Francisco J. Martínez: "We have begun to medicalize emotions".

In this interview we discuss how psychology has changed and what its new challenges are.

Francisco J. Martínez holds a degree in Psychology, a Master's degree in Clinical Psychopathology from the Ramón Llull University, a Master's degree in Community Mediation from the Autonomous University of Barcelona and a Master's degree in Psychosocial Intervention from the University of Barcelona.

He currently combines adult psychotherapy in his private practice with teaching in the Master of Online Clinical Practice of the Spanish Association of Cognitive-Behavioral Clinical Psychology (AEPCCC). He is also the author of articles on psychology in magazines such as Smoda "El País", Blastingnews and Psicología y Mente.

Interview with psychologist Francisco J. Martínez

In this interview we chat with him about how psychology has evolved, how emotions are managed from a health perspective, and the way in which personal relationships and social phenomena affect our mind.

1. Has your conception of mental health changed since you started practicing psychology, or is it more or less the same as the one you had during your university years?

The psychology career as I remember it placed great emphasis on understanding people's mental health through clear, reliable and determinant diagnoses that obviated the motivations for which the person goes to the psychologist. We were steeped in manuals concerned with dissecting symptoms and finding accurate diagnoses with which we could work through appropriate techniques for this or that disorder. All this is useful. Of course. But I was obviating that the person who approaches the psychologist uneasy about his mental health, usually indicates that he does not control his emotions. They are sad, angry, upset, demoralized? They are suffering mentally.

I like to explain to patients that proper mental health is one that allows the expression of each and every one of our emotions. If we imagine that our mental health is an old radio with two buttons, the emotion would be that which becomes each of the channels. If the button is broken, all the channels cannot be tuned, with one emotion prevailing over another.

The volume would be our second button. It would be the intensity of the emotion. Adjusting the volume according to our own judgment is what will help us to be able to listen to our favorite programs at the desired volume. Going to therapy often helps us to discover that there are channels we are not tuning into or that we may be listening to the radio too loudly or too softly.

2. How do you think the way people relate to each other has an impact on their mental health?

Something that is quite mythologized is why people come for consultation. Some think they come in search of self-knowledge, of the reasons why they are suffering mentally. Of course this is important, but in the first instance what they usually ask for is help with social integration.

The way they relate to others fills them with dissatisfaction. They wish not to be seen or perceived as "outsiders". The starting point is that the mental is essentially relational and that a mind cannot be constructed in isolation from other minds. From the moment we are born, the child's environment is what provides him/her with a mind capable of facing the obstacles and positive experiences that life has in store for us.

3. In research it is very common to believe that psychological processes can be understood by studying small parts of the brain separately, rather than by studying the interaction between elements or social phenomena. Do you think that the social science side of psychology has more to learn from psychobiology and neuroscience than the other way around?

Studying mental disorders from the cerebral, the tangible, from psychobiology, neuroscience, can be very good. But leaving aside the mental, the influence of society, is hopeless. Explained in more detail. If we seek to understand depression, anxiety, panic, schizophrenia, in short, everything that we can understand as mental suffering, dissecting towards the "micro" (genetics, neurotransmitters) we will omit what makes us particularly human.

In order to understand mental suffering, we must know what happens during our learning, what are our affections, our relationships, our family systems, our losses... All this is impossible to achieve if we want to reduce it to the interaction between neurotransmitters and the study of genetics. If we understand it from this point of view, we will be very lost. We fall into an extremely reductionist vision of the human being.

4. In an increasingly globalized world, some people emigrate because of the possibility of doing so and others out of obligation. In your experience, how does the experience of migration in precarious conditions affect mental health?

Those who migrate do so with expectations of growth (economic, educational...). To a large extent, emigration is preceded by a state of precariousness. For years I have been able to accompany people who emigrated with high expectations of improvement. Many of them had deposited years of their lives and all their savings to be able to break with poverty and help their families.

Much of the work that psychologists and social workers must do is aimed at reducing the high hopes previously deposited. Many psychological theories relate levels of depression or anxiety to discrepancies between idealized expectations and actual achievements. Arriving at the destination of choice and continuing to live in a precarious state that is sometimes even worse than when you started is clearly a bad indicator for the achievement of proper mental health.

5. Do you think that the way in which migrants deal with suffering differs according to the type of culture they come from, or do you see more similarities than differences in this aspect?

I would say that there are more similarities than differences in dealing with suffering. Already in mythology, migration is presented to us as a painful and even unfinished process. Religion with Adam and Eve or mythology with "the tower of Babel", explain the loss involved in the search for the "forbidden zone" or the desire for knowledge of the "other world". Both quests and desires end with unhappy outcomes.

In the first place, I consider the feelings shared by those who emigrate to be "universal". They live a separation rather than a loss. Nostalgia, loneliness, doubt, sexual and affective misery design a continuum of emotions and experiences dominated by ambivalence.

Secondly, it is a recurrent bereavement. Thoughts of return cannot be avoided. New technologies allow the immigrant to be in contact with the country of origin much more easily than before. In this way, the migratory mourning is repeated, it becomes a recurrent mourning, because there is excessive contact with the country of origin. If not all migratory experiences are the same, we can accept that in the great majority all these assumptions are present.

6. Increasingly, there is an increase in the consumption of psychotropic drugs worldwide. Some people say that this medicalization is excessive and that there are political motivations behind it, while others believe that psychiatry is unfairly stigmatized, or else they hold intermediate positions between these two positions. What is your opinion on the subject?

Psychiatry and pharmacology are of great help in many cases. In severe mental disorders they are of great help. The problem we are currently facing is that we have begun to medicalize emotions. Sadness, for example, is usually mitigated through psychotropic drugs.

Normal sadness" has been pathologized. Think of the loss of a loved one, the loss of a job, a partner or any day-to-day frustration. That psychiatry and pharmacology take charge of this "normal sadness" by treating it as a mental disorder makes the message that arrives something like "sadness is uncomfortable, and as such, we must stop experiencing it". This is where the pharmacological industry acts in a perverse way. Much of their motivation seems to be to make huge profits through the medicalization of society. Fortunately we have great psychiatric professionals who are reluctant to overmedicate.