Today I’d like to talk about an article I read on XO Jane, which somewhat relates to last week’s blog, and which will transition us to a new topic. The article, titled “THE MEDICALIZATION OF EATING DISORDERS IS KEEPING US SICK”, brings up a few valid points about the process of “recovery” as dictated by mental health professionals:
“And that’s when I started to question it — is identifying myself as an eating disordered person for the rest of my life really serving me?… At what point is it acceptable (or even helpful) to declare yourself “recovered” with a “D” at the end, rather than “recovering?”
I soon learned that there is a growing movement in Psychotherapy that functions under the assertion that diagnosing “mental illnesses” the way you might diagnose a physical ailment is rudimentary at best, and may actually be harmful to patients over the long-term.
“It’s very different to say our actions are unhealthy versus we are unhealthy” says Sheryl Canter, counselor and author of Normal Eating for Normal Weight. “If we’re just doing something unhealthy, we can stop. But if we are unhealthy, we’re doomed.” (She says this on her website, where she critiques the “Disease Model” of overeating in OA).
“There are a growing number of psychotherapists who don’t diagnose, and who advocate a movement away from…mental health diagnosis,” says Matt Lundquist, a New York based, non-diagnostic therapist. Lundquist asserts that one of the primary flaws with mental health diagnosis is that it assumes that the problem lies within the patient — it “assumes that you are the problem.”
As I did more research, it became clear that there is concern amongst psychotherapists that the “internalization” of a mental health diagnosis — i.e., a patient’s belief that something is fundamentally wrong with them — may have a negative impact on their psyche and behavior.”
I never had the experiences that this author did with her eating disorder. As I went into last week, I saw a specialist and a nutritionist. I was nine the first time I saw a therapist, and I’ve been in regular therapy since I was twelve, so any discussion of my eating disorder happened in a generic therapist’s office who had no training specific to eating disorders, and I was never in group sessions outside of hospitalization. Again, any group sessions in hospitalization were generic and not specific to eating disorders. When I was fifteen, I put on a considerable amount of weight and was therefore considered “cured”, so I no longer saw my specialist or nutritionist. I have never discussed in therapy my second relapse wherein I equated my body with food – or rather, I never discussed it with someone who was trained to deal with that type of eating disorder. I brought it up and it was dismissed. I don’t know what it’s like to be in recovery from an eating disorder, because while there are certain behaviors (such as but not limited to religious fasting) that could trigger a relapse, I largely consider myself over my old habits. But an eating disorder is not the only thing that the psychotherapy movement applies the concept of recovery to – they also apply it to bipolar disorder. And let me tell you, that pisses me off to no end.
I was first exposed to the concept of “recovery” in the context of bipolar disorder while staying in a respite center over the Christmas holidays. We met in group therapy sessions, which I found to be largely unhelpful, and during one of them were asked to formulate a plan for recovery. I cringed. Two things popped into my head: one, that “recovery” was a term that should only be used for addicts and people coping with purely physical issues, and two, that “recovery” implied that there was something inherently wrong with having bipolar disorder. I’ll let you in on a little secret: there isn’t.
When you frame a list of coping skills with the word “recovery”, you suggest that bipolar disorder is both an undesirable condition and something that you can “get better” from. Bipolar disorder is something you’ll be coping with for the rest of your life, so really what is “getting better” is the sometimes harmful and self-injurious behaviors that are the hallmark of bipolar behavior. And while I hope and pray that my children don’t end up with bipolar disorder as well, the same way I hope they won’t be diabetic, there are some definite upsides to having a different chemical functionality in one’s brain. During my brief stint in college, I advocated something that got me a lot of backlash, but that could make sense under the right context: the idea of “bipolar pride”. Does having bipolar disorder suck sometimes? Yes, yes it does. But as of right now, there is no cure for bipolar disorder. Treatments, yes. Cure, no. And even if there was a cure, I’m not sure that I’d be able to take it. There was a Cracked article titled “5 Great Joys in Life that Healthy People Never Experience” that surfaced last summer, and it gave us this little gem similar to a quote from author/friend Nathaniel Brehmer that I mentioned in “Fears – Crippling Fears”:
“If you’ve never experienced serious illness before, then the first time it does hit you, you’re like the confused and panicky lead actress in a slasher flick — all running around screaming for people to believe you, so overcome with fear you don’t even realize half your tits are out, just terror-flopping all over the place. But if you’ve been really, truly sick before, you’re not knife-bait: You’re the jaded antihero. You’ve seen too much of this shit already, and sure, maybe it broke you a little — but you know what comes next. They’re Richard Dreyfuss in Jaws; you’re Captain Fucking Quint.”
Particularly when you’re diagnosed as young as I was, you build up a vast array of coping skills to get you through shit that most people would find a hell of a lot more difficult to survive. This is why I mentioned earlier that the group therapy sessions I attended in that respite center weren’t terribly helpful – it’s all stuff I’ve been hearing over and over since the age of twelve. You start to learn pretty quickly that regardless of how bad it gets, you can get through it and it will get better later.
One of the other bonuses of having bipolar disorder is the sympathy and empathy that comes along with it. It’s a lot easier to put yourself in someone else’s shoes when you’ve been through the ringer. This is one of the main reasons I don’t think I’d want to cure my bipolar disorder – I can’t imagine what it would be like to not feel so easily and be able to relate to people. It’s a common trait of bipolar manias to enjoy that particular feeling – the feeling of being manic, I mean – but the truth is there’s a pretty wide range of emotions in my repertoire that a neurotypical person may not experience in their lifetime. That large breadth of feeling is a pretty difficult thing to give up. My experiences and my struggles have made me who I am today, and my fear of being “cured” and therefore completely changing who I am is pretty valid.
While I do like the idea of having a diagnosis (and for the record, I think mine is incorrect, or at least incomplete) – it gives you a tangible thing to hold onto when you’re constantly questioning “why” you feel the way you do – I definitely agree with Sheryl Canter that there needs to be more of a focus on fixing the actions rather than fixing the person. Feeling depressed? You have every right to feel depressed and own that emotion, and it doesn’t make you a flawed person. Cutting yourself as a coping skill for feeling depressed? Well, I commend you for using a coping skill, but it’s an unhealthy one and you need to focus on changing the action, which is flawed, versus changing the way you feel. Feeling manic? It can be a pretty great feeling, and can spawn a lot of creativity and a great work ethic. Irresponsible spending habits because you forget that going into debt is a bad thing while manic? That’s a flawed action you need to work on changing. You’re not a bad person for it; you just need to change that little habit.
I’m not “in recovery”. I’m a person with a different chemical functionality who uses coping skills to deal with the sucky moments in life. I am not flawed, although like many people – including neurotypical ones – some of my actions are. It’s a simple concept, and for some people struggling with mental illness, a revolutionary one.