As a therapist, I have seen a variety of issues within the mental health and healthcare system that has almost knocked me completely off my feet. Some of the things I have seen have put me in denial, shocked me, angered me, and confused me. The problem isn’t always so much about mental illness and the poor treatment of illness, but the ways in which we (as mental health professionals) have been taught to view pathology. Sadly, mental illness affects a great deal of our society, about 7.7 million adults and 20% of teens suffer from severe mental illness such as bipolar disorder and schizophrenia. About 1 in 88 children suffer from autism spectrum disorders and a great number of boys are repeatedly diagnosed with ADHD, oppositional defiant disorder, or conduct disorder. Even larger numbers of children, adolescents, and adults are medicated with some of the most common medications today: Concerta, Strattera, Ritalin, Celexa, Trazadone, and Adderall. It’s something I witness on a daily basis.
But one of the most problematic issues I have witnessed over the years is the pathologizing of children and adolescents (even some adults) who seem well-adjusted. This is mostly due to ignorance and bias, but it may also be due to what I like to call “blindness to normality.” A blindness to normality seems to occur amongst healthcare providers who constantly work in mental health centers characterized by extreme disease or criminalistic behavior triggered by severe mental illness. For example, individuals who have long worked in inpatient settings seem to have a tendency to view the world in terms of illness. It seems to have become an automatic response to life. The “blindness to normality” seems to occur amongst a large number of mental health professionals who deal with illness regularly. It almost feels like a syndrome. Everyone begins to assume ALL individuals who seek therapy are severely impaired. While mental illness is very real and affects a large number of people, we must be careful not to pathologize every single person who seeks psychiatric treatment or gets in trouble with the law.
“Over-pathologizing” individuals is something I have witness multiple times during my career development as a therapist. It’s disturbing because we miss the opportunity to identify the beautiful traits of those who may only have a mild problem or may have only engaged in “criminal” behavior due to lack of knowledge, negative peer influence, desperation, or negative environments. Everyone deserves to be understood and most people have a reason for why they do what they do. Our job is to figure that out, not label right away.
I am of the firm belief that everyone should be given a fair chance to prove themselves or express themselves. Labels can be useful in helping us to identify need or severe illness, but they can also be detrimental because they box individuals into corners they may not deserve to be in. For example, when I started as a mental health clinician some years ago, I counseled an adolescent male from Mambai India for depression and anxiety. He reported that he had two criminal charges for conspiracy and possess of a deadly weapon. He was soon labeled “antisocial personality disorder” with “sadistic traits” and depression. As I met with him bi-weekly, I learned that he did have emotions, he did regret his behavior, and he wanted to turn his life around. Emotions and regret is something sociopaths or antisocial people do not feel. He explained his childhood and the pressure his father put him under to be “rough” and “tough.” His criminal charges appeared a day after his father called him a “sissy” and verbally abused him. He wanted to prove himself. The psychiatrist in his local Mambai mental health Clinic labeled him “criminal” and placed on his profile a title that would destroy him. He was nothing of the kind and deserved treatment for his depression, skill development, and someone to have faith in his better side. Today, he is a lawyer and fights for the rights of children in abusive homes.
The points of my article today are simple:
- Watch labels
- Be careful not to over-pathologize people, but be open to the truth of severe illness
- Question all labels of your loved one and accept the truth when it is fair
- Not all “criminal” behavior is motivated by a cold-hearted person
As always, stay informed