Critical Perspectives on Mental Distress – finding meaning in distress experiences
Duration: 9.43 mins
Speakers:
Interviewer, Patricia Caplen
Professor Philip Thomas, Institute of Philosophy, Diversity and Mental Health, University of Central Lancashire, UK.
How does your perspective give meaning to people’s distressed experiences, such as hearing voices?
I think the first thing it’s important to say here is that I don’t believe that I have any magical way of helping people to understand. The work that I’ve done, and I have done a lot of work with people who hear voices and I’ve written a great deal about the importance of meaning in relation not only to voices but to unusual beliefs or strange ideas or whatever, but I would never say and never make the claim that I have some special therapy or magical way of being able to do that. What I suppose I’ve been trying to do over the years is to draw attention to the importance, not just for people who hear voices, but for all of us, to find some sort of sense of meaning and understanding in the purpose of our lives and I happen to believe that that’s important for all of us, that every single person needs to be able in some way or another to make sense out of his or her life, the reason we’re here, you know, what it means to be a good person or a bad person, the sort of important moral and ethical questions that we all have to face as human beings. And I believe that those questions are absolutely essential and vital for people – let me rephrase that – are even more essential and vital in states of alienation and distress because those sorts of states are often triggered off by major moral events in peoples lives like being abused or being subject to some sort of abuse or violence, or becoming unemployed or experiencing a bereavement. All those sorts of major issues that get us to question who we are, the nature of our being, what sort of human beings we are, our worth as human beings, can also trigger off severe episodes of distress. So those sorts of events cry out for some sort of meaning and interpretation, and so too does the distress associated with that, whether it’s in the form of hearing voices or whether it’s in terms of developing a set of new strange ideas that seem to set you apart from the rest of humanity in some sort of way, like for example believing that you’re Jesus Christ or that you have a special purpose in life. One of the difficulties with psychiatry is that the way I was trained as a psychiatrist and the way I believe that all psychiatrists these days are trained, doesn’t really pay a great deal of attention to the importance of meaning. What psychiatrists are more interested in is description, describing people’s experiences, in order to be able to put them into this pigeon-hole or that pigeon-hole and also explaining people’s experiences and explaining people’s experiences, as I said earlier, in terms of disordered brain function in one sort or another. Now I believe there’s a great big difference between on the one hand explaining something and on the other understanding it. Now understanding, in order to understand something, we need to try and search out what its meaning is and that’s a completely different project, it’s a completely different venture. The way we understand things and the way we work out the meaning of something, is to be able to place it in context and let’s just take the example of hearing voices because I think that’s a really good example. When somebody hears voices, psychiatrists describe in narrow terms certain very limited aspects of the experience and in doing that, what they do is they completely remove the experience from the context of the person’s life and from the person’s cultural context. The reason they do that is because they’ve been trained and the sort of scientific method that psychiatrists rely upon means it’s really important that they focus upon certain narrowly defined essences of the experiences rather than looking at the whole experience. And the reason that’s important is because those essences if you like tie into the particular notions of the diagnosis. Now there is no way that you’re going to access meaning from that. How do we access meaning? Well we access meaning by looking at the experience in relation to context and there are two particular contexts that I believe are important here. One is the context of the person’s life history. So for example, trying to find out in detail from somebody when the voices first started. You’ll very quickly discover that they started long before they ever came to see the psychiatrist and often they started in the person’s earlier life, often in childhood, and often there was some serious event that occurred in relation to that that triggered the voices off. Most commonly it could be some form of abuse, an abusive relationship of some sort; equally it could be an illness or the loss of a sibling or of a parent. It could be a painful experience at school of bullying or something like that. So there are lots of experiences that occur that can trigger voices off. And often the relationship – and this is where the work of Marias Ramanzandra Esher is so important because what Marian Ramanzandra Esher have done in Holland is to show very clearly how the content of the voices, the things the voices say to somebody, is actually disguised but still represents the original trigger event that was responsible for triggering the voices off. The other important series of contexts that I happen to believe are really, really important is the person’s cultural context. Why is that important? Well if we think of ourselves, let’s say in Western European cultures where we are today in the 21st Century, we have a very materialist and rational way of understanding ourselves. We’ve done away with the spiritual side of our lives that Western cultures and societies have become increasingly secular over the last 150, 200 years. Now, we also, we’re not just living in a Western European culture, we’re living in a culture where people from many other different traditions live as well, like people from South Asia, from Africa, from the Caribbean, that don’t share those particular Western European traditions that go back in our own culture, let’s say, a couple of hundred years. And within those traditions it’s quite acceptable for people to have different sorts of experiences. For example, in people from India and from Pakistan, the experience of hearing voices is given a quite specific framework of understanding through the notion of [0:08:10] and this provides a very powerful way for people from within those cultural traditions to be able to make sense – not just to make sense and understand what’s going on but to have some sort of response. So that for example within the Islamic tradition, which is – I do a lot of work in Bradford and I work very closely with a lot of Muslim colleagues – there are very clear ways within which you can help and support people within an Islamic tradition, either through spiritual healing or through the use of holy verses from the Koran or through the work of an Imam, to help people to cope and understand their experiences. Now I’m not saying that that should take place instead of Western biomedical explanations, but I think in these days where we value choice and diversity so much, it’s really important that we pay just as much attention to those spiritual aspects of people’s lives as we do to the bodily and the psychological aspects.
It's fascinating. Thank you very much.
OK.
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