Sunday, 3 June 2012

Ancient Trauma, Ancient Treatment

We often hear alarming reports that mental health issues and disorders are on the rise in our modern, stressful world. Yet as a mental health practitioner, I do not believe there is an increase in mental health disorders, we’re simply getting better at recognizing them.

Mental health disorders have been with us throughout history, but until the rise of psychological research in the last 100 or so years, they were often misinterpreted. One such case in point can be found in the Bible;

Mark 5:5 -
“And always, night and day, he was in the mountains, and in the tombs, crying, and cutting himself with stones.”

In the chapters from which this quote is drawn, Jesus is said to have heard of this man and his troubled state and had sailed with his companions
“unto the other side of the sea, into the country of the Gadarenes” to visit him. When Jesus asked the man his name the man replied “My name is Legion: for we are many”.

Jesus is credited to have exorcised the
“devils” who had possessed the man and cured him, yet credited this miracle to the compassion he had brought to the man in the name of the Lord. The story concludes with the once afflicted man returning to his home in Decapolis where he published writings describing how Jesus had restored him to a normal life.

If we examine this story with a modern mental health point-of-view, the man’s symptoms suggest something other than demonic possession. First, spending his days and nights
“crying and cutting himself with stones” suggests that the man was continually overwhelmed with emotional distress and had resorted to self-injury to momentarily give him relief from these distressing emotions. This is now commonly referred to as Non-Suicidal Self-Injury and is to be included as a V-code anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. It often accompanies other anxiety, depressive, and post-traumatic disorders.

Persons who struggle with self-injury most commonly use it to regulate emotions that can be overwhelming or – on the other end of the scale – absent. For those who cannot cope with their negative emotional distress, self-injury serves to focus their feelings in an external way (As one person put it;
“To make my outside look and feel like my inside”) And for those who struggle with a dissociative disorder, there are times that they feel so disconnected from their own bodies and reality that they begin to doubt if they are still alive. Feeling the pain and seeing the blood of a self inflicted injury allows them to return to their body and feel real again.

The full diagnosis of the man in the country of the Gadarenes will never be known, but how he identified himself may provide a clue: When asked his name he replied
“My name is Legion, for we are many.” This suggests very strongly that the man suffered from what is now known as Dissociative Identity Disorder. (This condition used to be called “Multiple Personality Disorder” but that term is no longer used)

According to the American Psychiatric Association, Dissociative Identity Disorder is most frequently associated with severe physical and/or sexual abuse as a child. This coupled with recent surveys that indicate that upward of 85% of those who self-injure also disclosed physical or sexual abuse as children, it would fit that the man from the country of the Gadarenes had experienced some serious abuse as a child that left him with post-traumatic symptoms.

The other piece of this story that aligns with the modern evolution of mental health practice is the main
“cure” that Jesus spoke of; Compassion. I believe that Jesus did more than cast out devils to help this man from the country of Gadarenes – I believe he was the first person who accepted this man as he was, who listened and was present with him instead of trying to judge, imprison, correct, or shun him as others had done prior to his arrival.

The story may be ancient, but the principal message of seeking to understand and to treat with compassion is one that every mental health practitioner can learn from.

Aaron D. McClelland, RPCc

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