'The question is not how to be cured; the question is how to live.' (Joseph Conrad)

Functional mental disorders; medical treatment

*For an explanation of the term 'functional mental disorders', see the page What Mental Illness Is 

Because we are, fundamentally, biological machines, the most obvious and frequently the most convenient way of dealing with  functional mental disorders (FMDs)* is to modify the activity of the brain by chemical or mechanical means, such as mood-altering drugs or electro-convulsive therapy.
The advantage of such treatments is that they provide an easy, and sometimes rapid, relief of symptoms.   The disadvantage is that, because they are used to alleviate symptoms, they do not address the causes of the disorder.   The fact that symptoms can sometimes be relieved by medical treatment does not mean that the causes are biological.   Dispelling a headache with an analgesic substance, for instance, does not prove that the headache was caused by a deficiency of the substance!   Also, some mood-altering drugs have long-term adverse effects on the brain, liver and lungs.   Electro-convulsive therapy is reputedly even more drastic and no one knows if some of its side-effects are permanent.

An alternative way

An alternative way of treating FMDs is to do nothing!  Surprisingly, perhaps, this works in about one third of the less severe cases reported, probably because nearly everyone has an innate capacity for health, both mental and physical.
But the appearance of doing nothing may be deceptive.   It may well conceal the sufferer's determination to recover with the help of family or friends, self-help books and magazines, for example.

Mind therapy

'... life itself is the best therapist. What (psycho)analysis can do is to make one able to accept the help that life offers, and to profit from it.' Karen Horney⁽¹⁾

Mind (or Psycho) therapy is based on the same self-help principle.   Guided by someone experienced in the tribulations of living, it aims to help sufferers find ways of making their lives more satisfying in the belief that this will make them less prone to ill-health and more likely to recover quickly if they do become ill.

What mind therapy is

Although mind therapy is sometimes called 'counselling', this can be misleading because counselling is about giving advice and mind therapy is not.   It is a procedure in which clients are helped to find their own answers.  It is not simply 'a shoulder to cry on', although that can be part of it.   The aim is to help clients  understand themselves better, as well as their relationship to their surroundings and to other people in particular.   It comprises one or more structured conversations aimed at helping clients resolve their mental, psychological, emotional, spiritual or existential difficulties.  

One of the the main causes of emotional distress, mental disorder or whatever we choose to call it, is difficulty making sense of what is happening around – and perhaps to – the client.   Consequently, most therapists attach little significance to the 'mental illness' categories favoured by medical practitioners.

What mind therapy is like

'(I believe) that significant change in the client occurs or is achieved in the client's actual social environment and not in the consulting room.' Sol L. Garfield(3)

Mind therapy is not  an easy option.   Karen Horney compared it to climbing a difficult mountain, guided by someone 'who is not too certain of the way himself, because, though experienced in mountain climbing, he has not yet climbed this particular mountain.'⁽²⁾
Another analogy is that of a research project in which the main topic of enquiry is the client's confused state. The therapist's function is to help the client decide which aspects of the project need to be more closely examined. 
The work done by clients between  the consultations is more important than the consultations — because these are mainly opportunities for discussing what the clients have discovered and thought about since the previous meeting.

Limitations of mind therapy

Mind therapy will not cure the symptoms of an illness if its principal cause is physical.   Although there is little doubt that FMDs alone can cause physical symptoms, medical advice should always be sought before resorting to mind therapy.   Then, if no physical cause is found, it is reasonable to assume that the symptoms are a result of mental disorder. 
None the less, it is important to distinguish between physical symptoms and mental symptoms.   Depression, anxiety, morbid thoughts, irritability, phobias and nightmares, for example, are mental not physical symptoms.   Confusion tends to arise because many of the 'mental illness' categories used to diagnose FMDs are nothing more than groups, or 'clusters', of physical and mental symptoms.

What a therapist does

A therapist's main function is to help clients examine each aspect of their situation carefully and in detail so as to establish how and why it has arisen.   By careful listening, s/he tries to see things as the clients see them.   Only when, s/he has done this, can s/he suggest explanations for the situation and ways of dealing with it that were not obvious before. 
By tackling the causes of the problem, the effect of mind therapy is more likely to endure, and incur less risk of relapse, than relying on medical or exclusively self-help approaches.

Self-discovery

One of the main obstacles to progress in mind therapy is that, in trying to find what is really troubling them, clients may also come across unwelcome facts about themselves and thus increase their distress!   For example, the therapist may consider it helpful in the long run to challenge some of the client's beliefs, or suggest that the action s/he intends to take may not achieve the objective s/he wants.   This can create great disappointment and even resentment. 
Although that risk cannot be avoided, the impact can be softened and absorbed.   Conscientious therapists warn their clients of the risk and at no point do they abandon them, even if relations between them have become strained ...

Mind therapy is not always appropriate

Because it is based on the principle of self-help, mind therapy will not work for people who want relief from their symptoms without exploring the causes.   In order for it to work, clients must be prepared to question their beliefs and perhaps try out new ideas.   If they falter and question whether it is worth continuing, the therapist can only encourage them to continue by pointing out the progress they have so far made; but a responsible therapist will not urge them unduly.

Effectiveness of mind therapy

The effectiveness of mind therapy has  – rightly  – been questioned on a number of occasions.   The water is muddied, as it were, by the fact that mind therapy can help people who are not suffering from the medically-categorised mental disorders as well as those who are.   In medical settings, efficacy usually means that the patients' symptoms have abated or that they no longer seek treatment, but in other settings it can mean changes in the clients' behaviour or their existential outlook.     

Measuring its effectiveness

Also, the meaning of 'effectiveness' varies from person to person and from situation to situation!   What was the therapy intended to do?   Was it the client who decided its purpose; or the therapist, or someone who controlled the client in some way?   And was the purpose realistic or was it just wishful thinking?  
Finally, is it realistic to try to measure  effectiveness for whole groups of people or can it be measured only in relation to individual clients or patients?  

Mind therapy and medically-categorised mental disorders

Because of the different purpose of medical treatment, attempting to measure its efficacy against that of mind therapy is unrealistic.   We can only compare the proportion of people who have been helped by mind therapy with the proportion of those who have not!   On this crude criterion, it seems from reviews of many reported studies that mind therapy is effective.⁽⁴⁾
None the less, two separate studies of people who were 'clinically-depressed' showed that 'the changes in functional brain activity following pharmacotherapy and mind therapy were remarkably similar.' ⁽⁵⁾

What Mental
 Illness Is

Mind Therapy 
Introduction

Mind Therapy;
 Efficacy Factors

Employing a 
Mind Therapist