Check Yourself (Again): More Mental Health Blunders

Common pitfalls in our quest for psychological well-being.

Posted Mar 10, 2017

In a recent post I discussed several mental health ‘blunders’—common mistakes that, in my clinical experience, may hinder psychological well-being. Here are a few more:

Confusing what started the problem with what maintains it

When looking to solve a mental health problem, many people believe it necessary to find its root cause. This idea makes intuitive sense because it works in many areas of life. If I find water on the living room floor, I look for a hole in the roof. However, in the realm of mental health this logic proves problematic for three main reasons:

  1. When it comes to mental health problems, root causes often can’t be found. Our knowledge of psychology is not at a place that allows us to answer questions of origin convincingly. We can’t answer the ‘why’ question regarding depression with the same precision that we can answer the ‘why’ question with regard to your car sputtering. We don’t know brains like we know cars.
  2. Even when causality can be at least partially established, mental health problems tend to have more than one root cause. People are complex, and most human outcomes are multi-determined.  For a pertinent thought experiment, ask yourself why you love your partner. There’s not one reason, but many, and they interact in mysterious ways.
  3. Even when we can identify a single specific cause of a problem, it may be of little help in actually solving the problem. This is because what causes a problem is not what maintains it. The late American psychologist Gordon Allport used the term “functional autonomy” to refer to this principle, about which he wrote extensively. Defined succinctly, it refers to the tendency of a developed motive system to become independent of the primary or innate drive from which it originated. Allport saw two levels of this idea: “Perseverative functional autonomy” refers to the tendency of certain habits (such as addictive behavior) to continue in the absence of the original impetus. “Propriate functional autonomy” refers to self-sustaining motives related to values; for example, your habit of being polite may have started at the behest of your parents, but over time it has become a part of your sense of yourself, and that’s why it continues long after your parents are no longer alive.

This is applicable to mental health. For example, you may have started fearing dogs back in childhood because a dog attacked and scared you. But 20 years later, you are still afraid of dogs, even though the dog that attacked you is gone and you are no longer a child. What maintains your fear is your avoidance of dogs, which has prevented you from updating your idea of—and relationship with—dogs. Sound mental heath requires that we look at what maintains our problems in the present, rather than focusing solely on finding what had caused them in the first place.

Forgetting the role of internal representations

Contrary to popular opinion, Freud got quite a few things right during his glory years of wild theorizing. For example, he was among the first to advance the idea that internal unconscious processes shape our commerce with the external world. In other words, we do not see the world as it is, but as we are. We respond not to the objects and people in front of us, but to how they resonate inside our unique internal landscape—a complicated, often battered terrain shaped by our genes, learning experiences, attention habits, temperament, and memory.

Given this baggage, our responses are often quite out of synch with the real-world properties of the person or situation to which we are responding. This, in simplified Freudian terms, is the essence of neurosis. Our responses are said to be “neurotic” when they are disproportional to the actual situation, and hence fail to address it properly, leading to all manner of trouble.  

Such neurotic responses address not the present moment, but rather the internal ghosts from the past activated by aspects of the present moment. In this way all relationships involve projection, or ‘transference’ in Freud’s terms. We project onto others qualities, motives, and intentions that belong to us, not to them—and to the past, not the present. We then respond to these projections rather than to the actual person in front of us. This gap, between the outside world as it is and how it appears internally is not entirely bridgeable. But we can work to minimize it, to see that our perceptions contain more true score and less error; more signal, less noise; more facts, less hype. Sound mental health requires that we seek, as best we can, to fit our responses to the real-world facts and parameters of the situation (or the person) in front of us and not let the ghosts from our past dictate, and distort, our responses in the present.

Becoming stuck in the wrong metaphor

Human language is metaphoric. A “puppet government” is not made out of artificial figures representing human beings, and a “sea of sadness” is not an expanse of salt water. Language relies on linking different meaning systems; it takes advantage of our associative prowess, the human ability to see things in terms of other things, to generalize from one system to another, to find the common processes underlying different surface phenomena.

