Therapy Is about developing mental fitness rather than focusing on mental illness. Over the years I have become aware that one of the biggest problems I face as a therapist is the negative attitude of people towards emotional and psychological health. Compare it to the attitude towards physical health. The attitude towards physical health often has a positive, preventative proactive element to it. People look at physical health, to a large extent, in terms of cause and affect. Because of this many people exercise, practice healthy nutrition, avoid unhealthy practices like smoking and generally read and research aspects of physical health. Of course, not everyone is dedicated in this manner, but even those who aren’t are often aware that a healthy lifestyle exists if they choose certain options.
In contrast, the perception of mental health is quite different. Its negative focus is about failure and shame. If you suffer from depression you are considered weak, unfit and self indulgent. If you have PTSD or other problems that originate from childhood abuse you are told that you are ‘unwilling to let go of the past’. Similarly, if you experience addiction you are said to have ‘no will power’ and are ‘self destructive’. The result of this negative perception of mental health is that people are not inclined to look at their emotional problems in terms of self improvement as they would if they were physical problems. Instead they view these problems in terms of weakness and shame. Consequently they often avoid dealing with their emotional and psychological difficulties.
By the time many people arrive at my office, their lives have reached a point of crisis. They tell me that they have avoided these problems for years. They arrive, both ashamed for coming to see me, and desperate. I explain to them that they are not mentally ill or a weak, rather they are untrained in mental health as are most of us. They need to learn to acquire mental fitness in order to deal with their problems. I explain that the concept of mental fitness consists of 3 parts: 1/ Self reflection 2/ Awareness of feelings 3/ Regulation of Feelings. Each of these needs to be understood and practiced as one would any skill. I will explain them.
Self Reflection – Self reflection is the ability to understand who one is. I believe that the majority of people have limited self knowledge. In large part this is because they are often defined by their early environment and their family. For example, a client came to me with depression, self esteem and addiction issues. When we talked about his identity he said, “I am a big hole, there’s nothing inside.” His early life, as a child of an alcoholic father and a codependent mother, had a very powerful affect on his lack of sense of self. Because the family was so focused on the alcoholic father there was very little attention paid to him. As a result he never acquired a sense of self or any tools of self reflection. Our work together helped him understand his background and to start thinking of how he had lost himself and to begin looking at who he is.
Awareness of Feelings – A very important resource for mental fitness is awareness of feelings. Often people who feel lost, emotionally injured, stressed and anxious about their lives come to me feeling that they ‘have lost it’ and are mentally ill. I point out to them that they need to develop the skill of emotional awareness. When I say this, they often admit that, for the most part, they are unaware of their feelings. For example, a codependent client told me that she ‘just goes around feeling angry’ at her husband. When I asked her to identify other feelings she was unable to do this.. Anger was her ‘go to’ feeling. However, when we examined her feelings in greater detail she became aware of her sadness, loss, shame and lack of self esteem underneath the anger. This awareness helped her to focus more on herself and what she needed, rather than just being angry and stuck.
Regulation of Feelings – Certainly knowing one’s feelings is a necessary step in mental fitness. However, in order to exert a healthy control of these feelings we need to learn how to regulate them. This requires the ability to moderate one’s feelings, rather than react to them. How do we do this? It is my belief that we have to learn to ‘stand back’ from our feelings by gradually becoming an observer of them. We do this by learning a mindfulness or meditative practice that can give us some distance from our feelings. Through this we can focus on how they make us react in our bodies, emotions and thoughts. By doing this we can slow down our emotional process, create neural connections and pathways that give us a stronger base to regulate our feelings in a positive manner.
All of these skills: self reflection, awareness of feelings and regulation of feelings concern the development of mental fitness. They are not about mental illness, they are emotional and psychological skills that most of us are not taught as children. Too often we are taught as children to react, hide feelings, feel shame and generally look at emotional illness in terms of weakness. If we can shift this perspective to correspond to the way we deal with a physical illness that needs to be positively attended to, then we, as a society, can move forward.