Relationship realities for men
This bloke has some very useful and valid things to say about relationships, especially for men- worth the few minutes from your life to watch it, especially if you (men) are wondering why your partner is constantly complaining and unhappy.
click here to watch the short video
On Dreams- from The Saviour Syndrome by John Carroll (2023-pp 120-123)
The following are several pages taken directly from John Carroll’s most recent book. I think his ability to articulate the range of functions of dreams is most insightful, and demonstrates that psychologists do not hold a monopoly on psychological knowledge or wisdom. Here, a sociologist provides psychological insights which appear to be beyond the capacity of many contemporary psychologists, often unable to get past their obsession with cognition and behaviour.
“The unconscious mind is the inner sanctum, where what matters roams at will. And, within its domain, during sleep, inchoate (rudimentary) anxiety is translated into story after story, in order to tame it. The sleeping innocent is taken through the looking glass. The dreamer is the helpless slave of the dream, having no choice over the substance of the narrative, its mode of expression, or its emotional tone. He or she is “dead to the world”- what a fine English expression! That is, the rational, ego self is without power over anything; it is a self-important king with no kingdom. Dead to the world means alive to the inner and its voices, abiding in another order of reality, where the person is free to tune in without distracting noise, without being disturbed by the cacophony of the world. Here is a lesson in authenticity.
The conundrum is that every night, all humans compose twenty or more stories, sometimes with complex structure, coherence, subtlety, and sheer narrative flair of a first-rank literary work. These dreams are composed for an empty theatre. Except when the dreamer wakes up during the odd one or two, and unreliably recalls them. Even then, there is an additional inbuilt censoring- soon after, most of them are forgotten as they sink back into the misty unknown. It is as if we don’t want to know about these eruptions out of the subconscious mind, whether they be petty, surreal, dark, or instructive.
He's just a dreamer, it is said, dismissively. Perhaps this is a way of expressing embarrassment about the fact that the most interesting and creative self is hidden- the one who dreams at night- or, in the case of Faulkner, the one who rules from within, the real self.
The self-importance of many modern individuals hinges on their faith that they are in control of their own lives, that they act with free-will and rational choice, and that they are insightful about their encounters, inventive in their response to them. I choose myself; I steer my life. Yet, they harbour something that rules the night, and from there, much more of what they do. It represents a breath-taking blow to self-esteem, exerting irrepressible power over them and their lives. In further mockery of their humanist conceit, it is far more freely imaginative than their conscious being.
The psychological role that dreams play may be spelt out, to some degree, in a rational analytic exercise. Freud stressed that dreams seem to have the function of repairing the day, to save sleep from being disturbed by spill-over tension. They do so predominantly through wish fulfilment. A mother refuses her child an ice-cream, so the child compensates by dreaming it at night, and licking it with joyful pleasure. Adults make brilliant speeches in their dreams, win Olympic gold medals, display a stunning beauty that stops men in their tracks, and receive high recognition and adulation from others. The common type of night fantasy exudes banality, hard at work cuddling a diminutive self, suffering from petty insecurities, rancour, and rash ambitions. Wish-fulfilment dreams also serve to boost morale- recasting the timid, mediocre self as a world-conquering hero.
Then there are anxiety dreams, mostly taking the form of the stock repetitive kind: a tooth falls out; the dreamer appears suddenly naked in public, to their mortifying embarrassment; a flight, or an exam, and the subject is helplessly side-tracked, and by the end, disastrously late. Anxiety dreams also seem, in part, to play the role of repairing the day. They act cathartically, by translating free-floating, amorphous worry into a story, defining it in order to lance it, letting out some of the pus. These dreams depict the worst that might happen, and even more, project inflated caricatures of what is feared. They may serve to release tension.
Anxiety dreams extend into the borderland of nightmares. They too may act partly out of catharsis. But nightmares seem to express a will to self-destruction, a death instinct, with the subject magnetically attracted to disaster. They express a horror fascination with irredeemable catastrophe, and with death. The dreamer is hypnotically drawn towards the whirlpool, which sucks its victims deep down a vortex, where they will disappear, forever, into oblivion.
Occasionally, dreams reveal the truth. The provide insight that the daily conscious self has failed to gain. They may even serve as a wake-up call, and a warning. A friend whom one has seen as an entirely good person, a Dr Jekyll, is shown as having a Mr Hyde malevolent side, harbouring ill intent. Or, a driving personal ambition, decked in glittering hope, is exposed as delusory. By contrast, an embryonic or undeveloped capacity may be displayed at full strength in their dream, in successful performance to the world.
The kind of psychology just rehearsed is speculative. The truth is we don’t have much idea why we dream, never mind who does the dreaming. That dreams are created in the unconscious mind, while the subject sleeps, is clear and uncontroversial. The same unconscious mind is deeply implicated in the life story.”
Well, I would only add that John Carroll diminishes the great insights he displays about dreams in the final paragraph, unfairly so. It is a sad comment on contemporary psychology that a sociologist actually shows much more awareness about the nature of dreams (and in accordance with what the dream-science tells us) than do many psychologists who have abandoned dreams as unimportant, random electrical activity which serves no purpose, provide no meaning, and therefore not to be given any significance in the endevour of helping people psychologically. Bravo John Carroll!
ADHD drugs for adults?
As have many psychologists, I have experienced a radical increase in the amount of adult clients presenting to me with a self-diagnosis of ADHD in the last couple of years (since everyone had more time during the pandemic lock-downs, and pharmaceutical industry funded-groups inundated social media with ADHD ‘information’). There is a valid debate about the concept's legitimacy and reasons why it has gained more popularity, which has nothing to do with medical science, but a lot to do with the nature of our culture and how it is failing children terribly; people’s needs for a ‘grand theory’ to explain why their lives are difficult and challenging; our culture’s denial of the role of trauma in all emotional/psychological problems in living; and with drug company needs for mega-profits now that the anti-depressant ‘bubble’ appears to have burst (reduced profits from antidepressant sales have motivated pharmaceutical companies to find an alternative diagnosis- also requiring a drug treatment- to the ubiquitous ‘anxiety and depression’ diagnosis which became a catch-all label for anyone experiences challenges in life since the late1980s. Several years ago, the drug companies saw the writing on the wall and ceased funding research into new antidepressants, realising that they had reached a high-water mark of diagnosis and drugging for depression- which is usually unacknowledged and untreated trauma in disguise, not a medical/psychiatric ‘disorder’).
The question of drug treatment for ‘ADHD’ adults is the focus of this article. Firstly, I don’t have a problem with any adult putting any substance they want into their system, as long as they are exercising informed consent.
