All that I am, all that I ever was…

I am more than my mental health. I am more than my homelessness. I am more than any one aspect of me. I am Addy. And this is…

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Day 05: Nature, nurture, a mix, or something else?

Today’s prompt in the 30 Days of Mental Illness Awareness Challenge asks:

Do you believe nature, nurture, a mix, or something else has an impact on mental health?

__Biopsychosocial Model (CAUSES)

~ The Biopsychosocial Model I created for the ’causes’ of my mental health issues ~

I believe in the Biopsychosocial Model; which means I believe there are biological, psychological and social causes that impact on one’s mental health. We are, after all, just a combination of our unique and plentiful life experiences.

For those unfamiliar with the biopsychosocial model (BPS), it is a model that was created by psychiatrist George L. Engel in 1977 that posited a combination of biological, psychological and social factors play a significant role in human development. Which is in contrast to the traditional model of medicine that suggests every disease can be explained in terms of an underlying deviation from normal function; such as a pathogen, developmental abnormality or injury.

Earlier this year, as part of the Mi Recovery program I undertook, I wrote a post that shared my own Biopsychosocial Model in relation to the causes, symptoms and treatment of my mental health issues. This exercise was an enlightening experience and one I would whole heartedly recommend to others looking to understand the whys and wherefores of their mental health.


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Mi Recovery: Biopsychosocial Personal Treatment Plan (aka Self-Love!)

“The Biopsychosocial Personal Treatment Plan (aka Self-Love!)”

ME_468_AcceptingSelfLove

“A trigger is a recognisable risk that can produce or stir-up symptoms. Triggers can be preventable,”

In week one of the Mi Recovery series we built a biopsychosocial model of the causes, symptoms and treatments of our mental illness(es). Now, in week three, we look at how we can use this model to identify techniques and strategies in which we can combat our triggers.

Since my breakdown in 2007 I’ve done a lot of work in understanding, analysing and identifying my triggers. The manner in which I’ve been living (homeless, socially isolated, no support structure) has forced me to educate myself on what needs to be avoided in order to prevent catastrophic collapses of my mental health. Personally, I think it’s vital that anyone dealing with mental health issues spends some time identifying their triggers; for doing so gives you knowledge – and knowledge is power!

There is no easy way to identify a trigger; sometimes they are obvious, sometimes they sneak up on you, but with time, committment and support (I can’t express how important this latter factor is when it comes to dealing with triggers!) it is possible to produce a list of things that trigger you.

For example, the smell, taste and presence of Gin and Tonic sends me right back to the night I was assaulted in Adelaide ’07, whereas articles on emotional abuse, rape or victim blame mentality have the potential to dredge up a cavalcade of unwanted memories and emotions. There are also a plethora of songs I cannot go anywhere near, as well as people, places and movies that can send my spiralling out of control.

Whenever I am confronted with a trigger my gut reaction is to avoid at all cost! But, as I recently wrote about, triggers can be preventable. Approaching triggers from the biopsychosocial approach is one such way to identify potential new strategies and wrestle back the control that triggers have on our lives.

My Biopsychosocial Personal Treatment Plan (aka Self-Love!)

“Enjoyable and healthy activities that I do for myself, that decrease stress and symptoms, help my moods and help me manage the things that trigger my symptoms.

Personal Treatment can affect all aspects of the person – the physical/biological, the psychological and the social. Personal treatment is a holistic approach. Research says that people who have included Personal Treatment activities in their lifestyle are more likely to recover than those who rely on medication,”
~ Pat Deegan ~

The first step in applying the biopsychosocial model to our triggers is to work out which categories they each fit into; are they biological, psychological or social in origin?

For example, if your trigger is a place, food or medicine – then they are biological triggers. Whereas (in my opinion) loneliness, anniversaries and television series are psychological triggers and people, boarding houses and clothing are social triggers. However, how you categorise your own triggers is entirely up to you. There are no right or wrong answers, only those that are pertinent to your lived experiences.

This – utilising ‘The A-Z of My Emotional Triggers‘ and input from Meadhbh and Audrey – is what I ended up with:

__week3__Biopsychosocial Personal Treatment Plan-vert

Once you have identified biopsychosocial nature of your triggers, you can then use the same approach to brainstorm potential new strategies and lifestyle changes that could be implemented to help you manage them.

