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An inclusive approach to mental health

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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For many years, the prevailing view among both cognitive scientists and philosophers has been that the brain is sufficient for cognition, and that once we discover the neural correlates of consciousness, we will be able to understand the workings of the mind. However, theorists such as Shaun Gallagher (2005), Evan Thompson (2007), and Lawrence Shapiro (2005) all emphasize that mentality is not something that happens passively within our brains, but rather something we actively do in and through bodily engagement with our surroundings. This shift in perspective has important implications for the way we treat psychological disorders such as schizophrenia.

 

Throughout the Western world, drugs are a primary mode of treatment and many assume that mental illness results from faulty brain chemistry. However, there is evidence that antipsychotic medications are not sufficiently effective in managing delusions and hallucinations (Pilling et al. 2002). In addition, anti-psychotic drugs may cause cerebral abnormalities (Moncrieff and Leo 2010), apathy, muscle stiffness, weight gain, and tremors. Also, by focusing narrowly on the brain, drug-centred approaches overlook the role of bodily processes. Once we acknowledge that the mind is fully embodied, this pushes us to seek treatment methods that target the whole body. For example, yoga, dance-movement therapy (DMT), and music therapy all have proven to help schizophrenic subjects re-inhabit their bodies and regain a coherent sense of self. 

 

Visceglia and Lewis (2011) found that adults with schizophrenia who participated in an 8-week therapeutic yoga program showed significant improvements in psychopathology and quality of life compared with controls. It appears that through the repeated execution of sequenced movements and postures, as well as breathing exercises and meditation, subjects forged more of a felt connection with their bodies and also began to feel more “at home” in their surroundings. Breathing exercises and meditation can help to make the body feel more familiar, increase sensitivity to subtle bodily sensations, and help bodily sensations, movements, and feelings to flow more naturally (Mehling et al., 2011, p. 7). This, in turn, can help to minimize hallucinations and feelings of bodily alienation.

 

Similarly, DMT centres on the use of movement to foster the integration of bodily sensations and emotions. Rohricht et al.’s research (2009) showed that body oriented treatment had a significant positive impact on subjects suffering from chronic schizophrenia. This intervention included dance movement psychotherapy, sensory awareness exercises, and tactile self-exploration. At the beginning of therapy, patients reported feeling detached from their bodies. After therapy, there was a clearer differentiation of movement, feelings of lifelessness diminished, and their ability to verbally express their bodily sensations had improved. Subjects developed an increased awareness of body boundaries and an enhanced sense of agency and control. Such evidence suggests that through body oriented psychotherapy, subjects were able to engage directly with their bodies, so that their self-experience became more unified and coherent. 

 

Like dance, music can serve as a powerful therapeutic medium for those who are unable or too disturbed to rely on verbal language. Improvising, playing, composing, and listening to music all are thoroughly embodied processes that address symptoms from the bottom-up and allow for emotional expression. The review conducted by Mossler et al. (2013), which includes eight studies examining the effects of music therapy on subjects with schizophrenia, indicates that it results in improved general and interpersonal functioning and a reduction in negative symptoms such as affective flattening and loss of interest. 

 

Such evidence suggests that by targeting mental issues from ‘bottom-up,’ by engaging emotions and bodily feelings, these body-oriented modes of therapy have great potential for alleviating symptoms and strengthening subjects’ sense of self. It is true that such treatments may take longer, and be more expensive than medication. However, such interventions may be our best hope for bringing about lasting improvements insofar as they focus on the living body as a whole in order to treat a problem as a whole.

 

 
 
Michelle Maiese is Associate Professor of Philosophy at Emmanuel College in Boston, MA. Her research addresses issues in philosophy of mind, philosophy of psychiatry, and emotion theory.  She is the author of several books, including Embodied Selves and Divided Minds.

 

References

Maiese, M. (2015) Embodied Selves and Divided Minds. Oxford: Oxford University Press.

 

Gallagher, S. (2005). How the Body Shapes the Mind. Oxford: Oxford University Press.


Mehling et al. (2011). Body Awareness: A Phenomenological Inquiry into the Common Ground of Mind-Body Therapies. Philosophy, Ethics, and Humanities in Medicine 6 (6): 1-12. 


Montcrieff, J. and Leo, J. (2010). A Systematic Review of the Effects of Antipsychotic Drugs on Brain Volume. Psychological Medicine 40: 1409-1422.


Mossler, K. et al. (2013). Music Therapy for People with Schizophrenia and Schizophrenia-like Disorders. The Cochrane Collaboration, Wiley.


Pilling, S. et al. (2002). Psychological Treatments in Schizophrenia: Meta-Analysis of Family Intervention and Cognitive Behaviour Therapy. Psychological Medicine 32: 763-782.


Rohricht, F. et al. (2009). Ego-Pathology, Body Experience, and Body Psychotherapy in Chronic Schizophrenia. Psychology and Psychotherapy: Theory, Research, and Practice 82, 19-30. Shapiro, L. (2005). The Mind Incarnate. Cambridge, MA: MIT Press.


Thompson, E. (2007). Mind in Life: Biology, Phenomenology, and the Sciences of the Mind. Cambridge MA: Belknap Press.


Visceglia, E. and Lewis, S. (2011). Yoga Therapy as an Adjunctive Treatment for Schizophrenia: A Randomized, Controlled Pilot Study. The Journal of Alternative and Complementary Medicine 17 (7): 601-607.

 

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