. It would not have been possible without being part of an international movement, taking part with other people´s experiences, courage and knowledge.
Either relational or social, political, and economical issues are not to be solved individually. It takes a lot of people to make changes – as is shown in history and also today. It takes a village to raise our children, just as it takes a connected and committed movement to make change happen.
I have a dream of a movement less focused on psycho-individual aspects and more focused on a wider perspective. In practice, it means we need to try to stop fighting about different psychological and theoretical approaches and methods and instead try to extend our understanding and network. It is important to find allies outside our “comfort zone.” We will have to extend our network and invite people who have experiences other than “mental health” issues. People who know something else about being human, and human beings, and human life conditions. People who, in their daily lives, as well as in their political and social actions, know the importance of taking a stance, of cooperating, and of being connected in life and with other people.
While we as individuals may not become known, the chance to make real change, if we can come together in this way, will certainly increase.
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Interview with Carina Håkansson
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.