People often come into therapy with me with two very different expectations. Some people talk about the story of their life so far, and want me to help uncover their “truth”. Others come with a list of symptoms they want to have removed but do not see the point in going over their personal story. Both are looking at only part of a problem and are doing so because of the stigma surrounding mental illness.
The client looking for truth, is on a good path. I believe they are looking for answers to why they behave the way they do, especially when there seems like no logical reason. I can answer this partly through what is called “psychoeducation” and what is known as a “functional interpretation” of their behaviours (both of which I will explain in later blogs).
The client looking to remove symptoms is usually looking for exercises that maybe aren’t connected to their logic or meaning, something science has tested as a good solution. This is a good sign that the client knows something needs to change. These clients can be given homework and in-session exercises to help reduce their suffering. However, both clients are trying to put their problem into a box. This is not unlike an overweight person with diabetes taking their medicine religiously but refusing to try exercise and dietary changes.
Stigma is often most strong around questions that are not easily answered, and where morals are usually involved. Stereotypes then come into use around the stigma because the nature of the subject is just too confusing to consider as a whole.
The client looking for truth is working on the basis that mental health issues are attached wholly to meaning and story-telling. Thereby they approach their mental health issues like a school book report. There is an assumption that once they reveal the author’s themes they will be able to work out why they as the main character have made the decisions they have. This is based on the idea that insight is cure. Admittedly it is a fantastic first step, but in this case, the first step is a thought experiment and far easier to achieve than real behavioral change outside of therapy. Unfortunately this perpetuates the stereotype that mental health issues are an inherent problem-solving incompetency solved by applied logic… or more simply, that once you know why you’re doing something wrong it will be easy to fix. This stereotype, like most, is an incomplete truth.
The other realm of stigma is covered by the client who wants their symptoms to disappear. They usually understand that a change in their insight will not necessarily solve their mental health issues but do tend to believe that I own a special silver bullet which will help them remove their symptoms without having to touch on difficult thoughts and memories.
Remember that stereotypes are an efficient way of addressing life. They are used every day, by everyone. If you were constantly engaging fully with every choice in life you would either have to live in a yurt, or always at all times be on the look out for the consequences of every action you make which can bring on another host of mental health issues on their own.
I believe the most effective way of addressing the stigma toward mental health and toward engaging fully with services such as my own is by having the wider society understand the context of mental health issues. That we have to be at ease with the fact that you are going to walk away from a session better informed, but with no single answer.
All of these statements regard the issue of context. Stigma arises when we get lazy. We find it impossible to put our mental health issues in a nice neat little box in the same way people understand the medical sciences.
It is possible you will need to blame your parents, society, and yourself all at the same time.