This information comes from a doctor in sociology name Steve Rose and you can visit his blog clicking on the link at the bottom.
What does it mean to be healthy?
There are many perspectives on the topic: biological, psychological, and sociological.
Usually, we equate the concept of health with physical health, and more recently, the concept of mental health has also gained traction.
As a sociologist, I’ve been interested in the concept of social health. By this I refer to the health of a social environment. Although the social realm is a distinct object of analysis, it is interrelated with physical and mental health.
Healthy societies contribute to a healthy mind and healthy bodies. So what is a healthy society?
I define a healthy society as one that is socially integrated in a way that meets our basic physical and psychological needs, facilitating a sense of higher purpose.
This is a sociological take on Abraham Maslow’s view:
The good or healthy society would then be defined as one that permitted man’s highest purposes to emerge by satisfying all his basic needs.
For Maslow, his famous hierarchy ranks these needs from the most basic to the most advanced. I don’t necessarily agree with his strict rank ordering and a 2011 study on the topic confirms this skepticism.
Throughout my research on suicide, I’ve come to see how social needs are as important as our biological need for food. Those whose social needs are not met may find themselves at risk of dying by suicide.
Although I agree with Maslow’s broader theory of human flourishing, I prefer to draw on more recent psychological research on our basic social needs.
According to Self determination theory, we have three basic social/psychological needs: competence, autonomy, and relatedness.
Competence consists of the sense that one has specific skills and is progressing in their abilities.
A healthy social environment provides worthy goals with clear guidelines that act as signposts to human action. Without socially sanctioned signposts regulating our actions, individuals may feel lost or purposeless. The classic sociologist, Émile Durkheim, writes:
All man’s pleasure in acting, moving and exerting himself implies the sense that his efforts are not in vain and that by walking he has advanced. However, one does not advance when one walks toward no goal, or—which is the same thing—when his goal is infinity.
Consider any worth-while goal or endeavor and you will quickly realize it is marked by the stamp of social values. Our goals are often regulated by what is deemed valuable to a particular social context.
Although we need social regulation to give us purpose and a sense of contribution, this does not mean we need to simply conform, bringing us to the next fundamental need:
Autonomy consists of feeling that one is in control of one’s own actions.
In sociological terms this means social regulations are not overbearing and fatalistic. Although autonomy is important, too much of it can produce individualistic social contexts where individuals no longer feel connected to a broader community. This brings us to the last fundamental need:
Relatedness consists of the sense that one can depend on a close circle of other individuals.
In his classic sociological text, Suicide, Durkheim states:
“…when community becomes foreign to the individual, he becomes a mystery to himself, unable to escape the exasperating and agonizing question: to what purpose?”
Interdependence is the key to a healthy social context that balances individual needs with the needs of the group.
Interdependence requires goal alignment between the individual and the group. As stated in my article addressing the question, “What is a healthy identity?“:
…the military is a great example of institutionalized interdependence. Identities are built within a system of distinct, yet related, roles where one’s unique skills, abilities, preferences, and character, all contribute to an organization with functional capacities beyond the sum of its individual parts.
Unfortunately, interdependence is easily forgotten in modern individualistic social contexts:
Interdependence works on many levels: organizationally, nationally, and globally.
Healthy societies are like living organisms, institutions and organizations are the organs, and individuals are the cells that compose the organs.
Societies interact with other societies, just as our bodies interact with other bodies; organizations interact with other organizations, just as our bodily organs interact; and individuals interact with other individuals, just as our cells interact.
My vision is a world of interdependent social relations. A world were social environments facilitate individual flourishing. A world where economies work to fulfill human needs, rather than a world where human needs are sidelined at the expense of economies.
If you are living with unresolved trauma memory, whether or not it’s posttraumatic stress disorder (PTSD) or dissociative identity disorder (DID), you will almost surely bewilder people some of the time. We both know you want this not to happen, but, as is surely obvious to us, you have little or no choice in the matter, other than to avoid triggers to the extent that you know them and can anticipate them. The real problem here is that you can’t avoid all triggers. So, you will bewilder and maybe even frighten people a certain amount of the time.
