Posted in Advocacy, Mental Health

Why Do We Pathologize Pain?

We’ve come to pathologize emotional pain and human distress. That’s to say, we’ve come to medicalise it – give it labels that make it into a medical problem. And of course this serves a purpose in our society and our systems; I personally am hugely grateful for my mental health diagnoses because they help me understand myself and how I view the world. But the term ‘pathologizing’ goes beyond just medicalising emotions. It defines the problem that ensues from medicalising our emotions. 

According to the Cambridge dictionary, pathologizing means: ‘the act of unfairly or wrongly considering something or someone as the problem, especially a medical problem’. This is something we see in mental health spaces all the time, with very little awareness of it. The way we discuss mental illness is so often through an individual lens. We ignore how the modern world’s expectations affect what we see as disordered – for example a huge criteria for mental illness diagnosis is a lack of productivity. But productivity is defined by societal norms and expectations. We label someone as depressed, saying they have a chemical imbalance while ignoring the fact that they are living in poverty and perhaps if they weren’t their mental health would look very different. At best we say that these external factors are simply contributors and not an essential part of our human experience; we ignore how we define was is disordered or not entirely. 

There’s a million problems with this. It prevents us from trying to build a better world in a more informed way. It isolates sufferers and prevents them from getting the kind of care – like housing, community, less workload – that they actually need. I could go on and on about this (and I do quite often!) but today I want to answer the question – why do we do this?

Well pathologization stems in many ways from medicalisation. I think there’s benefits and issues within this itself, but it’s understandable why we do this. By giving clear criteria for diagnosis in a medical format it would seem we can more easily start a larger number of people getting treatment. Unfortunately this isn’t the case, but in theory this would seem to make that easier. It also allows us to have some kind of framework to understand ourselves and more easily find others who may have a similar experience – it has certainly helped me with this! And in theory it would help others have a doorway to understanding people with a mental illness by looking at it through a medical lens, so they would know how to start approaching the problem. Furthermore it also gives a structure for how we can syphon off funding for mental health care by making it a wholly medical service. All logical and on the surface optimistic reasons to medicalise emotional pain. 

But soon we see the problems come in such as trying to ‘fix’ people to medical standards too rather than to their own standards. We start seeing people as the medical problems rather than as people with diverse experiences. We try to fit people into one route for fixing the issue because that’s easier. Medical problems need medical solutions right? Medication and hospitalisation rather than community and economic support. We see them as scores and issues. And soon we are pathologizing them. The individuals become the problem they present with, and when the one-size-fits-all treatment doesn’t work, we assume it must be the individual’s fault. 

Maybe it’s just a natural progression from medicalisation then? But maybe it’s also a symptom of the way our western society functions as a whole. We are not exactly encouraged to see ourselves in the context of the world around us. We’re told we are individuals and isolated in many ways – so it would make sense that we see our problems as individual problems that need isolated solutions. So simply because of the way we have learned to exist in the world we don’t think to see our emotional distress as interconnected. 

Then of course, as already mentioned, we live in a society driven by productivity at ever increasing speeds. We have an intolerance for difference, for people who need different support or cannot fit themselves into the world’s expectations of them. So we need to label them as disordered rather than face the idea that the way the systems are running isn’t working. It negates society’s responsibility to change and accommodate. But the thing is as the world gets faster, the economy gets worse, pressures get bigger, more and more people are finding themselves with mental health issues. Do you really think this is a coincidence? The world is becoming more and more incompatible with human rhythms of nature, so more people are finding themselves in distress. But also if the expectations shift to demand more of us or different things from us, then whatever behaviour doesn’t fit those expectations ends up being labelled as disordered. 

And maybe it’s fear – we don’t want to face that we share emotions with someone with schizophrenia or bipolar. We don’t want to admit we relate to an autistic person, or can kind of see the sense in what that psychotic person is saying. We are scared that the difference lives in us too, maybe? And again – we have not learnt the skills to be able to conceptualise how others may live differently to us through their perceptions of the world. We have not learnt tolerance, nor we have not learnt to question the status quo – because it would threaten the status quo. 

I think we pathologize pain because it’s the easiest thing to do when everything else seems so overwhelming. But we can begin to change this simply by opening ourselves to compassion; opening ourselves to a different narrative. We are all human and we are allowed to have deeply painful, wonderful, beautiful human experiences. That means sobbing our eyes out or seeing shadows no one else can. Feeling does not make us the problem. 

