The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
Interview with Nessie Shaw
EM: You have significant experience working in mental health clinics. What’s been your experience working with clients in a mental health clinic setting?
NS: My experience in working in mental health clinics is that many people do not receive effective help and in many cases they end up with more health problems than they started out with. There are a number of well-researched reasons that cause this situation including:
Anti-depressant medications are overwhelmingly the dominant treatment modality and in many cases are ineffective. People are switched from one brand of antidepressant to another in an attempt to find a drug that works... When the medications don’t work people are labeled treatment resistant.
The research literature on antidepressant medications demonstrates clearly that efficacy has not by any means been established and is clouded by the fact that when people do report an improvement in mood no consideration is given to other variables that may be impacting the person positively. For example there are many intervening variables that are not controlled for in clinical trials, including: increased support, changed circumstances, taking on new meaningful activities and so on.
Many people experience serious side effects from high-powered medications including obesity, diabetes, anxiety and disinhibition and the sequelae that flow from these complications, including ironically, feelings of chronic depression. A diagnosis of depression so often results in that person developing an identity of permanent patient. A sense of powerless over circumstances and behavior becomes entrenched.
Psychological interventions largely do not address social factors that are well known to play a huge role in mental health. When people who are experiencing unhappiness, grief or anxiety related to a temporary change in life circumstances are diagnosed with depression that label often implies long term treatment. It is not uncommon to see people under the care of a psychiatrist for a decade or more with worsening symptoms, weight gain, diabetes and other health problems related to high doses of drugs.
EM: You’ve concluded that life purpose and meaning are “missing links” when it comes to emotional and mental health. Can you share some of your thoughts on that?
NS: Yes, from the literature and my own experience, one of the major symptoms reported by people diagnosed with depression is an inability to experience meaning and purpose. It has always seemed pretty obvious to me that helping people regain a sense of purpose and meaning would be the first place to start. The status-quo approach though is to wait for medications to kick in and the person’s mood to return to normal. I have never seen any structured emphasis in status quo therapy programs that include strategies for regaining meaning and purpose. And yet it is well-known that a sense of hopelessness and meaninglessness are the hallmarks of depression.
EM: What are some of your offerings in support of your interest in life purpose and meaning?
NS: I offer the Life Purpose Boot Camp course in face-to-face mode and also by email. I also offer ongoing email and phone coaching. In these programs I teach people how to discover what is personally meaningful and how to devise and implement coherent and effective strategies for living with purpose. People make major changes surprisingly fast when they have the insights, the tools and the support they need.
I teach people how to access a range of interventions to regain meaning, purpose and happiness with a focus on managing circumstances strategically as well as using interventions from mindfulness-integrated-cognitive-behavior-therapy. There are so many effective alternatives to the biomedical treatment approach to mental health disorders. (Read problems of living: sadness, grief, disappointment, chronic disease and so on)
NS: I have many concerns about the current paradigm in psychiatry. As I mentioned earlier I have grave concerns about the efficacy and safety of drugs used to treat so-called mental disorders, not to mention the psychological impact of reframing normal human suffering and unhappiness as a medical illness with long term implications for drug treatment. There is also the issue of the addictive nature of anti-depressant medications.
It is a shocking state of affairs when there is so much evidence that meaning and purpose can be regained and mental distress minimized or even alleviated with a range of evidenced-based social and psychological interventions. Social support, problem solving, brief solution-focused interventions, mindfulness-based-cognitive-behavior-therapy, and even regular physical exercise have been shown to be at least as effective (if not more effective) than anti-depressant medication.
EM: What has been your biggest learning experience regarding mental health?
NS: Much mental distress is a result of the impact of social structures and circumstances and not a result of human weakness. And we are affected more than we fully realize. Professor of Sociology Zygmunt Bauman sums it up when he says, “When trying to make sense of our lives, we tend to blame our own failings and weaknesses for our discomforts and defeats. And in doing so, we make things worse rather than better.” The current medical paradigm of framing the distress of difficult life circumstances as mental disorders reinforces and encourages this self-blame model and the worsening of our distress. Furthermore, the causes of our distress are left unexplored.
One of the reasons I enjoy teaching in a group format is that people get to recognize the universality of their problems as a great starting point for change. Being part of a supportive community is a major factor in mental health. Within this framework and environment a person can learn to access personal strengths, take on new meaningful activities, challenge the status quo and relinquish debilitating self-doubt.
Nessie Shaw has worked for over a decade in mental health clinics and hospitals devising and facilitating programs to help people regain meaning and purpose in the aftermath of a crisis in life circumstances. She now works in private practice.
Nessie works from the premise that while it is the impact of adverse circumstances that are the major factor in mental health and not a lack of personal resiliency, meaning, purpose and happiness can be regained with strategic and psychological-based skills (skills that can be learnt).
Nessie’s qualifications include: B.SocSc (Hons) Grad Dip Occupational Health, Grad Dip Mental Health, Diploma of Clinical Hypnotherapy.
Learn more at www.nessieshaw.com.au
Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at firstname.lastname@example.org, visit him at http://www.ericmaisel.com, and learn more about the future of mental health movement at http://www.thefutureofmentalhealth.com
To learn more about and/or to purchase The Future of Mental Health visit here
To see the complete roster of 100 interview guests, please visit here: