The Distortions of the Mental Health Lens

     Matt Donovan, a NHS psychotherapist, published a piece on the Mad in America website this week that questioned if it might not be the “lens” through which contemporary psychotherapy is viewed which is a basic problem.

     He writes, “If psychotherapy were best understood as a form of treatment (much like with physical disease)…we would expect clear differences between therapeutic models.” In other words, the “lens” – what Donovan calls the “conceptual framework” – known as “mental health services” itself defines “mental health” and therefore how psychotherapy as a field understands human distress.

     He notes that the very label of “patient” frames an already biased lens through which to view someone seeking help. A therapist then becomes a clinician, a physical not mental specialist. The word “therapy” itself, however, Donovan points out, means “to stand beside.” A therapist then is “being with,” not doing to,” the client, and is practicing empathy, not  correction, as “clinician” implies.

     That overriding “lens” influences the entire vocabulary that any given therapeutic practice is derived from.

     Donovan goes on to say that “outcomes vary significantly between therapists. Some therapists appear to be consistently more effective than others .” However, “the differences between therapeutic models are consistently so small that the phenomenon has been termed the ‘dodo bird effect.’”

     Therefore, he states, “techniques take a secondary place. ” He cites studies that show that the people who felt most helped by psychotherapy were those who felt they were understood by someone who was genuinely interested in them.

     Donovan’s comment is confirmed by an earlier landmark study. In 1965 the University of Chicago filmed sessions of Carl Rogers delivering his Client-centered therapy, Frederick

     Perls delivering his Gestalt Therapy, and Albert Ellis delivering his Rational Emotive Behavior Therapy. Comparing the film footage, the researchers were then able to extract the identical communication techniques each of these then giants of psychotherapy were practicing, regardless of their theoretical “lens” each therapist was “practicing.”

     A skill set could then be defined for basic those communication techniques that allowed a person to feel understood by someone who cared about them.

     If those simple skills are the core of effective therapy, then the entire “lens” of mental health treatment today could, in fact, be seen as irrelevant. And if that is the case — even with those therapists who are not “clinicians” — then how far removed from anything the least bit therapeutic has the current field of psychiatry strayed with its reliance on instant DSM diagnoses and solely pharmaceutical interventions to try to “help” some troubled client?
 
     Some psychotherapeutic help might or might not do much for person, depending on the practitioner, but psychiatric “help” is always guaranteed to harm.