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Home / New Zealand

Deborah Hill Cone: More money will not fix our mental health crisis

By Deborah Hill Cone
NZ Herald·
28 Jan, 2018 04:00 PM5 mins to read

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If only we can make it easier for people to feel they can be themselves and still be accepted. Photo / 123RF

If only we can make it easier for people to feel they can be themselves and still be accepted. Photo / 123RF

Opinion by Deborah Hill ConeLearn more

As I write this, I feel too hot, too sweaty, too fat, a little dumb, but, strangely, quite cheerful.

I water my plants. I make my bed in the morning. I feed the cat. My "good things log" records that this week: made vegetarian lasagne, de-nitted kids, took back library books. I am weirdly excited that I have finally organised a tradie to clean my gutters tomorrow. Pizza, friends, music and water blasting. You know; just an ordinary life.

None of these things are remarkable. But they are special for me.

Because I wouldn't be like this if I hadn't had therapy that worked. I may not even be here at all. And trust me, I had lots of therapy. Some of it made me worse.

Imagine you have snagged your coat on a nail. You cannot go forward without first going back to unhook it. Just carrying on pulling harder simply rips your coat. And creates more distress.

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And with the highest level of youth suicide in the developed world, it seems a lot of us are stuck.

The government has recognised that and announced a wide-ranging review of mental health. Commentators from both ends of the spectrum, who wouldn't normally agree on a whole lot, (Mike Hosking, meet the Association of Social Workers) have chorused in unison that what it is all about is: money and needing more of it.

Of course, funding does matter. But at the same time, it may not be the most important thing. Putting more money into telling people to pull harder on their coat is not going to get them unstuck.

As management guru Peter Drucker said: "There is nothing so useless as doing efficiently that which should not be done at all".

Currently, the kind of help which tends to be offered to anyone suffering with mental health issues is a short course of cognitive behavior therapy (CBT), a type of talking cure which attempts to address "distorted" thinking by replacing it with "rational" thinking. I know, me neither.

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CBT is considered the "gold standard" of therapy because it's (relatively) cheap, gratifyingly superficial and there are double-blind studies supporting its efficacy. Never mind that since 2011 the whole enterprise of psychological research is being challenged as statistically unsound, with the realisation so many studies cannot be replicated. In an age of data, it is not popular to point out that not everything that can be counted counts, and not everything that counts can be counted. Did I mention it's (relatively) cheap?

I have to acknowledge, CBT does work for some people. But if you have suffered trauma being told to think happy thoughts can be like sticking a band-aid on a gaping wound.

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I tried CBT, I really did, with three different therapists over a period of years. But since thinking had got me stuck in the first place, more thinking did not unstick me, it just kept me trapped. But I kept getting told by experts this was the proven method which would help. When all it did was give me something else to suck at.

Sometimes problems are not even the problem. Coping is the problem. And if you're coping in a way that creates more pain, trying harder doesn't help, it just hurts more.

The truth is that a person becomes a person through other people. So the kind of therapy which worked for me, was not about fixing myself, but about learning to connect (this is called a therapeutic alliance, in the jargon). I learnt I could be accepted, just as I am, despite being too intense, too much, stinky, imperfect, flawed, crazy. My therapist did this for me, while I learnt how to do it for myself.

Bit of a shame that I couldn't have learnt this a bit earlier in life. And that's the thing. Dealing with the underlying social dislocation which isolates us and foments distress and mental illness is so much harder isn't it?

If only we could just make it a little easier for people to feel they can be themselves, and they will still be accepted. (Our mainstream education system is still brutal for anyone who doesn't fit in).

It is acceptance and gentleness that heals. Whether that is a relationship with a "proper" therapist or some other connection with another human being, it brings us back to that "good enough" place, where we can clean our gutters and pay our library fines.

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Many people who become mentally ill, like me, feel they don't fit in to mainstream social norms. We develop an idea that we are "wrong" in some ill-defined but deeply flawed way. But I started to heal, when I realised I wasn't actually broken, after all. Sometimes you don't need to be fixed, you just need to be accepted.

I know that is not feasible for everyone to have the kind of therapy I had, but let's at least tell the truth. Quick fixes are not going to work for everyone, and rather than telling individuals to change, maybe we all need to change too. After Harvey Weinstein we have seen that social norms around gender can move dramatically within the space of a few months. So when is the #metoo revolution coming for mental illness?

Where to get help:

• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• Samaritans 0800 726 666
• If it is an emergency and you feel like you or someone else is at risk, call 111.

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