This is a transcript for a YouTube video which can be viewed here: https://www.youtube.com/watch?v=BiwXDOECYw8&t=128s. Because it is a transcript, it's not super well-edited and written for reading. But I hope you enjoy it anyway :)
Alright, let's start with the myth of genetic causation. How many of you have learned or been told directly by a healthcare professional that mental health is an inherited disorder? Or due to some sort of chemical imbalance in your brain?
I’ll raise my hand cause that is definitely the case for me.
Well… get ready to have your mind blown… the idea of genetic causation and chemical imbalance are not true.
Let me say that again. You DID NOT genetically inherit your anxiety, depression, bipolar, borderline, or ADHD, and you DO NOT have a chemical imbalance causing your mental health distress.
In fact, quoting Dr. Mate here, “No physical findings, blood tests, biopsies, radiographs, or scans can either support or rule out psychiatric diagnoses […] there are no measurable physical markers of mental illness, other than subjective (a person’s description of their own mood, say) and the behavioral (sleep patterns, appetite, etc.)”
So, how is it possible that we are so misinformed about mental health?
Psychiatry and psychology have been in a constant battle for recognition as a “hard science.” A science that is exact, quantifiable, and precise. Leaders in the industry have been aspiring to this for decades, and we are no closer to finding exact biological and genetic markers than we were in the 1970’s.
In 2013, when the fifth edition of the Diagnostics and Statistics Manual of Mental Health Disorders (DSM-5) was published, Dr. David Kupfer, head of the task force responsible for organizing and publishing, said,
“In the future, we hope to be able to identify disorders using biological and genetic markers that provide precise diagnoses that will be delivered with complete reliability and validity. Yet this promise, which we have anticipated since the 1970s, remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”
Not only are we still waiting, but we are also very confused about the truth of our mental illnesses.
Pathology
If you live in a Westernized culture with a Western approach to medicine, you exist in a framework that is pathologically focused. In the context of mental health, this means we hone in on dysfunctional processes, define them with a diagnosis, and then create a treatment plan focused on eradicating symptoms.
Most of our modern-day approaches to mental health are narrow-sighted and work toward the elimination of symptoms as opposed to the integration of them. This might include the use of medications to numb or mute the mental and emotional distress you experience. And half-hearted or nonexistent attempts to get to the roots of what ails you.
It is also important to note here that our cultural view of pathology and symptom elimination says as much about our cultural biases and values as it does about the disorders. In some cultures, a person who sees visions and interacts with undefined and unseen forces would be regarded as a shaman and elevated to the highest levels of the tribe. In Western culture, it is likely they are placed in a mental hospital and heavily medicated.
Now let me also state here clearly and explicitly. I am not against medications, and there are many people who benefit tremendously from pharmacological interventions. What I AM saying, though, is that oftentimes, medications are overused and over-relied upon to address symptoms. This approach mutes our ability to listen to the symptoms and keeps us trapped. Because, again, we are not acknowledging the root of the problem. We are simply treating the symptoms.
Diagnoses
Mate writes, “Like all concepts, mental illness is a construct - a particular frame we have developed to understand a phenomenon and explain what we observe. It may be valid in some respects and erroneous in others; it most definitely isn't objective.”
Okay, so what does that mean? Well put simply, it means that diagnoses do NOT EXPLAIN ANYTHING. They are abstractions or summaries of a constellation of symptoms.
Diagnoses give us a shorthand accounting of the symptoms a person may report or observations regarding someone's patterns of behavior, thoughts, and emotions.
For some individuals, the diagnosis is the first time they are able to define a lifetime of experiences that are too diffuse to put their finger on, and this is an incredibly helpful part of a healing journey. But the mistake comes when we make the assumption that the diagnosis explains where the mental health issues came from.
The circular attempt at explaining causation is aptly demonstrated in the bipolar diagnosis. How do we know a person has bipolar? Because they have mood swings. Well, why do they have mood swings? Cause they have bipolar!
You can see here we are again simply focusing on symptoms. Not the underlying or root causes. We end up in this circular conversation without asking why?
Mate writes, “(...) diagnoses reveal nothing about the underlying events and dynamics that animate the perceptions and experiences in question. They keep our gaze trained on effects and not their myriad causes.”
So, what are the causes of the events and underlying dynamics that influence mental health?
ACE Scores
Let’s start with something that many of us have heard about before: childhood trauma and the ACE scores study. Ace stands for Adverse Childhood Experiences and is a series of 10 questions that determines the number of adverse experiences a child was subjected to.
