Making the World Go Away, and How Psychology and Psychiatry Benefit

Abstract

This chapter is based on two propositions. The first is that if we are ever to de-medicalize misery, then both the impact of people’s environments and their life experiences, as major causes of emotional distress, and the social significance of these connections will have to be made more prominent. The second proposition is that both psychiatry and clinical psychology so avoid giving prominence to people’s contexts in their theory, research and practice that we might reasonably ask why. Are they acting in accordance with evidence, has research demonstrated that life experience is not very important or, given what we know of the links between avoidance and fear, are psychiatry and clinical psychology actually rather fearful of context? This matter can be settled quickly. The evidence that what has happened and is happening to people in their lives plays a major role in creating various forms of emotional distress and behavioural problems – including psychosis – is very strong (Bentall, 2003; Read et al., 2005; Stoppard, 2000; Tew, 2005; Wilkinson & Pickett, 2009). As Bentall (2003) and Falloon (2000) have pointed out, this evidence is stronger than any we have for genetic or biological causes. So, if context is not at the forefront of psychiatric and clinical psychological theory and practice, then the avoidance is likely to be associated with something other than neutral presentation of evidence.