An apple a day keeps the doctor away, according to the old saying. Eating fresh fruit regularly is certainly associated with good health, but failing to eat fresh fruit regularly is not a causal factor in many illnesses. It is certainly possible to remain healthy without eating any apples at all. So the idea that eating an apple a day will actually prevent illness is foolish and quaint. We smile at it.
In mental health, though, similar foolish ideas seem to be more and more common…
Christopher Columbus
Before exploring this further, you have to understand something about Christopher Columbus. And who better to help you understand it than Alone, blogging as The Last Psychiatrist (and the latest addition to my blogroll):
The Last Psychiatrist is a weblog about our failure to be critical. Why do we practice the way we practice? How do we know what we know?
Read about Christopher Columbus before returning here to find out what apples and explorers have to do with CBT:
If you’ve just read that, then you should now understand:
What matters here is why such a meaningless debate is the one most people are possessed by; yet the other, more urgent one– are we even being taught anything correctly in school?– passes without even a thought.
The reasons being that:
…the debate is not about the the accuracy of the information, but the presence or absence of a political biases.
We got what little information we have…from the same few sources; no wonder we don’t know anything, and we all don’t know the same things.
Mental health
In mental health, the equivalent of “an apple a day” or “Columbus thought the earth was flat” is the idea that living your life in a “good” way can prevent mental illness. No one seems to question this foolish idea.
There is some disagreement about the precise meaning of “good”, though. In what ways can being “good” prevent mental illness according to this growing myth?
Here’s one version from the Mental Health Foundation: How to look after your mental health It recommends that you should be good in ten different areas, and one of them includes, perhaps predictably, “lots of different types of fruit and vegetables.”
And here’s another from the BBC’s headroom site, “a campaign to encourage you to look after your mental wellbeing”, where the Mind Spa section provides you with questionnaires, records your details, and offers advice on living your life in a “good” way in seven categories that include Food and fitness.
Another version at Mindapples, still not questioning the myth, invites you to contribute your own ideas. You can take the Mindapples test and contribute to the project: “What’s the five-a-day for your mind?”
CBT
This idea has invaded CBT, too. Have some therapists abandoned psychotherapy entirely, and replaced it with “good” ways to live your life?
It’s certainly good for psychotherapists to help their patients change damaging behaviours, and even perhaps to teach life skills when a lack of specific skills is having an adverse effect. But life skills and “good” ways to live are not psychotherapy. They are neither prevention nor cure for mental illness.
If you go to a therapist expecting CBT, but all you get is life skills classes and advice on living your life in a “good” way, then you should understand that these things are not CBT. They are not any kind of psychotherapy. They are no more than a modern version of “An apple a day keeps the doctor away”.
I have similar issues with the ‘happiness’ movement. In basic interpretations, the message people take away is that they simply have to think themselves happy and it shall be so.
HP
Hi cbtish, thanks for posting about Mindapples, even if you’re disappointed that we’re not ‘questioning the myth’.
I’m not really trying to perpetuate – or question – any myths though, just give people a space to talk. I wouldn’t claim to be qualified to tell anyone what they *should* do, so if I’m peddling a particular story it’s probably ‘what works for one person doesn’t necessarily work for everyone’. You may disagree though, but that’s fine – come and join the conversation!
I do think it’s unhelpful to caricature the various preventative models (in physical and mental health) as attempting to replace curative therapies though. That’s obviously not their purpose. Eating an apple a day doesn’t cure cancer, any more than talking to your friends cures depression. But that doesn’t make eating an apple or talking to your friends ‘foolish’, or devalue hospitals or psychotherapy.
And besides – who mentioned ‘mental illness’ anyway? We’re talking about mental health!
[...] focus on prevention within mental health in recent years. I like this approach myself (although not everyone would agree), but I wonder if there’s actually a third dimension to physical health: the [...]