Marta (Madrid, 41 years old) attended the psychologist when his mother was diagnosed with a terminal illness. The (public) hospital had offered her and her family a Psychological assistance which he finally decided to make use of. “It was disgusting, naturally,” he explains. In the session with the psychologist, she continues, “she asked me how I was, how I was coping, what my fears were and my possible questions about the future absence of my mother … Although I left there calmly, and with another closed appointment, after a few hours I realized that everything I had talked about with the psychologist had already been verbalized by me before with my inner circle. And I decided that, for me, continuing to do the latter was a much more effective path. How to feel supported by my Family And my friends were much more important than feeling supported by a stranger. The next day I called to Cancel the appointment. I’ve never been back to a psychologist.”
In the antipodes of Marta, María (figurative name, Madrid, 56 years old), a teacher, her psychoanalyst told her, four years after she started going to therapy, not to come back, that he could not do anything more for her. “A shock,” he says. “I was left as an orphan. The psychoanalysis was in my routine, an hour I waited for the whole week.” Come on, instead of a means, it had become an end, something that his therapist probably detected. Of course: financially speaking, Maria came out on top, specifically, 75 euros per week, those that cost each consultation (in Spain the average in 2020 was 51.00 euros / hour, between the lowest rate, 45.25 euros / hour in Andalusia and 62.00 euros / hour in the Balearic Islands, according to research by mundopsicologos.com).
It is not that Maria’s salary was to shoot rockets, but it is that she had no choice but Pay the psychologist out of pocket. According to data from the Ministry of Health, In the Spanish public health system there are six of these professionals per 100,000 inhabitants, a real joke, especially when compared to Europe, where the Average is 18. In total there are collegiate 37,611 psychologists, according to the INE, of which only 3,000 work in the public sector. So few, that everyone who can afford it goes directly to a private one.
Who goes to the psychologist? According to the CIS barometer on mental health carried out in 2021, who self-identified as high social class were those who went to the psychologist or psychiatrist to a greater extent, specifically, since the beginning of the pandemic, 8.3%, compared to 5.9% of those who aligned themselves with the most modest classes. Of course, if we are to believe the Annual Report of the National Health System (SNS) 2020-2021, there were few, since, according to that document, the 29% of Spaniards suffers from any mental health disorder. What’s wrong with us? 74.6% of this percentage would suffer from anxiety, 60.7% insomnia and 41.9% depression.
But not only that. We also go to the psychologist, like Elena (figurative name, Madrid, 35 years old) to solve issues that are not as important as the previous ones: “It’s not that I was at a very critical moment, let’s say I needed find myself. But I began to get the impression that the solutions to my problems could be found by me, or by talking to a friend. There was also the stigma of defeat. It was a problem for me to admit to myself that I was going to the psychologist, so leaving him, after six sessions, was a relief. In some ways it was disappointing. I expected more advice, not having to be the one to open up. Also, I think opening up doesn’t always help…”
And if not, you can always splinter
If you can not afford a professional to help you can always disburse 1.72 euros per month, which is what it costs, with a prescription (normal contribution), a box of the famous Orfidal (50 tablets), the brand of Benzodiazepines best-selling in Spain. Here we have become so fond of benzodiazepines, (a psychotropic with many variants and dozens of trademarks) that the International Narcotics Control Board has pointed out to Spain how The country of the world where Consume legally in Greater quantity.
And so, a drug whose use is recommended for short periods of time – two, three weeks – in our country is taken, and with a prescription, often uninterruptedly and for years! And look, Orfidal can be scary, but it has some side effects that you laugh at some illegal drugs: it generates addiction, can induce amnesiaworsen depressive symptoms, masking suicidal tendencies… Or so his own prospect tells.
Is all of the above justified, the alleged epidemic of mental health disorders, the alarming figures of consumption of diazepames, lorazepames, clonazepames…? Or is it that we have forgotten how to deal with ourselves without external help (to which a study by Aegon seems to point according to which nine out of 10 Spaniards! consider that in the last year they have suffered some symptoms of depression and anxiety)?
For Antonio Cano Vindel, an eminence in the field, Professor of Psychology at the Complutense University of Madrid, president of the Spanish Society for the Study of Anxiety and Stress, what these data indicate “is that Something we are doing wrong When benzodiazepines are discouraged in clinical practice guidelines summarizing scientific evidence, countries such as Germany help consumers of these drugs Abandon your consumption applying techniques of cessation to drug addiction, while in Spain it is the most consumed psychotropic drug, and its consumption increases every year.” “Of course,” he adds, one of the mistakes we’re making “is Do not teach from school and at other stages of life to Managing stress and the problems of life, the anxiety and other emotions, so that when emotional distress arises, people feel sick, go to their health center where there are usually no psychologists, and doctors, who are overwhelmed and only have a few minutes to talk, prescribe benzodiazepines. without warning of its risks.”
The disturbing medicalization of normality
Further still, with a best-selling dimension, we would say, the controversial psychiatrist, researcher and writer is positioned. Allen Frances. In 2018 he published his book ‘Are we all mentally ill?’ (ed. Ariel) where he coined and analyzed the ‘medicalization of normality’ based, in his opinion, on psychiatric fashions, which he accused of generating a Overdiagnosis systematic mental illness. “Not all sadness is major depressive disorder as they would have us believe. Not all worries are a generalized anxiety disorder, “he complained, in an interview with ‘BodyMind’, where, as in his book, he blamed the Pharmaceutical to be an interested party in the vertiginous rise of diagnoses of depression or anxiety.
