Ram Psychology

 

 

 

 

 

 

 

 

 

Mental Health

 

Mental health in the NHS today is still dominated by the medical traditions which underpin psychiatry. Drugs remain the main tool available to doctors for use with patients who seek help for the “psychiatric” conditions which are commonly labelled as anxiety, depression and schizophrenia. Such usage of psychotropic medication assumes that there is a neurological basis for each of these quite common health conditions. Psychoactive substances act at receptor sites in the brain which are thought to mediate certain behaviours. The rationale behind prescribing psychiatric medicine has been the claim that so-called abnormal behaviours can be modified by the chemical action of prescribed drugs at these neurotransmitter sites in the brain.

 

      Animal models of behaviour are often used by researchers as the justification for drug usage to help to alleviate or manage the conditions of anxiety, depression and schizophrenia. Human beings, however, are advanced creatures, and the psychological conditions which scientists attempt to model in the laboratory, with rats and pigeons, for example, are of a qualitatively different order to the experiences of people in everyday life. Nevertheless, if depression is contrived in a laboratory, through the engineering of conditions by a scientist, and then modified by a drug intervention, then clearly a much more effective way to reduce the suffering of the animal is to remove the engineered conditions.

 

      Conditioned animal behaviour is well understood by the science of modern psychology. Contemporary animal learning theory has revealed powerful techniques that have been transferred to the clinician’s office, and also transferred to behaviour modification programmes in corporate organisations. When these techniques are applied in a positive way, reinforcement schedules can be useful, in appropriate clinical situations, to help to relieve the distress of patients who, for example, have been experiencing phobias, and also with children exhibiting behavioural problems in the home, or at school.

 

As an alternative to drug therapies, these tested psychological techniques are a welcome intervention in those NHS services which strive to relieve distress in patients, in all of its forms. Cognitive techniques have been added to the behavioural methods which have been used in clinical settings. Cognitive behavioural therapy is vogue, and has been used predominately, by NHS clinicians, to treat anxiety and depression, and even schizophrenia. Research is still ongoing to establish a convincing evidence base for this form of intervention, with regard to its efficacy, yet these health conditions, as experienced by patients, and defined in the literature, do not easily fit with the goals which some clinicians are trying to achieve. The experience of depression, for example, is not primarily cognitive, even if emotions and associated thoughts of helplessness, sadness or guilt may be evident within the mind of the individual.

 

      Depression which is defined as a “mental disorder” actually misrepresents the nature of the experience of the patient. Disordered or deranged thinking does not characterize depression. Bereavement or divorce; impossible situations at home or at work; withdrawal from others; loss of appetite and sleep; lack of interest in previously enjoyed activities or sex; plus, lethargy, loss of energy, or agitation and anger, can combine to make depression a more powerful and complex condition than simply an extreme form of sadness that can be treated with antidepressant “happy pills”, or re-engineered thoughts.

 

      The best way forward is not to make a pathology out of a psychogenic condition. Disease is not the best metaphor available for understanding individual distress which is experienced psychologically. If a person is suffering, and then seeks the advice of a doctor, there are different avenues which could be explored if NHS doctors were to look beyond the manifested symptoms which a patient presents with. This would require much more than just a sympathetic clinical approach to those mental health problems which are discussed. A deeper understanding of the human condition is required by all parties at the clinical level before real steps forward can be made.