“What is needed is a return to a culture of common sense and personal well-being, in which one is judged according to what kind of person one is and how one conducts one’s life.”
A recent Merion West article by psychologist Tomasz Witkowski serves as a useful segue for entering into wider discussions about personal well-being, particularly when it comes to down-to-earth, common-sense notions of what it means to be a well-adapted, fully-functioning person. Additionally, Witkowski’s piece sheds light on what might be the best approach for addressing the psychological problems experienced by certain individuals. Witkowski recounts how psychotherapy has mushroomed into over 600 different therapeutic approaches, and yet the results achieved are not significantly better than everyday, common-sense methods to restoring psychological well-being. However, as with almost all attempts to characterize and address human problems, context is important.
Witkowski cites the work of Vikram Patel, who has written a book on how to deliver psychotherapy. Where There Is No Psychiatrist is aimed at lay-persons who can offer support to others. The premise is that poor, under-supported people may suffer from psychological problems as much as those with the time and money to dwell constantly on their mental health. The nature and distribution of the psychological problems might be somewhat different between the two groups; people without leisure or money tend to think and act very differently from those who have either or both. Still, there can be no doubt that poor mental health is not confined to those who have access to mental health services (i.e. wealthier people).
The barefoot doctor schemes introduced in the developing world more than half a century ago were very successful at delivering basic healthcare to those previously without any, and Patel’s (very successful) initiative looks very much like a kind of barefoot psychotherapy. It does not need any attendant infrastructure or organization. With none of the complications inherent in an expert/client relationship, the barefoot psychotherapist is delving into a kit-bag of possible solutions, while accepting that the recipient is ultimately the authority on which approach is acceptable and which works best.
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