Secondly, drugs change experience and behaviour- that’s why we take them. ADHD drugs are just amphetamines with clever marketing (some are even metamphetamines). That low-dose amphetamines increase concentration and the ability to perform mundane tasks is a drug effect, ie. they have the same effect on nearly everyone, and this effect does not indicate a ‘disorder’- only that drugs alter experience, and this is how these drugs alter experience. If someone appreciates the altering, then they call it a therapeutic effect (if they don’t appreciate the altering, they call it ‘torture’. Most kids who are put on amphetamines for ‘ADHD’ take themselves off it as soon as they are able to because they don’t appreciate the effect, which includes more emotional dulling- something they often describe as ‘torturous’).
Third, even low dose ampthetamines come with risks, even for adults. Increases in heart rate and blood pressure, diabetes, increasing risk of heart attacks and strokes are adverse effects, especially for people in an at-risk age group (see J. Moncrieff- The Myth of the Chemical Cure). Moncrieff, a UK professor of psychiatry states that the heart attacks can be sudden and fatal, even in children (which reminds me of a drug company add I saw as an undergrad psych student which listed as a possible adverse effect “Sudden Death”-the same drugs are now more routinely prescribed to children, despite this risk).
The drugs lose their power to produce the same beneficial effects over time, which requires a constant increasing of the dose to produce the same desired effects (sedation, the ability to focus on mundane tasks). Due to this habituation of the nervous system, these drugs are addictive. People can have difficulties coming off the if/when they decide to do so- it can be a long and painful process. The drugs can also produce a ‘rebound effect’, ie. an increase of the pre-drug problem experience when the dose is wearing off. For some people (those who’s system are not able to adequately metabolise- break down and expel the chemicals in the drug), there can be a gradual build up in concentration of the chemicals in the blood, which goes to the brain and results in adverse effects- these can include:- depression, anxiety/panic, agitation, and even toxic psychosis (see my pharmacogenomics page). Some people can experience these adverse effects even at low doses. No prescriber can tell by examination or questions whether any patient is a poor or adequate metaboliser of amphetamines, and therefore whether they are likely to experience adverse effects or not.
There is a genetic test which reveals whether a person has been born with the right ‘loading’ of the relevant liver enzymes to adequately metabolise amphetamines or not (MyDNA- mental health medications test- costs around $150). My suggestion for anyone considering going onto any psych drug, including amphetamines, is to get this test done in advance, as it can predict 75% of a person’s reaction to the commonly prescribed psych drugs (which is far in advance of what any prescriber can predict).
As stated, my ethic around psych drugs (just like all other drugs) is informed consent, and people need to be well informed in order to exercise it. I hate seeing anyone suffer adverse effects which they were uninformed of because a prescriber either didn’t know of them or didn’t tell them. Most of the information prescribers get about psych drugs and their effects is not obtained at university during their medical training, but from drug company sales reps who have a demonstrated track record of falsifying clinical trial data, disease mongering, denying adverse drug effects and beefing up potential benefits. They call their marketing ongoing ‘education’, but it is a sales snow-job. While I have a concern about adults choosing to go on these drugs, my concern for children being put on them brings in a whole raft of other issues, ie. their increased vulnerability, and their inability to exercise informed consent.
Like all other ‘mental health disorders’, AHDH is an expression of trauma. The label refers to real phenomenon- difficult experiences and problems in functioning. But what is causing these problems? Canadian physician Gabe Mate provides an excellent explanation in his book Scattered Minds, detailing the role of attachment trauma in infancy, which sets the person up for developmental delays, seeing them somewhat stuck in toddler like inattentiveness, restlessness and inability to concentrate. Unfortunately, he still advocates the use of amphetamine drugs (which he is on) despite clearly seeing the psycho-social factors causing it. I suspect this has to do with his training as a physician, his social role as a prescriber, and perhaps his own un-processed attachment trauma. American psychiatrist Peter Breggin provides an excellent account of the dangers of amphetamines for children in Talking Back to Ritalin (a few years old now, but the research evidence showing the dangers of these drugs only has more evidence now as a result of more years of observations). Another excellent book is The Myth of the ADHD Child, by psychologist Thomas Armstrong- this book provides a broader cultural understanding of the social factors which contribute to kids that can’t settle or can’t concentrate in the ways required of them in schools and households. His analysis is broader that Gabor Mate’s, and includes dozens of non-drug options to help kids, their parents and teachers. I think these books are an excellent combination in creating a sound understanding of what is going on for kids who are given this label, and what to do about the challenges which they face.
Dissociative Identity Disorder (DID) – or ‘multiple personalities’
With DID, we're basically talking about extreme and complex trauma- or at least, the expression there of. How people express extreme trauma differs over time and from culture to culture. eg. how people expressed trauma in turn of 20th century Vienna (to Freud etc) differed radically to how people express it now, and how people express it now in America differs (even slightly) to how people express it in Australia, the UK, or (greatly) in Africa, India, China etc. Our culture gives us a ‘language’ with which to express our trauma. In my view, the entire psychiatric ‘bible’ (the Diagnostic and Statistical Manual which list hundreds of ‘psychiatric disorders’) is nothing but a catalogue of the different expressions of trauma, at least in North American culture. The really interesting question is “why such radically different expressions”, from asserting that you are being controlled by Martians, through to being addicted to gambling, with everything in between. There are again differences in (family) subculture, probably temperamental differences, and probably differences in initial attachment traumas which lead to such varying outcomes.
All psychiatric labels (including ‘DID’, ‘Borderline Personality Disorder’- BPD) are just short hand descriptive terms which point to certain phenomenon, used for the convenience of professionals, ie. they have no scientific validity in their own right (and usually very poor reliability). We get into trouble when we forget this, and reify the label, thinking that we are actually dealing with a ‘disordered personality’, rather than with a distressed human being (highly traumatized). The rationale for using them is that the ‘diagnosis’ specifies the treatment applied, just like in medicine. But research shows that in the mental health arena, this is not the case, ie people tend to use the intervention approach they typically use, regardless of the ‘diagnosis’.
We can be overly impressed by the label, again, forgetting that we are just talking about traumatised people. Coming along with the BPD label is a heightened sensitivity to being treated as a ‘disordered’ thing (a disease label)- to be objectified, viewed as a problem, viewed as inherently difficult, etc. All such views are further assaults on the humanity of people who have already suffered such violence.
My view on DID (which i think is not widespread, but here goes anyway) is that claims of having many personalities are just another language to express extreme trauma, usually beginning with complex developmental/attachment trauma, but then often followed up with sexual abuse, family violence etc. The notion of ‘multiple personalities’ gives the person a language whereby they can somehow express some of the damage done to them. It is a language given by their culture, like all other languages (as opposed to something that exists in nature, regardless of socio-cultural context). With every media presentation of multiple personalities (did it begin with the Three Faces of Eve?), the rates of ‘multiple personalities’ have ballooned. What used to be very rare has become relatively common as every year brings a new book, movie or TV series showing people how to ‘do’ DID.
