Psych Central


Where is the Self in Treatment of Mental Disorders?A lot of treatment for mental health concerns is focused on the disorder. Medications for the symptoms, cognitive-behavioral therapy for the irrational thoughts. Professionals always asking “How’re you doing?” “How’s the week been?” “How’s your depressive mood this week?” They look at your eye contact, monitor your lithium levels.

The focus for most treatment professionals is on a patient’s symptoms and the alleviation of symptoms. Few professionals delve into how a disorder — like bipolar disorder or clinical depression — changes our identity. Everything we know about ourselves.

Everything we thought we knew about ourselves.

That’s why this recent piece in the NYT Magazine by Linda Logan exploring this issue is so interesting and timely.

5 Comments to
Where is the Self in Treatment of Mental Disorders?

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  1. I actually finished reading Linda’s article a few minutes before stumbling over this one. More than simply a heartbreaking tale of survival, she provides a template for how and to what extent the core of our very being — each one’s sense of self — is set loose, erased and ultimately lost to us when suffering severe psychopathology. I felt a palpable sense of having lost something after reading the last few paragraphs.

    I believe what Linda describes happens to a lesser extent for everyone at times in our lives — an existential moment in which boundaries blur, life seems completely bereft of meaning and the will to continue struggling seems a distant and empty memory.

    Yet there is hope. There are a number of studies under way that seek to predict risk factors for anxiety, depression, PTSD, alcoholism and suicide. The studies in which I have most interest involve speaking to adolescents and their families, with adolescence being largely accepted as the second most powerful time for the development of self.

    Clinicians would likely benefit from being less concerned about symptom management and therapeutic outcomes, and with placing a greater emphasis on the whole person in treatment.

  2. While not related to the above story in the NY Times, I ask what about patients who get falsely labeled Bipolar who are in fact something completely otherwise, and the psychotropics do in fact cause much more harm or at least disruption?

    Mood swings are NOT just about bipolar! Boy, have I seen that first hand in my travels.

  3. I had read Linda Logan’s heart-breaking article in the New York Times on how doctors treat the symptoms of mental health disorders without taking the time or care to make a meaningful connection with the patient’s feelings, thoughts and sense of self, which often are in jeopardy because of the drugs that are administered. Thank you for bringing this article to your readers’ attention. I have very high regard for PsychCentral.

  4. This rang very true to me. But regarding chronic illness- the onset of life changing symptoms, the diagnosis, the categorizing for treatment paradigms, the loss of everything i ever was up to that point… i became the rheumatoid arthritic. People see my crippled hands 20 years later and my creative gait and they think they know me. I became untethered to my known self, truly adrift in the unknown ether. It became so unsettling that i anchored myself into a new existence. I still mourn the old one like a dead child but I nurture what I have amidst the loss.

  5. Linda’s article in the New York Times was indeed very timely and like others above, I too felt very touched by it.

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