Hopefully that made some kind of sense, my little brain ramblings on the internet. Sending so much love and support xxx

Posted in Advocacy, Mental Health

Over Pathologisation of Mental Health

We hear a lot nowadays about removing the stigma from mental illness, and that is incredibly important. After all, we all have mental health. But I also I think it’s essential while advocating in mental health spaces that we not only call for destigmatisation, but we also question the systems; call out the injustices of the systems meant to care for us. We must question whether medicalisation of mental health really helps us. Would it be necessary if our society wasn’t structured the way it is in the west? Does it further the link between mental illness and criminalisation? Because destigmatising mental distress isn’t only recognising that it exists, it’s asking why it exists, is the language we use to describe mental illness helpful, what does healing really mean, and how are we failing to learn the lessons from our madness? So here are some of my musings on the over pathologisation of mental health:

It individualises our pain without individualising our care – that is to say it tells us we are broken, it is our individual chemistry that is flawed, and we are to blame, yet also not putting us at the forefront of understanding our pain and choosing how we heal. It tells us we are too sick to know what’s really good for us, or that we don’t know ourselves well enough. It doesn’t allow us to learn who we are and what’s really at the root of our pain; doesn’t encourage us to put it into a sociopolitical context, and the context of what has informed our life. Doesn’t allow us to heal with others.

There is no community. No value given to peer support, to healing with others who are experiencing the same things or similar things or completely different things, but feel safe to heal with. Doesn’t encourage the connections that are vital to long term healing and alternative methods of care. If you want proof that peer support methods of healing work, look at AA – it revolutionised care for alcoholics. What was a death sentence became an opportunity for hope and healing.

Our pain is shunned and labelled, pathologised. Instead of learning to embrace the madness as part of who we are, we learn shame which in turn births more pain. Instead of learning to see mental distress as a natural human reaction, however difficult, we learn to be afraid of it. Language that could be used to free us is instead weaponised against us to strip us of our wholeness and our identity through clinical rotes.

But it doesn’t have to be that way. I don’t have all the answers. I listen to psychiatric abolitionists and I think, yeah, they have the answer. I listen to amazing healers in other cultures outside of the west and am filled with inspiration and hope. Then I look back at the world as it is and wonder if we don’t need to adapt our goals to be a little more realistic within the current frame of society here in the UK. I don’t have the answer nor a clear label for my ideology surrounding this all. But I do have hope. And I do know things are already changing. 

We don’t have to wait to build communities. We don’t have to wait to create new ways of healing. We don’t have to wait to find hope. 

You can also find a version of this post on my Instagram @our.happy.notes

Posted in Managing Mental Health, Mental Health, positivity

Identity in Mental Illness

As an autistic person with mental illnesses sometimes it can be hard to figure out who I am.

If you have diagnoses you might feel like you have to split up parts of yourself and your actions into boxes, like this part of you is autism and that part of you is anxiety, for example.

Or you might feel like your whole identity is your diagnoses.

Even without a diagnosis you might feel like parts of you are defined by the way you feel, split up and separate.

This can make us feel like we have to be ashamed of these parts of ourselves or like we are not really whole. It can be confusing to know who we are and find our identity in the midst of it all.

Then you add in other identity factors like sexuality, gender, and race which in many cases can complicate our mental health and understanding of ourselves even further – especially because it impacts how others see us, and this is even more prevalent for minority identities.

Rather than trying to see ourselves as a selection of different parts and separate ourselves into these parts, maybe we can start to think of it more like colours blended together and filters on the image of who we are.

Like my anxiety is red and it bleeds into my passion for theatre which is blue. They mix to create a purple in the middle, and that’s where stage fright lives. But all the colours are a part of me, blending together to make me who I am.

And my autism is a filter with a yellow tinge and that does affect how I view and interact with the whole world, but it isn’t my whole identity, nor is it separate to every other part of me. They all work together in different ways to make me who I am.

At the end of the day, you don’t have to have everything figured out about your life and who you are. No one does. It’s a journey and an ongoing process which can be really scary to think about. But it’s actually pretty amazing, all these colours that make up the rainbow of you, changing and growing each day. Remember – no one but you gets to define who you are; your identity is personal and you don’t owe it to anyone else, nor do you need to define who you are! 

