Over the past decade or more an increasing number of mental health professionals and others have begun speaking out against psychiatry, the Diagnostic and Statistical Manual (DSM), and the attempt to medicalize certain emotional and behavioral patterns. The DSM and the biomedical or disease model are based on deeply flawed assumptions — specifically that “mental disorders” are caused by imbalances in brain chemistry or are passed along genetically. Quite simply, but very significantly, for conditions such as anxiety, depression, ADHD, and personality disorders, these concepts have never been proven by research.

Another major deficiency in the current disease model and the DSM is that they ignore some fundamental facts about human behavior. These very simple, understandable facts, however, explain far more about human behavior and do so more completely, accurately, and parsimoniously than does the disease model.

Sadly, the ostensible disease model and the DSM are promoted by psychiatry and the pharmaceutical companies, two industries that make billions of dollars selling and prescribing psychoactive drugs despite well-documented harmful side effects and lack of efficacy. Big Pharma, colluding with their paid researchers in academia, has spent millions or perhaps billions of dollars convincing physicians and the America public that popping a pill will “fix” the neurotransmitters in one’s brain and “treat” depression, anxiety, ADHD, or schizophrenia.

This theory has never been proven to be true. Neurotransmitters cannot even be measured in the brain to determine if there is some presumed shortfall or excess.

“In reality, science does not have the ability to measure the levels of any biochemical in the tiny spaces between nerve cells (the synapses) in the brain of a human being. All the talk about biochemical imbalances is sheer speculation aimed at promoting psychiatric drugs.”[1]

In fact, psychoactive drugs often make mental health and functioning worse.

“The evidence that psychiatric drugs work in the short term is flimsy and largely contrived by drug companies and the researchers they pay. Meanwhile, there are few studies and no convincing evidence that the drugs are helpful after several months or years of exposure. Worse yet, there is mounting evidence that all classes of psychiatric drugs, especially when taken for months or years, produce chronic brain impairment and diminished enjoyment of life. Psychiatric drugs frequently prevent recovery and often lead to chronic or permanent disability.”[2]

Millions of dollars in research funding have been thrown at trying to prove a biological cause of emotional problems, with an almost frantic avoidance by psychiatrists and pharmaceutical companies to even consider other explanations. This smokescreen of the disease model has distracted the profession and researchers from some obvious truths that actually do explain emotional wellbeing in a fact-based, common-sense, research-proven manner.

And, most unfortunately, the current mental health diagnostic system has for decades hindered therapeutic treatment and caused harm by:

  • stigmatizing clients as “disordered”, leading to social distancing[3] [4] [5]
  • leading clinicians to view clients as “diseased” and “disordered,” which shuts down avenues for acceptance, hope, and empathy
  • driving clients away from seeking treatment due to this stigma[6]
  • promoting helplessness and lack of accountability for personal change
  • promoting ineffective and harmful drugs over effective and harmless therapy or self-help
  • focusing on red herring biomedical causes of emotional distress and not addressing the real cause of suffering, such as environmental trauma, parental neglect, unhealthy relationships, or lack of self-acceptance
  • offering no therapeutic framework for treatment and no logical connection between diagnosis and treatment.

Even Thomas Insel in 2013, then the director of the National Institutes of Mental Health, issued a statement prior to the release of DSM-5 that distanced the agency from the DSM, citing its lack of validity.[7]

Perhaps one day a biological cause of anxiety, schizophrenia, depression, etc., will be found, but until that day the profession should use the facts that it does have to respond to these conditions.

In stark contrast, Self-Acceptance Psychology is based on several well-accepted and well-researched psychological concepts, which, when considered together, provide a powerful new paradigm to understand and promote long-term change in behavior.

Self-Acceptance Psychology offers numerous benefits, because it:

  • normalizes and de-stigmatizes thoughts, feelings, and behaviors as adaptive and self-protective
  • improves the likelihood that clinicians will view clients as normal and not disordered
  • encourages client accountability
  • directly addresses the emotion (shame) and cognition (low self-worth) that lead to most “mental illnesses”
  • suggests interventions based logically and directly on this case formulation
  • uses interventions that are harmless, unlike medications, and provide hope for permanent change.

Self-Acceptance Psychology is unique in that it combines these foundational ideas to form a compelling and innovative paradigm of human psychology. This paradigm is more easily understood, more accurate, and more powerful than the current disease model at explaining human thoughts and emotions and predicting human behavior. It also elucidates both inter-personal relationships and intra-personal relationships, or the relationship with self.

To summarize, based on the Five Causative Factors, we know that humans:

  1. respond with fear in predictable “fight-or-flight” ways
  2. respond with shame and fear when threatened with social rejection
  3. respond with shame to alter behavior in ways that preempt rejection
  4. respond with shame and fear to developmental trauma
  5. respond with shame and fear to attachment trauma, which is perceived as rejection

Self-Acceptance Psychology gives us a way to understand human psychology and behavior as being largely driven by the Five Causative Factors.

Consider these Five Causative Factors as a perfect storm that leads individuals to feel intrinsically unworthy and shameful. Factors #1, #2, and #3 are natural tendencies and all humans respond to these experiences within normal ranges. A childhood filled with love, safety, and acceptance predisposes a person to have more resilient responses to these experiences.

