The Problem about Chemical Imbalances in the Therapy Room

The term "depression" or any other psychological disorder is becoming more and more prominent in today's society. A century ago, the concept about mental health is almost unheard of, and it started taking the limelight over the years. Now, many of us are relatively familiar with the term "mental health". And thanks to COVID-19, many are learning that its okay to talk about mental health and take steps to take care our mental health.

Having said that, mental health still struggles with a "bad reputation" (i.e., mental health stigma). We cringe when we talk about our vulnerabilities/struggles, we suppress unpleasant emotions and tend to portray our best self in everyday life. Whenever we fail to do any of those, we tend to be critical towards ourselves and make sure that we work harder to hide our flaws or continue persevering through the deep dissatisfactions we've always felt (i.e., suck it up). In contrast, we become compassionate to people who struggle with physical health related difficulties. For instance, we'll give up our seats to the handicapped. We can obtain Medical Certification (MC) from doctors to excuse us from our current duties to recover from sickness.

The structural system that we live in (i.e., at home/school/work) is able to better recognise and support physical health needs more than mental health.

Indeed there is still a lot of work that needs to be done to remove mental health stigma, but we shouldn't minimize the progress that's being made thus far. After all, more people are becoming receptive in seeking for mental health intervention thanks to the years and years of mental health awareness campaigns- improving mental health literacy and encourage help-seeking behaviors.

Over the years, I've noticed that clients are becoming more knowledgable of their own mental health condition, and perceiving it as an issue relating to chemical imbalance. Indeed studies have shown that mental health and chemical imbalances in our brains affect one another. The problem comes when we attribute our mental health issue solely on chemical imbalance- When we reduce our very complex mental health problems to merely just an issue of chemical imbalance, then the only viable solution will be to address the chemical imbalances in our brain (which unfortunately can't be found in the therapy room). Naturally, the only method to address chemical imbalances will be medications. Bear in mind that psychotropic medications do not cure mental health disorders; they help in controlling symptoms and keeping individuals functional. Our body can also quickly build tolerance to these medications if nothing else changes in our lives. It's like trying to lose weight - if we want to lose weight sustainably, we have to change our lifestyle and diet instead of plain exercising.

Apart from being confronted with limited interventions, the word "chemical" in itself takes away one's accountability in exploring and addressing the underlying issue or beliefs. Even though "chemical" sheds off the self-stigma, it can be a guilt-free pass for individuals to victimise themselves in their struggles without feeling the need to reevaluate themselves (i.e., their beliefs, behaviors and environment). As a result, they often feel disappointed from therapy sessions because the intervention wasn't helpful and effective for them.

If chemical imbalance is the only underlying problem, then anything that falls short of addressing the chemical imbalances will be deemed as an ineffective treatment.

Psychotherapy is a collaborative effort between a client and therapist, hence the effectiveness of therapy also depends on the willingness/readiness of clients to embrace changes in their lives, including learning, unlearning and relearning themselves and the system they're surrounded with. Psychotherapy may not be able to restore balance in our brains and cure us from mental illness, but it helps clients to gain new perspective about their lives, roles and beliefs. When we can better make sense or grasp the complexity of our lives, we can then begin to give ourselves the freedom to unstuck in life. We need change (more than anything else) to get ourselves unstuck in life.

In the realm of psychotherapy, the journey in improving mental health does not end with merely attending psychotherapy sessions. In fact, it starts with stepping into the therapy room with an open mind- to be open in the process of deconstruction and reconstruction the self in a non-judgmental space. Psychotherapy begins to be helpful only if both the therapist and client are willing to participate the work of client's self-exploration.