Category Archives: Psychology

The Challenges of Diagnostic Labeling

Recovery from Social Anxiety and Related Conditions.

Robert F Mullen, PhD
Director/ReChanneling

For each new subscriber, ReChanneling donates $25 for workshop scholarships.

The Challenges of Diagnostic Labeling
The Challenges of Diagnostic Labeling

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This reposts an article recently published on Where the Light Gets In. The conventional pathographic model of mental health focuses on the diagnosis rather than the individual. Which reduces us to a label. It is crucial to impress upon the client that they are not defined by their diagnoses. But by their character strengths, virtues, and attributes. The Wellness Model of Mental Health recognizes that we do not recover from distress by focusing on our defects and deficiencies. But on our strengths and assets. 

When we label individuals or groups, we reduce them to a single, usually negative, characteristic or descriptor based on an event or behavior. As a result, we view them (or ourselves) through the label and filter out evidence that contradicts that stereotype. Labeling by diagnoses has a similar outcome.

Arbitrarily evaluating someone based on an isolated incidents or behavior is likely an inaccurate representation of that individual. One negative behavior or incident does not define someone’s character. Rather than focus on a label, it is more authentic to value the positive contributions of the person or group. We can then relate with compassionate insight, recognizing the diversity of human thought and experience.

Additionally, attempting to distinguish symptoms and identifying specific etiological and risk factors in emotional malfunction leads to speculation, errors, and misdiagnosis. This likely results in faulty treatment programs and adverse medications.

It is important to recognize that the person experiencing an emotional malfunction knows more about its personal impact than their diagnostician or therapist. This does not imply that error is inevitable, although it happens often with social anxiety disorder. It just posits the possibility. A healthy collaboration of client awareness and a doctor patient mutual dynamic is crucial to proper evaluation. In the wise words of Hippocrates, the pioneer of modern medicine. “If you are not your own doctor, you are a fool.” 

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“It is one of the best investments I have made in myself, and I will
continue to improve and benefit from it for the rest of my life.” – Nick P.

Five to one, one in five. No one gets out alive…

Margaret
November 3, 2023
Where the Light Gets In

The good days are finally outweighing the bad. And it’s been a long time coming.

I don’t doubt the role medication plays in this… in fact, I’d go as far as to say they’re probably the only reason my mood remains relatively stable. In a pre-emptive strike, my medication was increased recently.

I say “pre-emptive,” but in truth, I’d noticed the beginnings of a wobble. I’ve essentially re-entered the world as an actual adulting adult again. That’s not without its pressures. I didn’t really want to hang around and find out if weebles wobble enough that they eventually do fall down, so I did the only sensible thing and went back to my psych team to tell them that I was under a bit more stress than I’d previously been and I’d like to protect myself against the impact of that and the upcoming winter months. I had enough niggly signs that they agreed it was best to up the dose and add in some extra support.

To some, that might seem cowardly or lazy. Why should I think that just because I’m dealing with normal life stressors, that warrants upping my medication? Well, because I know my own limits. I know that whilst my mood wasn’t deteriorating, there is absolutely the potential for it to do so as I emerge into the world again.

Am I under any more pressure than anyone else? No. Am I, for whatever reason, less able to cope with those pressures than most people… yes. I recognize that. I accept it. And for the sake of my family, I have to be accountable for my own emotional and mental wellbeing.

I have deliberately shied away from talking about labels and diagnoses. This is the one area I really struggle with because it feels like I have more letters after my name than I can even count.

The one I struggle most with is “bipolar.” That’s a hefty label to carry around.

When you’re given a diagnosis, most psychiatrists are so risk-averse that nobody ever actually removes a previous diagnosis from your notes, even if there are questions over it.

When you’re given a diagnosis, most psychiatrists are so risk-averse that nobody ever actually removes a previous diagnosis from your notes, even if there are questions over it. Even if they don’t believe it fits. Even if there isn’t enough evidence for it to stand anymore.