Eye, he accused the pharmaceutical companies, but not only them. Frances also said that the redefinition, as a mental disorder, of experiences that were part of everyday life “has been very useful for some people who feel Comforted by having a diagnosis and stop feeling confused, alone and condemned to suffering.” And he warned that many of them “are diagnosed by Temporal conflicts that would probably get better on their own without the need for drugs.”
The (new) self-help boom… that doesn’t help
Those ‘instruction manuals of yourself’ that are today the books of self-help move, only in Spain, around EUR 30 million per year, 10% of the business in the non-fiction book category. With the pandemic, sales of this type of literature skyrocketed, as expected. In fact, according to a study by Idealo, the demand for self-help books reached increase by 512% during that time. Blessed are the gurus.
Cano Vindel believes that self-help is part of an explosion of ‘grandmother’s remedies’, businesses that from their point of view arise as a response to that ofMental health care, “in the form of self-help books, therapists without qualifications, youtubers, coaching specialists, sellers of permanent happiness, etc., as an alternative to the treatment of emotional and mental health problems.”
For Edgar Cabanas, psychologist, researcher at the University Camilo José Cela and at the Center for the History of Emotions of the Max Planck Institute in Berlin, author together with Eva Illouz From ‘Happycracy: How science and the happiness industry control our lives’ (Paidós), the obsession with constant analysis and scrutiny of oneself that characterizes our current society “is symptomatic of a widespread discourse on happiness that promotes the belief that the welfare and the sufferingthe success or the failure, health and disease Depend on chiefly of each: of willpower, personal choice, particular effort and individual change. We direct the focus to our interior because we believe that it is where the cause of our problems lies, as well as their solution. However, this is wrong, and although at first it seems that making our happiness depend on ourselves is a way to empower ourselves, the irony is that it makes us more Vulnerable, because it leaves us no choice but to blaming ourselves by all forms of frustration, anxiety or dissatisfaction“.
In the same vein, the apocalyptic discourse of Marian Donner in ‘Manifesto against self-help’ (Dome). “The problems have been privatized,” he says. And he explains that “what the industry of the self-help offers is nothing more than a lot of Tricks, Mattresses and ‘Tips of the Day’ that teach you to endure more. Everything for you to participate better in this game and forget how incomprehensible the world really is. So that you learn to manage your anger and your fears while enduring the unbearable.”
Cheap courses and expensive retreats to learn happiness
“For only 180 euros. Learn the techniques of meditation and conscious movement to reduce stress, anxiety, improve mood and manage emotions” (let’s see, if it is true that you learn all those things for so little money, psychologists and psychiatrists should all stay unemployed now). Another of the great trends in terms of remedies against dissatisfaction is to fill the free time of Courses -face-to-face or online- neurolinguistic programming, mindfulness, meditation, personal growth or Kundalini yoga… And if you really handle pasta you will undoubtedly be seduced by the fabulous universe of luxury retreats, where you will do detox tourism, When you arrive at your destination they will stay with your mobile, and instead of wifi, as in the Mandarin Oriental in New York, you will undergo meditation sessions, massages, relaxing baths with shungite (a mineral that, supposedly, protects from electromagnetic radiation) …
All this network of Remedies against the psychological distress ranging from the Orfidal to 1.75 euros a box to the 4,800 euros that can cost you a week of retreat in an acquaintance luxury hotel in Mallorca, has ended up becoming an industry that, explains Edgar Cabanas, “feeds on widespread malaise and offering us simplistic and individual solutions to problems that are really neither one nor the other. In the society of immediacy we not only want quick solutions to our discomfort, but we believe that such solutions exist.” However, in the best of cases, explains the expert, the only thing that industry offers us are “patches for those problems”, and at worst, “they divert our attention from where we really need to focus: on the conditions that generate and maintain these problems. However, if despite all the studies, data and knowledge we have about it, we continue to believe that there are easy, quick and individual solutions to problems that are actually complex and of social origin, the only thing I can think of is to sayA We believe it because it’s what we want to hear, even if it’s not what we want to hear.”
Are we looking in the wrong direction?
Of course many psychological problems need treatment, who could deny that. What the experts consulted are suggesting is simply that there is no action on what should be acted upon. Where Cano Vindel sees the need imperative of prevention and emotional training, Edgar Cabanas focuses not on the individual, but on the social: “Mental health is, mainly, a social problem. Social in at least two senses: that the mental health of each individual is a problem that affects society as a whole and that mental health problems (such as anxiety, depression or stress) have a social rather than an individual cause. It is no coincidence that the increase in aspects such as job insecurity (whose relationship is well established) or economic uncertainty have been accompanied by an increase in depressive symptoms and a decrease in well-being at a generalized level”.
The greater attention we currently pay to mental health should make us focus on these social determinants, explains Cabanas, since otherwise, “we will fall into the trap of pathologize, medicalize and individualize the Structural problems for a reductionism which in practice stigmatizes and holds people responsible for their suffering, which is counterproductive.” In the end, maybe what we have to do is agree with the breaker Marian Donner that “what we need are not pills, yoga or gratitude journals, but to realize that we are not the problem. If you feel like you don’t fit into the world, he said. Virginia Woolf, Maybe you shouldn’t ask yourself what problem you have, but what problem the world has.” Well, what problem do you have, son?