By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Why talking about mental health, mental illness and personality are so confusing.
Psychology and mental health treatment started out in a pretty close intimate relationship. Over the years the two disciplines have drifted apart.
Freud and Jung started us on the path to using talk therapy to help people overcome life problems and to treat mental illnesses.
The longer we have been on this path the more the disciplines of psychology and mental health have diverged. Today it seems that they are not even talking as we use very different language to describe the same or similar situations.
One place this results in confusion is when people tell their mental health practitioner about a symptom using psychology terms to describe what they are going through. One definition of Psychology is an academic and applied discipline that involves the scientific study of mental functions and behaviors.
This is quite different from the study of mental illness though the two may at times overlap. Both fields are struggling with finding and measuring mental wellness.
Psychiatry is mostly about diagnosing an illness.
In this way of thinking, you are sick or you are not. Some of this distinction comes from the ongoing division between categorical approaches, you have A or you do not have A, and continuum methods in which you move from mild symptoms to more severe symptoms and at some point, they get severe enough to need treatment.
Psychology talks a lot about how your brain works and how people make decisions. So one group of practitioners gives you one label and another gives you a different one. They aren’t even talking about the same things.
I see things in posts about being an ENTJ or similar designation. This comes from psychology’s effort to classify people’s basic personality. You will not find these designations in the DSM-5 which the mental health community uses to diagnose an illness. This results in some extreme frustration on the part of clients when we say there is nothing wrong with them and they know they are suffering.
You say you are shy. There is nothing called shyness in the DSM, therefore you are not mentally ill. You say “but you don’t understand, I am very very shy.” Sorry, that is not a mental illness and your insurance company or the public system will not pay to treat your personality. They also do not pay for personal development or growth experiences. You need to be sick to get treated.
You say but I am so shy I can’t leave my house to work. I am afraid of being around people and I can’t see my friends anymore. My shyness is keeping me a prisoner in my own home. You clinician says sorry, shy is not a mental illness we can’t treat that.
WAIT A MINUTE – Did you say you can’t leave the house? That could be Agoraphobia. You can’t be around people – could that be Social Phobia? While we can’t treat shy we can treat Agoraphobia or Social anxiety disorders.
See how the difference in terminology can cause problems?
Hyperthymic vs. Bipolar.
This came up in my series of posts on Hyperthymia. In mental health, you have Bipolar I, Bipolar II, Bipolar NOS or Cyclothymia. Hyperthymia is a personality type, not a mental illness so we don’t treat personality types. We consider most types of personality as just the way you are. So until it gets severe and we can give you a diagnosis this is not an illness and this is, from our viewpoint not serious.
Personality “Disorders” are whole other creature, again only loosely related to these personality types people learn in psychology classes.
In past posts, I have talked about the research on Hypothermia. Most of this is academic research and they see hypothermia as on a continuum. You could have varying levels of Hyperthymia. Some Hyperthymia is severe and needs treatment in their book. But since it is not in the DSM we therapists types look at this as one of those “just how you are” things. We don’t treat it until it gets severe enough to be reclassified as a disorder on the Bipolar spectrum. Once we call it something else it gets treated.
In upcoming posts, I want to talk about Delusions. For mental health practitioners delusions are symptoms of a relatively few mental illnesses. For the psychology researchers there are delusions and delusion-like experiences and so on. Since we have varying definitions and criteria this material may take a little translating. Hence I have tried to explain in this post why the various sorts of similar professions may not agree about what the research says and means.
Until next time stay happy or on your path to happiness and let’s see where this adventure we call recovery may take us.
Staying connected with David Joel Miller
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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.