This to me looks very much like a cultural phenomenon, with its epicentre in North America (like the epicentre of hysterical paralysis was Vienna in Freud's time). As with all languages, they either make sense to us or they don’t- and either there is perceived to be a benefit in learning them or not. Personally, I have never witnessed (via client or practitioner’s reports) a single case of successful resolution of DID via taking this language seriously and working within it (as opposed to the self-proclaimed experts who report to successful integrations and outcomes, etc- rarely if ever put to the test of evidence). As long the person believes that the DID ‘symptoms’ serve a purpose at some level, they will continue presenting with them. The purpose may be to create a vehicle by which they can present their pain, receive therapeutic attention, maybe reduce the impact of their trauma, etc- all valid goals.
My problem with DID is that it’s not a language that makes sense to me, or one that I am willing to learn (as i don’t see any potential benefits to it, apart from as an expression of their trauma- which I can work with using ‘regular’ language). It is a cultural language which makes no more sense to me as does Chinese (and this is not an indictment against Chinese, I just don’t speak it). In a literal sense, I don’t believe people have multiple personalities, beyond the regular recognition that we all have aspect to who we are, and these aspects can be quite different, e.g “I” am somewhat different when I am with old friends compared to when I am with my children or grandchildren, or with clients. I hope I am genuine in each context, but there is a different aspect of who I am that is called forth in different situations. I don’t see any benefit in referring to these as ‘different personalities’, as this is not a ‘language’ that adds anything to my understanding of myself, or to life in general (and my work in particular).
When clients present to me claiming to have different personalities, I am not inclined to take this literally (and remain unimpressed with the research ‘evidence’ which is sometimes trotted out by professionals to bolster the proposition- there are usually holes in the case big enough for a truck). For me, there is sufficient evidence that all mental health presentations are ‘languages’ (or at least, can be understood in those terms), and no evidence that ‘DID’ are cases of literal different personalities- metaphoric personalities perhaps, but I would have to see the benefits of running with the metaphor in order to go with it. I explain to such clients my model of DID (ie. it is a certain language). We discuss their ‘model’ (ie. their conviction that they are suffering from different personalities), and we see if we are able to find enough common ground to work together. My perception is that their ‘need’ for this language has arisen from extreme trauma; and therefore my theory of change involves addressing the trauma which made this ‘symptom’ necessary to express. If my and their way of making sense of their issues coincide enough, we are able to work together.
From this, I have had several clients accept my ‘language’ model, and have dropped (or at least altered their languaging of their symptoms), such that we have been able to work very successfully together in addressing their various traumas with EMDR. These people have ended up reporting that they are far less symptomatic, have benefited from reducing the impact of traumas, and generally feel more ‘whole’ (they have sometimes resorted to old language and reporting to feeling more ‘integrated’, which is fine as the language is no longer one of explaining confusing distress). I have also had clients who have found my ‘language’ approach too confusing or at odds with their own meaning- at which point, either I or they suggest I am not the right person to be working with them, and they move on to find a practitioner who will work with their language and meaning structure (I am yet to hear of a positive outcome, but that may not be a reflection of actual outcomes). My experience is that as I am really working with people suffering from complex and chronic trauma, we are likely to be in for the long haul- their therapeutic needs aren’t going to be quickly or easily met.
When there is no longer a need to express their trauma via symptoms (as their trauma has been adequately addressed- in my case, generally using EMDR), clients tend to report a growing confidence in their ability to manage their own lives without the additional support, feel like they have done a lot of healing, and become either far less frequent customers, or ex-clients.
Conventional psychiatric wisdom suggests that experiences covered under the term psychosis (eg. hearing voices and other hallucinations, appearing out of touch with 'consensus reality', experiencing things in different ways, etc) result from brain disorders- genetically determined aberrations in various brain chemicals. This has been a hypothesis for many decades, and despite vigorous efforts to find either a 'mental illness gene' or any guilty neurotransmitter, even just one reliable biological marker of psychosis has remained elusive.
This inconvenient fact has not stopped psychiatry (ably assisted by the big pharma) from marketing a range of powerful 'anti-psychotic' drugs as the main treatment approach to psychosis. These drugs are more appropriately called major tranquilisers, and are effective in simply stopping the brain from functioning, depending on dosage levels. This has been effective in controlling 'positive symptoms' of psychosis (eg. agitation, acting on delusions, etc), but does nothing for the much more common 'negative symptoms' of psychosis, such as fear and anxiety, social withdrawal and isolation, loneliness, etc. In addition, the drugs have been demosntrated to cause permanent brain damage, with Parkinson-type symptoms as well as general brain dysfunction- called Tardive Dyskenesia. Unfortunately, these damaging effects are inflicted upon people (most likely to be poorer than wealthier people) due to a social need to control unsettling behaviour in others, and on the basis of hypothesis which have no support in evidence. There are also thousands of Australian primary school aged children who are placed on these drugs each year.
A recent report from the UK argues that the psychiatric model for making sense of psychosis (ie. gene and biochemical theories, and associated labels and drugs) actually gets in the way of effectively helping people who are struggling with these types of problems. What causes these problems to begin with? Trauma has been demonstrated as a major factor, but for any particular individual, the key is to sit down and ask them. That is, to treat such people as human beings. I am reminded of some other British research which showed that successful interventions with 'psychotics' followed from asking "What are we going to do with you?" in a friendly manner- and then listening to their answers.
Another corner-stone of the psychiatric treatment of psychosis is that the person should develop good 'insight'- this simply means that s/he should come to view him/herself as 'sick' and requiring psychiatric treatment. Again, the evidence suggests that no such submission to psychiatric opinion is required for a person to get better. I have worked with many people over the years who have been given just about every possible psychiatric label- only to find when i met them that they were just a human being. And being treated as a human being (rather than as a fallicious disease entity) appears to be required to get better.
read the report at:-
This week (Oct 2014) has seen my favourite broadcaster, the Australian Broadcasting Commission (ABC), run a range of discussions and programs to coincide with mental health week. in Australia We have been inundated with the statistic that nearly 50% of the population are suffering from one form of mental illness or another. I can’t help but wonder what are the motives behind such an alarming (and alarmist) statement? Does it actually reflect reality, rather than reality bending driven by big-pharma who are seeking more and more customers? Or is it a desperate attempt for public sympathy and relevance by the ABC to withstand budgetary and ideological attacks from a hostile government? Is one in every two of us really mentally ill? Surely this statement requires some analysis.
