Everyone has a place in the world. They don’t always like it – but they have a place none the less. And everyone arrived ‘where they are’ because of a complex combination of circumstances, choices and characteristics that all contribute to whatever it is that makes us who we are.
I am occasionally asked why I chose to become a mental health nurse. The usual answer I give (the shorthand version, if you like) is that I find mental health work (either as a practitioner or a trainer) both fascinating and rewarding. But actually there’s more to it than that.
To really understand why I drifted in to mental health care you’d need to know how a number of very different causative factors came together to bring me to that point. These include…
Volunteering as a teenager in an elderly care day centre (primarily because I was bored);
Not being talented enough to realise my teenage dream of becoming an actor;
Leaving home in search of a theatrical career and becoming homeless;
Living either on the streets or in hostel accommodation during my early twenties;
Eventually finding employment in the hostel I lived in (Lincoln YMCA);
Being ‘thrown in at the deep end’ with a number of mentally disturbed hostel residents;
Witnessing a woman jump to her death from a multi-storey car park near the hostel;
Subsequently taking a series of care assistant jobs in mental health, elderly care and learning disabilities services;
Meeting and becoming engaged to a care assistant who was about to begin nurse training;
Following her into nurse training (to be together);
Entering mental health nursing (mainly because I didn’t fancy adult nursing).
So you see, although the shorthand answer is that I love mental health work the actual answer includes many more causes than that alone. In truth I drifted into this field as much by chance as anything else. I would never have imagined myself doing anything like this when I was at school. And that’s how it is for most people.
There is no single cause!
Of course we all understand this when we think it through. Almost nothing significant happens because of a single event. There are always other underlying conditions that make it possible. Unfortunately though we all tend not to think it through quite so often as we should.
Continuing for the moment with the theme of mental health I’d like to pose a question….
What causes schizophrenia?
If you were to ask 100 people that question you may not get 100 different answers but you’d find that a number of contradictory themes kept cropping up over and over again. Let’s look at two of these themes….
“It’s a biological brain disease”
This means that schizophrenia (the tendency to experience hallucinations, delusions and thought disorders) is caused by something in the person’s body or brain. Different people will offer slightly different versions of this explanation – some will talk about genes and heredity whilst others will attribute schizophrenia to chemical processes resulting from substance use or dietary processes. What brings them all together is the unifying belief that hallucinations, delusions and thought disorders are caused by physical issues and so physical remedies are required. The ‘single cause’ is assumed to be biology.
That’s why doctors prescribe medications for people diagnosed with schizophrenia. It’s a chemical remedy intended to ‘fix’ or ‘manage’ a chemical problem.
“It’s caused by social exclusion”
People who believe this will not focus upon trying to alter the workings of the brain and/or body. They’ll concentrate their efforts upon more social, cultural and environmental variables and try to solve the problems service-users experience through interaction and coping skills development.
There is extremely good evidence for this sort of intervention and it really can work wonders.
The problem with both of these approaches, at least in my opinion is that they are too superficial and self-limiting. They both fall into the trap of the ‘single cause fallacy’ and because of this they are both essentially inadequate explanations. There is more to schizophrenia than just biomedical (nature) or socio-cultural (nurture) causes in isolation and until we abandon single cause explanations and explore the totality of causes we’re doomed to fail . More significantly we’re also doing our service-users a major disservice. I’ve explained more on this topic in my commercial blog:
Why I’m not ‘anti-psychiatry’
But that’s not really the topic of this entry – it’s just an example. Another example comes from the world of politics and the ‘single cause’ explanations that politicians of all stripes would like us to accept. For example…
A little over a year ago the United Kingdom (or at least England) was blighted by riots in several major cities. The reasons for this seem complex and almost certainly include (among other things):
Poverty and alienation;
An increasing sense of hopelessness;
Disregard for the rights and welfare of others;
Lack of cohesion within the larger community;
The psychological need of desperate people to scapegoat ‘the other’.
The leader of the Liberal Democrats, Nick Clegg famously predicted that there would inevitably be riots if the Conservatives won the 2010 general election. He understood the link between the ruthless capitalism of Conservative ideology, widespread poverty and the desperation of the masses all too well.
And yet both during and immediately after the riots (and after he’d led his party into coalition with those same Conservatives) he conveniently forgot all that in favour of the party line about ‘lack of respect’ and ‘mindless yobs’. Even when directly asked to comment upon any other possible causative factors he declined to do so.
Whenever someone tries to convince you of a ‘single cause’ for a serious event ask yourself :
What aren’t they considering?
The more we allow ourselves to be drawn into the ‘single cause fallacy’ the more vulnerable we become to manipulative arguments from others, be they politicians, internet bloggers like me (yes I can fall into the same traps as everyone else) or the bloke ‘holding court’ in your local pub.
So the next time someone tells you that disabled people are all benefit scroungers who don’t want to work or that the global economic crisis was caused by the UK’s previous prime minister stop and think for a moment before you fall victim to their particular brand of superficiality.
What aren’t they telling us?
Of course, as another blogger reminded me earlier this week, ‘We don’t know what we don’t know’. It can be difficult to work out just what the other person isn’t telling us because, by definition, we don’t know. But there are a few questions you can ask yourself that may help:
If this was a debate what would the other speaker have said?
If I had to explain this what would I have said?
Does this explanation fit with what I already know about the world?
The trick, as ever, is to think for ourselves. The single cause fallacy isn’t only widespread – it’s dangerous too.
About the ‘Fallacies’ series
The ‘Fallacies’ project was built up from a series of instalments that first appeared online during the summer of 2012. It is republished as part of a larger set of changes intended to rationalise the contents of several different blogs into just 2. The other remaining blog focuses mainly upon social care and mental health related issues. It can be found at http://www.TheCareGuy.com
Filed under: Fallacies, mental health | Tagged: conservative, Lib Dem, Liveral Democrat, mental health, nick clegg, riots, YMCA | 5 Comments »