WWe are living, we are told, through a “mental health crisis”. mental health services can’t cope with the explosion in demand in the last two years: 1.6 million people are on waiting lists, while another 8 million need help but cannot even get on these lists. Even kids are showing up on A&E desperate, wanting to die.
But there is another way of looking at this crisis, one that does not place it firmly in the realm of the medical establishment. Doesn’t it make sense that so many of us are suffering? Of course you do: we live in a traumatic and uncertain world. The climate is unraveling, we are trying to keep up with the rising cost of living, still fraught with pain, contagion and isolation, while the revelations about the police murdering women Y undress the children shatter our faith in those who are supposed to protect us.
As a clinical psychologist who has been working in NHS services for a decade, I have seen first hand how we are failing people by locating their problems within them as some kind of mental disorder or psychological problem and therefore depoliticize your anguish. six sessions of CBT, designed to target “useless” thinking styles, will it really be effective for someone who doesn’t know how they’re going to feed their family for another week? Antidepressants are not going to eradicate the unrelenting racial trauma a black man is surviving in a hostile workplace, and qualify people who experience sexual violence with a psychiatric disorder (in a world where two women a week are murdered in their own home) does nothing to keep them safe. As expected, mindfulness is not helping children who are navigating poverty, peer pressure, and competitive exam-driven school conditions, where bullying and social media damage abound.
If a plant were wilting, we would not diagnose it with “wilted plant syndrome”, but would change its conditions. However, when humans suffer in unbearable conditions, we are told that something is wrong with us and we are expected to move on. Continue working and producing, without acknowledging our pain.
In an effort to destigmatize mental distress, “mental illness” is framed as a “illness like any other” – rooted in supposedly faulty brain chemistry. In fact, recent research has concluded that depression is not caused by a chemical imbalance Brain Ironically, suggesting that we have a broken brain for life increases stigma and disempowerment. The most devastating thing about this myth is that the problem and the solution are located in the person, distracting us from the environments that cause our anguish.
Individual therapy is brilliant for many people, and antidepressants can help some people cope. But I am concerned that a purely medicalized and individualized understanding of mental health will put bandages on large open wounds, without addressing the source of the violence. They encourage us to adapt to systems, thus protecting the status quo. This is where we fail marginalized people the most: Black people’s understandable expressions of pain at living in a structurally racist society are too often medicalized, labeled as dangerous, and met with violence under the guise of “care.” Blacks are more likely to be tasers, sectioned, restricted, and overmedicated than anyone else in our mental health services today.
The UK could learn a lot from liberation psychology. Founded in the 1980s by Salvadoran activist and psychologist Ignacio Martin Baro, argues that we cannot isolate “mental health problems” from our broader social structures. Suffering emerges within people’s experiences and histories of oppression. Liberation psychology sees people not as patients, but as potential social actors in the project of freedom, valuing their own lineages, creativity, and experience, rather than being forced into a white, eurocentric and individualistic idea of therapy. It directly challenges the social, cultural and political causes of distress through collective social action.
This framework makes a lot of sense when we hear that the pandemic in the UK has hit poor people hardest. Does it mean that wealthy and privileged white men do not experience suffering? Of course they do. We are still learning about the complicated ways that these structural problems affect our daily lives. For example, how the pressures of individualism and capitalism can lead to isolation and substance abuse, or how colonial violence towards immigrant families plays out within homes and on bodies.
Let me be clear, I’m not saying that people in distress should be on the picket line. The pain can be debilitating. But those of us who support people in distress, like mental health workers, have a key role to play in social transformation. Social action is the medicine that alleviates the personal and collective suffering of people.
Instead of trying to change the “mindset” in therapy, we need to change the hierarchies based on race and class, housing, and the economic system. Universal basic income has psychological benefitsand recent studies show how improves “crisis of anxiety and depression”. As a clinical psychologist, some of my most powerful work has not been in the therapy room but in successfully advocating for safe housing for, or working in the community with, queer, black, and brown facilitators in organizations like Beyond equalityto prevent gender violence. the net Psychologists for Social Change shows us a practical imaginary of this work. We also need social change that is preventative, like investing in youth and community-led services like healing justice london Y 4front. They work to change trauma in marginalized communities through building social connections, social action, and creativity, toward futures free of violence.
None of this is to dismiss the value of individual therapy (after all, that’s part of my job). But therapy must be a place where oppression is examined, where the focus is not simply on reducing distress, but on seeing it as a survival response to an oppressive world. And ultimately I would like to see a world where we need fewer therapists. A culture that claims and embraces the madness of the other. Where we take the brave (and sometimes chilling) risk of turning on each other in our understandable and messy pain.
Significant structural transformation will not happen overnight, although the pandemic has taught us that big changes can happen fairly quickly. But change will not happen without us: our distress might even be a sign of health, a telltale indicator of where we can collectively resist the structures that are hurting so many of us.
To return to the plant analogy, we must look at our conditions. Water can be a universal basic income, safe sunshine, affordable housing, and easy access to nature and creativity. Food can be love relationships, community or social support services. The most effective therapy would be to transform the oppressive aspects of society that cause our pain. We all need to take whatever support is available to help us survive another day. Life is hard. But if we could transform the soil, access sunlight, nurture our interconnected roots, and have room for our leaves to unfurl, wouldn’t life be a little more livable?
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Dr. Sanah Ahsan is a clinical psychologist, poet, writer, presenter, and educator.
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