A Quick Fix (March/April 2004)

Friday, 01 April 2011 17:50

OpenMind - Journal of the mental health association MIND

March/April 2004

A Quick Fix

Dorothy Rowe

I've been in Australia meeting clinical psychologists, school counsellors, therapists and counsellors. I found that they were keenly interested in everything I had to say about mental distress, especially depression. There's a high rate of suicide in Australia, and the suicide rate for young men is amongst the highest in the world. The Federal and state governments take the problems of depression and suicide very seriously and so everyone who works in the mental health field is under intense pressure to achieve results. The managers in the government health and education systems see organising mental health services in the same way as they see organising physical health services, that is, identify a problem and create a solution. If a person is ill apply a treatment to cure the illness. Consequently people who are suffering mental distress are said to be ill and given a diagnosis. People are given labels - 'She's a bipolar', 'He's got ADHD', 'She's a BPD' - and their personal experience is ignored. Private health insurers (there's no NHS in Australia) give only extremely limited financing to psychotherapy, and so clinical psychologists, counsellors and therapists who work privately, as many do, know that most of their clients cannot afford long term therapy. As a result at my workshops I would be asked to talk about specific therapeutic techniques which were sure to work. Some people asked me, 'How can I cure depression in four sessions?'

Such expectations make my heart sink. If only we didn't use the language of illness to talk about ourselves and the distress we feel. Instead of trying to force mental distress into the straightjacket of a problem and a solution we'd talk about what it is to be human and about how life presents us not with problems which have a solution but with dilemmas which we cannot avoid but to which we have to adapt in one way or another. We can choose ways which allow us to feel fulfilled and content, or we can choose ways which lead us to feel mental distress.

There's the dilemma of love and loss. If we love, we can lose the people we love. The people we love don't always love us. Lovers can leave, parents grow old and die, children grow up and have their own lives, friends move away. But if we try to avoid the pain of loss by refusing to love we become very lonely.

The possibility of loneliness leads us to the dilemma of being part of a group or of being an individual. You love your family and want to be close to them, but then they smother you or try to make you into what they want you to be. You struggle to be free so you can be yourself, and you find yourself alone.

Being alone can mean being free, but being free means loss of security. Make your house or your life completely secure and you're in a prison. That's the dilemma. The more freedom, the less security. The more security, the less freedom.

How can we balance love and loss, being an individual and being part of a group, being free and feeling secure?

There's no one absolute and forever answer. It's a matter of juggling, of being flexible, ready to change. But change is scary and often we get things wrong. All we can do is to understand that in trying to deal with these dilemmas we are using ideas which we create and which we are always free to change. Many people don't realise this. They think their ideas are real, fixed, and unchangeable. School counsellors in Australia use a teaching programme called ACE (Adolescents Coping with Emotion) that helps teenagers understand that every situation they encounter can be interpreted in a multitude of ways, and that they're free to change their interpretations. They learn that they can't avoid life's dilemmas but they can reinterpret them.

If only there was an ACE programme to teach managers and politicians that life is not an illness to be cured but a process which seen in certain ways can lead to pain, or seen in other ways can lead to wisdom.


Ann Wignall, Janne Gibson, Nicole Bateman, Ron Rapee ACE: Adolescents Coping with Emotion Department of Child Psychiatry, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.