Mental Health and the Brain: Working Group, March 16

Mental Health and the Brain Working Group:

March 16th, The Significance of Story in the Brain and Mental Health (Paul Grobstein) & Conflicting Stories (Debbie Plotnick)
Synopsis and forum for continuing discussion

Thoughts welcomed in the on-line forum below.

Participants
Martin Bayer, Laura Cyckowski, Adi Flesher, Sarah Gibbs, Ryan Golden, Paul Grobstein, Grace Marie Hollaender, Julia Lewis, Debbie Plotnick, Corey Rogers

Summary

This weeks meeting was begun by Paul Grobstein talking about "The Significance of Story in the Brain and Mental Health". Grobstein emphasized the point that people’s stories about themselves should be paid more attention to, particularly in training mental health workers and in the mental health realm in general. "Listening to other peoples stories" is important in the realm of mental health but also extends to traditional medicine. A person’s report of their internal experiences should be given as much weight as external observations by professionals. Grobstein also expressed the view that "from the inside"--internal experiences--mental health phenomena may be more similar and thus diagnoses and labels given by external observers (professionals, peers, etc.) may not be as useful in understanding any particular phenomenon. The case of Capgras Syndrome was used as a case study. Someone with Capgras, frequently with a brain injury, is capable of recognizing someone but insists that he/she is an impostor. The neurologist Ramachandran believes that some connection between the emotional parts of the brain and the rest of the brain is severed. Thus, someone may recognize a person but not "feel" anything and so creates the story that the person is an imposter. What Ramachandran fails to point out, however, is that there may be other stories to account for the absence of feeling, and that someone with Capgras might be helped to switch to a more adaptive story.

The second half of the session was lead by Debbie Plotnick and Corey Rogers, a mental health worker. The topic was conflicting stories and the need to listen to other people’s stories. Plotnick described her relationship with her daughter who was diagnosed with bipolar disorder and the conflicts that arose from her "story of her daughter's story" and Ashley’s own story of herself. (See A Personal Experience of Learning About Bipolar Disorder and An autobiographical essay.) Corey spoke about his involvement with a Peer Specialist program in the Philadelphia Department of Behavioral Health. This program aims to match people currently experiencing mental health issues with someone who’s had similar personal experiences. There was consent among the group that being able to share personal stories is therapeutic and helpful to oneself and others. The discussion moved towards the topic of self-disclosure. A counselor expressed the value in relating personal stories to clients, despite traditional training that discourages the counselor from revealing personal experiences. One participant shared that personally self-disclosure evoked a feeling of being in control and responsible. Another participant asked whether or not self-disclosure in general might make some people feel as if they’re losing part of oneself. There was general consensus that patients need to reveal as much about themselves in order to help the clinician help them.

--- summarized by Laura

Comments

Donald Saunders - Gastric Bypass Surgery's picture

Mind or Body?

You ask whether problems such as obesity are a physical or a mental problem and the answer is that this is clearly a physical problem and there is no mental illness element present here at all.

Obesity is a widespread and growing problem in the US and, in the vast majority of cases, it is a lifestyle problem caused by poor dietary choices and a lack of exercise. In part therefore we need to educate people starting at an early age and, as a society, we need to move away from a 'convenience' culture. Making life easy is all well and good but a return to good old fashioned cooking and pushing the lawn mower around the yard would do more than anything else to solve the problem.

Paul Grobstein's picture

mental health and stories

What struck me particularly about this session was the juxtaposition between my own arguments that thinking about "story" was important to thinking about mental health issues in terms of the brain, and Debbie and Corey's concern for paying attention not only to the stories of those in need of mental health care but those of the care-givers as well.  The implied reciprocity of story creation and recreation seems to me particularly important in a variety of mental health contexts (including but not limited to psychotherapy) and beyond.   
llamprou's picture

Hello All

Hello Everyone! For those of you who are new my name is Lisa Lamprou and I am a biology major here at BMC! I wanted to let all of you in on a recent seminar I attended and some thoughts I took with me! The seminar was at the University of Pennsylvania and the discussion was based around the link between mental illness and physical health. 

 

The talk basically presented the idea that many of the physical problems people are facing in the United States today are a direct result of not enough mental health education. This may at first seem unclear but let me elaborate.

 

Individuals in the United States today are suffering from a number of different diseases such as obesity, heart disease and diabetes. These diseases thus far have been treated as physical ailments, with the treatment being medication or surgery. At the seminar I attended the idea was put forth that perhaps the American people should be treated not as individuals who are physically ill, but instead as individuals who have mental health disorders. 

 

Lets take obesity as an example. The popular treatment for this disease is either a strict diet or gastric bypass surgery. This surgery although physically treats the individual - does not mentally do so. An obese individual's eating habits many times has to do with their mental and emotional health.  The seminar insinuated that perhaps many physical illnesses should be treated using mental health professionals and not necessarily physicians - or at least in a combination. 

 

Gastric bypass surgery will solve the problems of individuals with respect to their weight, but will it help solve their need to eat. Or their desire to be comforted by food? Many hospitals around the country now are implementing new rules regarding gastric bypass surgery mandating that those individuals who want the procedure must first prove that they have the mental capacity to control their eating habits. In order to qualify for the surgery these individuals must attend meetings in which they discuss the mental component of their illness.

 

Many times it is obesity that leads to diabetes, would it be possible to start treating people earlier using mental health and avoiding the epidemic all together. This is not meant to be controversial but I would love to get your thoughts on the matter. Would the American public be found healthier physically if the government took stronger measures to increase individuals mental health. 

 

Studies have been done showing that even children will consume larger amounts of candy because they are sad, or unhappy with their social circumstances. Perhaps the problem is that these days we partake in far fewer activities that release endorphins and in order to create artificial happiness we consume 'comfort food'. 

 

Any thoughts? 

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