Sunday, March 26, 2017

Context Can Beat Biology

Though popular media, advertising, and Big Pharma would have you believe otherwise, evidence for the primacy of context in emotional well-being continues to pour in. Context refers to considerations of a person's entire situation, including both internal and external factors, strengths and limitations, skills and deficits, in determining both well-being and the lack thereof. We are learning more about the power of harnessing processes humans already have to overcome their life problems.

It is as if people already know this intuitively. Recent studies demonstrate that those in treatment are more likely to refuse or not complete it if it only involves drug therapy than talk therapy alone, by a factor of more than two. Authors believe this pattern occurs because participants understand the non-biological components of their concerns. It has already been widely reported that talk and drug therapy combined is better in some cases, and talk therapy alone is superior in others.

Emphasizing notions of human context and inherent strength, other authors posit that even psychotherapy should not be thought of as a cure, just as medicine should not, but rather a method of change rooted in perspective-taking and philosophy of living. Highlighting the differences among the approaches, Kev Harding states:

“The differences between the idea that ‘mental health problems’ have their roots in ‘faulty genes’ etc. to be somehow (and implausibly) ‘managed’ or ‘cured’ by psychiatric medication, CBT, or a bit of both, in contrast to the idea that such problems have their roots in a person’s life experiences, circumstances, societal expectations, and do not necessarily mean that there is something inherently ‘wrong’ with the person in distress.”

For further reference, see my previous posts concerning the developmental and contextual origins of many issues faced by college students in particular. My experience has been that, in many cases when medicines are useful, it is largely because it enables people to be more open to benefiting from new experiences and perspectives.

On the micro level of skill development, many studies have demonstrated that learning even just one new skill, such as mindfulness or anxiety reduction, can lead to dramatic improvements in a host of human life problems. In one study it was found that learning how to reduce rumination, or "boiling your cabbage twice" as the Irish proverb says, resulted in an 80% recovery rate for depression after six months. That's exciting!

It's all about the power of people, people. To a significant degree, the solutions are already inside us.