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Minister for Mental Health

16/9/2015

 
PictureLabour's mental health advocate Luciana Berger.
Yesterday the newly-elected Labour Party leader Jeremy Corbyn unveiled his shadow cabinet. Part of the line up was a position new to British politics: shadow “Minister for Mental Health.” Liverpool Wavertree Labour MP Luciana Berger, 34, assumes the role. She was first elected to Parliament in 2010, served as shadow Minister for Energy and Climate Change, and then shadow Minister for Public Health, campaigning for the NHS.

Regardless of where you or I stand on the political spectrum, this seems like an eminently sensible idea. Partly thanks to the efforts of former Deputy Prime Minister Nick Clegg in the last government, mental health issues have become a major political talking point lately and featured prominently in the election campaigns this past spring. But actions speak louder than cheap political rhetoric: over the last Parliament, mental health service budgets, already on their knees, were slashed by more than 8 percent. Services are inadequate. Last year, 7,000 vulnerable people in the U.K. with mental health problems—a lot of them children—ended up being held in police cells, because there were no beds available.

Freedom of information requests by Berger earlier this year showed that NHS clinical commissioning groups on average spend just 10 percent of their budget on mental health, which accounts for almost a quarter of the NHS’ burden of disease.

One in four people in the U.K. experience mental ill-health every year, causing an annual loss of £26bn to the economy.

Berger said: “Mental health should be treated no differently to physical health. People with mental illness shouldn't have to expect different standards of care simply because of where they live.”

In a speech in Parliament in February, Corbyn said: “All of us can go through depression; all of us can go through those experiences. Every single one of us in this Chamber knows people who have gone through it, and has visited people who have been in institutions and have fully recovered and gone back to work and continued their normal life.”

On Sunday, his first morning as leader, Corbyn snubbed the BBC’s Andrew Marr show and instead visited his local NHS mental health trust, Camden & Islington.

PictureJeremy Corbyn: “All of us can go through depression; all of us can go through those experiences."
The ghost in the machine
One priority for any politician who wants to improve mental health services in the U.K. should be to promote a much greater diversity of available treatments. The NHS is far too therapeutically monocultural, wedded to the symptom-treatment medical model of clinical psychology, one that attempts to apply simplified, uniform labels to the vast diversity and complexity of human psychological distress, and a one-size-fits-all miracle cure-all in the shape of short-term cognitive-behavioural therapy (CBT). Psychotherapy and other more holistic and sophisticated approaches get squeezed out. Too often the notion of “stepped care” ends up being just one step—and not a very big one, either.

For more than two millennia, from the time of Socrates, psychology was essentially a philosophical endeavour. With the dawn of the Enlightenment, however, the Industrial Revolution, and a new age of reason which pledged its allegiance to rationality and logic, it abandoned its roots in favour of modernist ideas of “science.”

This shift was especially marked by the publication in 1913 of John B. Watson’s influential manifesto of radical behaviourism, which recognized “no dividing line between man and brute.” Watson was only concerned with the observable, measurable human responses to stimuli. What went on in between, in that messy “black box” of the human psyche, was of no concern. For the past century, this kind of “positivist” psychology that treats humans as machines has prevailed. It is still taught widely in universities. It directs much flawed, quantitative industry research that is influential yet of limited practical value to psychotherapists (the French existentialist Merleau-Ponty regarded the “science” of psychology as “always both naïve and at the same time dishonest”).

The new modernism is neuroscience. Brain scans are fascinating, but as explanations of minds, souls or consciousness, they are about as useful as a map of London is as an explanation of London. These neuroimages are but the flickering shadows on the walls of Plato’s Cave. They are fixated on the machine instead of the ghost in the machine.

At its best, psychotherapy dances with the ghost as well as the machine. It rejects attempts to delimit, confine or manualize the complicated business of being human and looks instead below the surface, considering historical causes of symptoms, unconscious and conscious motivations, intrapsychic and interpersonal conflicts, and environmental constraints and challenges. It embraces uncertainty (Voltaire: “Doubt is not a pleasant condition. But certainty is absurd”).

In a postmodern world, there are no absolute, objective truths when it comes to human beings and their psyches. Subjectivity rules, and my truth, my reality, my experience of being anxious, depressed, bipolar, schizophrenic, suicidal, disabled and so on might be entirely different to yours.

PictureNietzsche
As Nietzsche famously wrote, there are no facts, only interpretations.

The consulting room should not be a place where we go to learn how to live up to a CBT therapist’s modernist standards of how to think and behave. It is, instead, a place where we go to wake up, to discover our subjectivity, our beauty, our power—to find ourselves.


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    John Barton is a counsellor, psychotherapist, blogger and writer with a private practice in Marylebone, Central London. To contact, click here.


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