Metaphors can free us. They can engage the imagination and emotion and make us see new possibilities. But they can also imprison us. For example, scientists studying the brain have often used available metaphors to help frame and guide their thinking. Thus, Descartes thought the brain was a kind of hydraulic pump, pushing the spirits of the nervous system through the body. Freud likened the brain to a steam engine. By early twentieth century, the telephone switchboard became a common metaphor for the brain. All these metaphors are useful in illuminating some aspects of brain operation, but also limiting in obscuring or distorting other aspects. Our latest metaphor—the brain as computer—is likewise useful, because computers do a lot of the things that our brain does; but in the future it will no doubt seen as clunky as the earlier ones now seem.

Once we become aware of the fact that humans speak, and hence think, in metaphors, we can then seek to elucidate to ourselves, and examine critically, the metaphors that guide our commerce with the world. Do we see love as a journey or a garden? Is love war, a game, or a thrill ride? Is it a scarce resource not to be wasted, or an abundant gift we should share generously? The metaphors we use guide our thinking and drive our behavioral choices: the person who sees love as a garden has a different experience of it from the one who sees it as war. When we are stuck inside a seemingly insoluble jam, a new guiding metaphor may reveal the way out.

Forgetting that ‘too much of a good thing’ is a thing, and not good

A fundamental evolved feature of our internal architecture is to generalize from limited experience. This is a useful shortcut for survival in a world where we often have no access to the full picture. Having survived a snake’s bite, I’d be quick, and often justified, to generalize my fear from that particular snake to other creepy crawlies that resemble it.

Additionally, since we evolved in times of scarcity, our basic mechanisms are geared toward resource acquisition. We are prone to overeat more than we are to under eat. We are wired to want more of what is useful and good and less of what is aversive and painful. We compare ourselves more readily upward, envying those who have more, than downward, rejoicing at our good fortune compared to those who have less.

These dual tendencies interact with our common experience to predictable results. For example, we readily notice how a bit more money feels better than a bit less money. How a little recognition is better than none, and how a little excitement is better than boredom. From these experiences, we readily generalize a rule: ‘More is better.’

Alas, this rule, while appearing intuitive, is often wrong because it fails to take into account the full range of possible experience: We are not so familiar with having a ton of money, or with being super-famous, or with a state of maximum sensory stimulation. This is called the “restricted range” problem in psychology. The full story usually ends differently than the first chapter.

One classic illustration of this principle, developed by psychologists Robert Yerkes and John Dodson in the early 1900s and known as (wait for it) The Yerkes–Dodson law, dictates that performance increases with arousal, but only up to a point, after which increased arousal leads to diminishing performance. In other words, when it comes to arousal, more is better only to a point.

This basic principle holds true in many other areas: A strong ego is good, but narcissism isn’t; some food is better than no food, but too much food creates health risks; having some choice is better than having none, but too many choices result in buyer’s remorse, indecision, and reduced happiness. Sound mental health requires that we consider this reality in our decision-making. We should look for optimal levels, not maximum levels, of the things we want; the fact that something is not “most,” doesn’t mean it’s not “best.”

Neglecting to consider goodness of fit

This concept emerged from the early study of children’s temperament, but it’s applicable in many realms. It refers to the compatibility of a person’s temperament with the surrounding environment. The idea is that the child’s developmental success depends on their interaction with their environment and with the people in it. A highly active child may do better on the farm than in a cramped apartment, on the playground than in the classroom, and with an active rather than a sedentary parent.

The question is not whether a certain quality is categorically good or bad, but rather whether it fits with the environment—does the environment provide a niche in which the child can fit and flourish?

The notion that success is a function of the interaction between a person’s characteristics and environmental conditions is often forgotten, as the popular discussion tends to focus on the simpler, ‘sexier’ notions of bad or good character—or environment—in isolation. (Is it a good home or a bad home; a good school or a bad school; a good child or a bad child? Etc.) The concept of goodness-of-fit applies not just for child adaptation, but also to mental health in general. If something is not working in our lives, perhaps the problem resides neither with us nor with our environment per se, but with the interaction. Sound mental health requires that we consider fit when we evaluate our, and others’ wellbeing, rather than jump to blame ourselves, or others.

