Dr Bertie’s TEDx Talk 2024: The Myth of Mental Illness


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Here is the transcript of Dr Bertie’s TEDx Talk 2024. As is consistent with professional practice, all identifying information has been altered to protect client confidentiality.

The Myth of Mental Illness

I am a psychotherapist. It’s a great job, very interesting and fulfilling. Being a psychotherapist also gives me a front row seat looking at the inner canvas of people’s psychology. After sitting down for hours and hours listening to people’s psychological struggles, I learned something. Society has a skewed and archaic way of looking at mental illness, and that makes me angry. Imagine this, if I had panic attacks, and on top of feeling immense psychological distress, I had to carry the burden of worrying about being judged as broken and defective. Something about that feels very wrong to me. Here is why.

The medical model in psychology claims that mental illness is like physical illness, where because of some pathology or injury, the affected person deviates from some standard measure of “normality.” This premise paves a slippery slope to the flawed and stigmatizing conclusion that something is wrong with mentally ill people, that they are at fault, or weak, or abnormal, or inferior, or that they lack the moral fiber to fight an illness, the way our antibodies fight a virus.

Even though mental health stigma is being challenged in recent years, the remnants of shame live on in many.

Fortunately, there is a movement in psychology that challenges the validity of this medical model of mental illness. Gabor Mate, a New York Bestselling author and physician, has famously reframed the question of “Why addiction” to “why the pain?”

His view is that addiction is not the problem, it’s rather a solution to problems. He found that Addicts are people who suffer from trauma and so—their addiction is their way of self-medicating, to numb their profound emotional pain.

This view of looking at mental illness as a solution–no, let’s change the term mental illness now–this view of looking at mental health conditions as a solution, is consistent with my experience working as a psychotherapist. I find that mental health conditions are coping responses to trauma and other difficult life circumstances that bring about undesirable psychological consequences.

Let’s look at self-harm and suicidality. If you ask people why they cut themselves, they will tell you the physical pain lessens the emotional pain. If you ask people why they want to end their own lives, they will tell you they want to end the excruciating emotional pain. They want to feel that they are in control of at least ending their own suffering, and that there is a way out. There is logic and utility to these responses. No one judges taking an ibuprofen for a headache as stupid and weak. So, why do we do that to people with emotional pain?

But how applicable is this alternative, non-pathologizing explanation? Does it apply to other mental health conditions?

Let me share some of my clinical experiences to illustrate the function of a mental health condition. One of my patients, let’s call her Emma, Emma experienced depression in high school. With medication, she regained his everyday functioning, but her sad and empty feelings remained. As an adult, she actively looked for ways to change how she felt, by climbing up the corporate ladder, getting advanced degrees, collecting awards, picking up new hobbies, upgrading her wardrobe, all promising avenues but none made a real difference to how she deeply felt.

In therapy, the function of her depression became apparent. It was a way to temper down, or to “depress,” her complicated emotional pain. She was the golden child in her family. In order to maintain that status, she thought she had to hide parts of herself of which the family wouldn’t approve, whereby denying and ignoring her authentic feelings and thoughts. Unconsiously, this situation presented a no win situation and no resolution was possible: she either abandoned himself or risked being abandoned by her family. The agony and despair that came with this impossible dilemma was what her depression was recruited to mask: to numb her terrible feelings by feeling flat.

My other patient, let’s call her Charlene, presented her depression in a different way. Whereas Emma was a doer; Charlene was homebound. The luxury provided by her husband didn’t save Charlene from being plagued by a chronic empty feeling, the way Emma was. But different from Emma, Charlene was always tired, lacking energy or motivation to do things. Crippled by her depression, she felt useless, isolated and lost. She entered therapy hoping to find a purpose for which she could motivate herself to get out of bed. Though not having many friends, she had a brother who was very dear to her. When he left his day job to start his own business, Charlene promised to help. However, despite her conscious inclination, she would repeatedly procrastinate or forget to run errands for him. This created a huge rift in their relationship and made Charlene feel even worse about herself.

At first, neither Charlene nor I could understand the unconscious feelings and motivations behind Charlene’s resistance to helping her brother and her insistence on staying in bed. But then, we started talking about how she was given age-inappropriate responsibilities. Starting at 6, she would run errands for her parents in crime-infested nooks and crannies of her town, which terrified her. She would also cut and burn herself while cooking dinner for the family, and her parents would scream at her for making a mess. So, unconsciously as adult, as long as she stayed in bed and did nothing, she would be safe and out of trouble. She could also avoid feeling the rage from being exploited by her family back then, and the heartbreak that she wasn’t loved and protected like other children. Since no good choices were available, her psyche would rather lock her up in a bed-ridden depression, than to have her face painful feelings and risk her safety again.

These are not just Emma’s and Charlene’s stories. We’ll find this theme of “damned if I do, damned if I don’t” familiar, because it is in his story, her story, my story, and your story. While we don’t judge or dismiss a fever, we judge and dismiss feelings all the time: “Aww don’t cry,” “stop being angry,” “there is no need to be sad”–as if having feelings is a crime! To me, mental health symptoms are messengers to us that something needs our attention, but stigma is shooing and shooting these messengers left and right–to our very own detriment.

I think we can do better than that! Let’s start with us: be curious and listen with respect to these messengers so we can make the needed change to live a more fruitful, authentic life.

Thank you.