Triggered breakdowns in social situations can have serious consequences. One person I knew and worked with almost went to prison, because of violent defensive behaviors that were triggered by a sense of extreme threat, when she felt abandoned by an intimate. Another person I like and respect recently encountered a massive trigger, entirely unexpectedly, while out for a social evening with family. He became almost unable to function, and felt absolutely terrible because there were people present who surely had no idea what was happening.
There are many things that are truly awful about such situations, but one of the worst is the feelings of shame that seem always to follow such episodes. People tend to feel defective, and at fault. Now, we know this is entirely irrational, but the feelings are very real, and they are hard to avoid.
This is especially a problem with DID (think of it as a kind of super-PTSD), where shame issues and dynamics tend to be a Really Big Deal. I want to propose that working on resolving this secondary reaction to the primary problem of triggered functional breakdowns in the midst of life is an essential part of your healing. To make this happen you will need to correct how you think about yourself, and from that will come corrections in how you feel. A key part of this is becoming a better storyteller, as you will see.
Two things have to happen, if you are to bring about this engagement and then successfully resolve your highly distressing secondary shame reaction. You must learn what actually happened to you. This basically involves your constructing a story. You should start with a very simple one – something like this:
“Some years ago, a bad thing happened to me, and I was terribly frightened and hurt by it. I have not yet recovered from this, but I’m working on it. Until I finish this work, I will have periods of time where I become gravely frightened all over again and am unable to live my life in the way I’d like to. I can usually recover from this fairly quickly, but not immediately. I need to take care of myself until I have regained my ability to function. Then I need to return to my usual life and my ongoing healing work.”
You may not realize it, but you already have a story about what happened to you. I’ve heard these stories. Here are some:
I have a couple of immediate reactions to these stories, every time I hear them:
The correct story about what happened to you never includes the “it’s my fault” statement that so often people tell themselves initially. It DOES include a decent description of how stress-overloads can affect some people badly, and for a long time. Why not ALL people? We are still figuring this out, and don’t yet have a good answer. Lots of people fall off ladders, too, with only some of them breaking bones as a consequence. It just happens. It happened to you, and that’s what matters.
So, by whatever means it takes (usually the assistance of an experienced trauma therapist or PTSD professional) you simply MUST get the story you tell yourself straightened out. With that in hand, you’re ready for the next and final step.
This is probably the most important thing you will do with your story. You are simply not the only one with the wrong story. MOST people have the wrong story. That’s not acceptable. As part of your journey away from completely inappropriate and irrational shame about what happened to you, it is critical that you learn to simply tell the truth to other people, after you’ve learned to tell yourself the truth.
First of all, consider what that means. Think of what you do when you tell a kid about sex. Probably the most critical part of your story about sex is what you do NOT say. All you need to do is tell them what they want to know, and at least some of what they need to know – and all of it in simple, direct terms.
You need to do exactly the same thing with your family, your spouse, your relatives, your boss – or whoever, concerning your PTSD or your DID. Only two things will stop you: ignorance (which is taken care of by getting the story you tell yourself straight), and shame. And the good news about all this is that you really can do it little by little, just like kids and sex!
To successfully tell other people about your situation, think hard about what they need to know, and about what they can realistically understand (Can People Without a Mental Illness Understand Us?). Think again about telling a 10 year old about sex: you’re dealing with limited interest and limited ability to understand. Your story should be simple and accessible to them. Now, transfer that idea to the people in your life who you want to understand you better.
PTSD isn’t too tough to talk about, thanks to all the media exposure it’s gotten in recent years. However, a fair amount of that exposure contains some real misinformation. So, expect to correct two common thinking myths: (a) people with PTSD are far, far more likely to be frightened and withdrawn than angry and assaultive, and (b) PTSD is highly treatable, but too often it is not treated, so people end up living with it unnecessarily.
