Wednesday, April 14, 2021

Helping our patients with mental health issues by using the transdiagnostic approach

Regarding mental health problems, I usually like to take the “transdiagnostic approach”. Unfortunately, it’s not often taught in Medical School, but it probably worthwhile considering.

One simple exercise I usually get folks to do, is to draw a vertical and a horizontal line on a blank piece of paper to create four equal quadrants. Maybe you can try this too perhaps.

This piece of paper now represents our “mindspace”.

Now label the 4 quadrants representing 4 different sources of information as....

1. Outer objective data through our senses and what we can measure. It’s about the evidence in the real world. Folks who focus on this quadrant are more observant when “zooming out”, and when more “zoomed in”, are better at influencing outside objective variables (not so much feelings) to achieve an outcome or goal. The danger here is the tendency for obsessiveness about “things”, and overthinking when we are too “zoomed in”, and when we are too “zoomed out”, we may experience a degree of derealizations.

2. Inner objective data through our memory. These folks may have photographic like memory which is great for referencing, but when too “zoomed in”, may lead to PTSD type phenomenon and reliving past negative experiences. When used well, they are great at learning from the past, maintaining past traditions, and predict the future based on past experiences.  When not used well, it can create a lot of pain, suffering, and anxiety. 

3. Outer feelings and vibes from our surroundings, tribe, and society as a whole. When “zoomed out” from this quadrant in a healthy way, these folks are great at reading the room and it’s possibilities, but when too “zoomed in”, it can lead to a lot drama. With the right amount of “zoom”, they are great at creating social harmony by managing the vibes and feelings from those who they interact with.

4. Inner feelings i.e. our own feelings. These folks are great with “gut feelings” and following their values with authenticity. When healthy, they are great at accepting themselves for who they are, and also others for who they are. They are great at processing their own feelings and creating more inner harmony.

So the question is, which quadrants do you have a bias towards?

Which ones are your main focus, attention, and playing space?

Which quadrants are you very good at controlling or managing?

Which one/s are your “blindspots”?

Are your “zoom control” functioning very well in each of these quadrants? Do you tend to over “zoom in” or over “zoom out”? Have you got the right “balance” and control? Medications can be good for “zooming out” but are highly non specific when it comes to affecting which quadrants.

Being more aware and mindful of this, may help us navigate our mindspace and world with better psychological flexibility, “control”, and adaptability.  Schools are good at teaching the top 3 domains, but not so much the inner feelings/values domain.  Often, the aim of counseling, especially with Acceptance Commitment Therapy ACT,  is to help fill this void. 

With better adaptability, there may be less risk of adjustment issues and it’s associated stress, anxiety, or depressed mood.

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