It is just two years since the death of civil libertarian psychiatrist Thomas Szasz, and it appears that his basic message (see 'The Myth of Mental Illness') again needs restating. Psychiatry, a profession now almost entirely dependent on funds from big-pharma, has been pushing back the definitions of mental illness for decades. The latest edition of the Diagnostic & Statistical Manual (the DSM- psychiatry's ever growing list of 'mental illnesses') attracted howls of criticism long before it was published, with former contributors warning that it had been rendered useless due to its apparent desire to define an ever increasing amount of human experiences as ‘illnesses’. While the net of what is captured under the term ‘mental illness’ has been broadened to the point of absurdity, it will come as a shock for many to learn that there is still no consistent neurological basis demonstrated for even the major ‘mental illnesses’, such as schizophrenia, bi-polar disorder, major depression, etc, let alone the raft of other human experiences which are now described as illnesses. Further, there are still no proven genetic bases for what are presumed to be ‘mental illnesses’. This reality stands in stark contradiction to the claims which psychiatry has maintained for decades that ‘mental illnesses’ are brain disorders (with genetic predispositions) and are comparable to any other medical condition.
One of the essential points Szasz made is the fact that medicine already has a speciality dedicated to brain disorders, ie. neurology. If a brain basis to ‘mental illness’ is ever found, this will simply result in an addition to the list of neurological disorders and a reduction from the list of ‘mental illnesses’. As such, what are referred to as ‘mental illnesses’ by psychiatry are essentially human experiences for which no neurological basis in known.
The term ‘mental illness’ is merely a metaphor. However one wants to define the ‘mind’, whether one be a materialist or idealist, a dualist or monist, the term does not mean brain. Materialists refrain from the serious use of the term ‘mind’, and instead prefer to acknowledge only the reality of the brain. If they use the term ‘mind’ at all (as in Ian Hickey’s Brain & Mind Research Institute), they are using it metaphorically as a concession to a public which is not ready to concede the unreality of the ‘mind’- what they really mean is the brain. As opposed to psychiatrists, it is more likely to be some philosophers and psychologists who still use the term mind in any genuine manner, to refer to an aspect of the human organism and functioning not synonymous with the brain.
What is it that is 'ill' in ‘mental illness’? The ‘mind’? However the mind be conceived, it is not a physical entity. As such, ‘minds’ can only be viewed as ill or diseased in the same way that an economy or a joke can be seen as sick, ie. metaphorically. No one suggests that a joke can be made healthy via the administration of drugs, as that would be straining the metaphor beyond a workable limit. Yet, this is precisely what psychiatry (and the ABC) are doing- treating a metaphor as a literal reality. None of this is to say that many people who are called ‘mentally ill’ are not experiencing very real problems in living (although not all of them are upset by their beliefs and circumstances). I am only disputing how we are to make sense of their experience, not that their experience is real.
If the use of the term ‘mental illness’ were only a case of poor semantics, it would hardly matter. However, what follows from the use of this medical metaphor for human problems in living is both the forced incarceration and treatment (an invasion of civil liberties which is usually not permissible within criminal law), and the neurological damage which can accrue to people from the physical treatments of psychiatry. Stigma is another inevitable and damaging consequence for people whose identity has been ruined by labeling. Stigma is the inevitable consequence for a categorical way of classing human beings- you are either mentally ill or mentally healthy. The reality is that what are referred to as 'mental illnesses' are usually human responses to adverse experiences which differ only by their degree, not by kind. As long as psychiatry sticks with its categorical view, humanity is divided between the 'ill' and the 'healthy'- rather than seeing the common humanity between all of us. A dimensional approach (barely affected/moderately affected/extremely affected) has a far better chance of not resulting in stigma.
Most of us are aware of psychiatric disaster stories, such as the ‘deep sleep therapy’ of the Chelmsford Hospital in Sydney, wherein many psychiatric patients were killed (several of whom were pregnant to the chief psychiatrist). Or the primitive forms of psychosurgery in which the patient was partially murdered the by destruction of their personalities and memories, changing their sense of self. But how many people are aware of the permanent neurological damage caused by equally destructive modern approaches to psycho-surgery, or to people on anti-psychotic drugs (Tardive Dyskenesia)? Or that an ever increasing amount of Australian children are being put on these drugs each year- this includes primary school aged children. What does Patrick McGorry intend to do with those who his early psychosis detection centres identify as being susceptible to psychosis? Contemporary psychiatry offers nothing other than psychiatric drugs (not entirely true- psychiatry is still enthusiastic for ECT, which simply kills off enough brain cells so the person temporarily forgets what was depressing them).
British professor of psychiatry, David Healy is in no doubt that the skyrocketing of suicide rates in the Western world over the last 30 years is not just a random fluctuation, but has followed the radical increase in prescription of SSRI antidepressants (and he cites compelling statistics in support of his case). The list of well demonstrated brain damage from psychiatry goes on. Suffice to say that the breadth and range of well argued critiques against the widespread use of psychiatric drugs is too large to be detailed here.
The medical model requires that we talk in terms of ‘illnesses’- rather than being a reflection of psychological reality, this is merely a convention of language within the medical world. But is this sufficient reason to use the same language, or is it incumbent on psychologists to be ‘cleaner’ with our use of language, given what we know of the many serious consequences when medical language is applied to psychological phenomenon? While some psychologists have always seen themselves as vassals to psychiatry (adopting both its language as well as its world view and assumptions), most psychologists have found it difficult to both speak and think in psychiatric terms. Being social scientists as much as we are behavioural scientists, we simply know too much about social learning, the power of contexts, cultural/social/political differences, the history and philosophy of science and the sociology of illness/medicine/treatment to play dumb. How can we blindly resort to still unproven (in fact, largely discredited) theories of serotonin deficiencies when we are well aware of Seligman’s theory of Learned Helplessness of depression? How can we ignore what superficial psychiatric scrutiny of a person does to distort perception when we know of Rosenthal’s study of ‘Being Sane in Insane Places’? How can we settle for simplistic chemical imbalance theories when neuroscience is telling us how complex the brain is? How can we use psychiatric terminology when we know of studies which show that the label applied to a person’s suffering has no positive impact on the outcome of the intervention? Are we really able to maintain a silence when we read of research which demonstrates the brain damaging effects of antipsychotics, minor tranquillisers, antidepressant drugs, mood stabilisers, and ADHD drugs? How do we ignore our knowledge of the placebo effect, as it has been well demonstrated with such drugs? Can we really ignore what we know of damage to sense of self for people who have psychiatric labels applied to them, or the damage to self-efficacy for people who have been ‘saved’ by physical interventions extraneous to themselves from which they develop no life skills or valuable learnings?
