Much of the confusion and disagreement around 'what works' in mental health can be traced back to the erroneous idea that there must be one thing that really works. One thing that will really change your life and make everything OK.
You've heard something like this before, right? It's all about medication, or psychotherapy, or positive lifestyle changes, or coping skills, or removing systemic and psychosocial barriers. Just get that one thing right and everything else will fall into place.
The truth is that none of these things really work—at least not in isolation. What's closer to the truth is that mental health is much more like tower of unique Swiss cheese slices, where each slice has a unique pattern and distribution of holes; in other words, each slice is different from any other slice. A single layer of cheese will leave holes. A second layer will cover some of the space left by the first layer. A third layer will cover yet more of the space left by the first and second layers—and so on.
Think of each layer of Swiss cheese as a mental health intervention. Any individual layer will have at least some 'holes'; it will leave some 'space' not fully covered. Any individual layer, on its own, will fail to completely cover everything.
Medication is a great example here: even the most effective pharmacotherapy can't address every facet of your mental health. At best, medication can help to stabilize extremely challenging symptoms and allow you to more effectively engage in activities necessary to daily living. (That's no small thing, by the way.) But medication can't help you to overcome ambivalence, resolve trauma, build coping skills, or make lasting behaviour changes in your life. Nor can it address systemic and psychosocial barriers you might be facing, such as housing, finances, education, and oppression. And it certainly can't automatically restructure your life by getting you to make changes to your diet, physical activity, sleep schedule, and social life.
But does that mean we should jettison medication entirely? Not at all. It's one of the slices, after all—but it has holes. The same is true of any other mental health intervention. In order to maximize your chances of recovery and long-term psychological health, you need to start stacking 'slices' of mental health interventions. Allow the slices to work together in filling the 'holes' and covering the 'space' left by any individual slice. The more slices you've got, the more area you're covering.
So, I guess what I'm saying is.... mental health is like a stack of Swiss cheese slices.
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