Coaching for Mental Health: Ethical Dilemma or Ethical Development?

Appendix 6: My deliberation: where angst becomes addiction?

Mental ill health is a survival strategy, though apparently inappropriate and aberrant, it is a reaction to painful and unacceptable life conditions. The healthy response to loss of any kind; person, job, self belief or ideal, is the grief process. If accepted and worked through it becomes a valuable learning resource, gaining new insights and new skills, adding to the body of contexts to draw on for a full life. If the grief process cannot run its natural course, it may become stuck in survival mode at any point, such as anger or despair, resulting in addiction to an aberrant pattern of behaviour, or substances. “Depression weakens you. Weakness is the surest path to addiction”. Noon day Demon (p.242). Remaining stuck may avoid more pain, but as with addiction to alcohol and drugs that are initially used to avoid or decrease pain, it no longer remains the servant but increasingly the master. Addiction to despair and negative thinking becomes a way of life.

It is recognised that for substance addicts there is no medical solution, there may be therapies that can assist the recovery process, but only when an addict commits himself to his own recovery. The sad fact is that they usually only do that, when they hit rock bottom. Also unfortunately, rock bottom is only reached when all the caring, covering up and rescuing by others is removed. At this point, the addict has an opportunity to face himself, dislike what he sees and decide to change. Likewise with addiction to negative thinking, without a bottoming out, a breakdown, there is no breakthrough. To the observer, the carer, the rescuer, this is nightmare time, as for the addict, what he sees may be more than he can cope with and there may appear only one solution, suicide.

The health care system sees death as their failure and the mental health system sees suicide as theirs. Hence a massive containment exercise, pacifying and sedating long term. The carer becomes the benevolent gaoler, with the best of loving motives but the worst possible outcome. The slow internal suicide of the addict as he increasingly loses his power and passion, giving up on himself, others and the whole world. His addiction of choice, whether for substances or people, becomes the only security in his life, a destructive friend but nevertheless a friend. Addiction to negative thinking underpins all other addictions, with its catastrophizing, taking everything personally and ricocheting between extremes. In contrast, for rounded health: “some love themselves and some love others and some love work and some love God: any of these passions can furnish that vital sense of purpose that is the opposite of depression.” Noonday Demon 2001 (p.15).

The connection between addictive behaviour and depression is finally being addressed by mental health projects.


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