Fiona writes: The title of Eric Maisel’s latest book had me nodding. I’ve never liked the idea of sticking labels onto people, either in my role as a psychotherapist or in my life outside the consulting room.
In the first section of this book, Eric wants us to see how diagnosable mental health problems are more useful for the mental health industry than they are for the individuals seeking help. He is persuasive, and much of what he writes chimes with my personal experiences.
I wonder if some nuance was lost in this critique – my own experience is that there is much good in the psychotherapy profession, and also much that is dysfunctional in the coaching profession (to which Eric belongs). Maybe I’ve been in a privileged and unusual position as a psychotherapist but as a result of my trainings I was already ‘on board’ with most of what the book propounds.
The second (larger) section of the book describes an alternative approach to dealing with ‘depression’, including making our own meaning, self-care, and taking responsibility for our emotional well-being. The emphasis is on ‘natural emotional responses to life’ rather than pathologisation (this might not be a real word), and individuality and complexity versus over-simplification and diagnosis. I found these chapters both practical and inspirational.
Overall I was given much food for thought. What effect are we having on people when we (in our position of power) provide people seeking help with a paradigm for their distress? What are the advantages and disadvantages to our clients of these labels? How can we be better at letting go of all our preconceptions and approach each person without thinking ‘oh, this is what’s happening’ or ‘oh, they need this’? How can we meet as two human beings?
This is an important book for people who’ve had their own experience of being ‘labelled’, and for their loved ones. It should also be read by mental health professionals as a reminder that, as Terence reminds us, nothing human will be alien to us. We are all in the same rickety boat.
I was grateful for the opportunity to read this book, and to take part in Eric’s blog tour. Here’s to ordinary human unhappiness!
Eric included these questions and answers as a part of his blog tour ‘pack’ (he was very efficient) and they give you a good sense of the book. Here’s where to buy it in the UK (paperback or Kindle) and in the US (paperback or Kindle).
Q and A with Eric Maisel – Rethinking Depression
The first section of your book focuses on debunking depression as a “mental illness,” which is not to say that sadness and unhappiness cannot be debilitating. Can you briefly describe the main thrust of your argument?
What I hope to demonstrate is that there is something profoundly wrong with the way we name and treat certain human phenomena. When we call something a “mental disease” or a “mental disorder” we imply a great deal about its origins, its treatment, its intractability, and its locus of control. The mental health industry has its reasons for calling life’s challenges “disorders,” but we have few good reasons to collude with them. I ask that readers who do feel depressed seek help. I hope that this book aids people in understanding what help to ask for from professionals and what help we should realize they can’t possibly offer us.
If there is no “mental disorder of depression,” why are millions of people convinced that “depression” exists?
As soon as you employ the interesting linguistic tactic of calling every unwanted aspect of life abnormal, you are on the road to pathologizing everyday life. By making every unwanted experience a piece of pathology, it becomes possible to knit together disorders that have the look but not the reality of medical illness. This is what has happened in our “medicalize everything” culture. In fact, the word depression has virtually replaced unhappiness in our internal vocabularies. We feel sad but we call ourselves depressed. Having unconsciously made this linguistic switch, when we look for help we naturally turn to a “depression expert.” We look to a pill, a therapist, a social worker, or a pastoral counselor — even if we’re sad because we’re having trouble paying the bills, because our career is not taking off, or because our relationship is on the skids. That is, even if our sadness is rooted in our circumstances, social forces cause us to name that sadness “depression” and to look for “help with our depression.” People have been trained to call their sadness “depression” by the many forces acting upon them, from the mental health industry to mass culture to advertising.
If there is no “mental disorder of depression” but only human sadness mislabeled as “depression,” what are your thoughts about antidepressants and psychotherapy?
Chemicals have effects and they can alter a human being’s experience of life. Chemicals can affect how your mind works. Chemicals can affect how you sleep. Chemicals can alter your moods. That a chemical called an antidepressant can change your mood in no way constitutes proof that you have a mental disorder called depression. All that it proves is that chemicals can have an effect on mood. There is a fundamental difference between taking a drug because it is the appropriate treatment for a medical illness and taking a drug because it can have an effect. This core distinction is regularly obscured in the world of treating depression. Psychotherapy, too, can help remediate sadness for the simple reason that talking about your problems can help reduce your experience of distress. Psychotherapy works, when it works, because the right kind of talk can help reduce a person’s experience of unhappiness. To put it simply, chemicals have effects and you may want those effects; talk can help and you may want that help. Antidepressants and psychotherapy can help not because they are the “treatment for the mental disorder of depression” but because chemical have effects and talk can help.