Again, there are no right or wrong answers as to how you approach this. In creating my list I decided to take a two-pronged approach, firstly by looking at things I could implement to help fight my triggers in general:

General Strategies

And secondly, by creating ideas specific to the more difficult triggers in my life.

Given my current situation, the most obvious trigger to tackle first was the person who has been – through no fault of their own – triggering me of late:

cats After this, I decided to take a look at the issues of songs, sleep (lack of) and the isolation/loneliness that plagues me so:cats2

And, as a final experiment, I decided to brainstorm strategies I could implement next Tuesday (being the 7th May and one of my “bad days“):

Specific Strategies 2

A few notes on the above tables:

  • All text in black is specific to me.
  • All text in purple is specific to Meadhbh.
  • All text in orange is specific to Audrey.
  • Some of the ideas in the ‘Strategies & Lifestyle Changes’ table may seem extreme to others (e.g. is self-harm really a viable treatment option? is leaving Wodonga really something that would help deal with my triggers? is it really possible for me to give myself comfort?) but, like I said, they are pertinent to me.
  • Some of the ideas overlap as I believe they fit into multiple categories (e.g. ‘tell her about the person she reminds me of’ or ‘face head-on’)

How the Biopsychosocial Personal Treatment Plan could help…

In all honesty, given my current mood, I’m still processing this approach to dealing with triggers – hence why I haven’t explained it all that clearly (sorry!) - so if you have any questions about this activity or how I’ve applied my triggers and strategies, don’t be afraid to ask.

However, I do believe it is a worthwhile activity to undertake. In creating the above lists I have identified hitherto unseen strategies that could help in my ongoing battle with triggers. The exercise has also helped me realise my current coping mechanisms (flee, run away, avoid) have done little to help but a lot to hinder my recovery.

In creating this list I have acquired knowledge over my triggers. Thus – once I’ve implemented some (or all) of these strategies – I will have power over them to.

Like I said, knowledge is power.

And power…is strength.


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Mi Recovery: The Biopsychosocial Model

At the culmination of the first week of Mi Recovery we played the warm-down ball game I have become so familiar with courtesy of the Hearing Voices Support Group. The moment Meadhbh suspected this was about to happen she squealed in girlish glee and prepared to intercept the rolled up Velcro (apparently the budget wouldn’t stretch to an actual ball) whilst I sighed in apprehension about having to say something worthy and meaningful about what I’d taken from the group; which was plentiful!

In approaching this series, I have decided to focus my weekly review around whatever I say during this warm-down game. Yesterday – and this is a direct quote – it was…

“…the biopsychosocial model.”

__Biopsychosocial Model

For those unfamiliar with the biopsychosocial model (BPS), it is a model that was created by psychiatrist George L. Engel in 1977 that posited a combination of biological, psychological and social factors play a significant role in human development. Which is in contrast to the traditional model of medicine that suggests every disease can be explained in terms of an underlying deviation from normal function; such as a pathogen, developmental abnormality or injury.

It was this model that we used to examine the theory of mental illness, and the causes, symptoms and treatments we (as individuals) have experienced on our life’s journeys.

As everyone’s experiences of mental illness are unique, our diagnoses (whether that is a Mood or Anxiety Disorder, a Psychotic Illness, a disorder resulting from alcohol/drug use or a combination of all four) are largely irrelevant. It is our life experiences that determine the course of our mental illness and the symptoms/treatments thereof.

The biopsychosocial model allows us to look at our lives from three perspectives in order to determine what events have been most relevant and, in turn, how we can use this knowledge to take control of our lives and find new paths on our road to recovery.

My Biopsychosocial Model

The core component of the biopsychosocial model is how it allows us to see how experiences through our lives our linked. As such, the model is approached from three viewpoints:

1. Causes

These are all the elements that can be/have been attributed to be the cause of our illness. For example, some people believe mental illness is genetic (which would be a biological cause) whereas others believe some of the root causes of mental illness are isolation (which would be social) and trauma (which could be considered psychological).

