Mental health - again!

I know that this is a highly contentious subject but I just cannot understand why it is now proposed that Australian schools should be provided with “mental health and wellbeing counsellors”.

These are children growing up in a fractured world with raging hormones just trying to “fit in”! 

Now don’t get me wrong! I am fully aware of the indisputable fact that there are many mentally distressed people who are in desperate need of help and support. My “beef” is with how this distress is diagnosed, categorised and finally the efficacy of any treatment offered. 

Firstly, let it be known, and widely known, that there is no consensus or definition of “normal”. What is a “normal” human being? There are roughly 7.2 billion people alive today. That means there are roughly 7.2 billion different people going about their lives, doing different things and behaving in different ways. Does this mean there are roughly 7.2 billion different ways of being “normal”?

Please tell me!

Then we come to the diagnosis of “mental illness”. A popular “diagnostic tool” is the HONOS – Health Of Nations Outcome Scale (please check this on line if you doubt me). Now this scale, as with any others used to “diagnose” a patient’s mental health, and there are plenty of them, is purely subjective. It is a “tick a box” exercise. Using this HONOS each question – there are twelve of them – must be rated 0 to 4. More than a previously determined “score” and you are diagnosed as depressed, schizophrenic, psychotic – or whatever and in need of help. 

Ok. When that is done – what now?

The important question now arises - what is the cause of any distress?

The answer? Nobody knows. Simple. There are plenty of, “the inference is”, the assumptions are”, “there is hope that further research will determine”, etc, etc….!

Again let it be known, and widely known, that there are no objective tests, no biological cause – no blood tests, no fMRI tests (functional Magnetic Resonance Imaging), no genetic link, and particularly no causal link between an apparent “symptom” and the distress evident in the presenting patient. The symptoms enumerated in the DSM5 (Diagnostic and Statistical Manual version 5 of the American Psychiatric Association –APA), used world-wide, were agreed by a committee.

The simple fact is that the “etiology” - the cause – of most mental disorders (Huntingdon’s and Alzheimers disease are more or less determined) are not understood enough to accurately distinguish the “mentally ill” from the rest of us.

Now we enter the minefield of the treatment of “mental illness”. The fall back position of psychiatrists and clinical psychologists is to consider a “mental illness” as a biological condition and treat it as such with a perfect cornucopia of psycho-pharmaceutical drugs produced by “big pharma” to their enormous profit. There is limited evidence regarding the efficacy of these drugs compared to other treatments (“Big Pharma” are very reluctant to release any research that does not support their advertising). Furthermore the side effects – heightened risks of metabolic disorders, rapid weight gain, diabetes, sexual disfunction and heart disease for instance – are carefully sidelined.

That some people do derive benefit from these drugs cannot be denied. They do. But these drugs never “cure” – they are a stop-gap offered to often desperate patients by medicos “stumbling in the dark”.  Often a “suck it and see” approach is applied – “Try this one. If that doesn’t work, try this at double the dose”, kind of thing. But then again, many people get better on their own or feel better with a placebo (sugar pill).

So – to get back to my opening statement about treating school children - until we know the CAUSE of the obvious mental distress experienced by some patients, how can anyone determine, with any certainty, what treatment should be offered? 

Finally I will repeat a quote, from the Indian sage Jiddu Krishnamurti (1895-1986), who said, "It is no measure of health to be well adjusted to a profoundly sick society".

There we have it in a nutshell!

Hubris

In this day and age, when pride and excess seem to be common themes, and when extraordinary claims are made by individuals about their abilities and mental prowess, particularly by leaders – both public and business – it is well worth recalling that the ancient Greeks had a name for this – “Hubris” (defined as placing oneself on the same level as gods). And this hubris will be called to account. It always is.

Never forget that the “law” of cause and effect will always apply. Humans reap what they sow. It has always been thus. This “law” is unwritten and not codified but applies in every situation – it cannot be avoided and is forgotten or ignored only at great personal cost. This law incorporates the profoundly realistic doctrines of “Hubris” and “Nemesis”. Whenever there is any kind of over-weening and excess; whenever people or societies go too far either in dominating others or exploiting them, or exploiting nature, for their own advantage this unseemly exhibition of pride, this hubris, has to be paid for. 

