I am on a break from social media right now, so I’m doing old fashioned things like reading newspapers on Sunday morning over a breakfast of sesame croissants with brie.
I found this really interesting. The fallacies made me rethink some of my own prejudices.
The one I identify with a lot is number 4 - the idea that therapeutic solutions just re-inscribe the kind of individualism which is one of the reasons why everyone's so miserable...
But of course, like you say, social problems can have individual solutions (they have to, once an individual needs help) and good therapy can help people help other people, too.
It's probably worth mentioning group therapy here, which is very effective for some people, I think in part because you're helping others right from the outset.
oh its a hard taboo here in south asia (except in urban areas). Infact I can say my relatives in rural areas would find the idea of just talking oneself out a sign of profound weakness and abnormality.
May 25, 2022·edited May 25, 2022Liked by Irina Dumitrescu
I recently learned from a friend in med school that, in pretty much all states in the U.S., the medical licensing board asks whether you are currently being treated for a mental health condition, and if you answer in the affirmative, you’re required to authorize disclosure of all clinician records (therapy notes, diagnoses, etc.) to the licensing board so they can assess whether your ability to practice medicine is “impaired.” Over half of the states extend the timeframe to ask whether you have EVER been treated for a mental health condition, and some licensing boards ask about this when you’re up for renewal too.
I thought this was especially shocking given the high rates of burnout among physicians—which, as the child of a psychiatrist, I’ve witnessed personally. It’s almost like we’re expecting our doctors to be superhuman. On the one hand, we “laypeople” are told to seek help if we’re struggling, but what does it say if the folks who treat us are discouraged from doing so?
This made for a really odd read. I don't typically think of countries in the West struggling with something like therapy the way we do here in Nigeria.
Therapy is almost completely taboo here. Not only is it looked down on, finding it when you do need it isn't that easy at all. I'd know from my own personal experience.
In fact, mental health isn't a thing here broadly speaking. There are people who have to hide the fact that they need to take drugs to survive from their employers or else they wouldn't be employed.
Again, it's strange to see that Germany functions like this too.
There is a very strong anti-medication ideology here, which has both good and bad effects. So for example, it can be extremely difficult to get antibiotics. On the system level, that's not a bad thing. But if you happen to be the person spending a month, six weeks, sick and miserable because you aren't getting better on your own the way the doctor suggests you should, you just wish they would give you the drugs.
Similar thing goes for pain killers. Doctor will do just about anything to avoid giving you a pill. I remember having a wisdom tooth out and having to all my dentist for a prescription. The pain killer he prescribed me was one that also makes people queasy, so after taking one and spending a day in even more misery, I just decided to endure the pain. At the same time, seeing what suffering opioids have led to in North America I can understand the logic of trying to do with less medication.
But I think these are also part of a larger cultural value of "toughness," which outside of medical contexts can be applied in ways that just feel cruel. It's not that toughness is not valuable in many situations, it's just that it has limits. Sometimes, there is more strength to be found in understanding and dealing with our weakness rather than gritting our teeth and pretending to be fine.
We have stopped being scientists. We only care about getting a publication, a position, loads of cash. Instead of thermodynamics which occurs everytime and is reliable, we want the first mention of a result in terms of statistics, AND we don't want those statistics argued with. It is just the one set of statistics upon which we will then base everything. There is a replication problem in science. Why do you suppose that is? Because we don't want reliability. We want to be the first and only. Nothing else matters. Even Nature argues with this like they are wrong.
What are we dealing with now? I have lived since 1956. In that time we have lost the capacity for compassion and kindness for humans and nature if we ever had those. I have watched expenses and profits follow the infinite growth curve model of success for all these years. Experts will say everything but our choices to not care about each other or the world are at fault. They say ever-increasing everything is natural. It is normal. Ever-increasing conflict is normal too. Ever-increasing lies to have power, money, and control are normal. Rome with so many slaves that shackles were a mainstay product is normal (https://www.smithsonianmag.com/.../why-was-man-buried.../). Rome is the template for success for many people, especially those in power. But, we go even further back than Rome with our lust for war, money, and control. We should definitely look at ancient Greece for this. Thucydides illuminates this for us with respect to the behavior of Athens, regarded by many as the way to be. Especially look at the Melian Dialogue. Athens destroyed Melos for the sake of power. The Melians predicted Athens' fall. Fall Athens did, but the lust for power did not. We see it today in the GOP. Trump is the ultimate rich boy who uses lies to gain money and power. It works well for him. Why do people follow him and men like him? Why do people follow abusive fathers? They are used to it. We are used to the abuse of power.
I really appreciate this, especially as someone who grew up Lutheran and therefore surrounded by more than a few German-Americans (and general church culture) that said you should keep your problems to yourself and solve your mental health problems on your own. Naturally, I internalized a lot of that, and have spent decades fighting that tendency. The pandemic and its effects on mental health sped along that process. But it has been hard to deprogram myself, despite several times making use of therapists in my time. The mental health crisis here has worsened to the point that I really fear for the county’s future.
Your piece is rightfully, righteously angry. And necessary.
Phew. Having grown up in a German gymnastics club where probably half of the members were first-generation immigrants, I don’t find this too hard to imagine. I would say it’s right in line with our right wing conservative view of the world. Toughen up, like that’s worked so well. What I do know is at least here in America we have a full-blown mental health crisis. I personally know very few teenagers and fewer teenage boys, yet I know three (unrelated) teenage boys who are struggling with thoughts of suicide. Right now none of them are able to get into see a therapist. I have at least three friends who had someone in their family commit suicide in the last three months.  it doesn’t help that our system still treats mental health as if it’s separate from physical health which as you point out is absolutely insane. We’re pretty much left on our own to try to figure it out so bring on the meditation and you know mental health apps to give us a fighting chance. I’m quite certain our paid time off policies and the culture around it don’t help at all. We definitely have an overwork culture. I read a couple Substack’s on this topic, https://jonmalesic.substack.com/archive and https://mentalhealth411.substack.com/?utm_source=%2Finbox&utm_medium=reader2-nav, way more expert than I. Yes we could never have too much mental health.
I'm so very sorry for what your friends are going through, and have gone through. It frustrates me to no end that people who want help, who want, in fact, to become stronger and more "resilient", have such a difficult time getting it. (And affording it can be another matter altogether as well.)
I found this really interesting. The fallacies made me rethink some of my own prejudices.
The one I identify with a lot is number 4 - the idea that therapeutic solutions just re-inscribe the kind of individualism which is one of the reasons why everyone's so miserable...
But of course, like you say, social problems can have individual solutions (they have to, once an individual needs help) and good therapy can help people help other people, too.
It's probably worth mentioning group therapy here, which is very effective for some people, I think in part because you're helping others right from the outset.
That's a very good point, especially since the article only reported on a scene of group therapy! But then it framed it all as individualistic....
oh its a hard taboo here in south asia (except in urban areas). Infact I can say my relatives in rural areas would find the idea of just talking oneself out a sign of profound weakness and abnormality.
I recently learned from a friend in med school that, in pretty much all states in the U.S., the medical licensing board asks whether you are currently being treated for a mental health condition, and if you answer in the affirmative, you’re required to authorize disclosure of all clinician records (therapy notes, diagnoses, etc.) to the licensing board so they can assess whether your ability to practice medicine is “impaired.” Over half of the states extend the timeframe to ask whether you have EVER been treated for a mental health condition, and some licensing boards ask about this when you’re up for renewal too.
I thought this was especially shocking given the high rates of burnout among physicians—which, as the child of a psychiatrist, I’ve witnessed personally. It’s almost like we’re expecting our doctors to be superhuman. On the one hand, we “laypeople” are told to seek help if we’re struggling, but what does it say if the folks who treat us are discouraged from doing so?
And how will they understand their patients' struggles, when neither they nor any of their colleagues seek treatment?
This made for a really odd read. I don't typically think of countries in the West struggling with something like therapy the way we do here in Nigeria.
Therapy is almost completely taboo here. Not only is it looked down on, finding it when you do need it isn't that easy at all. I'd know from my own personal experience.
In fact, mental health isn't a thing here broadly speaking. There are people who have to hide the fact that they need to take drugs to survive from their employers or else they wouldn't be employed.
Again, it's strange to see that Germany functions like this too.
There is a very strong anti-medication ideology here, which has both good and bad effects. So for example, it can be extremely difficult to get antibiotics. On the system level, that's not a bad thing. But if you happen to be the person spending a month, six weeks, sick and miserable because you aren't getting better on your own the way the doctor suggests you should, you just wish they would give you the drugs.
Similar thing goes for pain killers. Doctor will do just about anything to avoid giving you a pill. I remember having a wisdom tooth out and having to all my dentist for a prescription. The pain killer he prescribed me was one that also makes people queasy, so after taking one and spending a day in even more misery, I just decided to endure the pain. At the same time, seeing what suffering opioids have led to in North America I can understand the logic of trying to do with less medication.
But I think these are also part of a larger cultural value of "toughness," which outside of medical contexts can be applied in ways that just feel cruel. It's not that toughness is not valuable in many situations, it's just that it has limits. Sometimes, there is more strength to be found in understanding and dealing with our weakness rather than gritting our teeth and pretending to be fine.
