The Problem with Mental Health Experts

 mental health expert filling out form

It’s very easy to be intimidated by trained mental health professionals with regard to what mental health is--or is not.

I know this might sound unnecessarily provocative or argumentative, but I don’t mean it in that way. I’m just speaking as a matter of fact.

I work in the area of mental health myself as an occupational therapist in a psychiatric hospital and I have also had the experience - thirty years or so ago – of suffering from what is usually called paranoid psychosis as a result of taking too much speed when I was living in South London in the eighties.

As a result, I experienced paranoid thoughts and perceptions intensely for six months and continued to experience them less intensely for the next ten years after that.

I never spoke to anyone about it at the time, and I never sought any help--which was very difficult at the time but which I now believe was to my advantage.

What Is "Mental Health?"

My understanding now, all these years later, is that mental health means being able to be with your own experience in as honest a way as is possible. I came to this understanding by practicing daily meditation and, crucially, by not taking on advice from other people. This is in complete contrast to the normal approach to mental health, which is where we are encouraged to take on advice. We are in other words encouraged to adjust ourselves as best we can to some ideal standard that is being imposed upon us by the experts.

Trying to adjust our thinking, or the way that we feel, to be in line with how either I or someone else think it should be is actually violence – and violence can do nothing apart from cause harm and extra suffering, in my view. "Should" is always violence! What after all has "should" to do with anything?

Saying that we should be some way other than the way that we actually are is “invalidating”, to use the current buzzword. We’re making ourselves wrong.”Sometimes people try to soften this approach by saying that first we should acknowledge how we feel and then, having done this, either “move on” or “do something about it.” This is just camouflaged aggression, however. It might sound plausible when we first hear it but it’s still punishing because we always run into the problem of not being able to do anything about it--or not being able to move on.

This is where we start to feel “double bad” because not only are we feeling bad to start off with, we are also now feeling bad about not being able to do anything about feeling bad! We are compounding our suffering by reacting against it and not only this, we are turning our back on our own experience, which is the only thing that can ever help us. “The cure for the pain is in the pain,” Rumi says.

My understanding now is that our mental health is to be always exactly where we are in the present moment. The present moment is where the healing is, not in straining to be somewhere different, not in some “ideal state.” This is where I feel the mental health services almost always go wrong because there is always this emphasis on our own mental health being somewhere else other than in our current experience, being the way we actually are.

No matter how you look at it, this equals pressure and – what’s more – it equals pressure that we can’t ever obey. No one can coerce themselves into changing their mental state. It can’t be done – the more we try to do this, the more we get stuck. “What you resist persists,” says Jung.

It goes against common sense to say that our mental health is always in the present moment, but where else could it be? We can’t actually be anywhere else – that’s not possible!

Therapeutic Double-Binds

The situation where there is pressure to do something that can’t actually be done is what’s sometimes called a “double-bind.” A double-bind is where we have been put in a situation where we can’t win no matter what we do! We’re guaranteed to lose no matter which way we play it. If we try, we lose, and if we don’t try, we also lose!

The key point about a double-bind is that we can’t see what’s actually going on and because we can’t see it we keep on trying to “get it to work” and we keep on feeling bad about not being able to get the desired result. We blame ourselves for not getting the right result and this self-blame feeds backs into the “invalidation” process. Double-binds are ultimately destructive to our mental health.

I don’t believe that mental health workers see the double-bind either. If they did then they wouldn’t be jinxing people under the guise of helping them. Most of us wouldn’t want to do that! As far as I know, there isn’t any training available in “how not to double-bind your clients” in most mental health services, and I have been working in psychiatry for 25 years now. The rebel Scottish psychiatrist Ronald Laing talked about double-binds way back in the 1960s, but the term has rather passed into disuse these days – no one seems to have heard of the concept.

The "Expert Culture"

Mental health care would be changed so radically if we would take on this understanding, even though this is so very much more easily said than done. Instead of being the experts telling people about their conditions and what they should do about them, we would have the much more demanding role of supporting people suffering from mental distress through their experiences, without putting pressure on them (either spoken or unspoken) to be different from the way they actually are.

This is such a difficult thing to do though; it requires a lot of courage to be with others in their suffering without placing all our reliance in some model or theory of what is going on, which tell us what steps should be taken. It is so much easier to tell our clients how they should be and what direction they should be moving in rather than witnessing how they actually are and supporting them in it. This is because in order to support someone in their experience as it is (and not be implicitly judging them) we need first to have experience of being with ourselves in our existential pain.

Speaking for myself, I had tremendous difficulty being present with myself in what was happening to me and not judging that situation as “something that shouldn’t be happening.” Even now, not judging or resisting how I am feeling (or what form my life is taking) is still one of the biggest challenges that I can think of.

Not judging is the ultimate secret of life – I would say!

From my experiences on both side of the fence (so to speak) I know that nothing is as powerful as finding someone who is not afraid to meet you where you actually are and is not judging that situation as being somehow wrong and trying to put pressure on you not to be that way. That is the biggest thing that I have ever learned, and I see the truth of it every day of my working life.

But the point that I am making here is that we don’t train our mental health workers this way. We teach them the other way.  We give them knowledge of technical skills and the idea that they know (in some way) what’s going on without themselves having to go through it. We give them “false knowledge” – knowledge from out of a textbook.

This is the “expert culture,” only there are no experts in mental health. There can’t be any such thing as an expert in mental health just as there can’t be someone who is an expert in living someone else’s life. No one else can ever tell us how to be with our own pain.

Telling people what to do or how to do it is the invulnerable position, the position of the “trained expert.” We don’t need invulnerable advice-giving experts, however. We need mental health workers who aren’t afraid to be vulnerable, who aren’t afraid to not know what is going on, who aren’t afraid to not have the answers. Given the present system, however, this is a very big ask…

Nick Williams was born in 1960 in a town in Yorkshire, England called Barnsley He went to school in Maidstone in Kent, in England and went to University of London in 1988, dropped out six months later and became a squatter in London. For the next ten years he became involved in what is sometimes called the ‘alternative lifestyle’. During this time he traveled to India several times. He then went back to college in Canterbury and got a degree in Health Education and Natural Science. A year later Williams went back to college in Brunel University London and studied to be an occupational therapist. When he qualified he moved to the Republic of Ireland and got a job working in a psychiatric hospital, where he still is. He runs mindfulness groups in the hospital and also in the community, along with a community creative writing group. His understanding of what mental health is or is not is informed by his experiences rather than anything he learned at college.

You can read more of his writing on his websites, which are listed below.