The Emotional Bus
Identifying a psychopathology
Introduction
My lecturer, a psychiatrist, once gave a talk on anxiety and everybody in the audience thought that they had anxiety. She gave another talk on depression and everybody in the audience thought that they had depression.
She meant that as a joke of course but I began to ponder about what she said.
DSM
A commonly used manual to help identify psychopathologies is that of the Diagnostic and Statistical Manual of Mental Disorders (DSM). In there you find lists of attributes that may be used to diagnose mental disorders.
One common word that you may find in the DSM is the word ‘persistent’. In order for a mental condition to be worthy of diagnosis and treatment it has to be persistent.
Are you persistently in despair?
Are you persistently angry?
Are you persistently battling thoughts of suicide?
At this juncture, it is important to inform that mental illnesses can sometimes be very hard to diagnose. They are not like other physiological conditions such as diabetes which can be diagnosed with simple blood tests.
There is no clear medical test for many mental conditions. As such, doctors and psychologists make educated guesses based on symptoms and find the most fitting condition to diagnose patients with.
A Trip on the Emotional Bus
This analogy came to me a few days ago. I found it insightful and fitting for this article.
Picture this: We are all on a journey on a bus. There are several stops on the bus route. These stops include happiness, sadness, anger and despair etc.
Most people are able to alight from the bus and linger at these bus stops for short periods of time; After which they board the bus and move on to another bus stop.
Sadly, there are some, who due to their biology, current circumstances, past experiences or a recent traumatic event, are unable to board the bus. They linger in despair, anger and resentment. This is when they encounter what we now term as psychopathology.
This analogy also aptly describes why the audiences at the anxiety talk thought they had anxiety and those at the depression talk thought they had depression.
Indeed, at some point of their lives, they had alighted at the anxiety/depression bus stop and lingered there for some time. Fortunately for them, they were able to board the bus and proceed on with their journey.
Appreciating our Emotions
I am currently reading Carl R. Roger’s “On Becoming a Person”. It is a book that describes Roger’s signature method of therapy — Person Centred therapy.
It is a method that emphasises heavily on emotions, in particular, experiencing the constant ebbing and flowing of one’s emotions. According to Rogers, there are seven stages of awareness.
If therapy continues successful for many years, the client eventually reaches stage seven where he/she able to experience fully the emotions that he/she is held in within a particular moment.
Moving with the bus analogy, a person at the final stage will be able to observe exactly which bus stop he/she is at and appreciate the beauty of the bus stop objectively and undistorted not inventing anything that is absent and not ignoring anything that is present.
Rogers adds that if a therapist has a problem a client’s experience (i.e. intense anger, intense sadness), it may be indicative that there is an area in the therapist that still requires healing and growth.
In the bus analogy, it would be akin to the therapist taking a journey with the client on the bus. They alight at a bus stop, the client is completely okay with looking around and taking in the sensations. In contrast, the therapist is not okay, he looks around awkwardly, afraid of what he might find.
Suffice to say, this is not helpful at all to the client. This is exactly why I have mentioned before, in a previous article that to be a good person-centred therapist, one has to be prepared to make the effort for constant growth. It is not easy.
Moving back to the topic on psychopathology, Rogers believed that there is no psychopathology. We are all on a journey. There may be some who are stuck at a bus stop and are unable to board the bus. There may be some who are afraid to look around the bus stop to take in the sensations and process the input.
These, he argues can be ‘cured’ if there is a person, a brave soul (i.e. counsellor), who is able to hold the hand of the person open his eyes and help him up the bus once more. In this act of love, the person moves from a state of fixity (i.e. stuck at the bus stop), to a state of constant flux, becoming more and more aware and appreciative of his emotional movements, be they positive or negative.
Conclusion
I have been down lately. From time to time, I feel depressed. I have been depressed before. This time, it is very different. I have grown to appreciate the feelings of sadness and despair.
In addition, instead of being trapped at the bus stop, I am readily able to board a bus and to escape through prayer and meditation. When I am at the bus stop, I am no longer afraid of looking around. I boldly look and appreciate the subtle details of the bus stop.
At the bus stop of depression, I found intense disappointment, helplessness, hopelessness, resentfulness, guilt, anger, hatred and desire for revenge.
When I boarded the bus and proceeded to the stop of normality, I looked back with a fresh set of lenses and felt compassion and pride for the depressed Denise. She has become so brave. She no longer closes her eyes at the horrors of life. She is now willing to experience fully the act of being a ‘bad wife’, ‘bad mother’, ‘bad daughter’, ‘selfish woman’ and ‘ambitious bigot’.
At the state of normality, I do not feel intensely guilty for the experiences at the former bus stop. I put on my counsellor’s hat and say: “I am so proud of you Denise. You have suffered so much of late and you have been so brave and strong. In spite of all that is happening, you are still alive and sane. In your brokenness, you still genuinely care for people. This is not as common as you would like to believe. You deserve some credit. Here, have some positive strokes. You deserve to be pampered today. Tomorrow, let us take another trip together on the emotional bus.”
God Bless!