However, developmental trauma (Factor #4) or lack of attachment (Factor #5) are variables in each person’s life that can increase maladaptive behaviors, including hyper-vigilance to threat and rejection, high levels of shame, and lack of cognitive coping skills. A person raised with trauma or lack of attachment has an easily activated threat/protective response system, but they have a less well-developed ability to respond with their soothing/contentment system. This makes it difficult for them to self-soothe in a compassionate way.

It becomes quite clear that shame is a key underlying emotion that drives a large part of human behavior for both inter-personal and intra-personal relationships.

Fear is one of the most powerful emotions we experience and has wide-ranging effects on physiology, emotions, moods, attitudes, cognitions, and behaviors. Yet despite the volumes of research and factual evidence on the threat response and its tremendous primal influence on human emotions and physiology, the current disease model essentially ignores this fundamental fact when describing human behavior.

How can the profession continue to overlook the very obvious fact that “mental disorders” labeled as anxiety, depression, bi-polar disorder, PTSD, and ADHD are merely natural, protective responses to fear-provoking situations? Why should we label them as disorders, causing stigma and shame, and treat them with harmful, brain-altering medicines when these responses are merely hyper-vigilance to and over-reactiveness to threat?

And, since all emotions are valuable responses, it makes one wonder: If fear is to be considered a “mental disorder,” then why is happiness not considered a “mental disorder”? It is time to reframe and de-stigmatize some mistaken, but commonly held beliefs about emotions: Fear is not a “mental disorder.”

Self-Acceptance Psychology is designed to help clients understand the threat response, stop automatically reacting to this response, and then turn up the love response, specifically love for oneself. Finding compassionate acceptance for oneself is the first step to loving oneself and others.

So we know that finding acceptance and avoiding ostracism are natural, primal elements of human social nature (Factor #2). And when we are afraid, we react with “fight-or-flight” fear responses (Factor #1), even if those fears are only caused by an emotional threat, such as criticism or humiliation (Factor #3). Combined, these primal feelings and behaviors are the cause of most of our modern psychological and behavioral problems. Most of the diagnoses in the DSM are actually descriptions of a person who is hyper-vigilant to being emotionally shamed, victimized, or rejected by others. Or who has also become highly self-shaming, leading to feelings of self-rejection.

It is clear: Shame is a major driver of human behavior. Why is this fact completely ignored in the DSM?

Self-Acceptance Psychology proposes a link between the lack of secure attachment and intrinsic feelings of shame. Psychological “conditions” are merely strategies to self-protect from difficult emotions, cognitions of low self-worth, and attachment distress.

The power of Self-Acceptance Psychology is that it not only explains inter-personal relationships, but also helps explain a person’s self-image and how that can result in emotional conditions such as anxiety and depression.

If you grow up not feeling loved and accepted by your parents, this leads to not only a difficulty feeling safe in relationships with others, but also a tendency to not feel safe with yourself. Simply, if you loathe yourself, it is not possible to be comfortable with and accepting of yourself, leading to an experience of fear or threat merely due to the relationship you have with yourself.

Self-shaming can be considered self-protective and adaptive in that it is an attempt to fit in and be loved and, more importantly, as a way to figure out how to love yourself. Yet chronic high levels of self-criticism lead to feeling deeply unlovable to others and unlovable to yourself.

Attachment to ourselves, or self-acceptance, is the most important emotional skill we need.

If you are not self-accepting, the world looks frightening, relationships look frightening and even your intrinsic self looks unknowable, unworthy, and frightening. Many authors have noted the importance of having a healthy relationship with yourself to have healthy relationships with others. Yet most treatment perspectives fail because they do not address self-acceptance and self-compassion.

It should be noted that the DSM fails to mention the significance of self-attachment or self-acceptance even once in its hundreds of pages.

Reducing fear and helping people feel less shameful is the first step to success in therapy. Learning skills of mindful self-compassion and self-acceptance enables a patient to reduce the experience of self-loathing and resulting fear, which helps provide a safe internal environment for change. If the self is no longer a threat, change becomes possible.

The good news is: Self-acceptance is already a skill humans have naturally. We are not born to live chronically with fear, anxiety, and self-blaming. Self-Acceptance Psychology is not about learning to adopt a different personality, so much as getting rid of unhealthy learned habits. By uncovering our inherent self-attachment, we can become happier and have improved relationships with others and with ourself.

[1] Breggin, P.R. (2001) The Anti-Depressant Fact Book. Cambridge, MA: Da Capo Press, p. 21

[2] Breggin, P.R. (2014) Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions. Amherst, NY: Prometheus Books, p. 262

[3]Schomerus, G., Schwahn, C., Holzinger, , A., Corrigan, P.W., Grabe, H.J., Carta, M.G., and Angermeyer, M.D. Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatrica Scandinavica. 125: 6, 440-452, June 2012.

[4] Read, J., Haslam, N., Sayce, L., & Davies, E. (2006). Prejudice and schizophrenia: A review of the ‘mental illness is an illness like any other’ approach. Acta Psychiatrica Scandinavica, 114, 303-318

[5] Angermeyer, M.C., Holzinger, A., Carta, M.G., & Schomerus, G. (2011). Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. British Journal of Psychiatry, 199, 367-372.

[6] Oliffe, J.L., Ogrodniczuk, J.S., Gordon, S.J., Creighton, G., Kelly, M.T., Black, N., Mackenzie, C. (2016) Stigma in Male Depression and Suicide: A Canadian Sex Comparison Study. Community Ment Health J. Jan 5, 2016.

[7] http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml