Rates of mental illness are rapidly increasing in the Western world. Depression and anxiety have become common place, and they're just the tip of the iceberg compared to more severe mental illnesses such as bipolar, schizophrenia and so-called personality disorders such as borderline personality disorder.
So why has mental illness become such a problem in a society which offers more opportunity, longer life expectancies and greater possibility than ever before? What causes mental illness, and how can it be cured?
I'm not a psychiatrist or doctor so don't take what I say as medical advice, but my opinion is that virtually all mental illness is caused by a build-up of psychological pressure in the primitive emotional centres of our brains. The cure is to learn how to release this pressure in a safe environment with empathy from another human being.
Think of your brain as a pressure cooker of emotion. During our lives, events happen that cause us to feel emotions. These emotions range from pleasant to unpleasant, and their intensity from mild to overwhelming. Under normal circumstances we naturally release these feelings in the present moment as the event occur. As a child we cry freely when we are sad, we smile when we are happy, we rage when we are angry, and we shake when we are frightened. It's as if the vents of the pressure cooker are open, the feelings flow freely and we move on without even remembering most events.
If the emotion we experience is overwhelming, we may be left traumatised and it may take some time and/or require empathy from someone else in order to recover. But for the most part, our brains are wired to heal most emotional wounds automatically through the natural expression of our feelings.
However, most of us weren't brought up under circumstances that allowed us to freely express our feelings. Often our parents were triggered by our distressing emotions and sought to shut us down in order to relieve their own discomfort. In social situations such as kindergarten, we learned that teachers and other students didn't necessarily appreciate our free expression of emotion. We may have even been taught by religious teachers that some emotions were bad or wrong. Adults who were uncomfortable with their natural feelings taught us to hide our own. When we saw other people's emotions such as anger expressed in ways that clearly hurt us and other people, we bought into the idea that certain emotions were evil.
We first learned how to handle emotions from the people around us when we were very young; particularly our parents. They're also our primary potential source of both the secure attachment we need to feel safe in the world, and the empathy we need to heal inevitable emotional wounds as they occur. Having too many emotional wounds left unhealed is traumatic. I've met a lot of people with mental illnesses, and I'm yet to find a single one who had two emotionally available parents present to provide this crucial empathic bond during their formative years.
A lack of secure attachment in an infant leads to a lifetime of anxiety because the world feels like an unsafe place. You can't get a secure attachment to a parent who isn't emotionally available, no matter how much that parent may love and cherish you deep down. Love is an emotion: If your parents felt uncomfortable feeling love in their heart and showing love in their eyes when you were an infant, you'll learn to suppress your love too. This is particularly important in the mother/son relationship.
I don't believe in the simplistic notion of a genetic predisposition to a "chemical imbalance in the brain" that can only be rectified with medication. Sure, genetics play a role and there's plenty of evidence that mental illness is hereditary. But something has to happen to cause the chemical imbalance. That something is a lifetime of suppressing your emotions. Emotionally inexpressive parents have emotionally inexpressive children because children don't feel safe freely expressing their feelings around adults who also aren't freely and safely expressing theirs. I believe this is the primary mechanism by which mental illness is passed down in families, not via genes.
To compound this problem, we live in an emotionally repressive society that treats feelings as second class compared to thoughts. Compare the income of the average artist to the average engineer, and you'll immediately notice that analytical thinking is valued more highly in our society than emotional expression.
Yet something is amiss: 9 of the top 10 most popular YouTube clips are music videos. Why? Because music bypasses our analytical brains and allows us to feel something. We crave this kind of connection both with ourselves and other people. We may have been taught to disconnect from our feelings, but the most primitive core of our brains is still wired to feel. Analytical thinking is a relatively late evolutionary development in our brains: Thinking can suppress our feelings for a short period of time, but eventually our emotions will always win.
Suppress your feelings long enough, and they scream louder and louder in order to get your attention in the form of a mental illness. To see how this happens, let's go back to the pressure cooker analogy.
Each event we experience is remembered along with the emotion that was present at the time. The more emotion, the stronger the memory. This is why you can remember exactly where you were when you heard about the terrorist attacks on September 11, but you probably can't remember what you did on August 11; because it has no emotional significance for you. The unpleasant emotions associated with traumatic events form a kind of psychological pressure inside the primitive subconscious part of your brain. The more emotions you have unexpressed, the more pressure you will experience.
Even just a single sufficiently traumatic event can cause enough overwhelming emotion can leave you emotionally scarred with Post Traumatic Stress Disorder. But the effect of emotional stress can also build up over time.