Bipolar is the one I hate with a fervour matched only by my hatred of Nigel Farage. In the same breath that I was given the diagnosis, I was told that the condition has a one in five mortality rate, and that’s why I was being kept such a close eye on.

That’s a terrifying statistic to live with. I have a higher chance of dying from the illness I have than if I’d been diagnosed with some cancers.

True to form, this diagnosis simply fuelled my fear and anxiety. And when I’m anxious, I obsess. The intrusive thoughts ramp up and become harder to manage.

In the wake of being told those figures, I became sure that The Doors song “Five to One” was prophetic. That the lyrics (I refer you to this cleverly titled blog…) were a precursor to a fate that I was powerless to avoid. Despite the fact that being one of the four in five is statistically more likely, I convinced myself I’d been given a death sentence. And so, that one line in the song played on a loop in my head. It went round and round so often in my head that there was barely any room for anything else.

I cursed the doctor for their thoughtless delivery. I cursed a God I didn’t even believe in for his cruelty. And I grieved for a life I was now sure would be cut short. I was waiting for the death knell to sound, and yet, somehow, it felt as though it was ringing in my ears every single day. Except that the death knell was clearly Jim Morrison in this case.

Why do I hate the label of “bipolar” so much? Well, because I feel like it doesn’t fit. It feels like a lazy way of neatly packaging up a whole truckload of trauma into one nice, neat little word, It feels like a medical cop-out.

The same doctor who delivered the death knell also told me that “bipolar disorder is the closest thing the psychiatric world has to high blood pressure. They know what medications work, the know how to control it and what works without exception” – except that’s pure bollocks.

I say it’s bollocks because there is no clinical test for the disorder… nothing in your blood that can be measured, nothing in a brain scan that will be evident. There is not a single medical marker other than your psychiatric evaluation – which isn’t so much an evaluation as a run through your life history.

I’ve never met a male with the diagnosis, although I’m aware they do exist. What I have seen, however, are scores of women with histories of sexual, physical, or emotional abuse with the diagnosis. I’ve seen dozens of women who are untreated peri or full-blown menopausal with the diagnosis.

And it leaves me wondering if the label is a cop-out for writing a woman off without actually hearing her.

I’ve variously been told in my life that I suffer from psychotic depression, that I have Emotionally Unstable Personality Disorder (having someone tell you that your personality is a disorder is pretty shit too by the way…), that I have OCD traits, anxiety (okay, this one I agree with). I don’t know that any of these labels are helpful for anything other than permitting me to access mental health support.

The thing is, those labels are all over my medical notes. So now I have to practically be dying before I’ll se a GP for a physical ailment, lest they put it down to my mental health…

Proactive Neuroplasticity YouTube Series

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Social Anxiety Recovery Workshops By Dr. Robert F. Mullen | Rechanneling.org

WHY IS YOUR SUPPORT SO NECESSARY AND ESSENTIAL?  ReChanneling develops and implements programs to (1) mitigate symptoms of social anxiety and related conditions and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing neuroscience and psychology, including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to regenerate self-esteem. All donations support scholarships for groups and workshops.

INDIVIDUAL RECOVERY. The symptoms of social anxiety make it challenging for some to participate in a collective workshop. Dr. Mullen works one-on-one with a select group of individuals uneasy in a group setting. ReChanneling offers scholarships to accommodate the costs. What is absent in group activities is provided in our monthly, no-cost Graduate Recovery Group. In this supportive community, graduates interact with others who have completed the program.  Contact ‘rmullenphd@gmail.com’.

Committing to recovery is one of the hardest things you will ever do.
It takes enormous courage and the realization that you are of value,
consequential, and deserving of happiness.

The Hostility of Mental Health Stigma

Recovery from social anxiety and related conditions.

For each new subscriber, ReChanneling donates $25 for workshop scholarships.

