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Mental health, Sex and gender

‘There is only one mental condition, the human condition’

Martin Seager is a Consultant Clinical Psychologist with Change, Grow, Live, and Branch Consultant with the Central London Samaritans.

03 March 2017

One pet hate
If there was a ‘Room 101’ for things psychological, I would definitely place there our naive tendency to believe in panaceas and bandwagons. After the hype about major tranquillisers in the 1950s, the 1960s heralded the belief that behaviour therapy would cure everything including schizophrenia, followed by similarly bold claims for family therapy and CBT in succeeding decades. The latest bandwagon of our times is ‘mindfulness’, which is similarly being claimed as a cure for everything. In truth it may be a very valuable tool, but only in certain contexts and mostly as a repackaging of relaxation, self-hypnosis and meditation techniques, which were already invented.

One defining moment
In 1988 when I had recently qualified as a clinical psychologist, I remember being at the World Behavioural Therapy Congress in Edinburgh and witnessing perhaps B.F. Skinner’s last major conference presentation. Due to poor health he appeared on video, not in person. Other than feeling sympathy for a man who had achieved so much and now looked frail, I will always remember him restating defiantly his belief that ‘the best way of understanding the behaviour of human beings is through controlled experiments with animals’. Looking back, I can see I was witnessing a change in the history of psychology where the old school of pure behaviourism was coming to an end and being replaced by something more cognitive. However, even at that age I remember thinking, ‘If we could truly generalise the results of animal experiments to human beings, why don’t we just do the experiments on humans in the first place?’

One core philosophical belief
Western science in my view mistakenly assumes that time-space accounts for everything and therefore what we call ‘mind’ gets falsely confused with the brain, privileging biology, chemistry, physics and mathematics over psychology. This means that subjectivity is devalued as a bias rather than being seen as the root of all scientific observation and theory. Psychology is therefore devalued as a ‘soft science’ when in truth it is at the gateway of all science. For this reason too, art and science get falsely split as ‘soft’ and ‘hard’ in our education system, and so all the rich data about the human condition in our art gets ignored by science. This is a disaster for science in general and psychological science in particular.

One piece of satire
I wrote a satirical poem to illustrate the problems of objectifying the human heart, soul and spirit in the language of depersonalising pseudo-science. The poem is called (after T.S. Eliot) ‘The Empirical Love Song of Alfred E. Prefab’:

An affectional bond has been detected,
A skin response has been affected,
Neurotransmitters are activated
And positive affect correlated

The cortex has been stimulated
And dopamine invigorated
What else is there to be stated?
‘Empirical love’ is validated!

I hope this inadequate love poem shows humorously what is missing from our traditional model of psychological science! And as Leonard Cohen, one of my heroes, might have said: ‘If these thoughts don’t interest you even for a moment, you are lost!’  

One glaring omission from the psychology curriculum
I am saddened that our profession seems to be no better than the rest of society in being blind to the fact that men and boys also have needs and problems arising from their gender. Raising this subject always incurs unreasoned resistance and even at times hostility. This in itself shows the need to keep promoting the issue. As a scientific and humanitarian profession, it is our duty to study and ameliorate the problems of all groups equally and yet there is still a prejudicial assumption in society as a whole that the male gender carries no disadvantages or inequalities. This is despite the fact that, for example, men make up nearly 80 per cent of suicides, 85 per cent of homeless persons, 95 per cent of prisoners and 97 per cent of those dying at work. Psychologists should be leading the way in researching, teaching about and responding to this issue. I am gratified that we have at least now achieved the right to hold a ballot to establish a Male Psychology Section of the BPS.

One positive vision for the future of psychology
Over the last 30 years, like many others I have been dismayed by the persistence of what is often called the ‘medical model’. Part of the reason for this persistence I believe is the bad science and philosophy referred to above which psychology at times colludes with. However, another factor is the lack of a positive alternative to the usual anti-psychiatric polemic. In 2006/7 I got together a group of eminent psychological thinkers (including Peter Kinderman and Lucy Johnstone) to advise the secretary of state for the NHS, Patricia Hewitt, on the universal psychological needs of the human condition. We came up with five fundamentals: (a) to be loved, (b) to be heard, (c) to belong, (d) to achieve, (e) to have meaning and purpose. When I present these at lectures and conferences, no one has ever argued with them. There is only one mental condition, the human condition. By switching from an emphasis of treating mental conditions to meeting the needs of the human condition, we could reduce stigma and offer a positive and normalising vision that portrays psychology as part of a wider public health agenda, rather than as a narrow alternative to drug treatments.

One formative experience
As a first-year student I struggled with feelings of severe depression, which retrospectively I can now see were all about finding my own identity, self-worth and making the transition to adulthood. This was painful at the time but without those experiences I would not have become curious about where mental health and mental distress come from, so I probably owe my career as a psychologist to these troubled times. This period in my life started me on a developmental path that continues to this day. It also started a spiritual lesson that the places of the mind are every bit as enveloping as physical space and that to help others we must connect with them from the inside, not simply observe from the outside.

One favourite poem
‘Days’ by Philip Larkin sums up the human condition.

One great irony
Another hero of mine, Sigmund Freud, started out in neurology and spent his whole life discovering and refining the simple but ingenious theory that mental health problems come not from our brains or nervous systems but from the meaning that things have for us in our minds. It is ironic then that 100 years later, ‘modern’ mental health science is going backwards and trying again to reduce everything to neurology!