by Nathan Chua
It pains me to see a number of people who come to me and say that they have spent so much time and resources trying to cure their “mental illness” with a handful of medications, only to find out that after years of their hard work and dedication to the treatment, they have come full circle to the same old problem. Maybe it was instinct, but in all my years in this field, I have always had an affinity to talking through rather than medicating out of psychological issues. I never thought the idea that there was some germ or biological impairment involved in psychological struggles was tenable. Contextual behavioral science seems to bear my hunch out.
I must admit, some parts of my work in the past, especially the ones that dealt with developing insight, may have sounded like there was something broken or wrong with someone’s history or biology. I can vividly remember part of my training in grad school where the class had to figure out what diagnosis/diagnoses to give a client. It was tough! Why? Because the diagnostic manual, the simplified version for that matter, was about 600 pages long, and there were so many overlapping symptoms among the hundreds of diagnoses that I frankly was amazed at how the professor was able to come up with one or two! I thought that only a genius with a freakish memory can come up with an accurate diagnosis, let alone making a diagnosis that matches that of the professor’s.
As I have learned now from the philosophy behind Acceptance and Commitment Therapy (ACT), such a practice may not necessarily come up with the best results. Far be it for me to make an indictment on the whole diagnostic and classification system. There certainly is a place for such, but I guess the bottom line here is, finding out what works best for the client. In certain cases, such diagnoses can, for many clients, become a kind of self-fulfilling prophecy or a crutch that is liable to be used in gaining the attention of others.
What attracted me to ACT is its pragmatism. If I was to join this field of work, I want it first of all to work for my own issues and struggles. Secondly, I want to see results that are meaningful and effective to my clients, which is precisely what pragmatism is after.
Moreover, seeing the world through ACT eyes means espousing not just the alleviation of human suffering but also the promotion of human prosperity. As Maslow had proposed with the coming of the humanistic approaches in psychology, humans have certain aspirations that no other creatures on this planet share with them…self-actualization.
My first nine years of work primarily was devoted to alleviating suffering, which is how the disease model “works.” Get rid of your difficult thoughts and feelings or learn to manage them, then all will be okay. One can just go back to the same tired old life that got them into therapy in the first place.
So why have I devoted my last two years of continuing education to ACT? Well it is a matter of asking myself if just managing my emotions was good enough to make me realize that I have lived a full and purposeful life. But life would be so much more fun and challenging if I went for not just managing my inner thought processes, but also being gungho to what for me means doing something out of my limited time on earth.
As of now, I think this is the best science we have for attending to our problems of living. The science has yet to determine that there is a certain biological cause to the effect of mental wellness. Otherwise, don’t you think that the world’s geniuses in the field would have come up with a drug that takes care of all of that?
Who knows? We might end up finding it in the future. But I go only as far as what the scientific evidence shows me to be useful in helping others better their lives, now! So I have chosen this route, until a better science proves this to be inadequate.