But you are wonderfully unique, allowed to take up space, and your rainbow is so much more than you could ever imagine.

Posted in Advocacy, autism, Mental Health

Diagnosis – Good, Bad, or Dependant on the System?

Validation:

It can be very hard to access treatments and be validated by ‘professionals‘ within this system without a diagnosis. Budget issues and a mental health system based in oppression that seeks to produce productivity rather than healing and often doesn’t recognise its intrinsic links to all other aspects of capitalist society doesn’t help this. However, more importantly, without a diagnosis it can be hard to validate ourselves – to give ourselves permission to display certain symptoms, feel what we feel, and believe that it’s real.

Getting a diagnosis can be a validating and liberating experience for many people – my autism diagnosis certainly was for me. It helped me understand myself, put my entire life into context, and connect with other people going through similar experiences. That was incredibly useful with all my diagnoses – finding people going through the same thing and learning how they were managing in a world often not built for us which helped me find ways to define and facilitate my own healing. Community truly is a powerful force. It teaches us that we are not alone, and is one of the most invigorating tools in supporting mental health; my diagnoses are helping me find mine.

But we must ask the question – why do we lack validation without a diagnosis? Why have we not been taught validation and community by the systems surrounding us? If human experience was universally understood as fluid and acceptable, would we need diagnoses at all?

Stigma and Stereotyping:

However, diagnoses have also been used as oppressive tools throughout history, and being given a diagnosis can be a terrifying experience. For example women could be put into mental institutions if their husbands thought they weren’t living up to their duties and this was justified under the label of hysteria. Nowadays Black women are significantly more likely to be diagnosed with BPD – this may be a misdiagnosis of a neurodivergency (chronically under recognised in Black people) or due to how their traits and emotions are perceived so different within the system. Black people are also four times more likely to be detained under the Mental Health Act in the Uk – a hugely oppressive tool that twins criminal incarceration.

It may feel like a condemnation to receive a diagnosis due to preconceived notions of stigmatised mental illnesses, and lack of care options. Sometimes it can seem like a lifetime of suffering and inevitable failures lie ahead. It may even be harder to be taken seriously within the system – especially in psychiatry wards where any legitimate complaints can be brushed off as ‘symptoms’. Telling family and friends may elicit negative reactions due to their preconceived ideas, regardless of how positive the experience was for the individual

Stuck in a Box:

Although it can be liberating to understand your behaviour through the lens of a diagnoses, it can also be challenging when dealing with others and interpreting your own experience. It can be difficult to know where you start and where the illness ends, or to what extent you should view yourself as your illness. It can be difficult to know whether an emotional reaction is ‘natural’ or a symptom or a potential warning for future issues. It can be difficult to be heard and seen as anything but your diagnosis and your experiences as anything separate or unrelated to it by others.

Diagnosing a mental illness is not straight forward. No one person presents the same, and often two psychiatrists will have completely different opinions leading to misdiagnosis/ confusion for the individual trying to grapple with many opinions and find understanding.

And yet once given a diagnosis we are often stuck in a box or a more rigid understanding of who we are and how me must think and will behave. Does that seem logical? It doesn’t to me. But it’s understandable within a system that looks for easy processing, and profit – both achieved through the over medicalisation of human distress. 

When the DSM was first released in 1952 there were 102 diagnoses in it. By 2000 there were 365. This has since reduced again – but you can see how inexact and dramatic the medicalisation has been.

Nonetheless, getting a diagnosis, finding community and comfort it in, can be a very positive experience. My autism diagnosis certainly was for me, and being able to say I’m bipolar helps me feel whole and proud of everything I’ve been through. But getting those diagnoses, navigating conversations, therapy, and life with them has been challenging and complicated. And I am privileged in many ways. Bottom line – receiving a diagnosis is not something to be afraid of, and if your experience was good then that is amazing, and valid! But negative experiences are just as valid too. Perhaps even more so because they often fall on the more marginalised. And everyone’s emotions, pain, and trauma are valid with or without a label. We deserve a society that teaches us that.

Sources

  • Sedated: How modern capitalism created our mental health crisis by James Davies
  • verywellmind.com 
  • mind.org.uk
  • Phenomenology of Borderline Personality Disorder, The Role of Race and Socioeconomic Status, Natacha M. De Genna, PhD and Ulrike Feske, PhD
  • My brain