Cupids Health

Is Disorder Healthy? Rethinking the Language of Mental Illness


In the program notes
of a recent concert at my son’s university, the choral director wrote: “
while the music in
this concert is mainly secular in nature, each piece contains imagery which
tells the story of our collective movement through the life cycles of order,
disorder, and re-order.” 

The
phrase brought to mind the groundbreaking research of developmental
psychologist Ed Tronick, who in his moment-to-moment analysis of videotapes of our
earliest love relationships, offers evidence for the critical role of moving
through mismatch to repair in healthy development.
 Tronick’s research, founded in
dynamic systems theory, shows us how disorder followed by re-order is in fact
the process by which we gain energy and grow. 
If
disorder, and the process of moving through disorder to re-order is a not only healthy, but an essential part of human development, perhaps it calls for a
rethinking of what we now name mental “illness”
A recent controversy
on Twitter exemplified the emotionally charged nature of this conversation. My
colleague Suzanne Zeedyk referenced my blog post Big Pharma and the Question: Is ADHD Real? Below
is an excerpt that speaks directly to this question.

The
latest research by Peter Fonagy, psychoanalyst and director of the 
Anna Freud Centre in London,
leads us to focus not on “what is the disorder” but rather “what makes us
well?” 
In a brilliantly laid
out argument
, Fonagy and colleagues present the concept of
a “p” factor that is common to all forms of mental suffering now categorized
under the structure of mental health “disorders.”

An irate twitter follower responded with this provocative comment, “ADHD is not a mental
illness, Suzanne. What a horrific insult.” Suzanne responded with a
comment that in my view is right on the mark. “There is no shame in any
life struggle, whatever you call it. All struggles are real.”

She makes an essential point, that may account for the
intensity of reaction to any questioning of our current paradigm of mental
illness. Questioning of the language may be heard as a denial of an individual’s
experience of suffering. Can we recognize that the suffering is real, without
calling it an “illness” or a “disease?” 

How is her twitter follower right? When we recognize that
from the moment we are born, our behavior and emotions are a vehicle for
communication and for making sense of our experience, we can understand
behaviors associated with ADHD not as an illness, but as a form of
communication.

As I describe in my book The Silenced Child, the problem comes when rather than listening to the meaning
of that communication, we instead silence the communication either with behavior
“management” or medication.

For if behaviors serve an adaptive function, are actually a way of
coping or holding ourselves together, eliminating the symptoms might be a
short-term solution. 
While medication can have a
role to play in relief of profound emotional suffering, if we fail to offer
ample time and space to listen for the meaning of behavior,
 we should not be surprised if
“symptoms” reappear in different and sometimes more problematic
forms.

“But its genetic” or
“these are brain diseases,” are frequent response to this reframing of our
concepts of mental wellness and illness. Once we recognize that our genes,
brains, and bodies develop in relationships, the false duality of biology
and experience, of nature and nurture collapses.  Expression of our genes
and wiring of our brains occurs in the interactive process of mismatch and
repair in our closest relationships starting from birth. It used to be thought
that brain wiring was pre-determined; that our brains had a fixed wiring plan.
But now we know this is not true. Formation of new neural connections- the
“wires” that make up the brain- is flexible not only in early development, but
throughout our lifespan.  
If we understand
“disorder” as “normal” we need to re-think our
system of mental health care that now equates “disorder” with
“illness.” Fonagy points us in the direction of a solution when he writes:
“In that sense, many forms of mental disorder
might be considered manifestations of failings in social communication.”

 When
we move through the experience of disconnection to moments of connection and
healing, we grow and change. Relief of emotional suffering lies not in
naming and eliminating problematic behavior, but in creating ample opportunity
for a mosaic of social connection, with all its inherent messiness and
disorder.



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