'We are not enabling people to make informed choices about their health and wellbeing'

Ella Rhodes hears from Lawrence Howells ahead of his British Psychological Society webinar.

What will your webinar cover? 

The webinar outlines a novel approach to understanding and supporting people with emotional difficulties. It begins with an understanding of emotions as normal human phenomena that serve important functions in our lives, at the individual and societal level. It moves on to show how difficulties with emotions can be understood as emotional ‘traps’, that are maintained by problematic ways of responding to emotions, and how evidence-based interventions can help people get out of these ‘traps’. 

The approach is consistent with CBT and has been described as a 'developmentally attuned approach, which is transdiagnostic and, with its primary focus on emotions, is better targeted than traditional CBT for young people' by Professor Patrick McGorry (Professor of Youth Mental Health) and as a 'paradigm shift' by Professor Jamie Hacker Hughes (past President of the BPS). 

The approach enables psychologists and other professionals to provide evidence-based support and intervention to people without using the diagnostic model, psychiatric labels or terms of illness. It is a normalising approach that aims to encourage people to view themselves as fundamentally similar to others and to make changes to how they respond to emotions to bring about the changes they want in their lives. 

Developed primarily for young people, the approach works for clients of all ages. Participants will leave with an understanding of the need for alternatives to diagnosis and an introduction to this fresh approach and how it might support their work. 

How did you first become interested in this area?

Working as a clinical psychologist in a specialist youth service brought into sharp focus many of the dilemmas I’d struggled with for some time. The idea that some of the young people I was working with were ‘ill’ and somehow fundamentally different others didn’t fit with my experience. I could see lots of young people in a day, some of them struggling with exams, some of them feeling miserable, some of self-harming and others having had difficult experiences in life. Drawing a line somewhere along this breadth of experience to define some experiences as ‘normal’ and others as ‘symptoms of an illness’ didn’t seem to make much sense. It also made me focus more on how we define what was ‘well’ and on what I and others in my service were trying to achieve.

I strongly believed we should incorporate a developmental model into our work and that our aim had to be to support their development into adulthood. This involved, for example, supporting the development of self-efficacy, encouraging a positive self-identity, and fostering behaviours likely to lead to a healthy, fulfilling life. Using an unreliable, diagnostic model of illness, that disempowered and labelled people as different seemed increasingly at odds with this aim.

Over time, I moved away from diagnostic and illness models and instead turned to a model of emotion science that fit much better with models of cognitive, emotional, and social development. This is the approach I now take with everybody with whom I work, beginning with an understanding of how humans experience emotions and the kinds of emotional traps they can get caught in. 

My work since this time has focused on demonstrating that there are alternatives to the diagnostic model that we can use to understand ourselves and those with whom we work. I have written two books, the first for clinicians and the most recent a self-help book – Understanding Your 7 Emotions – designed to allow the general population to use these ideas to make sense of their own experience.

What still needs to change in this area? 

Many of us in healthcare are increasingly aware of the limitations of the diagnostic model of mental health. We know that a diagnostic label in mental health is qualitatively different to many diagnoses in physical health; mental health diagnoses are collections of experiences that have been grouped together and called an illness, but which are not linked with any identified underlying cause. Despite this, the diagnostic model is increasingly used by health professionals, education professionals and the general population. 

There are a variety of different models that represent alternatives to a diagnostic view of mental health, which include my own, the Power Threat Meaning Framework (PTMF), research into Adverse Childhood Experiences (ACEs) and Acceptance and Commitment Therapy (ACT) to name but a few. 

Most of the information available to people regarding mental health does not include information about the limitations of the diagnostic model or about the available alternatives to it. As a result, we are not enabling people to make informed choices about their health and wellbeing and this needs to change.

Could you tell us something that might surprise someone not familiar with this area of work?

Science shows us that every emotion we experience has a useful and valuable function that supports us individually and collectively as a society. Even emotions that are often thought of as harmful, like anger or shame, are extremely important in human society and have clearly identifiable functions.

What do you hope people will take away from the webinar?

I hope people will leave with a clearer sense of the value of emotion science in mental healthcare and general wellbeing, and a stronger belief that there are increasingly viable alternatives to the diagnostic model of mental health.

- Find more information about the webinar and about the book.

Read more about Lawrence’s work in this article from The Psychologist.

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