With DID, the challenge is significantly tougher. I strongly recommend that you not attempt to actually describe DID, at least not at first. It’s tough to give a simple account of alters and switching. Few therapists can do it, so your chances aren’t good. Instead, just describe it as “complicated PTSD” (not complex PTSD [C-PTSD] – that’s different). I’ve seen (and heard) that this usually works rather well.
Remember, you’re talking to a 10 year old. They don’t need to know much! There are large payoffs for getting your story straight and then telling it to others. It will clarify and strengthen your own mind, and it will truly help those around you. When we understand what’s actually happening – even a little, we tend not to get frightened by it, and this benefits everyone.
By being an ambassador for yourself, for people like you, and for the disorder you’re working to overcome, you became a major asset to all of us. I personally think this is an opportunity you really shouldn’t pass up! But do it for yourself, first of all, for you are without doubt the most important person the story, at all points in this process. You first, then come talk to us!
Social rejection is painful.
When we feel rejected, our self-worth is dealt a heavy blow. We lose a sense of security, a sense of belonging, and perhaps a sense that we matter.
At its most extreme, the pain from social rejection can lead to suicide, according to the interpersonal theory of suicide.
Although we know social rejection is painful, neuropsychological research has revealed how social rejection affects the same regions of the brain as physical pain, and therefore respond similarly to the affect of painkillers.
In the study, participants were given acetaminophen (commonly known as Tylenol), or a placebo pill. After three weeks of regular doses, those who received the drug reported lower levels of social pain, in addition to showing lower levels of pain in fMRI brain scans:
…acetaminophen reduced neural responses to social rejection in brain regions previously associated with distress caused by social pain and the affective component of physical pain…
These findings are particularly relevant given the recent opioid epidemic. Beyond over-prescription and their highly addictive properties, this drug of choice might also tell us something about the health of our social context.
Beyond coping with physical pain, individuals who feel rejected may be self-medicating with opioids to cope with social pain.
We can see this phenomenon in studies on populations with a heightened risk of opiate use: groups with low income, low education, those lacking permanent housing, those who are unmarried, recently released prison inmates, veterans, and LGBT groups.
Once someone begins experiencing an opiate addiction, they may then find themselves feeling even further rejected, especially if it results in heightened poverty. In turn, this perpetuates the downward spiral of self-medicating to further reduce the social pain, in addition to the physical pain of withdrawal.
Promoting social health means combating barriers to social integration. These barriers include stigma, prejudice, economic inequality, and lack of social programs/support for individuals undergoing major life transitions, as seen among veterans in transition to civilian life.
When treating and preventing opiate addiction, we need to be mindful of the social dimension of the issue, in addition to the biological and psychological.
Mission: TAPS is a national nonprofit organization offering comfort and care to anyone affected by the death of someone who served in the Armed Forced. We offer peer-based emotional support, crisis response and intervention, grief and trauma, casework assistance, long-term survivor wellness, and community and military education and outreach.
Results: Each year, TAPS hosts and participates in events across the country to provide support to all who are grieving the loss of a loved one who has died while in military service. Through our national and regional seminars and good grief camps, retreats, special presentations and fundraising events, TAPS is able to provide hope and healing. Our special presentations offer survivors, caregivers, military personnel, supporters and friends the opportunity to learn more about military grief and learn about the mission of TAPS.
Target demographics: families of fallen military service members heal and rebuild their lives.
Geographic areas served: the United States and around the world
Programs: TAPS is a national non-profit organization made up of, and providing services at no cost to, all those who have suffered the loss of a loved one in the Armed Forces. The heart of TAPS is its national military survivor peer support network, which brings together the families, friends and coworkers of those who are suffering a loss. TAPS, an official Veteran Service Organization, also offers bereavement counseling referral, provides case worker assistance that carries the work of the casualty assistance officers into the future, hosts the nation’s only annual National Military Survivor Seminar and Kids Camp, publishes a quarterly journal mailed at no charge to survivors and care givers, maintains a comprehensive website, and offers a toll-free crisis and information line available 24 hours daily through 1-800-959-TAPS. TAPS offers total care and support for the military family experiencing a casualty. Please call on us to help!