Francisco J. Martinez: “We have begun to medicalise emotions”
Francisco J. Martínez has a degree in Psychology, a Master’s degree in Clinical Psychopathology from the Universidad Ramón Llull, a Master’s degree in Community Mediation from the Universidad Autónoma de Barcelona and a Master’s degree in Psychosocial Intervention from the University of Barcelona.
She currently combines adult psychotherapy in her private practice with teaching in the Master of Online Clinical Practice of the Spanish Association of Clinical Cognitive-Behavioral Psychology (AEPCCC). He is also the author of articles on psychology in journals such as Smoda “El País”, Blastingnews and Psicología y Mente.
Interview with psychologist Francisco J. Martínez
In this interview we talk to him about how psychology has evolved, how emotions are managed from health and how personal relationships and social phenomena affect our mind.
Has your understanding of mental health changed since you became a psychologist, or is it more or less the same as it was during your college years?
The career of psychology as I remember it put great emphasis on understanding the mental health of people through clear, reliable and determining diagnoses that obviated the motivations for which the person goes to the psychologist. We soaked in manuals concerned with dissecting the symptoms and finding correct diagnoses that we could work with using techniques appropriate for this or that disorder. All this works. Of course it does. But it was obvious that the person who approaches the psychologist uneasy about their mental health, usually indicates that they are not in control of their emotions. He’s sad, angry, upset, demoralized… He suffers mentally.
I like to explain to patients that good 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 that which comes to be each of the channels. If the button is broken, you can not tune all channels, prevailing an emotion over another.
Volume would be our second button. It would be the intensity of the emotion. Adjusting the volume according to our own opinion 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 we don’t tune in to or that we are perhaps listening to the radio too loud or too soft.
How do you think the way people relate to each other impacts their mental health?
Something that is quite mythical is why people come for consultation. Some think that they come in search of self-knowledge, of the reasons why they suffer mentally. Of course this is important, but at first they usually ask for help to integrate socially.
The way they relate to others fills them with dissatisfaction. They wish not to be seen or perceived as “strangers”. The starting point is that the mental is essentially relational and that a mind cannot be built in isolation from other minds. From birth, it is the child’s environment that provides him or her with a mind capable of coping with the obstacles and positive experiences that life throws at us.
3. In research it is very common to believe that psychological processes can be understood by studying small parts of the brain separately, rather than by studying the interaction between elements or social phenomena. Do you think that the social science-based side of psychology has to learn more from psychobiology and neuroscience than the other way around?
Studying mental disorders from the brain, the tangible, from psychobiology, neuroscience, can be very good. But to leave aside the mental, the influence of society, is hopeless. Explained in more detail. If what we are looking for is the understanding of depression, anxiety, panic, schizophrenia, in short everything that we can understand as mental suffering, dissecting towards the “micro” (genetics, neurotransmitters) we will omit that which makes us particularly human.
In order to understand mental suffering, we must know what happens during our learning, what are our affections, 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 point of view, we will be very lost. We thus fall into an extremely reductionist view of the human being.
4. In an increasingly globalized world, some people migrate because of the possibility to do so and others because of obligation. In your experience, how does the experience of migration under 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 with poverty and help their families.
Much of the work to be done by psychologists and social workers is aimed at reducing the high expectations previously placed on them. Many psychological theories relate levels of depression or anxiety to discrepancies between idealized expectations and actual achievements. Arriving at the chosen destination and continuing to live in a precarious state, sometimes even worse than the one in which you started, is clearly a bad indicator for the achievement of good mental health.
5. Do you think that the way migrants deal with suffering differs according to the type of culture they come from, or do you see more similarities than differences in that respect?
I would say that there are more similarities than differences when it comes to dealing with suffering. From mythology, migration is presented to us as a painful and even unfinished process. The religion with Adam and Eve or the mythology with “the tower of Babel”, explain to us the loss that supposes the search of the “forbidden zone” or the desire of the knowledge of the “other world”. Both searches and desires end up with unfortunate outcomes.
Firstly, I consider the feelings shared by those who emigrate to be universal’. They live a separation rather than a loss. Nostalgia, loneliness, doubt, sexual and emotional misery design a continuum of emotions and experiences dominated by ambivalence.
Secondly, this is a recurring duel. You can’t help but think about the return. New technologies allow the immigrant to be in contact with the country of origin much more easily than before. In this way, migratory grief is repeated, it becomes a recurrent grief, because there is too much 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 true.
6. Increasingly, there is an increase in the consumption of psychotropic drugs around the world. In the face of this, some say that this medicalization is excessive and there are political motivations behind it, while others believe that psychiatry is unfairly stigmatized or maintain intermediate positions between these two positions. What is your opinion on this subject?
Psychiatry and pharmacology are helpful in many, many cases. In serious mental disorders they are of great help. The problem we are currently facing is that we have begun to medicalise emotions. Sadness, for example, is often alleviated by psycho-pharmaceuticals.
The “normal sadness” has been pathologized. Think of the loss of a loved one, the loss of a job, a partner, or any of the frustrations of everyday life. That psychiatry and pharmacology take charge of this “normal sadness” by treating it as a mental disorder makes the message that comes is something like “sadness is uncomfortable, and as such, we must stop experiencing it”. Here the pharmacological industry is where it acts in a perverse way. Much of its motivation seems to be the achievement of substantial profits through the medicalization of society. Fortunately, we have great professionals in psychiatry who are reluctant to over-medicate.