The way that we understand “mental illness” has an enormous impact on how we view individuals suffering from psychological and emotional conditions. Do we believe these individuals to be suffering from a “disease” beyond their control or from normal responses to abnormal situations? There is much debate over whether or not psychological and emotional conditions such as depression, anxiety, or personality disorders exist at all. For those of us immersed in the field of mental health, it may be possible to forget to even question the validity of these “disorders.”
Rational Choice Theory of Neurosis (RCTN) posits that individuals “consciously and deliberately adopt neurotic disorders when confronted with intolerable levels of stress” (Rofe, 2010). The idea is that through complex cognitive processes of unawareness, we forget our own self-involvement with symptoms. RCTN assumes that when individuals are faced with intolerable levels of stress, ways of responding to the stress become very limited.
Choice theory tells us that individuals essentially “choose” symptoms to deal with stress, because this is the best way the individual can come up with at the time to deal with the situation. Symptoms function as distractions from the original source of stress, which alleviates some of the emotional distress being experienced. How does the idea that we essentially choose symptoms to deal with stress sit with you? How does it change the way you view mental illness to think of symptoms (e.g., anxiety, depression, substance abuse) as the best choices we can come up with at the time to alleviate distress? While some of these symptoms may act as temporary distractions from the core problem, they often make matters worse.
Much of what defines the way the public thinks of mental illness originates in the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. This is the tool that psychologists and other mental health professionals use to diagnose mental disorders. While this manual is currently in its fourth edition, the fifth edition will be coming out in May 2013. To reiterate the changing picture of “mental illness,” consider the way that multiple disorders in this manual are being drastically revised, or eliminated altogether, in the upcoming edition.
What thoughts and feelings come up for you when considering what “mental illness” really is? Do you find yourself feeling defensive, curious, or agreeable to the suggestion that what we consider to be “mental illness” is actually a choice (albeit a maladaptive one)? We all have different ideas about what mental illness is and is not; these ideas are usually a composite of a lifetime of personal experiences and acquired knowledge. How has your own personal experience impacted the way you conceptualize mental illness?
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Rofe, Y. (2010). The rational-choice theory of neurosis: Unawareness and an integrated therapeutic approach. Journal of Psychotherapy Integration, 20(2), 152-202.
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