Categories include physical, emotional, and sexual abuse, neglect, substance abuse, domestic violence, parental separation, parental incarceration, and familial mental health. The higher the ACE score, the more likely a child is to grow up with long-term physical and mental health issues and higher rates of chronic disease.
These ACE scores are helpful in determining how traumatic a child’s upbringing was, which gives us more insight into the causation of mental and emotional issues.
I am not going to cover this in more depth in this video, but I have linked a video of a TED talk covering the ACE study and its long-term implications.
I had a supervisor who used to tell me that the DSM-6 will have one diagnosis: Trauma. Under the umbrella of Trauma, there will be a thousand designations of how that trauma is expressed.
He was obviously joking, and it is a bit simplistic, but the concept is true. Trauma, especially childhood and attachment-related, is a leading indicator of mental and emotional disturbances.
There is compelling evidence that high ACE scores even affect brain structure and explain many of the abnormal neuro-imaging findings we increasingly see with psychiatric patients.
This history of trauma is on of the things Mate is talking about when he says we are distracted from the myriad causes of mental health.
Relationships
Secondly, let's talk about relationships and connectedness. We are social creatures who need to be social and to feel connected with other humans. It is a non-negotiable need, and it gets stifled in all sorts of different ways. Some of these are covered in the ACE scores, and others are less overt, more subtle, and happen over prolonged periods of time.
It is also important to note that maltreatment alone is not necessarily enough to exert negative impacts on the neurobiology of the brain and the functioning of the mind. Some of us can experience horrifically traumatic things, but we have a support system of caring and empathic others that help us move through this.
Bruce Perry, a leading expert in the field of trauma and mental health, explains, “The most powerful predictor of your functioning in the present is your current relational connectedness, and then the second most powerful component that we see is your history of connectedness.”
Put simply, relationships matter.
Implications of this Model
So let’s sum it all up. Why do we neglect to recognize the role of trauma the importance of relationships, and persist with the myth of genetic and biological causation?
In my most optimistic frame of mind, I would say we are simply misinformed and playing catch up.
In my most pessimistic, I would say we have an entire health industry built on shakey ground that requires us to believe in unchangeable, inheritable, and constant factors, so we must remain dependent on symptom management.
I also think there is an unwillingness with many people to truly look at their shit. It is much easier to believe there is a quick fix out there that will eliminate all of our suffering than to accept that healing, truly healing, might require you to face some hard truths that you have likely spent your whole life avoiding.
We don’t like feeling culpable. And as Mate so eloquently writes,
“Genetics - that neutral, impersonal handmaiden of Nature - seems to absolve us of responsibility and of its ominous shadow, guilt. If genes truly rule our fate like capricious, microscopic gods, then we are off the hook.”
I see this all the time in my practice. We don’t want to be responsible for our suffering. And we most surely are not responsible for all the hardships that come into our lives. But we ARE responsible for coming to terms with that pain.
AND
With the right guidance, this actually becomes a quest for purpose and meaning. Not a continual cycle of helplessness and hopelessness.
Wrapping Up
Alright, so you’ve made it this far, and you are probably wondering, “Great, so what do I do about it?”
I empathize with the question we always want to know what to DO. I am going to make more videos about what we DO and how that process unfolds, but I want to leave you with a couple of bits of direction today.
First, you start to get curious about your experience. Here are a couple of questions that might be helpful for you.
Reframe the question. It is no longer; why is this happening TO me? It is; why is this happening FOR me?
What are your mental health issues asking of you?
What are they bringing you into contact with that nothing else can?
Once you really shift that mindset, you can start to get even more curious.
Have I felt this before?
Who do I feel this with? When do I feel it? Is it familiar? Does it remind me of any time or place during my life?
Who taught me this?
Who is the critical voice in my head? Where did I learn that?
These questions begin to open a whole new world where you are no longer relating to yourself, your mental illness, and your experience with judgment. You have now become the empathic other your soul needs. You can now listen.
This process is simple, but it is NOT easy. I know that for sure, both from my own life and the lives of my clients. But it is doable.
I promise when you begin to engage with yourself and your story in this manner, it actually becomes a quest for meaning. It gives you purpose. And it relates to a deep part of you that knows. The capital S Self that is seeking growth and expansion.
If you want to engage in this process, feel free to reach out to me. My info is in the description of this video.
Thanks for watching. If you liked what you saw and heard, please subscribe to this channel so you get notifications each week when I put out a new video. I appreciate you watching. See you next time.
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