‘What’s Wrong With You? Nothing. What Has Happened to You? Something.’ by Dr Michael Cornwall

mcornwall‘Licensed Mental Heath professionals are trained and are required to find out what is wrong with people.

Unfortunately, 90 percent of the people who could benefit from professional mental health services, in my opinion, are suffering from feeling something is wrong with them. They already feel bad about themselves, like they are failing in life. They often feel a lot of guilt, shame and self-loathing. They are often already judging themselves.

They may have been overwhelmed  by losses, by life events, or have not had their crucial needs met, or have been unloved, neglected, bullied, abused or mistreated by family and others. Because of what has happened to them, they may struggle to not identify themselves as someone who’s lot in life is to be rejected or harmed by others.

Enter the room with them, the totally well-intentioned mental health professional. Too often that encounter adds to the person in need feeling like they are somehow strange, abnormal, defective or damaged goods. Because right away out comes the DSM and the search begins for a valid category of psychopathology symptom cluster. The questions begin – questions aimed at finding abnormal psychology symptoms so a diagnosis can be made and treatment begun as soon as possible.

Graduate psychology and medical school classes in psychopathology train budding mental health pros in preparation for the landmark hour, when they are fully qualified and will legally diagnose their first client or patient. All mental health pros have to diagnose if they want to get paid. Medicaid or private insurance requires a DSM diagnosis.

Iit seems to me that if the medical model of psychiatry and the DSM were like other medical specialties that diagnose physical health problems, then finding out what is wrong ASAP would be absolutely right.

Because when we suddenly become physically ill, we want to know what is wrong with us as soon as possible.  In fact a universal problem with modern health care is that people often have to wait for days or weeks to get a definite diagnosis for even serious physical health problems.

That time lag doesn’t seem to be an issue where DSM diagnoses are concerned. I know people who have been diagnosed bipolar within 30 minutes of their first ever contact with a mental health professional.

Psychiatry has convinced many of us that our natural responses of emotional distress – via depression, anxiety, and the often waking nightmare of extreme states, are symptomatic proof that something is wrong with us that can be quickly diagnosed and should be treated like a physical illness.

There lies the problem.

The solution is to realize that emotional suffering is not proof of the individual being outside the normal range of human emotional experience. Anger is anger. It isn’t a symptom. Terror or despair or self hatred are not symptoms. Intense emotional states that can also give rise to hearing voices, or the creation of fantastical stories we weave to try and give meaning to our emotions, are also our human birthright as much as joy, peace and love are.

We all are capable of having any of the range of human emotional experiences, to any degree of intensity. They are formed by what happens to us and how our needs get met or not met.

The professional clinical assessment that is part of every contact with a client or patient is a detached, analytic, medical profession tool that is totally what should be used if we go to the doctor to find out why we are, for instance, coughing up blood. If that is happening something is seriously wrong with us.

If we feel like killing ourselves it’s not because something is wrong with us in the same physical, medical emergency way.  Something has powerfully happened or is happening in our relationships with others, and we are probably immersed in our most vulnerable feelings about our inherent value and are struggling with our unmet need to be loved.

The detached clinical, diagnostic response is not what we need when feelings of hopelessness, fear or despair are overwhelming us. A broken heart is not a heart condition. A broken spirit does not happen because of a serotonin shortage.

The clinical approach interferes with mental health professionals being sufficiently compassionate.

The suffering of the people I serve as a therapist sometimes brings me to tears. It happens unbidden and I don’t try and stop it. When they see my eyes tear up, a light of recognition goes on in their eyes. It is the light of their being seen by another person who cares.

When I was a medic in the Army treating men in physical agony, my professional responsibility was to not  let myself weep then, but to attend to them with a very detached focus in order to effectively clear the airway, stop the bleeding, and treat for shock.

It’s a tragic shame that emotional suffering has been categorized and treated by the medical profession just like it is a physical injury or physical disease.

They aren’t equivalent.’

This blog first appeared on the Mad in America website.

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