These are the problematic issues which I think of whenever I hear the non-sense statistic that 50% of us suffer some form of mental illness. Yes, we know that there is suffering in the world- but clearly, not all suffering is evidence of a medical/psychiatric condition which requires chemical ‘correction’. Racism, unemployment or overemployment, sexism, abuse of children, and poverty all cause psychological suffering. We already know this. As psychologists, we need to stand confident in the wisdom of our own discipline and resist the invitations to join the great psychiatric enterprise of chemically altering an ever increasing chunk of humanity. Psychiatry is terminally joined to big-pharma. Psychology is not. Our language needs to reflect the humanities legacy of our discipline, and reject the promise of status from adopting the medical model. Disease mongering is alive and well- soon, there will be no form of human distress not considered an illness. I expect more from the ABC, which is staffed by smart people who have been able to use their critical thinking skills with a broad range of issues in the past- why not with this issue?
What causes ADHD?
'ADHD is casused by out of control brain chemicals'- that is why drugs are given to kids, right? Well- no, actually. Despite the stunning success of drug companies in selling this hypothesis to not just the medical profession, but also to society at large, there is scant evidence in its support. Parents and schools, often pushed to the brink of their ability to cope by difficult behaviour from children, are very eager to believe that the child is suffering from aberrant brain chemicals- the drugs often do subdue the child's behaviour, at least initially. However, the fact that drugs change behaviour does not mean that the pre-drugged behaviour was a medical or psychiatric condition, resulting from chemical imbalances in the brain. Alcohol changes behaviour, often making one more gregarious and confident- does this mean that sobriety is a psychiatric condition which is treated by the introduction of alcohol? Clearly not, but this is the dodgy logic used by the medical model when applied to children's difficult behaviour.
So, what does seem to cause such behaviour? Research recently reported from the UK, following a sample of 19,000 children over many years, has clearly demonstrated that the behaviour which attracts an ADHD label is highly correlated with poverty, the young age of mothers, and the relationship status of parents (single or together). What these results suggest is that the children of parents who are struggling to cope with their lives, perhaps due to poverty, young age or doing it on their own, are more likely to behave in erratic and difficult to manage ways. As no experiment could ever be done with this issue, which may indicate causes of 'ADHD', the best we can do is to look at the correlations. As correlation does not prove causality, is it possible that rather than these characteristics of the parents 'causing' the ADHD of their children, the behaviour of the children 'cause' the factors in their parents, ie. poverty, young age, relationship status? Although the answer is obviously a 'no', the linked research clearly shows that this is not the case. This only leaves the possibility that parental coping (influenced by factors such as poverty, age and relationship status) is the key factor in subsequent children's behaviour. The implication is obvious- ADHD is not a medical or psychiatric condition, but a social-political one, effecting those in the least resourced and powerful positions in society. Drugging such children for their challenging behaviour is simply chemically altering the consequence of social-political inequality. Children's brains are adversely effected by the drugs- there is evidence of long term harmful consequences. Is this the way a civilised society should be treating its most disadvantaged?
Anticipation of pain worse than pain
In the final chapter of 'The Hidden Psychology of Pain', i discuss the importance of the psychological sense of time, and being in the present moment. When pain has become chronic, expectations of it always being there become well entrenched- this is not neurotic, but is based on one's experience up to that point in time. As with any unfavourable circumstance, we tend to build a narrative or story around the experience. It usually has three components:- our current experience (i am in pain now); our past experience (i have been in pain for two years); and a future prediction (based on past and current experience, i predict that i will be in pain tomorrow). There are many problems with this natural way of joining the past, present and future. One of the main problems, when doing this in regards to pain, is that the anticipation of pain is often worse than the experience of being in pain now. Our ability to cope with adversity in the present moment results from a combination of both the current situation (including the resources and limitations inherent to the situation) and who we are in that particular moment. Solutions to problems, to the extent that they can be found at all, result from this combination. If i have a flat tyre that needs changing, the situation itself will have resources in it (eg. a wheel brace and jack in my car) as well as limitations (my spare tyre is flat).The solution to the problem then results from a combination of the situation and me in that situation (eg. i know how to use a wheel brace and jack,or how to get help with it). Solutions to problems do not occur without 'me' (the relevant person) being in the situation. As such, when we anticipate problems, because we are guessing about a future event which is not yet happening, 'we' are not yet in the situation itself. As such, no solution to the problem is possible as a major component of a solution ('the person) is not actually yet in the situation. When seriously considering an unsolvable problem, anxiety is often experienced as we tend to feel helpless in relation to it.
It is the same with chronic pain. When we anticipate being in pain tomorrow, there is nothing we are able to do about it in terms of coping, simply because we are not yet in tomorrow in order to be able to cope with it- we can only cope now, not in some time in the future. Coping is not yet possible. As a result, we tend to dread tomorrow (if it is a bleak possibility we are thinking about). Researchers have demonstrated experimentally that the anticipation of pain is worse than the actual experience of pain. The story that we tell ourselves is very important.If our story is full of expectations about being in pain (e.g i will not enjoy my child's wedding because i will be in too much pain to actively participate), then we are adding additional layers of psychological distress. This can have the effect of exacerbating the existing pain.
While being 'mindful' is not the magic bullet to pain which its advocates suggest, there is value in cultivating an ability to simply remain with what is- not with what might/might not be. We can generally cope with 'what is'- we may not like it, but we rarely ever die or psychologically fall apart because of adversity (i am aware that this does happen sometimes, but usually not). Every moment is different from the last. Any guess we make about the next moment is just that- a guess. All scientists know that guesses, or hypotheses about the future are only ever discussed in terms of probabilities- things that may or may not happen. It is a reasonable hypothesis that if i hit this particular button on my key board, the corresponding letter will appear on the screen. But is it an absolute certainty? Any number of electrical problems could occur to stop this result from happening, so the hypothesis can only be stated with, for example, a high degree of confidence like 99%. It is the same with chronic pain. Every new moment is different. We may be convinced that the next moment will involve the same amount of pain as the last, but variations in an individual's experience of pain argues against this. The fact is that we never know what the next year, month, week, day or even moment will bring us. As long as we are convinced that it must include unmanagable pain, because thats what the last moment gave us, then we are adding to our burden of psychological distress and this is likely to have a worsening impact on our pain. This theme is discussed more in the final chapter of 'The Hidden Psychology of Pain', and research demonstrating the deleterious effects of pain anticipation is discussed in the linked article.
How real is the 'unconscious mind'? In 'The HIdden Psychology of Pain', i state that the brain is able to perceive an eight hairy-legged object moving in our peripheral field of vision and react to it with alarm, even if we have no conscious awareness of there being a large spider near us. This phenomenon demonstrates that much of what goes on within the brain occurs at a level for which there is no knowledge- some neuroscientists suggest that as much as 98% of brain functioning is largely unconscious. It appears that our conscious awareness is merely a very handy tool, devised over many eons of evolution in order to scan the environment for danger. It can be thought of as something like the light cast by a torch on a dark night. The focus of attention will be brought into high relief, however the rest of the night's darkness will remain un-illuminated. It is clear that at any one time, we are only consciously aware of a certain amount of stimuli which is hitting our sensory apparatus and creating an impact on our brain. Conscious awareness is no doubt an extremely handy tool, and if our ancestors didnt possess it, we wouldnt be sitting here now thinking about it. But, as evident from current neuroscience, we are much more than just our conscious awareness. It is somewhat ironic that our sense of self, what to me makes me 'me', is largely derived from this pretty handy tool, even though it is only a small portion of what is going on within us.
The following article discusses some of the current research which demonstrates how unconscious much of our perception is.
Childhood trauma and chronic pain
In 'The HIdden Psychology of Pain' I make a case for the relevance of early life experiences, such as trauma, and the experience of chronic pain in adulthood. Apart from being a plausible sounding theory, there is plenty of research evidence which demonstrates this link- childhood trauma is way over-represented in the chronic pain population. While the 'pain industry' (eg. medicine, physiotherpay and a range of other physical treatment approaches) state that chronic pain results from structural pathology of the body (or more honestly admit to not knowing why people experience chronic pain), the reasons for this affliction become less mysterious when the relevant research is taken into account. Childhood trauma, resulting from experiences such as sexual abuse, violence, high levels of family conflict, bullying etc, leaves a psychological 'scar' on a person which tends to reverberate throughout the person's life. Chronic pain is often an attempted solution which is unconsciously generated in order to address what is perceived to be an even greater problem- this can often be the reverberation of psychological trauma. With the aid of current research evidence, the reasons for chronic pain are not especially mysterious and puzzling. Usually, we need to only look at a person's experience of life- often, their childhood experiences, and how the residual trauma is being triggered by an aspect of their current life experience.
The following article details some of the relevant research on the association between childhood trauma and chronic pain.
How important is sleep?
In The HIdden Psychology of Pain, i dedicate a chapter to problems relating to sleep as this is often a major side effect of chronic pain. There are many things which people can do to improve their quality of sleep, and these are detailed in the book.
But how important is it to get good sleep? Researchers in the UK have recently demonstrated the psycological harm which can accrue to people who are deprived of even one night of sleep. Subjects in the research study began to show psychological symptoms that were similar to schizophrenia after only 24 hours of sleep deprivation. As stated in my book, it appears that the psychological benefits of sleep arise from the stae of sleep which is associated with dreaming- the Rapid Eye Movement (REM) stage of sleep. Other research has demonstrated that when people are able to get all the stages of sleep other than REM sleep, they begin to suffer psychologically, even though that may have obtained enough non-REM sleep in order to still function.
Our culture is essentially REM deprived. All substances which effect the central nervous system , eg. alcohol, cannabis, sleeping tablets, anti-depressant drugs, inhibit our brain's ability to engage in REM sleep. In terms of alcohol, a person need only have as little as two standard drinks to have their REM sleep heavily curtailed. On average, Australians consume around 15 standard drinks of alcohol per week, meaning that the average Australian is inhibiting his/her capacity for REM sleep. Around one in twenty Australians are on anti-depressant drugs, some of which inhibit 100% of REM sleep, with others inhibiting less amounts. As such, it appears that most people are simply not getting enough REM sleep, so important for psychological well-being, even though they may be sleeping 'enough' hours per night. When you consider the research (see link below), this is frightening. Not many of us will be so sleep deprived that we are propelled towards psychotic-type symptoms, but it appears that many, if not most of us are REM sleep deprived enough to be causing us psychological problems.
What causes PTSD in combat veterans?
This may seem like a silly question, as the obvious contender of combat experience would seem like the logical answer- there is nothing pleasant about trying to kill other humans, or having them try and kill you. However, despite the most obvious possibility, researchers of Vietnam vets founds that the biggest predictor of post combat PTSD was trauma incurred during childhood and adolescence. Recent research with Danish vets of the war in Afganistan has again confirmed this finding. Soldiers who experienced family violence during their childhoods, parents stalking or threatening their former partner, and violent punishment which resulted in physical damage, were more likely to suffer from PTSD following their war experience, regardless of the nature of their combat experiences. Soldiers who did not experience childhood trauma were unlikely to suffer from PTSD, regardless of their war experience. And soldiers carrying childhood trauma were more likely to fare well while in the theatre of combat because of the high level of support from their fellows; and to subsequently suffer more when returning home as this higher level of support was no longer available.
This research (linked below) shows the importance of negative childhood experiences, and informs us as to the accumulative nature of trauma. The real answer is for us as a culture to take care of people, especially little people, more than we currently take care of things.
The current high level of suicide by veterans is likely to be resulting from a combination of factors such as PTSD, and pre-disposing childhood trauma, as well as the misguided attempts to treat such problems with a crude pharmacological approach. Many people suffer extreme adverse reactions from anti-depressant drugs, including increasing depression and suicidality, anxiety and panic; and sometimes psychosis. The study of pharmacogenetics can explain in scientific terms why one drug can appear to help one person and nearly kill another. Unfortunately, veterans are being treated primarily with psychiatric drugs, and secondarily (if at all) with psychotherapy. They deserve better.
Alan Watts on the nature of pain
The following quote, from my favourite spiritual philosopher, may only make sense in relation to his overall spiel (much of which can be heard these days on excellent You Tube clips of his many recorded discussions- well worth listening to them). These themes are explored in more detail in the final chapter of 'The Hidden Psychology of Pain".
"…how does the mind absorb suffering? It discovers that resistance and escape- the “I” process- is a false move. The pain is inescapable, and resistance as a defense only makes it worse; the whole system is jarred by the shock. Seeing the impossibility of this course, it must act according to its nature- remain stable and absorb.
To remain stable is to refrain from trying to separate yourself from a pain because you know that you cannot. Running away from fear is fear, fighting pain is pain, trying to be brave is being scared. If the mind is in pain, the mind is in pain. The thinker has no other form than this thought. There is no escape. But so long as you are not aware of the inescapability of thinker and thought, you will try to escape.
From this follows, quite naturally, absorption. It is no effort; the mind does it by itself. Seeing that there is no escape from the pain, the mind yields to it, absorbs it, and becomes conscious of just pain without any “I” feeling it or resisting it. It experiences pain in the same complete, un-selfconscious way in which it experiences pleasure. Pain is the nature of this present moment, and I can only live in this moment.
Sometimes, when resistance ceases, the pain simply goes away or dwindles to an easily tolerable ache. At other times it remains, but the absence of any resistance brings about a way of feeling pain so unfamiliar as to be hard to describe. The pain is no longer problematic. I feel it, but there is no urge to get rid of it, for I have discovered that pain and the effort to be separate from it are the same thing. Wanting to get out of pain is the pain; it is not the “reaction” of an “I” distinct from the pain. When you discover this, the desire to escape “merges” into the pain itself and vanishes.
Discounting aspirin for the moment, you cannot remove your head from a headache as you can remove your hand from a flame. “You” equals “head” equals “ache”. When you actually see that you are the pain, pain ceases to be a motive, for there is no one to be moved. It becomes, in the true sense, of no consequence. It hurts- period.
This, however, is not an experiment to be held in reserve, as a trick, for moments of crisis. It is a way of life. It means to be aware, alert, and sensitive to the present moment always, in all actions and relations whatsoever, beginning in this instant.
Alan Watts. ‘The Wisdom of Insecurity’ (1951). P.97
Depressed mood and chronic pain
We are never either just physical beings or psychological beings- but are always both. The biomechanical view of the human organism almost totally ignores the psychosocial aspect, requiring a reintroduction of psychological factors in order to redress this imbalance. It may seem, therefore, that books such as mine are also committing a one-sided error by focusing almost exclusively on psychology. There are repeated references throughout my book that we are never just psychological beings, nor that we can ever ignore psychological factors. We simply need to be equipped with valid information in regards to what physical factors are genuinely associated with pain, and which ones are demonstrated through research to be merely correlational to chronic pain, e.g long standing disc pathology.
The research article linked below demonstrates the role which depressed mood can play in making us more sensitive to chronic pain. The brain processes both emotional and physical pain in similar ways. When a person is experiencing a lot of emotional pain, they are more vulnerable to experiencing chronic physical pain. Addressing the reasons why a person is experiencing emotional pain is therefore a viable treatment approach to working with chronic pain. Simply treating depression with drugs, as though it is a disorder like a flu that can be resolved with an antibiotic, is simply not likely to help. There are too many people who suffer adverse side effects to all of the prescribed antidepressants for this to be a viable option for treating even depression, not to mention chronic pain. CBT is also not likely to get to the life experiences which have resulted in depressed mood; nor is it likely to successfully treat chronic pain. Fortunately, there are a range of transformational psychotherapies which are known to successfully treat depression (and the trauma which is often underlying it), such as EMDR, Coherence Therapy, Emotion Focused Therapy, NLP, Gestalt, etc.
Move when having back pain
Despite the natural inclination to rest when experiencing back pain, the research consistently demonstrates the value of moving. However, a bit of common sense is also needed- if you are suffering from a recent injury (referred to as acute pain), then the opposite of what makes sense for chronic pain may be viable options. For example, resting an injured part of your body makes sense, allowing the healing process to occur. Also, research indicates that physical therapies (chriopractic, physiotherapy, massage, etc) can be effective in alleviating acute pain from a recent injury.
The problem with both rest and physical therapy is that what makes sense in the short term can easily become problematic in the long term. While rest may make sense, too much rest is definately not what health authorities suggest. With back pain, for example, publications like 'The Back Book' recommend that people keep moving as much as possible, in as gentle a manner as possible. There is nothing to be gained by overdoing movement when injured, but the opposite (no movement) is dangerous in that it can create bad psychological habits (eg. allowing one to become phobic about movement), and can slow down natural healing by decreasing blood and oxygen supply to the pained area via lack of movement. Movement, like massage and physical manipulation, brings blood and oxygen back to the pained area- and this is essential for healing to occur after an injury.
There is a great deal of research which shows that inactivity is common in people who's pain progresses from being acute (less than 3 months duration) to chronic (more than 3 months duration), and this is not because they are in more pain. Lack of movement and over-resting is a key factor in pain progressing from acute to chronic. Other psychological factors include the range of distressing emotions which can accompany physical pain, eg. anger, fear, anxiety, grief, shame, hopelessness, etc. It is also common for people to be vulnerable to chronic pain because of underlying psychological issues, e.g generalised fear, poor self concept, feeling trapped and helpless in life, feeling overwhelmed, and all of the distress that comes from having been traumatised by life experiences. A relatively minor and common back injury may escalate to chronic pain in a person suffering psychologically, rather than resolve in the normal time frame of less than 3 months.
In order to prevent acute pain from becoming chronic, people are well advised to keep moving (as demonstrated in the research cited below), and also to start thinking psychologically about their pain (as seen in 'The Hidden Psychology of Pain').
Psychological treatment for pain research
With between 1/3 and 1/5 Australians and 1/3 Americans experiencing chronic pain, it can be rightly referred to as a problem in epidemic proportions. The following link is to a webpage in which Ken Pope cites 39 different studies reported in peer reviewed medical and psychology journal articles in 2013/2014 which demonstrate the effectiveness of psychology in treating pain issues. Reading the list and brief descriptions of the interventions, it is clear that the research is covering a range of psychological interventions which appear to be effective. The only way this is possible, for psychological interventions to successfully treat physical pain, is if physical pain has a large psychological component. This is NOT, however, to say that the pain is all in one's head! The pain is nearly always entirely real, and felt in the sore part of the body. But the mind/brain always has a role to play in the perception of pain, even if we do something as physical as stand on a nail. Our emotions, perceptions of the circumstance, perceptions of our self, and a range of psychological factors which we have no conscious awareness of all play a role in allowing our brain to wind up with the conclusion that pain is the appropriate thing for us to be feeling. Chronic pain is when the pain has become entrenched, over at least a 3 month period- the time which the body takes to repair most forms of damage. When it has become entrenched, there is an even greater role for psychological factors, such as fear, anxiety, grief, hopelessness, anger etc, to feed into the experience and thereby maintain and exacerbate the pain.
Unlike the treatment of acute pain (short term, usually resulting from an injury), most physical interventions for chronic pain have no proven track record of treating it, beyond the temporary relief which it can offer. Intervening on the psychological component provides a way forward for many people suffering chronic pain.
What causes depression & anxiety?
Since the late 1980's, pharmaceutical companies have been very effective in convincing us that emotional problems result from 'chemical imbalances in the brain'. While many of us were never convinced of this, research continues to show that problems in living result from problematic life experiences; and that there is at best only scant proof of the chemical imbalance theory. It has come to light that the serotonin deficiency theory for depression was dreamed up by the marketing branches of drug companies, not by the research branches, in order to sell Prozac. As a result of phenomenal marketing to sell this idea, we are all now viewed as being Prozac-deficient, and one in every 10 Australians is on an antidepressant (one in every 5 Americans).
