Coaching for Mental Health: Ethical Dilemma or Ethical Development?
Current Research and Mental Health
Much existing therapy is based on psychotherapeutic exploration of past issues, cognitive behavioural programmes and on mood moderating drugs, but with development in brain research it is being found that some of these are inappropriate and potentially dangerous.
“Most research on brain activity has until recently focussed on thinking patterns and ignored the far more tricky issue of how we express and feel emotion”. Neuroscientists and Psychologists at a research conference March 2002 debated developments of the amygdala, which “has immense potential, not just for understanding how we think and feel, but for helping people with emotional problems”. Observer 10 March 2002 (News 5)
Orthodox medicine’s focus on this area of research validates what other specialists have been suggesting for decades. Using research, experience and common sense, they have been offering a holistic, integrated approach to body-mind interaction. The MindFields model operates “from a real understanding of what it means to be a human being”. Griffin and Tyrell (1999 p.12). Appendix 3: MindFields Model. This complementary research has also identified the amygdala as pivotal in emotional cognitive reaction.
Emotional and intellectual development appears to have evolved first with the emotional/limbic system arising out of the amygdala at the base of the skull. Here gut reactions of fight and flight, pleasure and pain reside. The neocortex developed with the necessity for detached and objective action and problem solving skills with the abilities of creativity and imagination, and acts as a pattern-matching instrument – reactions and deductions based on the last pattern match. “That pattern of perception is then given an ‘emotional tag’, which may or may not be ‘logged’ by the higher cortex, the cognitive, (thinking) brain. This means that people feel a certain way about something before the thinking brain thinks about it—if it even does. The stronger the emotional tag to a perception, or conditioned response, the less the thinking brain comes into play. Strong emotions hijack the higher cortex, prevent us from thinking clearly, effectively making us more stupid.” Mark Tyrrell. 2002 (p.9)
If stupidity and mental aberration are the result of inappropriate conditioned responses to stimuli, then for emotional and cognitive health there is a primary need to change these deeply entrenched patterns. This same premise underpins cognitive behavioural therapy, but as the amygdala’s emotional reaction holds precedence over neocortical objectivity it means that soothing, creative, rehabilitative interventions are required, not thought reprocessing. Robertson, a researcher on brain rehabilitation, points to the efficacy of antidepressants as proving “that thoughts change in line with the mood changing” not vice versa. 2000 (p.26).
Useful though some medication is, “In the USA, 8 of the 10 top-selling prescription drugs are for stress-related problems, such as ulcers, hypertension, depression and anxiety. Science is proving that dependency on these drugs can lead to additional stress from side effects or addiction”. www.heartmath.com. Additionally Psychiatrist David Healy claims that “the influence of the pharmaceutical industry within psychiatry is all-pervasive” and is vocal in highlighting the dangers of antidepressants. Guardian Education May 21 2002
Psychodynamic techniques and some forms of counselling and psychotherapy are now contraindicated in the US for depression and other disorders as a result of The US Public Service Agency Study. (Depression and primary care. 1996. Vol. 1 and 2). Therapists have been sued for using techniques that exacerbate the anxiety by reinforcing the trauma of the past.
It has been found that a percentage 20% – 25% of the population is susceptible to compulsive and addictive behaviour. The use of some standard counselling methods increases hypersensitivity and can result in compulsive personality disorders or addiction. It is however difficult to initially identify vulnerable individuals and in response the MOD has recently ceased using debriefing sessions after traumatic military actions as it is creating greater incidences of Post Traumatic Stress Disorder.
Effective strategies to soothe the anxious mind include removal of any abusive stimulating agents, whether they be drugs, alcohol, people or environment, and ensuring that basic needs are met. A report from The Mental Health Foundation Strategies for Living (2000) states the need for “…emotional support, feeling accepted, finding peace of mind and meaning in life, security, pleasure, taking control and having choices” and recommends “that mental health professionals should take a more holistic approach to mental health and appreciate that individual treatments and services may be only a small part of the strategy adopted by someone living with mental distress” New Therapist. 2000 (p.4). Some other proven tools that are finally being publicly acknowledged are nutrition, exercise, relaxation, visualisation, acupuncture, homeopathy, self-help groups, employment and humour. Appendix 9: Existing provision.