We always assume any problem is not society's construction and the methods it uses to enforce its laws, taboos, and assumptions. What does society want? Money, power, and control. These are three aspects of the same phenomenon. We see it in science: https://www.nature.com/articles/d41586-022-01332-8?utm_source=Nature%20Briefing&utm_campaign=2cd0c9d8c5-briefing-dy-20220518&utm_medium=email&utm_term=0_c9dfd39373-2cd0c9d8c5-45622742&fbclid=IwAR3v82IbdX0VaRDw3yBRDMdcx9-OzqfgI_MLmGjoe_z9IYdBiyVMfq9JReg
We have stopped being scientists. We only care about getting a publication, a position, loads of cash. Instead of thermodynamics which occurs everytime and is reliable, we want the first mention of a result in terms of statistics, AND we don't want those statistics argued with. It is just the one set of statistics upon which we will then base everything. There is a replication problem in science. Why do you suppose that is? Because we don't want reliability. We want to be the first and only. Nothing else matters. Even Nature argues with this like they are wrong.
We see it in politics: https://www.nytimes.com/2022/05/22/opinion/biden-trump-republicans-democrats.html?smid=fb-share&fbclid=IwAR3SOY_dGdVs7XPcPcR4MR_-AasbnVDDbG6uuZx0_vGSh8EnNeQh2fFzlJA
What are we dealing with now? I have lived since 1956. In that time we have lost the capacity for compassion and kindness for humans and nature if we ever had those. I have watched expenses and profits follow the infinite growth curve model of success for all these years. Experts will say everything but our choices to not care about each other or the world are at fault. They say ever-increasing everything is natural. It is normal. Ever-increasing conflict is normal too. Ever-increasing lies to have power, money, and control are normal. Rome with so many slaves that shackles were a mainstay product is normal (https://www.smithsonianmag.com/.../why-was-man-buried.../). Rome is the template for success for many people, especially those in power. But, we go even further back than Rome with our lust for war, money, and control. We should definitely look at ancient Greece for this. Thucydides illuminates this for us with respect to the behavior of Athens, regarded by many as the way to be. Especially look at the Melian Dialogue. Athens destroyed Melos for the sake of power. The Melians predicted Athens' fall. Fall Athens did, but the lust for power did not. We see it today in the GOP. Trump is the ultimate rich boy who uses lies to gain money and power. It works well for him. Why do people follow him and men like him? Why do people follow abusive fathers? They are used to it. We are used to the abuse of power.
You point out how we see this in therapy with respect to the effects of society on individuals, who, startingly, don't matter to society. https://medium.com/illumination-curated/this-early-morning-110971bbadf6
We see this everywhere. Only one side of the equation, the society side, is true. The other side only exists to irritate.
How long can a race sustain this?
I really appreciate this, especially as someone who grew up Lutheran and therefore surrounded by more than a few German-Americans (and general church culture) that said you should keep your problems to yourself and solve your mental health problems on your own. Naturally, I internalized a lot of that, and have spent decades fighting that tendency. The pandemic and its effects on mental health sped along that process. But it has been hard to deprogram myself, despite several times making use of therapists in my time. The mental health crisis here has worsened to the point that I really fear for the county’s future.
Your piece is rightfully, righteously angry. And necessary.
Phew. Having grown up in a German gymnastics club where probably half of the members were first-generation immigrants, I don’t find this too hard to imagine. I would say it’s right in line with our right wing conservative view of the world. Toughen up, like that’s worked so well. What I do know is at least here in America we have a full-blown mental health crisis. I personally know very few teenagers and fewer teenage boys, yet I know three (unrelated) teenage boys who are struggling with thoughts of suicide. Right now none of them are able to get into see a therapist. I have at least three friends who had someone in their family commit suicide in the last three months.  it doesn’t help that our system still treats mental health as if it’s separate from physical health which as you point out is absolutely insane. We’re pretty much left on our own to try to figure it out so bring on the meditation and you know mental health apps to give us a fighting chance. I’m quite certain our paid time off policies and the culture around it don’t help at all. We definitely have an overwork culture. I read a couple Substack’s on this topic, https://jonmalesic.substack.com/archive and https://mentalhealth411.substack.com/?utm_source=%2Finbox&utm_medium=reader2-nav, way more expert than I. Yes we could never have too much mental health.
I'm so very sorry for what your friends are going through, and have gone through. It frustrates me to no end that people who want help, who want, in fact, to become stronger and more "resilient", have such a difficult time getting it. (And affording it can be another matter altogether as well.)
yes, those two words "resilience" and "grit" are the worst. It seems to be part of a culture of deliberately not helping.
Thanks for this informative post.