My last two books
showed how we can rethink psychology and how we understand people. Those books produced what I call a ‘post-internal’ way to think about people, which changes many of the basic research ideas for psychology.
For me, the most important topic in psychology which is poorly thought about is that of ‘mental health and illness’. We are not getting the behaviours seen in mental health into the right contexts in order to understand them, and then we are certainly not doing well at changing them.
So my first challenge was to show how we could rethink the many areas of mental health in order to observe it differently and to change it for the better and reduce people’s suffering. That is where this book sprung from!
I hope readers get the idea that what we call ‘mental health’ is not about diseases of the body or the ‘mind’, but are behaviours shaped by the awful environments people are living within, and this includes social relationships, economic issues in life, cultural contexts and the lack of opportunities.
With a post-internal understanding one can include the effects from all our contexts and how they impact on and shape our behaviours, and this includes those very different behaviours people show when they are trying to cope in bad situations.
The book does not give all the answers about which contexts in life are important for mental health, but it shows how we can do this with systematic observations and research of individual cases.
Particular interesting features are the strong role of modernity (living surrounded by strangers, capitalism and bureaucracy) as a context for new types of ‘mental illness’ such as the generalized depression and anxieties which are now rife. This also shows how the changing nature of ‘self-identity’ in modern life has also led to these increases in the ‘modern’ mental health epidemics, since self-identity in modernity has become fraught with problems for younger people.
The book also deconstructs the DSM into the observable behaviours it lists, and shows how we can re-group these into more functional groups which make better sense for understanding ‘mental health’ behaviours.
Also, the book shows how some larger contexts of oppression and colonization have led to greater reports of ‘mental health’ behaviours. This includes the oppressed groups: females, refugees, the poor, and Indigenous people. Case studies from the authors own field research with Indigenous communities shows more details of how we can progress this agenda.
Finally, the radical idea is put forward that social science research (especially social anthropological methods) needs to replace the current methods of research which are based on traditional medical research models, since social scientists are the ones who best know how to observe and document the subtle and nuanced contexts in which people live.
There are many misconceptions when thinking about mental health. First, it is not a disease but behaviours shaped by the worlds we live in, and have lived in. This includes the way the talk and think (cognition).
Second, the cognitive metaphors for understanding people are too abstract to be of much use. The book shows how the main ideas can be kept while treating cognition as behaviours also shaped by the social contexts in which we live. The main cognitive ideas and cognitive therapy ideas are given new ways of being thought, including slow-fast thinking, cognitive dysfunctions of depression, and the cognitive biases which are used to ‘explain’ many clinical features.
The final misconceptions follow from the above: we need to treat the mental health behaviours as arising from the worlds in which we live, and not from something inside us, whether disease, mind, cognitive processing mechanisms, or brain functioning. This leads to the book showing how broad political and societal structures can be contexts in which mental health behaviours are shaped. This is shown for the effects of modernity, capitalism, bureaucracy, stranger or contractual relationships, colonization, and patriarchy. These are conditions of life from which arise mental health problems when people cannot cope, and interventions for mental health must also therefore include changing these conditions of modern life, especially if we wish to reduce suffering from generalized depression and anxiety.
I am working on a deconstruction of the current systems of psychotherapy. This looks at the raw goals and activities carried out within 19 current therapies, and shows how they can reduced to five main functional activities which help reduce suffering. This is done by removing the jargon, marketing and theories and looking just at what is done, very much like I did for the DSM in this book.
People do not ‘have mental illness’; people live, and have lived,
in contexts that do not support healthy behaviours.
The world of mental illness is typically framed around symptoms and cures, where every client is given a label. In this challenging new book, Professor Bernard Guerin provides a fresh alternative to considering these issues, based in interdisciplinary social sciences and discourse analysis rather than medical studies or cognitive metaphors.
For Bernard Guerin
, 2017 sees his trilogy of books
completed with Routledge and all appear in print. These all work towards a new ‘post-internal’ psychology of the future and how we can rethink the past 150 years of psychology in exciting ways that allow new interventions to reduce suffering.
The final book of the trilogy is a timely and articulate challenge to mainstream approaches to mental health, in which Guerin asks the reader to observe the ecological contexts for behaviour rather than diagnose symptoms, to find new ways to understand and help those experiencing mental distress. This book shows the reader:
• how we attribute ‘mental illness’ to someone’s behaviour
• why we call some forms of suffering ‘mental’ but not others
• what Western diagnoses look like when you strip away the theory and categories
• why psychiatry and psychology appeared for the first time at the start of modernity
• the relationship between capitalism and modern ideas of ‘mental illness’
• why it seems that women, the poor and people of Indigenous and non-Western backgrounds have worse ‘mental health’
• how can we can rethink the ‘hearing of voices’ more ecologically
• how self-identity has evolved historically
• how thinking arises from our social contexts rather than from inside our heads
Offering solutions rather than theory to develop a new ‘post-internal’ psychology, How to Rethink Mental Illness
will be essential reading for every mental health professional, as well as anyone who has either experienced a mental illness themselves, or helped a friend or family member who has.
His current research mainly follows this third book and develops new methodologies to carry out this approach. He has published several papers from this research which talk informally (‘yarning’) over several occasions with people who have had a DSM diagnosis at some point; asking them to talk about the many contexts of their lives from which their behaviours arose. They are even given their own formal DSM diagnostic criteria and asked to put these behaviours into context. This produces very meaningful conversations about their histories and the way that their ‘diagnostic’ behaviours are powerful (but perhaps misguided) strategies to overcome bad situations in their lives.
One study with Indigenous Australians showed how their diagnostic behaviours (Borderline Personality Disorders) arose from both the historical colonial contexts of their families and communities, and well as from personal strategies to deal with the dysfunctional social environments in which they were raised. From this arose the guiding principle: peoples do not have borderline personalities; they have had borderline socializing environments.