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Comparing Mental Health Client and Mental Health System

Ron Unger, coordinator for MindFreedom Lane County, compares a distressed client and a distressed mental health system. There are many similarities. Ron is a full time mental health counselor in Eugene, Oregon, USA.


Mental health system safety behaviors

by Ron Unger

Ron UngerIn an attempt to control their anxiety, people will often avoid situations that trigger their anxiety, even when these situations do not represent an objective threat. An unfortunate “side effect” of this strategy is that people who use it fail to find out that they could actually manage these situations and learn how to calm themselves while in the situations. Cognitive therapists label these acts of avoidance as “safety behaviors,” and a major part of therapy usually consists of getting clients to experiment with dropping these behaviors in a controlled way while thinking more objectively about the consequences of them.

It is, however, not just “clients” who get tricked into using safety behaviors. A good case can be made that the mental health system as a whole frequently acts out safety behaviors that are detrimental to both clients and to society as a whole. One of the most controversial areas to consider in this respect is the use of neuroleptic (often called “antipsychotic”) medications to treat clients long term.

Comparison of client safety behavior (avoiding social situations) with possible mental health system safety behavior (insisting on long term neuroleptic use.)



ClientMental health system
Believes experience “proves” that the safety behavior is necessary, rather than noticing that this is just one possible interpretation of past experience.Believes experience “proves” that the safety behavior is necessary, rather than noticing that this is just one possible interpretation of past experience.
Jumps to conclusion that safety behavior should be continued long term based on short term evidence (leaving & avoiding social situations results in anxiety reduction and feeling better.)Jumps to conclusion that safety behavior should be continued long term based on short term evidence. (putting client on neuroleptics reduces current symptoms & people around client are happier.)
Experiences long term negative consequences to the behavior (social isolation results, and client fails to learn that social situations and their fears of those situations could be managed successfully).Experiences long term negative consequences to the behavior (negative brain and health effects, including mortality, and system fails to learn that client may recover more successfully without medications).
Long term negative consequences of the safety behavior are attributed to the threat that the safety behavior was intended to avoid (client blames the dangerousness of social situations, or the intensity of their fears, rather than their decision to practice avoidance.)Long term negative consequences of the safety behavior are attributed to the threat that the safety behavior was intended to avoid (client stagnation or deterioration is blamed on the “mental illness” rather than possibly due to the decision to rely on neuroleptics.)
Interprets temporary re-emergence of the original problem when safety behaviors are interrupted as proof safety behaviors should be continued indefinitely (sees anxiety and panic that happens when does go to social situation as proof that he/she cannot handle them.)Interprets temporary re-emergence of the original problem when safety behaviors are interrupted as proof safety behaviors should be continued indefinitely (sees symptoms that emerge when client stops medications as proof client cannot learn to manage a non-medicated state of mind.)
Client is long term victim of strategies intended to protect him/her. 
Client is long term victim of strategies intended to protect him/her (though mental health system and society also suffer from less success & higher social burden.


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Peter Lehmann, editor, author, psychiatric survivor activist

Peter Lehmann of Berlin, Germany serves as one of the MindFreedom International representatives with the United Nations, and is a long-term supporter of MindFreedom campaigns and activities. Peter is a psychiatric survivor who has worked passionately for decades in Germany, Europe and internationally with a variety of groups for significant change in the mental health system. Peter is editor and publisher of a variety of books challenging human rights violations in the mental health system and promoting alternatives. His most recent book (co-edited with Peter Stastny, MD) is called "Alternatives Beyond Psychiatry." This book provides chapters from 61 leaders in changing the mental health system, and is available in the MindFreedom Mad Market.
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