“Medication, surgery, and radiation are the weapons with which conventional medicine foolishly shoots the messengers called symptoms.”
Western Medicine is firmly entrenched in three fundamental ideologies when it comes to chronic mental and physical pathology: A disease-based perspective, symptom-focused treatment, and mind/body separation.
The prevailing view held by western medicine is that chronic mental/physical pathologies are caused by diseases, which exist independently of the host (person) and its environment. Diseases are seen as either things or entities that people have ("I have depression", much like the cold or flu) or as fundamental traits that people are ("I am an alcoholic", much like gender or race). In my view there are several problems with such a mindset:
- Having a disease implies that it is separate from oneself, a mysterious invader wreaking havoc on the internal system. This creates a disposition that the illness is something to be fought, e.g. the war on cancer. While this (perhaps arguably) makes sense for infectious diseases like a cold or flu with a clear viral or bacterial cause, it's an untenable position – or better stated, an untenable assumption – for chronic, non-communicable (non-infectious) illnesses for which no such cause has been found.
- Being a disease implies that the disease is who the person is, permanently. A person with such a belief can't help but identify with their condition. Most popular with addictions, this highly stigmatizing perspective implies (or even declares) from the outset that cure is impossible. When someone says "I am an addict", the connotation is that the addiction is who they are – much like saying "I am human" or "I am a nice person." On the other hand, viewing the addiction as a dynamic process rather than a fixed aspect of a person is a significant shift in perspective which, at the risk of sounding hyperbolic, can change everything.
- The vast majority of chronic disease, such as autoimmune conditions, cancers, depression, and addictions, have no known cause (despite decades and billions of dollars worth of research). Perhaps the time has come to reassess our fundamental views on what exactly these diseases even are.
The Focus on Symptoms
Western treatment of chronic illness is entirely symptom-based – medications, procedures, and lifestyle changes aimed at reducing symptoms rather than curing or eliminating the disease. So entrenched is this perspective on chronic disease that the term non-communicable essentially implies incurable. As WebMD casually states: "Keep in mind that there are no treatment options that lead to curing a non-communicable disease from your body." While they're referring to physical illness here, the same is essentially true of mental illnesses as well.
Why this approach? On one hand, it's a natural outcome of the fact that a cure has never been discovered for any non-communicable disease. If disease is a thing, and you can't cure (get rid of) it, then all you can do is attempt to manage its symptoms. But more fundamentally, this is the result of how we approach chronic disease treatment in general. As author and speaker Gabor Maté has pointed out, rather than ask what truly causes these conditions, western medicine focuses on what to do about them; i.e. how to get rid of them (or more accurately, their symptoms).
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard resource in North America for diagnosing mental disorders. The criteria used to diagnose the nearly 300 disorders in the manual are all symptoms. So not only are our approaches to treatment based on symptoms, but in the mental health field the diagnoses themselves are entirely symptom-driven also. A psychiatric diagnosis therefore doesn't explain anything – it simply assigns a name to a collection of symptoms, and says nothing about causality. Small wonder then that the medications used to treat (i.e. manage the symptoms of) these conditions are often marginally effective at best, and come with substantial side-effects.
Mind and Body, or Mindbody?
Although science has definitively established the inseparability of mind and body, medicine continues to largely operate as if they are discrete entities that don't influence each other. This creates a narrow view of disease that, particularly with chronic physical conditions, makes truly effective treatment all but impossible.
The fact that this mindset contradicts our day-to-day lived experience makes its prevalence all the more remarkable. Think of the last time something startled you, or the moments after waking up from a bad dream. How are our bodies impacted in these situations? Our hearts race, we feel tense, anxiety flows through our veins. This is the mind impacting the body.
The reverse can be shown just as easily: Consider your mental state the last time you were sick with a cold or the flu. Depending on the level of physical symptoms, this can range from being groggy and mildly annoyed to flat-out miserable. This is the body impacting the mind.
A Deeper Look at Dis-ease
The fundamental question rarely asked with respect to disease is: Why? Let's take autoimmune diseases as an example. Why do they exist? Why does a person's immune system suddenly start attacking their body? Why have the rates of essentially every autoimmune condition been on the rise for decades? Autoimmunity is particularly interesting: What could possibly cause a body to attack itself? While few people today find autoimmune conditions surprising due to their prevalence, they were considered “biologically implausible” during the first half of the 20th century – scientists and doctors simply couldn't imagine the immune system being capable of self-harm. That western medicine has subsequently normalized these diseases – along with our inability to cure them – speaks volumes about its mindset and the effectiveness of its approaches to treatment and prevention.
Some form of the above questions can be asked for any chronic condition, physical or mental. Why does depression exist? Why do a person's emotions become blunted, with nothing but an undertone of sadness/despair left over? Why has the rate of depression been on the rise for decades? Inquiries such as this can lead us down the road of identifying causes – and therefore better treatment approaches – rather than simply managing symptoms in perpetuity.
My view on what causes these types of conditions aligns with what Gabor Maté has been saying for 20 years: They are the result of coping strategies from childhood, which were originally helpful (essential to survival, in fact) but later become maladaptive. The stress that these adaptations cause to the system is by far the most likely contributor to any given chronic condition. (See the Trauma section for information on this.) The remarkable amount of scientific evidence supporting this view is overshadowed only by how many of us – including doctors – are unaware of it.