The Hostility of Mental Health Stigma
The Hostility of Mental Health Stigma

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The Hostility of Mental Health Stigma

Mental Health Stigma (MHS) is the hostile expression of the abject undesirability of a human being who has a mental illness. It is the instrument that brands the mentally malfunctional defective due to stereotypes. MHS is purposed to protect the general population from unpredictable and dangerous behaviors by any means necessary. MHS is fomented by prejudice, ignorance, and discrimination. The stigmatized are devalued in the eyes of others and subsequently in their self-image as well.

Between 50 and 65 million U.S. adults and adolescents have a mental illness; 90% of those will be impacted by mental health stigma, a presence that elicits unsupportable levels of shame and jeopardizes the emotional and societal well-being of the afflicted.

Trajectory

The Signaling Event. MHS is triggered by a set of signals or a signaling event, i.e., an occasion, experience, news story, or encounter where the visibility of behaviors and mannerisms associated with mental illness elicit a reaction.

The Label. Labeling defines the signaling event and distinguishes it from other labels. ‘Woman’ is a label; it is specific, restrictive to gender, and says certain things that distinguish it from other labels. A successful label elicits a strong public reaction. The defining characteristics of the label become the stereotype. Labeling is subject to the labeler’s belief system and, like stereotypes and stigma, is reliably inaccurate because of implied expectations of behavior. 

Dr. Mullen is doing impressive work helping the world. He is the pioneer of proactive neuroplasticity utilizing DRNI—deliberate, repetitive, neural information. — WeVoice (Madrid, Málaga)

The Stereotype. Labeling gives the signal a moniker for identification; the stereotype defines it and gives it meaning. Stereotyping is a cognitive differentiation of something that piques one’s interest; everyone stereotypes. Mental health stereotyping is distinguishable by pathographic overtone that identifies the victim as unpredictable, potentially violent, and undesirable. 

Ironically, 14th-century asylums in Spain and Egypt were built to protect the mentally afflicted from the dangerous and violent members of society.

Mental health labeling and stereotypes support and collaborate with preconceived notions of mental illness, generated by the natural aversion to weakness and difference. This is supported by an ignorant and prejudicial belief system and, on occasion, personal experience. Labels and stereotypes are unbound by truth or evidence; believability is the ultimate criterion.  

Stigma. A stigma is a brand or mark that negatively impacts a person or group by distinguishing and separating that person or group from others. The branding concept originated with the ancient Greek custom of identifying criminals, slaves, or traitors by carving or burning a mark into their skin. Stigma is identified by three types: (1) abominations of the body, (2) moral character stigmas, and (3) tribal stigmas. The first refers to physical deformity or disease; tribal stigmas describe membership in devalued races, ethnicities, or religions; and moral character stigma refers to persons perceived as weak, immoral, duplicitous, dishonest, e.g., criminals, substance addicts, cigarette smokers, and the mentally ill. 

Mental Health Stigma

The objective of MHS is the perceptual protection of the general population from the unpredictable and dangerous behaviors associated with mental illness by any means necessary, including deception, misinformation, and fear-baiting. Its ultimate goal is to negatively impact the social reintegration of the victim. 

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“It is one of the best investments I have made in myself, and I will
continue to improve and benefit from it for the rest of my life.” – Nick P.

  • Anticipatory stigma is the expectation of a stigma due to behavior or diagnosis, and subsequent adverse social reactions. This causes resistance by the potential victim to disclose any physiological aberration.  
  • Stigma-avoidance identifies those who avoid or postpone treatment fearing the associated stigma will discredit them and negatively impact their quality of life. Studies indicate almost one-third of the potential victims resist disclosure, impacting the potential for recovery.
  • Family stigmatization occurs when family members reject a child or sibling because of their mental illness. Throughout history, it was commonly accepted that mental illness was hereditary or the consequence of poor parenting. A 2008 study found 25% to 50% of family members believe disclosure will bring shame to the family. (Courtesy-stigma reflects supportive family members.)

An active stigma is a parasitic one. If it finds enough suitable hosts, the parasitosis can spread rapidly by traditional means. Studies show the aversion to mental illness is prosocially hard-wired which provides an abundance of hosts.  

