“We have begun to medicalize emotions”

Francis J. Martinez He has a degree in Psychology, a Master's Degree in Clinical Psychopathology from the Ramón Llull University, a Master's Degree in Mediation Community from the Autonomous University of Barcelona and Master in Psychosocial Intervention from the University of Barcelona.

He currently combines adult psychotherapy in his private practice with teaching in the Master's of Online Clinical Practice of the Spanish Association of Cognitive-Behavioral Clinical Psychology (AEPCCC). He is also the author of articles on psychology in magazines such as Smoda "El País", Blastingnews and Psicología y Mente.

Interview with psychologist Francisco J. Martinez

In this interview we chat with him about how psychology has evolved, how the emotions from health and the way in which personal relationships and social phenomena affect our mind.

1. Has your conception of what mental health is changed since you became a psychologist, or is it more or less the same as the one you had during your university years?

The psychology major as I remember it placed great emphasis on understanding the mental health of people through through clear, reliable and decisive diagnoses that obviate the motivations for which the person goes to the psychologist. We soaked up manuals concerned with dissecting the symptoms and finding correct diagnoses with which we can work through appropriate techniques for this or that disorder. All this works. Clear. But he ignored that the person who approaches the psychologist worried about her mental health, usually tells you that she does not control her emotions. He is sad, angry, upset, demoralized... He suffers mentally.

I like to explain to patients that proper mental health is one that allows the expression of each and every one of our emotions. If we imagine that our mental health is an old radio with two buttons, the emotion would be what each of the channels is. If the button breaks, it will not be possible to tune in all the channels, one emotion prevailing over another.

The volume would be our second button. It would be the intensity of the emotion. Adjusting the volume following our own opinion is what will help us to be able to listen to our favorite programs at the desired volume. Going to therapy in many cases serves to discover that there are channels that we do not tune in or that perhaps we are listening to the radio too high or too low.

2. How do you think the way people relate to each other has an impact on their mental health?

Something that is quite mythologized is the reason why people come to the consultation. Some think that they are approaching in search of self-knowledge, of the reasons why they suffer mentally. Of course this is important, but at first what they usually ask for is help to integrate socially.

The way in which they relate to others fills them with dissatisfaction. They wish not to be seen or perceived as "outsiders." The starting point is that the mental is essentially relational and that a mind cannot be built in isolation from other minds. Since we are born it is what is close, the child's environment is what provides it so that it has a mind capable of facing the obstacles and the positive experiences that life offers us.

3. In research, it is very common to believe that psychological processes can be understood if they are studied. small parts of the brain separately, rather than studying the interaction between elements or phenomena social. Do you think that the branch of psychology based on the social sciences has to learn more from psychobiology and neuroscience than the other way around?

Studying mental disorders from the cerebral, the tangible, from psychobiology, neuroscience, can be very good. But leaving aside the mental, the influence of society, is hopeless. Explained in more detail. If what we seek is an understanding of the depression, the anxiety, panic, schizophrenia, in short, everything that we can understand as mental suffering, dissecting towards the "micro" (genetics, neurotransmitters) we will omit what makes us particularly humans.

In order to understand mental suffering, we must know what happens during our learning, what our affections are, our relationships, our family systems, our losses... All this is impossible to achieve if we want to reduce it to the interaction between neurotransmitters and the study of genetics. If we understand it from this perspective, we will be very lost. Thus we fall into an extremely reductionist vision of the human being.

4. In an increasingly globalized world, some people emigrate for the possibility of doing so and others out of obligation. In your experience, how does the migratory experience in precarious conditions affect mental health?

Those who emigrate do so with expectations of growth (economic, educational…). To a large extent, emigration is preceded by states of precariousness. For years I have been able to accompany people who emigrated with high expectations of improvement. Many of them had deposited years of life and all their savings to be able to break out of poverty and help their families.

Much of the work that psychologists and social workers must do is directed toward lowering previously high hopes. Many psychological theories link levels of depression or anxiety to discrepancies between idealized expectations and actual achievement. Arriving at the chosen destination and continuing to live in a precarious state, sometimes even worse than the starting state, is clearly a bad indicator for achieving proper mental health.

5. Do you think that the way in which migrants deal with suffering is different depending on the type of culture from which they come, or do you see more similarities than differences in that aspect?

I would say that there are more similarities than differences when it comes to coping with suffering. From mythology, migration is presented to us as a painful and even unfinished process. Religion with Adam and Eve or mythology with "the tower of Babel" explain to us the loss that the search for the "forbidden zone" or the desire for knowledge of the "other world" entails. Both one and the other search or desire end with unfortunate outcomes.

First of all, I consider the sentiments shared by those who emigrate to be “universal”. They live a separation more than a loss. Nostalgia, loneliness, doubt, sexual and affective misery design a continuum of emotions and experiences dominated by ambivalence.

Secondly, it is a recurring duel. Thoughts about returning cannot be avoided. The new technologies allow the immigrant to be in contact much more easily than before with the country of origin. In this way, the migratory duel is repeated, it becomes a recurring duel, because there is excessive contact with the country of origin. If not all migratory experiences are the same, we can accept that in the vast majority all these assumptions are given.

6. Increasingly there is an increase in the consumption of psychotropic drugs throughout the world. Given this, there are those who say that this medicalization is excessive and that there are political motivations behind it, while others they believe that psychiatry is unfairly stigmatized or they maintain intermediate positions between these two positions. What do you think on the subject?

Psychiatry and pharmacology are of great help in many cases. In severe mental disorders they are of great help. The problem we are currently facing is that we have begun to medicalize emotions. The sadness for example, it is usually mitigated through psychotropic drugs.

“Normal sadness” has been pathologized. Let's think about the loss of a loved one, the loss of a job, a partner or any day-to-day frustration. That psychiatry and pharmacology take care of this "normal sadness" treating it as a mental disorder makes the message that arrives something like “sadness is uncomfortable, and as such, we must stop experiencing it”. This is where the pharmacological industry acts perversely. Much of their motivation seems to be to make huge profits through the medicalization of society. Luckily we have great psychiatry professionals who are reluctant to over-medicate.