There is no health without mental health; The vision to see and then to make wise choices

Tom Rue, MA, LMHC, CASAC
Posted 8/21/12

Last week, during Mental Health and Suicide Prevention Month, the White House held a briefing to discuss mental health priorities in 2014. The phrase “mental health” appears frequently in the …

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There is no health without mental health; The vision to see and then to make wise choices

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Last week, during Mental Health and Suicide Prevention Month, the White House held a briefing to discuss mental health priorities in 2014. The phrase “mental health” appears frequently in the mass media, perhaps most often in a negative connotation. However, it is useful to view mental health in a more positive perspective, more than merely the absence of a mental illness.

Mental health is for all of us, not just those “others.” It is as important as physical health. In fact, there is no health without mental health. They are inseparable.

Mental health is reflected in our responses to all of life’s challenges—how one handles stress, relationships, sexuality, separations, rejections, quality of sleep and appetite, and how losses are processed. Some people cope with life’s struggles by the misuse of alcohol or other drugs. These self-defeating behaviors and self-destructive coping methods are often fatal. Sooner or later, death is mandatory for all, but recovery and redirection remain an option as long as life persists.

Just as mental illness does not discriminate, neither does recovery. For purposes of the present discussion, the disease of alcoholism and other addictions come under the broad umbrella of mental health concerns. A common symptom or trait in these illnesses is denial and resistance to change. Asking for help is an act of courage. Making sustained change shows strength.

It doesn’t matter so much what factor tips the decisional scale motivating a person to want to live more healthily, or exactly where they might fall on a motivational scale. If 10 represents someone who is taking action to change, and one represents someone with no interest whatever in changing, as long as someone falls between five and 10, they are in the same category of recovery. It doesn’t matter if their incentive is to stay out of jail, not to die of an overdose, or simply to enjoy life more fully. If they have that desire, they have started to get better.

This is more than a semantic point. Identifying with a recovering community is essential to recovery. The slogan “Identify, don’t compare” urges us to look for similarities between others’ stories and our own, rather than at our differences. Looking around the room in group therapy or at a meeting or when talking one-on-one with peers or professionals and saying, “These people are different from me,” is comparison. Looking around for similarities is identifying. One view leads to isolation. The fruits of the other offer support and hope.

It is not uncommon to speak with patients who claim they are in treatment because they have “no choice” due to being “mandated” to attend. The reality is that everyone who enters treatment is mandated, if not by external pressures like the justice system, then by an incentive that is closer to home like a spouse, a child, or a parent. Or perhaps they have been “mandated” by a landlord, by an employer, by their liver, or by a desire to live rather than die. In some sense, everyone in the treatment room is mandated or they would not be present. No one is there because they enjoy spending their days talking about how to manage conditions that have left their lives in chaos and resulted in innumerable losses.

On another level, it is equally true that choosing to engage in treatment is an exercise of free will, making the choice between the healthy option (recovery) and the less desirable option, whether a legal penalty, job loss, homelessness, or other consequence. When a perception of coercion occurs, personal autonomy is undermined, and perceived loss of self-determination can result in negative affect and disengagement from treatment activities. Psychological and physical healing (recovery) are possible whenever a person chooses to engage in treatment, regardless of the alternative.

Free will and motivation are essential ingredients in behavioral change and recovery. It helps to recognize the reality that people always chart their own course, basing informed decisions on awareness of benefits, risks and likely consequences, drawn from both what they learn by identifying with the stories heard from others and from their own experiences.

If you want to get better, you can. There are truly no mandates. Some choices are easy, some difficult. Sometimes the fewer options that are on the table, the easier it may be to select the healthiest choice that leads to getting better.

[Editor’s Note: Tom Rue has been a professional counselor since 1985. He is a Licensed Mental Health Counselor in New York State, certified as a clinical mental health counselor by the National Board for Certified Counselors, an AMHCA Diplomate and Clinical Mental Health Specialist in Substance Abuse and Co-Occurring Disorders, and a Credentialed Alcoholism and Substance Abuse Counselor with a private practice in Monticello known as Choices Mental Health Counseling PLLC. He can be reached at 845/513-2005 or www.choicesmhc.com.]

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