Contributing Factors to MHS. The stigma triad of ignorance, prejudice, and discrimination is generated and supported by preconceived notions, general obliviousness, a lack of education, and society’s deep-rooted fear of its susceptibility. The primary attributions to MHS are public opinion, media misrepresentation, visibility, diagnosis, and the disease or pathographic model of mental healthcare. 

The Hostility of Mental Health Stigma

How Mental Health Stigma Impacts the Victim 

MHS impacts the victim through a series of stigma experiences:

  • Felt stigma. The anticipated or implied threat of a stigma.  
  • Enacted stigma. The activated stigma. 
  • External stigma. The victim holds the perpetrator responsible for the stigma. 
  • Internalized stigma. The victim assumes behavioral responsibility for the stigma.
  • Experienced stigma. Victim’s reaction to the stigma.

The victim anticipates their mannerisms, behaviors or diagnosis will generate a stigma (felt stigma). When the stigma is realized it becomes an enacted stigma. The victim blames the person who originated the stigma (external stigma) or assumes responsibility due to behavior (internalized stigma). When the stigma impacts the victim’s well-being, it becomes an experienced stigma

MHS Impact. Mental health stigma can negatively affect the victim’s emotional well-being and quality of life by jeopardizing their:

  • Safety, health, and physiological wellbeing 
  • Livelihood
  • Housing
  • Social Status
  • Relationships

Solution

Mental health stigma will not be mitigated or eliminated until the mental healthcare community embraces the wellness model over the disease of mental health. The disease model of mental health focuses on the problem; creating a harmful symbiosis between the individual and the diagnosis. The wellness model emphasizes the solution. A battle is not won by focusing on incompetence and weakness but by knowing and utilizing our strengths, and attributes. That is how we positively function―with pride and self-reliance and determination―with the awareness of what we are capable of. 

Establishing new parameters of wellness calls for a reformation of thought and concept. In 2004, the World Health Organization began promoting the advantages of wellness over disease perspective, defining health as a state of physical, mental, and social well-being and not merely the absence of disease or infirmity. The World Psychiatric Association has aligned with the wellness model and it has become a central focus of international policy.

Evolving psychological approaches have become bellwethers for the research and study of the positive character strengths that facilitate the motivation, persistence, and perseverance helpful to recovery. Wellness must become the central focus of mental health for the simple reason that the disease model has provided grossly insufficient results.

A WORKING PLATFORM showing encouraging results for most physiological dysfunctions and discomforts is an integration of positive psychology’s optimum human functioning with CBT’s behavior modification, neuroscience’s network restructuring, and other personality-targeted approaches. including affirmations, autobiography, and methods to regenerate self-esteem and motivation.

This new wellness paradigm, however, should not be a dissolution of medical model approaches but an intense review of their efficacy, and repudiation of the one-size-fits-all stance within the mental health community. 

Proactive Neuroplasticity YouTube Series

Social Anxiety Recovery Workshops By Dr. Robert F. Mullen | Rechanneling.org

WHY IS YOUR SUPPORT SO NECESSARY AND ESSENTIAL?  ReChanneling develops and implements programs to (1) mitigate symptoms of social anxiety and related conditions and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing neuroscience and psychology, including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to regenerate self-esteem. All donations support scholarships for groups and workshops.  

INDIVIDUAL RECOVERY. The symptoms of social anxiety make it challenging for some to participate in a collective workshop. Dr. Mullen works one-on-one with a select group of individuals uneasy in a group setting. ReChanneling offers scholarships to accommodate the costs. What is absent in group activities is provided in our monthly, no-cost Graduate Recovery Group. In this supportive community, graduates interact with others who have completed the program.  Contact ‘rmullenphd@gmail.com’.        

Committing to recovery is one of the hardest things you will ever do.
It takes enormous courage and the realization that you are of value,
consequential, and deserving of happiness.