Mental Illness vs. Mental Injury

I’m a formally educated mental health provider. Specifically I’m a Licensed Clinical Social Worker AND a Licensed Addiction Counselor.

My training focused on the biological/genetic causes of symptoms. It also focused on (my summation) “lifestyle choices that led to deficits in functioning and struggles with interpersonal relationships.”

This model places all responsibility for struggles on the individual. A person is reactive and overly/inappropriately emotional because of bad genes. Bad genes and then bad choices.

Actually, that explanation isn’t common. Usually her emotional “struggles” are attributed to faulty coping strategies within her. She’s crying or yelling or shutting down because she hasn’t learned or practiced the appropriate coping strategies. This is the basis of DBT. 

In DBT one receives a dense manual of skills and strategies and is coached on how to practice new ways to respond to the stuff happening inside oneself. If you practice enough then you’ll transform yourself into a more palatable person who weaves into society more smoothly.

Of course, that’s my interpretation after years of teaching it and using it as a cornerstone of therapeutic practice.

I’ve changed my opinion on it recently.

In the mental INJURY model one’s behavior isn’t due to internal deficit or disorder. Rather, it's a response to the external world chronically and systematically wounding and shaping a person into a wounded individual.

Slings and arrows of outrageous fortune, as Hamlet would say.

Would we judge a soldier returning from battle with a broken leg and scars all over her body? 

Would we say she wasn’t skilled enough to dodge mines or bullets? 

Would the treatment be to learn about how the enemy places mines so that her leg would get better?

That’s ludicrous. We’d splint the leg and salve the skin and provide warmth and support and compassion.

We’re walking through the world encountering beings who have been brutalized by social warfare. Race. Gender. Sexual identity. Intellectual differences.

There are so many walking wounded roaming our world.

We have been shaped and mutated by the world. NOT our “dysfunctional” response to it. We have been attacked and shamed and diminished and invalidated. We have been brutalized by families and communities and then told that the problem is US. That we’re too challenging or too trusting or too unskilled. Too much limbic system and not enough frontal lobe.

This serves to make us ashamed of ourselves. 

My definition of shame: a deeply uncomfortable experience that something we’ve done or something we’ve not done makes us unworthy of love and connection.

If the fundamental concept of our suffering is that it is happening because of something WRONG with us then the process of healing is already corrupted.

I say fuck that.

I say place the blame for the injury where it belongs. On the outside forces that created it.

After that is done we can start healing from a place of compassion for ourselves. We can heal from a place that’s safe from the forces that wound us.

Shame is the carrier oil of trauma.

Compassion and acceptance are the carrier oils of healing. Of joy. I believe great joy is possible.