Ram Psychology Mental
Health Mental
health in the NHS today is still dominated by the medical traditions which
underpin psychiatry. Drugs remain the main tool available to doctors for use
with patients who seek help for the “psychiatric” conditions which are
commonly labelled as anxiety, depression and schizophrenia. Such usage of
psychotropic medication assumes that there is a neurological basis for each
of these quite common health conditions. Psychoactive substances act at
receptor sites in the brain which are thought to mediate certain behaviours.
The rationale behind prescribing psychiatric medicine has been the claim that
so-called abnormal behaviours can be modified by the chemical action of
prescribed drugs at these neurotransmitter sites in the brain. Animal models of behaviour are often
used by researchers as the justification for drug usage to help to alleviate
or manage the conditions of anxiety, depression and schizophrenia. Human
beings, however, are advanced creatures, and the psychological conditions
which scientists attempt to model in the laboratory, with rats and pigeons,
for example, are of a qualitatively different order to the experiences of
people in everyday life. Nevertheless, if depression is contrived in a
laboratory, through the engineering of conditions by a scientist, and then
modified by a drug intervention, then clearly a much more effective way to
reduce the suffering of the animal is to remove the engineered conditions. Conditioned animal behaviour is well
understood by the science of modern psychology. Contemporary animal learning
theory has revealed powerful techniques that have been transferred to the
clinician’s office, and also transferred to behaviour modification programmes
in corporate organisations. When these techniques are applied in a positive
way, reinforcement schedules can be useful, in appropriate clinical
situations, to help to relieve the distress of patients who, for example,
have been experiencing phobias, and also with children exhibiting behavioural
problems in the home, or at school. |
As
an alternative to drug therapies, these tested psychological techniques are a
welcome intervention in those NHS services which strive to relieve distress
in patients, in all of its forms. Cognitive techniques have been added to the
behavioural methods which have been used in clinical settings. Cognitive
behavioural therapy is vogue, and has been used predominately, by NHS
clinicians, to treat anxiety and depression, and even schizophrenia. Research
is still ongoing to establish a convincing evidence base for this form of
intervention, with regard to its efficacy, yet these health conditions, as
experienced by patients, and defined in the literature, do not easily fit
with the goals which some clinicians are trying to achieve. The experience of
depression, for example, is not primarily cognitive, even if emotions and
associated thoughts of helplessness, sadness or guilt may be evident within
the mind of the individual. Depression which is defined as a “mental
disorder” actually misrepresents the nature of the experience of the patient.
Disordered or deranged thinking does not characterize depression. Bereavement
or divorce; impossible situations at home or at work; withdrawal from others;
loss of appetite and sleep; lack of interest in previously enjoyed activities
or sex; plus, lethargy, loss of energy, or agitation and anger, can combine
to make depression a more powerful and complex condition than simply an
extreme form of sadness that can be treated with antidepressant “happy
pills”, or re-engineered thoughts. The best way forward is not to make a
pathology out of a psychogenic condition. Disease is not the best metaphor
available for understanding individual distress which is experienced
psychologically. If a person is suffering, and then seeks the advice of a
doctor, there are different avenues which could be explored if NHS doctors
were to look beyond the manifested symptoms which a patient presents with.
This would require much more than just a sympathetic clinical approach to
those mental health problems which are discussed. A deeper understanding of
the human condition is required by all parties at the clinical level before
real steps forward can be made. |
Ram
Psychology |
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From Mentality to Spirituality |
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