During the 1970s a revelatory breakthrough happened in psychological therapy. Led by Aaron Beck, it aimed to make psychoanalysis more scientifically driven. Beck postulated that depression was caused from the unconscious hostility that individuals initially repress, and then direct against themselves.
He also observed that people’s thoughts were often based in a negative cycle. And argued that if individuals could articulate these thoughts, then control them, eventually, this negative energy would dissipate. These ideas, and others, played an important role in bringing about Cognitive Behavioural Therapy.
The treatment, according to Richard Layard and David M Clark’s recently published book, has brought psychological therapy to a point where it can transform people’s lives.
Using Beck’s approach as a starting point, Thrive: The Power of Evidence-Based Psychological Therapies (Allen Lane) aims to convince readers that providing first rate public policy in mental health is paramount in building a more productive, egalitarian, and humane society.
At a quick glance this sounds like a simple truism.
However, backed up with a stack of well-researched data, both authors convincingly argue that even the most developed and wealthiest nations still don’t treat mentally ill patients with the adequate care they deserve.
Despite its political undertones, the book has a nonpartisan appeal. Both authors argue that putting mental health top of the political agenda is a no brainer: whatever side of the ideological fence you sit on.
Left leaning liberals who believe that high taxes should be used to build institutions that benefit society from the bottom up will warm to Layard and Clark’s humanitarian outlook. This favours qualified therapists giving excellent treatment.
Right leaning neoliberals who value the creation of more wealth, and a society with less dependency on benefits will equally be persuaded by the book’s focus on improving mental health practices for the purpose of increasing individuals’ economic output.
The topic seems like a particularly poignant issue to discuss in light of recent ridiculous negative coverage in the press here in the UK on mental health. This arose from the fact that the 27-year-old German pilot, Andreas Lubitz, who allegedly murdered 150 people by deliberating crashing Germanwings Flight 9525 into the French Alps on purpose suffered from depression. Editors would do well to read this book and learn a thing or two about mental health: thus expanding their vocabulary on the subject beyond cliched and pejorative terms like “bonkers” “madman” and “loony”.
While Layard and Clark admit that there is certainly a long way to go before a bad dose of depression is treated in the same vein as, say, breaking your leg, they do spend considerable time discussing some recent positive outcomes. Even if they are singing their own praises.
The statistics from the book speaks volumes. In most advanced western countries, mental illness accounts for 38 per cent of the total amount of morbidity and 40 per cent of all work absenteeism. And, on average, as many people die annually around the globe from suicide, than from homicide and warfare combined.
In England since 2008, a radical new development called IAPT (Improving Access to Psychological Therapies), which both authors played a vital role in implementing, has helped to treat 400,000 patients annually with mental health issues. With its emphases on systematically delivering evidence based psychological therapy within the NHS, it has ensured that nearly half of all patients have made full recoveries by the end of their treatments.
The enthusiasm and belief in progress for mental health is invigorating to read. And the explanations given here for what causes illnesses like depression and social anxiety are delivered in a concise and lucid manner.
Quite recently, I have personally benefited enormously from this free treatment, via the NHS: undertaking six sessions of PCT (Personal Centred Therapy) to try and come to terms with stress and trauma that I recently underwent in my own life, due to a relationship breakdown I experienced. Something I have previously written about here.
I cannot recommend this process enough. After my own six sessions I personally felt like I came out the other side of the therapy like a different person. And for anyone who has never experienced therapy, but feels they may have some issues that they would like to offload with someone in a professional capacity, I would strongly recommend contacting your local GP and self referring.
However, if the book has one small weakness — and I emphasise the word small here — it’s the unconditional faith both authors place in the value of empirical based psychotherapy.
Jungian analysts such as Lionel Corbett, have long argued that depth psychology, which focuses more towards empathy, compassion and even culture, rather than a scientific and quantitative based approach that always yields results, is needed in abundance when treating patients where human suffering is often unresolvable and unexplainable.
Again, I speak from personal experience here. Twenty years ago, I watched my own brother, who suffered from depression, spend nine months in a psychiatric hospital in South Dublin. He was treated by numerous doctors; took a concoction of different medication that was often based on simple trial and error ; went through various methods of occupational therapy; underwent ECT treatment; and was often put on suicide watch, where he was isolated for days on end in a room where the doors were constantly locked.
He took his own life a couple of years later, jumping off the cliffs in Howth Pier in north Dublin. His body was eventually found three months later, at the bottom of the seabed, by a fisherman, just off Lambay Island. I’m not directing any blame here towards health professionals, who obviously did their best with the knowledge they had at the time. But simply pointing out that, in some cases, human suffering still has a mysterious and inexplicable end result: no matter what scientific methodologies are applied, or how advanced they seem at the time.
Several doctors I have since spoken to about this simple fact have fully agreed with me.
Clark and Layard’s thesis suffers from one serious weakness: it assumes that the extremely unpredictable and irrational dimensions of the human condition can constantly be reduced to a single utilitarian argument. They treat happiness like an economic entity that rises and falls with the aid of a simple explainable graph. When actually, the human mind is far more complicated than they make out.
Notwithstanding this small difference of opinion, Thrive: The Power of Evidence-Based Psychological Therapies is still a positive manifesto for improving mental health treatment everywhere. It ought to be read by anyone wishing to learn how mental illness can be understood; successfully treated in many cases; and talked about with the compassion, dignity, and sensitivity it truly deserves.
