Continuing Professional Development: Psychology and Mental Health (Week 4)

For the last three weeks I've been posting about a course I've been taking called Psychology and Mental Health: Beyond Nature and Nurture.

This week we focused on the role of psychological mechanisms in the development of mental health problems and the maintenance of well-being. The sources we were presented with suggest that a psychological perspective adds a vital additional element to the ‘nature-nurture’ debate, because it is through these psychological mechanisms that we interpret and respond to the world. 

Our course leader Peter Kinderman, Professor of Clinical Psychology at the University of Liverpool, argues that our mental health is essentially a psychological issue, and that biological, social, and circumstantial factors affect our mental health and well-being by disrupting or disturbing psychological processes. The way in which we make sense of the world, the way in which we understand ourselves, who we are as people, the way we make sense of other people, the way that we react socially, how we think about the future, and how we think about the world in general, this sense making, this framework of understanding of the world is fundamentally important in determining our mental health and well-being.

To get us started we are provided with a copy of Peter Kinderman’s, A Psychological Model of Mental Disorder. This article discusses the relationship between biological, social, and psychological factors in the causation and treatment of mental disorder. He suggests that a comprehensive psychological model of mental disorder can offer a coherent, theoretically powerful alternative to reductionist biological accounts while also incorporating the results of biological research.

We are told that Peter was able to test out some of these ideas in a research study that he conducted with the help of the BBC; testing out the idea of whether a combination of different factors could predict the level of mental health difficulties and well-being that a person was experiencing.

They were interested in whether biological factors, which were measured by looking at the experience of mental health problems in a person's family of origin, in their parents and in their siblings, could predict mental health problems, which would then have a variety of psychological and social consequences. Or whether, on the other hand, life events like trauma in early childhood or experiencing a range of negative life events in the last six months would predict people's mental health problems. Or as they hypothesised, whether psychological factors - rumination, where people would go over and over things in their minds, or self blame, where people would blame themselves for the difficulties they were experiencing - would explain more of a person's mental health problems.

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When they looked at the results, it seemed that social factors were very influential in predicting people's mental health problems, with biological factors playing a part, but a less important part. But importantly, both social and biological factors were mediated by the psychological factors. So, they asserted, rumination and self blame seem to be the gateways towards mental health problems.

You can see the paper itself and also a brief magazine article (Rumination: The danger of dwelling) hosted by the BBC on their website.

Peter says that this way of thinking about mental health has some quite profound consequences. If you realise the way in which a person thinks about the world, the way in which a person responds to events in their lives, makes a difference to their mental health, to their well being, to anxiety and depression, it does change the way in which we should approach mental health problems. It brings it back to the idea that how we think about the world matters. Because it changes the way in which we feel and behave. This gives us some different opportunities for how to help people who've got emotional difficulties. But it's also important for people who themselves are suffering, because rather than blaming them for their difficulties, it means that there are things that they can do themselves to get out of the problems that they find themselves in. It gives people a sense of agency and control over their own mental health.

Finally we were invited to take part in some of Peter’s current research: Causal and mediating factors in mental health and wellbeing. A follow up study to the research that has formed the basis of this week’s part of the course. 

At the end of the course we are asked if we believe adding psychological processes to the mix add anything useful to our understanding of the ‘nature-nurture’ debate? Do we think these kinds of factors are important in determining our mental health and well-being? Do we think an understanding of psychological processes mean that we can offer more useful ways of helping people - perhaps through therapy? 

What do you think?  

If rumination is posing a difficulty for you or a client there are a couple of things you could try.

1. Identify the thought or fear. What is it that you or your client fears? Keeping a journal might be a helpful way of identifying this. Mind Tools have a proforma that can help to identify the causes of short term stress or anxiety. 
2. Think about the worst-case scenario. This might sound like it would make matters worse, but people are incredibly resilient and when we realise we can handle the worse case scenario it takes away the control it has over us. 
3. Let go of what you can’t control. Ask your client: what can you change? Encourage them to let go of what is out of their control and take charge of what is. 
4. Look at mistakes as learning opportunities. Nobody wants to make mistakes -- but how we react to them makes a big difference in whether we learn from them. When clients make a mistake or receive critical feedback, they shouldn't panic. They should be guided to think of it as an opportunity for learning, and remember that the process of "failing" -- when you're willing to pay attention -- is often what leads to the greatest successes.
5. Schedule a worry break. Clients could schedule 20 to 30 minutes a day to worry and make the most of it. This allows for a time and place to think about all their biggest insecurities while containing it to a specific period of time. At other times of the day, they should remind themselves that they will have time to contemplate later.
6. Mindfulness. Mindfulness has received a lot of attention recently and many companies in the private sector are promoting mindfulness amongst their employees. Becoming more aware of the present moment can help us to enjoy the world around us more and understand ourselves. 
7. Exercise. Clients could go for a walk. A change of scenery can disrupt our thoughts and give us new perspective.
8. Try therapy. If after trying the above, ruminative thoughts are still presenting a problem therapy might be able to help. Cognitive behaviour therapy, for example, could help to dispel misconceptions that may fuel the problem, and equip clients with the knowledge to begin their recovery.