How Do We Talk About What’s Wrong?

Steven Topper LCPC

Is depression something that occurs in your body or in your mind? Is it on the outside of your skin or on the inside? How about anxiety? Typically, ways of talking about these disorders use a dualistic framework: there is the physical and the mental, and they are separate entities. We think of the problems listed as mental. Problems of the mind. This type of classification makes sense. A broken arm is clearly physical. We can point to it and see it. It’s more challenging to point to anxiety. It might be described as a conglomeration of emotions, thoughts, and physical sensations. This is all to say that it’s mental with physical accompaniments. We’ve long described psychiatric diagnoses in this way — more as mind than matter. 

The Case Against Dualism

More recently researchers and clinicians have discussed these two components in constant relationship with each other. The mental impacts the physical and vice versa. We have public events (speech, behaviors, facial expressions) that are influenced by and influence private events (thoughts, memories, emotions). And both of these things occur within an environment where there are consequences to public behaviors but not private ones. Another way to describe dualism is to use the term mentalism: that mental health problems exist in our mental world (thus the name mental health!). This framework of understanding has taken us a long way and helped us through many issues. Yet there may still be downfalls to speaking about psychological pain dualistically. In fact, viewing our problems through this dualistic lens may make us more stuck in unworkable behaviors while invalidating the complexity of the human organism. So why do we talk about these things from this framework?There are plenty of reasons it can be helpful to talk about mental health issues through the lens of dualism. We often separate mind (nonphysical) and body (physical) as ways of differentiating between humans and animals. We can say that we certainly have both, while some animals may only have brains (physical) and not minds (nonphysical/mental). Further, we hope that it decreases stigma. So much of our suffering is hidden from the view of the public. When I tore ligaments in my knee, many people stopped to open doors or offered to carry items for me with plenty of frequency. When we struggle with depression and anxiety, it’s common for those around us to tell us to, “Suck it up” in categorically different ways than how my knee injury was treated. Further, if we can describe these things as mental, it justifies why we can’t find evidence for them on MRIs and in our genetics. Neuroscientists have continued to try finding biological markers for these disorders, though the work has been difficult. and provide us a clearer picture of what is going on. We can’t see people’s thoughts, so they must be private. Dualism is a way to describe something we can’t see clear evidence of in ways we are used to relying on physical evidence.

What could be problematic about this framework? An unexpected consequence is that we end up focusing on what we can’t control. When I say my depressive thoughts and feelings prevent me from completing tasks, I’m focusing my attention and reasons on aspects of my experience that thwart control. Thoughts and feelings can be very difficult to control. For instance: don’t think of a pink elephant. Attempting to shape internal responses often leads us trapped in repetitive loops of less workable behavior. If our language focuses on that part of our experience (the stuff not up to us), we’re less likely to notice and work toward viable changes. In the end, we cannot trick ourselves and we may know that doing something healthy won’t actually make us feel better. In fact, it’s likely that doing that thing will be unpleasant right away! Which leads to more troubling internal stimuli: anxiety, uncertainty, I’m not good at this, it won’t work anyway, this is stupid. Utilizing the dualistic/mentalistic perspective actually keeps us stuck in unworkable behaviors because we focus exclusively on the side of things we have such little control over.

There is another barrier imposed by dualistic thinking. We lose contact with our dynamic nature. I’ve never heard anyone say my feet walked me to the store. What we say is I walked to the store out of an understanding that the whole being plays a role in walking to the store. Even though only my feet make contact with the ground, the complexity of movement in my ankles, knees, hips, the center of gravity, and decision-making all contribute to the behavior of walking. In a similar way, if we’re dualistic, we lose track of how dynamic we as humans are. In an effort to understand why we lose the depth. We cauterize key contextual features to our behaviors and relationships that could be really important. An alternative to dualism is monism. Viewing my entire being as walking. This allows us to utilize a framework whereby we are beings in motion, constantly moving and shifting and changing. And while we can think of ourselves as the sum of our parts, we can also view ourselves through the lens of this dynamic and transient whole. We may begin to notice how our behaviors influence others, what works for us and what doesn’t, and if there are meaningful things we can do in the world that we never saw before. Shifting from dualistic thinking to monistic thinking could open up new and exciting worlds for us because we aren’t trapped in our minds! From there, we may be able to explore our worlds and the people within them more fully and richly. 

If you want to know more about how your views can influence your behaviors, Contact Symmetry Counseling today to meet with one of our Chicago counselors in person or via online counseling.