In anticipation of beginning this blog, I’ve been collecting ideas from news articles, books, and other sources over the past year. Here’s my Top 10 list of the important ideas or trends that I am seeing in the fields of mental health and addiction treatment:
De-stigmatizing addiction and mental illness, beginning with changes in the language we use to describe these conditions: from “mental illness” to “behavioral health,” from “mentally ill” to “disorders of mood or thought,” from “alcoholism” to “alcohol use disorder,” from “personality disorder” to “personality style,” and from “borderline personality” to “emotion regulation disorder.”
Patient-centered care. I laughed when I first read about this as an innovative concept in medicine, because social workers (and other therapists) have always been patient-centered in our thinking; but I’m glad to see that physicians are recognizing the importance of taking a patient’s needs and perspective into account before recommending a course of treatment or medication.
DNA is not destiny. The fascinating field of epigenetics, or the expression of genes, reveals that environmental factors, including the family we grow up in, the life stressors we are exposed to, the trauma we witness or experience, even the relationships we have, all play a part in determining how, when, and whether a particular gene may make its presence known in our lifetime.
Neurons that fire together, wire together. Neural plasticity means that experience shapes our neural pathways throughout our lives. While the force of habit is strong, like deep ruts in a dirt road, it is possible – through consistent and persistent effort – to change habitual ways of being, thinking, and perceiving. We can use the mind to change the brain, which in turn changes the mind.
Meditation, not medication. We are recognizing the value of mindfulness practices – such as meditation, yoga, Tai Chi, Qigong – to restore emotional equilibrium, improve mental clarity, and promote physical well-being, as well as to reduce the need for medications for some conditions.
Trauma-informed treatment. A growing body of evidence demonstrates that it is better to treat trauma issues at the same time as substance abuse, addiction, or mental health problems, rather than sequentially. We also have better assessment tools and a wider range of options to treat trauma, and recognize that people can heal from trauma through different ways.
It’s not what has happened to you, but how you make sense of it that determines whether you will be able to have healthy adult relationships or be a good parent. Creating a coherent narrative of your life experiences – making sense of your life and finding its meaning and purpose – is more important than what happened in childhood or what kind of family you grew up in.
I am not my addiction. The message of the film The Anonymous People is that we need to see people with drug and alcohol problems as people first, not as “addicts” or “alcoholics,” and to emphasize the importance of recovery as a process of efforts to change behavior that is on-going. “I am a person in long-term recovery from alcohol abuse” feels more positive than “I’m an alcoholic.”
Behavioral economics: As we learned from the book Thinking Fast and Slow, people don’t make decisions using logic and reason nearly as much as we think we do. Emotions often drive decision-making, because they work faster (being more closely connected to our instincts) and require less effort than using the the more highly evolved but slower processes of our logical pre-frontal cortex.
The Gut Brain. There are more serotonin receptors in the gut than in the brain, meaning that truly, “food determines mood.” We’re just beginning to understand what this means. The standard American diet promotes diabetes, obesity, inflammation, high blood pressure, and depression. You are what you eat, so follow Michael Pollan’s guidance, and eat food, mostly plants, not too much.
I will be writing more about many of these topics in the future. Meanwhile, I’d love to hear your thoughts about what are the most important new ideas affecting our health, mental health, and overall well-being.