The following is my own personal BPS model of the causes of my mental illnesses. Yours, should you wish to write one, may look very different:

__Biopsychosocial Model (CAUSES)

Notes on my model:

  • Some may argue with my overlapping of homelessness as being biological, psychological and social. But having spent a large period of my life homeless, it was the only place that fit for me.
  • I have placed sexual minority in the overlap of psychological/biological because it has both a biological (I was born with it!) and psychological (if you have the password, I’ve explained this here) component.
  • The most contentious placement would probably be “abuse” which many at the group believed should be placed solely in psychological; I however believe it has a HUGE social component, hence my placement of it in the overlap.
  • If you have any questions regarding the items and their placements, don’t be afraid to ask! :)

2. Symptoms

The second viewpoint is ‘symptoms’, which are all of the symptoms we experience as a result of our mental illnesses. For example, the butterflies in the stomach or sweaty palms of anxiety (which would be biological), an increase in destructive voices (which would be psychological) or isolating behavior (which could be seen as a social symptom).

As with both the causes and treatment of our illness(es), these symptoms are unique to the individual. This is what I came up with when approaching my symptoms via the BPS model:

__Biopsychosocial Model (SYMPTOMS)

Notes on my model:

  • I have placed victim-blaming in the social/psychological overlap as I believe it has both of these components. The victim blaming we receive from others (social) and the blaming abuse victims place on themselves (psychological).
  • Over-indulgence relates to me as: excess alcohol consumption and over/comfort spending.
  • Personally, I believe self-harm begins as a psychological symptom that becomes a biological one, hence the overlap between these two factors.
  • The most contentious placement (and one which I mulled over for nearly two hours) was hypersexuality. Although many may see this as predominantly a social or psychological symptom, based on my own experiences of this state, it can become a biological one.
  • If you have any questions regarding the items and their placements, don’t be afraid to ask! :)

3. Treatments

One of my biggest (and longest standing) issues with the mental health and psychiatric industries is the “one-size fits all” approach to mental illness treatment. Everyone’s experiences of mental illness is unique, so why do people persist in believing that a singular course of action (be it medication, talking therapy etc.) will have the same effect on everyone?

Perhaps this is because I have (obvious) issues and grievances over how I’ve been treated by mental health services, perhaps not. Either way, treatments that may find their way onto your BPS are medication (being biological), talking therapies (being psychological) or support from family/friends (social).

In my personal opinion, one of the most important treatments (and one that is noticeably lacking from my own BPS) is nurture; the physical love we receive from those around us can have a significant impact on our ability to deal with the stressors and pain of mental illness.

I hope one day to be able to add it to my own biopsychosocial model:

__Biopsychosocial Model (TREATMENTS)

Notes on my model:

  • Given the MASSIVE overloading of psychological treatments, is it any wonder I am teetering on the verge of a massive psychological breakdown?!?
  • I believe distraction comes primarily from the distraction we can find on our own (psychological) and the distraction our friends/family can offer (social); hence the overlap.
  • HVSG stands for the Hearing Voices Support Group I attend (I was being lazy!)
  • I have included Meadhbh (and occasionally Audrey) as psychological treatments because when they’re behaving themselves, they can be a source of great comfort, support and love.
  • Mindmapping is a self-help therapy designed to interrupt and sooth triggers. I’ve been working with it for a couple of months now.
  • I’ve long believed endorphins can have a massively beneficial effect on managing mental illness.
  • The all-overlapping kimnyk is something I have discussed in my password protected pages and relates to a part of my sexual-personality that I’m not comfortable sharing in detail with the world due to the abusive, ignorant and damaging comments I’ve regularly received about it in the past.
  • Once again, if you have any questions regarding the items and their placements, don’t be afraid to ask! :)

Once you have written your own biopsychosocial model, how can you use it to assist in managing your condition and working toward recovery? By comparing the three viewpoints and identifying the wheres, whats and wherefores of your life, you can begin to see links between the symptoms, causes or treatments you may wish to explore further.

Personally, I have already realized the immediate need to begin balancing  how I treat my illnesses as the overload of psychological treatments is already becoming a cause – and, if a breakdown occurs – a symptom.

I’ve also noted (as I have in the past) the enormous detrimental effect my tendency to isolate myself during periods of distress has had on my mental wellbeing and recovery. I need to allow myself to believe that asking for help is not only acceptable but doesn’t mean I’m weak, worthless or not trying hard enough. This was hammered home yesterday afternoon, following the worst reaction to a trigger I’ve experienced in months!

As I continue with the Mi Recovery group and learn more about myself and my illnesses, I fully expect to refer back to my biopsychosocial model on a regular basis. Not only to add any new items but to use the connections I’ve highlighted to assist in my journey toward recovery, forgiveness and acceptance.

Perhaps you should try writing one of your own (in a supportive environment, of course) as you may be surprised by the things you discover.

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