Confusing correlation with causation

The ancient Greeks were curious about the body, but their approach to studying it was decidedly low tech. They looked and listened. Not surprisingly, the heart quickly caught their imagination. It is the only internal body part that makes a noise as it works. The heart, you know, beats. It also, the Greeks noticed, changes the pace of its beating in association (correlation) with the person’s changing emotional states. Thus, they concluded that the heart was the seat and source of emotions, and in the process they sentenced us to tarry amidst an endless stream of sappy hallmark cards, fluttering pink emojis, and maudlin pop tunes about broken hearts.

That was an early example of erroneously confusing correlation with causation. (The heart, in case you’re wondering, is but a pump for blood. The brain is where your emotional experience resides.)

Unlike the Ancient Greeks, that particular confusion has not vanished into history. It is very much alive. Our brain, after all, is a meaning-making machine. It looks for patterns and connections. When two things appear to go together, we are intuitively compelled to look for a cause and effect relations between them. And since believing is seeing, we often find it, even if it’s not there. For example, people who worry a lot often live to see their dire predictions fail to materialize; they take the correlation between ‘high worry’ and ‘things turning out OK’ to mean that their worry caused the good outcome. Therefore, they often end up worrying more. Sound mental health requires that we not jump to conclude causality from correlation.

Denying the role of genes

Talk of genetic influences scares people, because they often (wrongly) assume that genetic effects are unchangeable, and because the genetic argument has a lousy history of justifying all manner of cruelty toward marginalized groups. Moreover, genetic effects are not easily studied apart from environmental effects. Take parenting: you share genes with your parents, but also early environment. So what made you you?

Moreover, the heritability of a given trait is not static, but depends on environment. In food rich environment, whether you’re fat will mostly depend on your genes. In food scarce environment, it will depend on access to food. Additionally, genetic expression itself is contingent on environmental conditions. Genetically similar seeds will fare differently if one is planted in rich soil with plenty of light and water, while the other is planted in poor quality soil and receives no water or sun.

Still, ignoring the effects of our genes, and operating under the assumption that social conditions are the only mental health game in town is misguided. If your twin brother is schizophrenic, for example, you have a much higher than average chance of becoming schizophrenic, even if you were raised apart from your brother, under different social conditions.

At the end of the day, biology does not determine our mental health, but it sure as hell informs it. It should likewise inform our self-understanding. After all, everything that is possible must be biologically possible.

Psychology has a sorry history of blaming environment for genetic effects. Autism, schizophrenia, difficult personality, even homosexuality were at some point falsely blamed on inadequate mothering. Genes are as real as mothers, and are often infinitely more influential.

Living on automatic pilot

We are easily conditioned to behave repeatedly in similar ways, to develop automatic habits. This tendency has its benefits. Automatic habits do not require attention or awareness, and thus are not easily disrupted. Since they are performed mindlessly, they allow us to be mindful of other, important things—new learning; current threats, etc.

However, habits create two potential problems, mental-health wise.

First, habits are great only if they are great habits. Bad habits hurt us, and because they are automatic, they can do so both without our knowledge and against our will.

Second, even good habits extract a price, as they dull our lived experience. When you drive down a road many times, then by the force of habit you will no longer notice the road. You’ll become checked out, a zombie of sorts to the presence of the road. This is fine if the road is boring and dreary. But what if it’s beautiful? Then the habit causes you to miss out.

Luckily, we can do something about both problems. The road to changing a bad habit and/or waking up to lived experience fully begins with getting out of the ‘automatic pilot’ mode of our conditioned habits and into an aware state, from which we can make new, novel behavioral choices en route to creating new habits, and also re-learn to see with new eyes what we’ve been gliding through unwitting.

When Freudian analysts talk about ‘making the unconscious conscious,’ when positive psychologists talk about being ‘present,’ and ‘mindful’; when humanistic psychologists talk about ‘freshness of perspective;’ when behaviorists talk about ‘sensitization;’ when cognitive psychologists talk about ‘thinking about your thinking;’ when feminist psychologists talk about ‘consciousness raising,’ and when Gestalt psychologists talk about ‘contact,’ they are all in essence talking about disengaging the brain’s automatic pilot and becoming aware—or ‘woke’ as the kids say, to our own experience. Sound mental health requires that we nurture this capacity to take periodic conscious control of our experience, to change it if it’s bad, and to experience it fully if it's good.