Why is recognizing the role of unhappiness in our lives an important feature of “rethinking depression”?
To acknowledge the reality of unhappiness is not to assert the centrality of unhappiness. In fact, it is just the opposite. By taking the common human experience of unhappiness out of the shadows and acknowledging its existence, we begin to reduce its power. At first it is nothing but painful to say, “I am profoundly unhappy.” The words cut to the quick. They seem to come with a life sentence and allow no room for anything sweet or hopeful. But the gloom can lift. It may lift of its own accord — or it may lift because you have a strong existential program in place whereby you pay more attention to your intentions than to your mood. One decision that an existentially aware person makes is to focus on making meaning rather than on monitoring moods.
How does following your Existential Program make it possible for people to take control of their lives?
Living authentically means organizing your life around your answers to three fundamental questions. The first is, “What matters to you?” The second is, “Are your thoughts aligned with what matters to you?” The third is, “Are your behaviors aligned with what matters to you?” You begin by removing the protective blinders that human beings put in place to avoid noticing the many painful facts of existence, including painful facts about their personality shortfalls. You decide to understand “what meaning means” to you so that you can proceed to lead your life in ways that feel personally meaningful. You choose to take responsibility for your thoughts and your actions and to lead life instrumentally. You accept and embrace the fact that you are the final arbiter of your life’s meaning. With this approach to life, each day is a project requiring existential engineering skills as you bridge your way from one meaningful experience to the next. By accepting the realities of life and by asserting that you are the sole arbiter of the meaning in your life, you provide yourself sure footing as you actively make meaning.
So much of what you propose is dependent on people accepting responsibility for their own life’s meaning. How does one arrive at such a definition?
Nothing is more important than meaning, and nothing is so little investigated. I encourage people to understand and embrace the fact that meaning — what we value, how we construe our life purposes, what we make of the facts of existence — is a completely subjective affair. Not only is meaning subjective; meanings are bound to shift and change. Once we accept this view, meaning is always available to us. It is waiting for us. All we need to do is think and act in ways that tease it out of its latency. What we are teasing out is a certain psychological experience. Things do not have meaning; human beings experience meaning. Some activities, such as service, ethical action, and self-actualization, and some states of being, such as contentment, appreciation, and intimacy, are regularly experienced as meaningful. A list of these meaning opportunities make for an excellent “meaning menu” to peruse as we decide where we want invest our human capital. But they are not intrinsically meaningful. They are only meaningful when they are experienced as meaningful.
How does being one’s own meaning-maker affect how one approaches important decisions about life?
You weigh your actions against a vision you have of the person you would like to be, the person it would make you proudest to be; you take action; you learn from your experience to what extent you guessed right; and you make use of what you’ve learned as you weigh your next decision. We can give this a shorthand name: the principle of personal pride. We use the principle of personal pride to make our meaning. This may be the beautiful, imperfect, harrowing way — the way of making meaning.
How do you suggest people go about creating a life-purpose vision?
You might start by creating a life-purpose sentence or statement. In one great gulp you take into account the values you want to uphold, the dreams and goals you have for yourself, and the vision you have for comporting yourself in the world, and then you spend whatever time it takes turning that unwieldy, contradictory material into a coherent statement that reflects your core sentiments about your life. Your life-purpose vision is the inner template by which you measure life, and it remains that measure until you revise it. When you agree to commit to making meaning you agree to participate in a lifetime adventure. As you live you gain new information about what you intend to value and what you want your life to mean.
What guidance do you have for people experiencing what you describe as a meaning crisis?
Meaning crises cause profound unhappiness. When meaning leaks out of our life and our subjective psychological experience is no longer positive, we are obliged to restore meaning, or we will find ourselves bored, unhappy, or worse — in despair. I write extensively about possible options when a meaning crisis occurs, but I believe that one can handle the inevitable meaning crises that arise in a sensible, systematic way, by asking and trying to answer these questions: Do you want to deny what’s up? Do you want to buck up? Do you want to engage in some hopeful reframing? Do you want to make small, strategic changes, seize some new meaning opportunities, or make a huge change? By asking and answering these questions you begin to get a grip on the situation.
Why is embracing responsibility for making one’s own life meaning so liberating and such an antidote to depression?
As you become expert at existential self-care you begin to understand the extent to which you create meaning and the extent to which meaning is a deep, inexhaustible wellspring and an infinitely renewable resource. You can invest the increments of time that rise up before you with appropriate meaning: there is always another meaning available. You make it; it comes out of you; it is new each day; it is infinitely variable. You arise each morning and make your next meaning decision. When you arm yourself with your intentions and act this bravely your unhappiness can’t linger.