In a place called Many Movies I’ve Seen, the therapist’s office is clean, beige and has one or all of the following: an impressive bookcase, soft leather chairs, a sculpture of nothing-you-can-make out.
It’s such a cliche it makes you think that being in such a room is the cure in itself. Breathe deeply. Inhale the scent of chamomile tea. Don’t you feel better?
I have never been to Many Movies I’ve Seen, but I’ve been to the offices of psychiatrists and psychologists throughout the country. They don’t look much different from the offices of my GP or any other doctor I see. They are not imbued with magical calm, nor do they come equipped with clinicians who apparently have no clients other than you.
That is to say, infinite time (or the disregarded clock) does not exist in these places.
Out here, psychiatrists and psychologists are in great demand. There are more of us than them. Their time is limited. Phone calls may interrupt a session. They may be called away on an emergency.
They are not bad doctors and therapists. They are real ones working on stretched schedules. Far too many of us have fantasies of what therapists and the practice of therapy looks like. Stop it.
Mental illness is not one thing. It is not a term that, once you hear it, you easily understand what’s wrong and know how to fix it. The Diagnostic and Statistical Manual 5 (DSM-5) lists 157 mental disorders in 19 disorder categories.
You may have more than one disorder and your diagnosis may cross categories. A bit of this and a bit of that. There’s something oddly buffet about psych diagnoses. That’s not necessarily as bad as it sounds.
Or, to be fair, it could be a lot worse than it sounds.
Since the stigma of mental illness is still so prevalent, it’s hard to imagine we’ll ever be convinced that some of these things that plague us have names and definitions and we can be treated for them.
A big part of being in treatment is finding the right treatment for the problem and for the patient. Because wrong treatment is arguably worse than no treatment. And this is where we confront the magnitude of “we must remember this is an inexact science.”
It’s not as if we can simply reset the mind as we would a bone. Not simply. But we can try.
First, rule out the rest of the body. The brain may just be the messenger telling you something is wrong with some other part of you. Anxiety, depression, sleep troubles are all legitimate issues in and of themselves, or they may have been sent to tell you something about your thyroid or reproductive system. A good medical checkup can settle that. If you’re sound of body, you move on.
Drugs are often the first stop. Many people believe doctors are too keen to prescribe, but some very fine work in pharmacology is what changed the landscape. Better (and better understood) medicines allowed mental health patients to stop being incarcerated, hosed down, and generally treated like something between a criminal and a zoo exhibit.
Different kinds of medication can be used for most if not all disorders. But some issues can also be resolved with not-drugs (PTSD maybe) while others seem to be must-drugs (like paraphilic disorders).
Psychotherapy or talk therapy comes in many shapes and sizes. Cognitive Behavioural Therapy (CBT) has swum up to the top as the go-to measure. CBT’s view of illnesses and their treatment has a very practical, easy-to-grasp feel.
It’s like the best advice your mother would give you: you can learn to cope better, you can better understand yourself and others, face your fears. This is hideous oversimplification, but if it works for more disorders than I have space to name, it’s getting something right.
I wish I knew, right now, what specific forms of treatment work best for certain disorders. Maybe one day I will, but I suspect that will turn out to be a constantly changing set of opinions and theories. And – living in hope – what solid research points to.
For many disorders, some combination of medication and psychotherapy is needed. There are alternatives like art therapy, and complementary and alternative therapies (yoga, meditation, acupuncture).
All of these options, from the various forms of talk therapy to the different kinds of medications that may be prescribed, are worth exploring. (As in for yourself, and in later columns.)
I spend a lot of time asking readers to ask themselves questions. Getting into treatment may be one of your best bets for finding answers.
Remember to talk to your doctor or therapist if you want to know more about what you read here. In many cases, there’s no single solution or diagnosis to a mental health concern. Many people suffer from more than one condition.