At the Tokyo Olympics, Simone Biles earned a gold medal in my book, but not for her gymnastics. She earned it for her courage in advocating for her own mental health at the risk of disappointing her teammates, her country, and her fans. Given the stigma that surrounds mental health problems, her withdrawal from competition must have been at least as challenging as her gymnastic routines.
As a psychologist, I was pleased with the outpouring of support for Biles and delighted that more people are recognizing the importance of attending to mental health. However, I can’t help but feel we have a long way to go in countering the stigma of mental health issues. Raising awareness is a start, but it’s not enough. The stigma does not come simply from lack of visibility; it runs far deeper. To overcome it, we need more than courageous role models. We need to change the paradigm that separates mental and physical well-being.
Healing this divide begins with understanding where it came from. In the 1600s, René Descartes philosophized that the mind is distinct from the physical body. Modern medicine is rooted in this Cartesian worldview, and we segregate health from mental health – and the resources that come with each.
Our medical model divides our body up into pieces, separating the mind from the body. It treats components or systems of the body, not the whole person. We see a cardiologist for our heart, an endocrinologist for our hormones, and a gastroenterologist for digestive problems. For a glaring cognitive problem, we might see a neurologist, and for depression or anxiety, a psychiatrist. We tend to think of ourselves as double entities, minds with bodies attached or bodies with minds attached.
In reality, we function as a whole organism. The body is the physical manifestation of the entire being. It is the container for everything that makes us human—the heart, lungs, brain, blood, cells—and everything we experience: our whole range of sensations, emotions, and thoughts. While our minds are capable of certain transcendent experiences, our bodies are the containers of our mental experience. Our bodies technically include our heads and everything contained within them, the brain and the mind.
Some degree of suffering is inevitable for human beings. That suffering takes many forms—physical, emotional, mental, and spiritual—and those forms of suffering are inherently interrelated because all our parts are interconnected. We are whole beings with many layers of experience. While thinking about our body in terms of its parts has enabled the field of medicine to target and treat all kinds of physical problems and diseases, failing to understand ourselves as whole organisms has hampered our progress in treating other kinds of illnesses. If we insist on looking at the body as separate from the mind, we will miss both the cause of much of our suffering and our potential liberation from it.
The cause of much of our suffering is stress, the body’s natural, normal response to anything perceived by the nervous system as a threat. Stress can be mild or acute, traumatic, or quotidian. In an Instagram post about her choice to step back from competition, Biles wrote, “I truly do feel like I have the weight of the world on my shoulders.” Stress is always a factor in our lives, and it has the potential to generate, perpetuate, and exacerbate all manner of symptoms.
In my clinical practice, I work with people who have functional medical problems, also known as mind-body or psychophysiologic problems. These are real physiological symptoms that many people have in the absence of disease or any observable, localizable organic dysfunction. The classic functional medical problem is irritable bowel syndrome (IBS), which I, too, was diagnosed with as a teenager.
Mainstream medicine doesn’t have much to offer people with IBS. The usual goal is to manage, reduce, or control the symptoms. I try to help my patients to heal, not just chase symptoms for the rest of their lives. I know healing is possible, not because I have been told so by a physician – no physician ever gave me reason to believe this – but because I fully recovered without expecting or trying to. Today, it is well understood that stress and trauma contribute greatly not just to IBS but to many health problems.
If we take a holistic view of well-being and recognize that we are broadly susceptible to stress, what does that tell us about healing? My personal and professional experience has taught me that healing functional medical symptoms – as well as psychiatric symptoms – often requires unwinding layers of threat responses and longtime patterns of thinking, feeling, behaving, and relating. Our path to well-being invites us to heal old traumas.
This kind of healing happens within the context of safety and connection. Just as our minds are not separate from our bodies, our selves are not really separate from other people. We are social creatures living in a chaotic and stimulating world and have sensitive nervous systems that are picking up data all the time – whether or not we realize it. We are intertwined with our environment and our relationships, and, for better or for worse, have been for our entire lives. Our sense of danger and safety is as much a function of our interactions with people as anything else. We must recognize our health and therefore our healing as relational.
We need a health-care system that supports our relational healing, both intrapersonally and interpersonally. We must be willing to be a whole person and demand to be treated as a whole person. As Simone Biles has shown us, we must talk openly about our suffering in any of its forms and seek help. To do that, we must understand and radically accept ourselves as the whole beings we are. We do this by validating the existence of all of the parts of ourselves and everything we experience as human beings. We must learn how to offer compassion to our whole bodies and selves and to other people. We must allow ourselves to receive it, too.
Healing can be found in the warm, caring connection we might have with a physician who has a good bedside manner, with a skilled psychotherapist, and in secure, stable personal relationships. I’m not saying love is all we need. I’m simply saying that it is foundational to healthy health care. We need to shift toward a model and system that values the integration of the whole self and puts human connection above profit and efficiency. Only then will we heal both the suffering and the stigma of so-called mental health.
Dr. Jennifer C. Franklin
Dr. Jennifer C. Franklin is a mind-body psychologist specializing in the treatment of psychophysiologic disorders, particularly disorders of gut-brain interaction like Irritable Bowel Syndrome. She worked at the UNC Center for Functional GI & Motility Disorders, served as an associate editor for the Journal of Humanistic Psychology, and has expertise in mindfulness, stress, trauma, anxiety, relationships, creativity, and performing arts psychology. donthateyourguts.com