And all along, people have been suffering depression and anxiety because of the impacts of negative experiences in their lives. Traumatised people suffer- not exactly rocket science, but the implications are huge. If we accept this reality (as opposed to the chemical imbalance theory), then it means that we need to look at how we as a society treat each other- and it is pretty unimpressive. The amount of child abuse in our culture is horrendous, and always has been. People who dont cope with traumatic events as adults are typically those who have been traumatised in their childhood. Rather than confront and deal with this reality, our culture (led by the drug companies) has opted to largely ignore it, and instead promote the idea of individual pathology explaining emotional problems in living. Psychiatry has been a leading light in this pathology seeking, ably assisted by the drug companies which have afforded it a credible status as a legitimate branch of medicine (as opposed to its traditional status as being largely an embarrassment to medicine), with scientific sounding theories. Psychology has also participated in this individual pathology focus with its embracing of Cognitive Behaviour Therapy (CBT), despite it being a product of psychiatry. Both drug treatments and CBT have for the most part ignored traumatic experiences in preference to individual pathology theories, either chemical imbalances or thinking errors.
The other option is to listen to the research evidence (and example is seen in the link below), and acknowledge the role which adverse life events play in creating subsequent problems in living. This means that we as a culture need to confront what we do to each other (as seen in the Royal Commissions happening in Australia at the moment regarding the sexual abuse of children by institutions such as the Catholic Church). It also means that we need to offer sufferers psychological therapies which address the trauma they are carrying. There are a range of highly effective trauma therapies which are not pathologising of the individual, but which aid in the transformation to resolution.
At the moment, the Australian government offers 10 subsidised psychology sessions per year for people referred by GPs, however it offers 50 psychiatry subsidised sessions per year. Most psychiatric intervention conducted these days is drug intervention. So, people can have more drug intervention than they could need (once a week every week of the year for as many years as they want), but they can access only 10 psychology sessions per year. One has to question the amount of pharmaceutical company finger prints all over Australia's mental health policy.
Chronic pain passed on to kids
The bio-mechanical model cannot make any sense of why kids of parents with chronic pain are far more likely to experience chronic pain themselves, however a psycho-social understanding can. There is no suggestion that structural pathologies of the body (which usually result from lived experience, ie. injuries) are genetically passed on to off-spring. However, the bio-mechanical model blames these structural pathologies for chronic pain. The only way of making sense of off-spring of sufferers of chronic pain having the same affliction is in terms of either social learning (eg. learnt as a way of dealing with emotional pressure in the same way depression or anxiety may be learnt as responses to pressure), and/or as a result of growing up in a family where the predominant feeling is hopelessness and despair.
The current research (below) demonstrates that kids from single parent families where the mother is suffering from chronic pain are far more likely to suffer themselves than kids from either intact families (where one parent suffers chronic pain), or where a single dad suffers this affliction. The reality is that most kids in single parent families are growing up with their mums (not with their dads), so what ever challenges are happening for the mum are more likely to impact on them than challenges going on for the dad. Where they are growing up in two parent families where one parent suffers, at least the other parent is not suffering, so there is a role model for not suffering, and there is likely to be less suffering for the whole family (a gross generalisation, but true in many ways, eg. economic disadvantage of single parent families).
Do kids learn to 'do' chronic pain from a suffering parent? Why wouldn't they, at least in an unconscious manner? We learn from our parents all sorts of ways of being, from religious beliefs through to irrational passions for unsuccessful football teams. Despite personality having a large genetic component, much of it is still socially learnt- over a childhood, we see our parents responding to life in patterned ways, and we internalise many of these patterns. If chronic pain is an unconscious strategy for dealing with distressed emotion which is too threatening for conscious awareness, there is no reason why this tendency could not be learnt, along with everything else we learn from parents. This may create a vulnerability to manifesting emotional pain as chronic physical pain (as an unconscious 'coping strategy'), but I suspect it then takes challenging life events to create the need for diverting pained emotions in this way. Maybe being in a single parent family with mum suffering from chronic pain (as well as perhaps her ongoing conflict with the ex-partner, financial harship, loneliness, lack of social support, resulting depression, etc, etc) could be fuel for this vulnerability to be launched?
These possibilities are all entirely plausible from a psycho-social perspective. The structural pathology theory of chronic pain cannot even begin to explain why the observation of more chronic pain amongst kids of sufferers has been found. More evidence that if we want to make sense of chronic pain, we need to understand the person's body in context of their lived experience, which includes psychological and social factors.
Talk therapy for osteoarthritis
Researchers at Manchester University have recently (March 2014) demonstrated the value of talk-therapy for people suffering from osteorthiritis. This is significant as osteoarthritis is an example of a demonstrable physical pathology in the body- it can be seen on X-rays. However, research is demonstrating that we can have a bone-on-bone problem, and still not be in pain. As such, something else must be present for people to suffer pain associated with osteoarthritis. This something else is a psychological factor- and that is why psychotherapy can be effective, as it is addressing the specific individual psychological issue which is contributing to the experience of physical pain. Yet another example of the evidence which is slowly but surely accruing of the inseparability of mind/body. A bio-mechanical approach is simply unable to address the complexity of the human organism, and any hope of alleviating chronic pain must take into account the broad range of realities- be they physical, emotional/psychological, social, cultural and even political.
We live in a culture which is in a state of denial about the endemic nature of trauma. Instead, we have had decades of marketing branches of big pharma telling us that emotional problems are the result of aberrant brain chemicals (which obviously require their drugs to 'balance'). Why is our culture so reluctant to acknowledge trauma? Part of must be to do with the remnants of British Victorian era stoicism (which probably resulted from upper class kids being brutalised and sent off the boarding schools at young ages- these kids ended up running society and setting the overall tone of what is 'normal'). And highly relevant to the centenary of WW1, it became apparent during the war that most men were adversely affected by mass murder in the trenches. Initially, the military and government were curious about "shell shock", however, as the numbers of victims reached into the millions, governments/military decided to shut down the discussion, fearing the risk of a massive compensation bill. They turned their backs on the psychological victims of industrialised warfare- and as a culture, we were meant to deny and suppress trauma as well. This changed in the aftermath of the Vietnam war, which coincided with larges scale social changes such as the counter-culture movement, and the womens movement- we became more open to other people's suffering, and the extent of suffering in the Vietnam vet population was undeniable (it is a fact that more American vets suicided after the Vietnam war than were killed there). As such, the study of trauma began relatively recently. Emotional/psychological/psychiatric problems do not result from aberrant brain chemicals, or dodgy genes. These are myths that have been popularised by the marketers of big pharma purely for money. People suffer from bad treatment, especially when inflicted during childhood. We want a sane world? look after the kids..