Hubris seems to invite Nemesis and the “Goddess” Nemesis is implacable in the pursuit of her cause – justice; to track every wrong back to its doer. To the ancient Greeks Nemesis was conceived as shaping the demeanour of mankind; of keeping society in equipoise. She was often portrayed holding scales, a sword and a scourge. Nemesis deals retribution in due proportion to what is deserved – in a just balance.

Where governments, and the laws they promulgate are not founded on the ultimate reality behind all phenomena, described in that fascinating compilation of ancient wisdom “Tao Te Ching”, as the Tao (Dao) - the Way (the Flow of the Universe) – society will falter. 

For clearer understanding of this statement it may help to recall what Confucius had to say about justice and laws some twenty-five centuries ago: 

 “If you govern the people by laws, and keep them in order by penalties, they will avoid the penalties, yet lose their sense of shame. But if you govern them by your moral excellence, and keep them in order by your dutiful conduct, they will retain their sense of shame, and also live up to this standard.” 

In light of the astounding lack of moral leadership (and the subsequent loss of trust) shown by many of today’s leaders (both government and business) which reflects back on society and world events, I truly believe that it is time for everyone to stop, even take a step back and look, I mean really examine, their actions and see whether they make any sense.

The old saying applies to all – “pride comes before a fall” and no one can foretell what the effects of this “fall” will be or when it will take place.

Nemesis in her deliberations misses not one of all. 

Another way of putting this is in the old saying, “the mills of God grind slow but exceeding fine”.

Life

It is strange how the human condition is perceived and recorded. Not necessarily the dry APA (American Psychiatric Association) style required for “research papers” presented by neuroscientists or psychiatrists in their appropriate “Journals” but the more human kind - nearer the “heart” of humanity. The best of these are good novelists and especially, in my estimation, poets.

The human conditions or emotions most recorded in poetry, song and novels are, I believe, love, birth, life and death – those important milestones in anyone’s life.

As I have stated many times before, poetry affects me in more ways than I can possibly say. Poetry seems to touch some hidden part of my soul. There have always been poets – often, in olden times, troubadours bringing news and songs to far flung villages. And it was discovered very early on that the best way to remember long stories was to render them into verse. The rhyme and rhythm was easier to recall.

The rhythm is often associated with the beating of the human heart and a good reciter of poetry seems to capture that as he or she reads from the volume or recites from memory. This resonates with the listener.

I can only read in English so everything I read is either originally written in that language or translated. Whether it is the flexibility and the vast vocabulary of that language I’m not sure but there is a massive treasure trove of English poetry.  

I usually include a verse or two from a poem that has made an impression on me but now I attach below, the whole of what I think is my favourite poem written by a man I greatly admire and who suffered greatly – the American, Henry Longfellow. He married twice but both wives died – the first after a miscarriage in 1831 and his beloved second wife died an awful death, burned in a tragic accident in their home in 1861, a death from which he never really recovered. He died in Cambridge, Massachusetts, at the age of 75 in 1882. A great poet and a great man.

The Day is Done

The day is done, and the darkness

Falls from the wings of Night,

As a feather is wafted downward

From an eagle in his flight.

I see the lights of the village

Gleam through the rain and the mist,

And a feeling of sadness comes o'er me

That my soul cannot resist:

A feeling of sadness and longing,

That is not akin to pain,

And resembles sorrow only

As the mist resembles the rain.

Come, read to me some poem,

Some simple and heartfelt lay,

That shall soothe this restless feeling,

And banish the thoughts of day.

Not from the grand old masters,

Not from the bards sublime,

Whose distant footsteps echo

Through the corridors of Time.

For, like strains of martial music,

Their mighty thoughts suggest

Life's endless toil and endeavor;

And to-night I long for rest.

Read from some humbler poet,

Whose songs gushed from his heart,

As showers from the clouds of summer,

Or tears from the eyelids start;

Who, through long days of labor,

And nights devoid of ease,

Still heard in his soul the music

Of wonderful melodies.

Such songs have power to quiet

The restless pulse of care,

And come like the benediction

That follows after prayer.

Then read from the treasured volume

The poem of thy choice,

And lend to the rhyme of the poet

The beauty of thy voice.

And the night shall be filled with music,

And the cares, that infest the day,

Shall fold their tents, like the Arabs,

And as silently steal away.

                        Henry Wadsworth Longfellow