Wednesday, November 22, 2017

The mindbody split

The mindbody split is nowhere more obvious than in the medical model approach to health. There is an unfounded assumption that mental health has only a psychological cause and a physical health issue has only a physiological cause. But we are not disconnected bits and pieces, every single part of us is interlinked and interdependent. The health of the whole depends on the health of its parts.

When it comes to mental health, I think we’re often frightened of the power of the mind and the devastation that can ensue when things go awry. We feel we don’t have as much control over the mind as we do the body, hence the heavy emphasis on medication as the main treatment by psychiatry to keep people in check. Short term, this is often necessary, however problems arise when this is the long term approach and treatment. Medication does not get to the root of the issue, symptoms are just suppressed and the long term effects of medication on the body and mind of the person suffering are horrendous and often cause an early death. Sadly, society in general doesn’t seem to care as long as ‘these people’ are out of sight or kept quiet.

When mental health professionals speak of dissociation, they often don’t differentiate between psychological and somatic dissociation. I think some of them aren’t even aware of somatic dissociation as a phenomenon. This mirrors the mindbody split that is evident in most of the world. It is also because of the major emphasis on psychological processes in psychology and psychiatry. However, there is some dissonance here because of the current emphasis on biologic psychiatry and many somatic symptoms being included in psychiatric diagnoses. The truth is, there is no coherent theory of mental illness in mainstream psychiatry and there never has been.

Why am I speaking of dissociation in particular? Because of its inherent link with trauma. Trauma is one of the biggest unresolved issues in our world and is responsible for many of the problems that we see; addiction, violence, wars, abuse, neglect, homelessness etc. Irish psychiatrist Ivor Browne, defines trauma as unexperienced experience and I believe the mechanism by which an experience remains unexperienced, is dissociation, both psychological and somatic dissociation.

We’ve all been traumatised, or hurt. It’s just a matter of to what degree. Judging by all the problems in the world today, it is safe to say that many of us remain traumatised. Which also means that we’re all dissociated and again it is a matter of to what degree. There is nothing to be frightened of here, it is normal and human to want/need to avoid pain, the more pain we feel or is inflicted upon us, the more we will dissociate. I think it is crucial to normalise trauma and dissociation so we lessen any stigma and shame attached to these phenomena. Problems arise when we act our trauma out, individually and collectively, which is why it is so important that it be taken seriously and effective approaches to resolving it are widely used.

I’d like to see the day when the treatment of any health issue is truly integrative and proper weight is given to both somatic and psychological issues. As regards dissociation, screenings such as the Dissociative Experiences Scale (DES) and Somatoform Dissociation Questionnaire (SDQ ) could be combined, because where does the mind begin and the body end? There is no clear delineation, they are interlinked and interdependent and we need to assess the health of both.

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