If your ability to express yourself has been suppressed, it's like blocking the vents on the pressure cooker. As more and more difficult life events create more and more unpleasant emotions, the pressure builds up and up. You get mood swings as the emotions in your subconscious try desperately to alert you to the problem. But your conscious mind doesn't recognise what's going on, because you've never been taught how to handle your emotions.
Your subconscious can only communicate with you via your feelings and you've been trained at school to ignore them and just keep pushing on with life regardless. Along the way you become a lawyer or an engineer, or some other profession when analytical thinking rules and feelings don't get a look in. Anxiety and depression start taking a hold as your subconscious continues to try desperately to get your attention; but you keep doing what you've been taught by society: ignore how you feel, and just get on with things.
Eventually the pressure cooker explodes in the form of a full-blown diagnosable mental illness. Of course pressure cookers don't explode neatly; they all look different when they finally rupture. This is why your psychiatrist has a diagnostic manual full of different categories to label you with when you finally present to them because you can't work out why you can't get out of bed any more.
But the categories are largely a distraction because the treatment for all mental illness is the same. In fact, the categories get in the way of the psychiatrist seeing you as a vulnerable human being overwhelmed with feelings that need validating. Instead, he gives you a label and a prescription to ease your pain. But that's not a cure.
The good news is that you can learn how to cure your own mental illness. To do this you need a large dose of two things:
- To express how you truly feel in each moment
- Empathy from another human being
Learning to express how you feel is not as easy as it might first appear. After years of emotional suppression, we lose the ability to even identify how we feel. The most important feelings to express will be the ones you are least comfortable with, and most likely feel ashamed of. Like anger, or sadness, or fear. It probably won't even feel safe expressing these at first, because it didn't feel safe when you did it originally as a young child.
Expressing how you feel in the present moment releases the valves on the pressure cooker so that no further pressure builds up. All those suppressed feelings about the emotionally charged events of the past can then start percolating to the surface of your subconscious mind where you will feel them again. You're likely to feel worse before you feel better. You may feel feelings you haven't felt in a long time, and given that you suppressed them because they felt overwhelming back then, they may feel overwhelming again now. This requires a safe place with people who you trust, and plenty of time so you can go slow to avoid being traumatised by your own buried emotions.
The second ingredient you need to accelerate the process is empathy from another human being. Our brains are wired for emotional connection and having a empathy from an emotionally available person is key to unlocking and healing the emotional wounds beneath mental illness.
Most psychiatrists are not well placed to provide empathy. Psychiatrists are medical doctors who specialise in diseases of the mind. Doctors are traditionally trained to be emotionally detached from their patients; this is really important if you are a surgeon, but it's the exact opposite of what you need in order to provide empathy to a client with a mental health issue. Medical training also doesn’t deal with the painful emotional charges the doctor is still carrying in their own subconscious, which you're likely to trigger when you express how you feel. So psychiatrists are much more comfortable giving you a diagnosis and associated medication to suppress your psychological pain than they are giving you the degree of empathy you really need.
And besides, it's unlikely you'd be able to afford the number of visits necessary to get the level of empathy you require even from an empathic psychiatrist.
A truly empathic therapist will have their own latent emotional charges triggered by you when you begin sharing your true feelings. Psychology has traditionally taught that therapists should maintain a certain emotional detachment from their clients too. Many psychologists lack the ability to be really present emphatically as it isn't part of their academic training: most psychologists are trained in academic institutions like universities set up to teach people how to think, not how to feel. This is why Cognitive Behavioural Therapy is so popular: it's comfortable for the psychologist, because it doesn't cause them to delve deeply into their feelings; but it won't allow you to go very deeply into yours either.
Medication can help relieve the symptoms of psychological pain in order to reduce it to a manageable the level where you can function well enough to express your feelings and get the empathy you need. It can also be a life saver; you can't heal your mental illness if you've killed yourself because the pain became too overwhelming.
If you're on medication, you definitely should not stop taking it just because of what I've said here. Most psychiatric medication requires a careful withdrawal process which should be monitored by your doctor or psychiatrist. If you're considering going on medication though, it might be worth learning to express your emotions and getting empathy first before heading down that route. If you need it as a stop-gap measure to get by right now though, I say take it.
Learning to express how you really feel in a safe environment where you get the empathy that you need, is the key to curing your mental illness. Finding an empathic therapist, therapy group or community is really important. It's almost impossible to do this on your own. Courses such as Path Of Love, The Hoffman Process and Passionately Alive can be a great way to kick-start this process. Books like Marshal Rosenberg's Non-Violent Communication: A Language of Life (also known as Empathic Communication) can help too. You can also learn more about how to master your emotions in Part 2 of The Confident Man Program Guide.