I am maintaining a list of the top ten “secrets” in the mental health field. Here is Part II, items five up to the big number one (items six to ten are can be found in Part I):

1. Cognitive problems

Cognitive disabilities can have a tremendous effect on people who appear to be fairly high functioning. This problem is not assessed enough and it is not treated enough. This abdication of responsibility is causing many people to lose their livelihoods, to have disrupted lives, to become homeless, and to suicide. As with issues that are mostly in the past, (the wave of false allegations of childhood abuse, the high prior levels of therapist having sex with clients, therapists not taking certain steps to deal with threats made by their clients, and children being harmed by excessively invasive “therapy” procedures), I believe that law suits will be necessary to create the attention and care that this issue deserves. The neglect of this issue and the tremendous harm this neglect is causing boosts cognitive problems to number one on my list.

2. Sleep

Although they may appear to sleep sufficient hours, many people suffer from non-obvious defects in sleep. This problem is causing people to become stuck in their maturation (developmental delay), to develop out-of-control emotions, and to develop cognitive problems. For example, we must address the role of defective sleep in post-traumatic stress disorder.

3. The “state change” pattern

For more about this, see my blog entry “Spirituality and Mental Health: Psychotherapy Beyond Words.” This pattern tends to produce rapid improvements in many problems, including trauma and anxiety, and can play a huge role in stress management. It has been a part of techniques used in mainstream psychotherapy, self-help, and even cults such as Scientology. However, the techniques that it is a part of get the credit, and few clinicians have connected the dots to recognize the active ingredients of this maneuver. Adequately understood, this pattern can enhance the value and range of psychotherapy for many people. A good understanding of this can lead us to enhance the techniques we learn, as well as to adapt them more effectively to each individual.

4. Inflammation and sensitivity to foods and environmental substances

This problem causes personality and functional changes that can be very disturbing, yet there is a great deal of misdiagnosis. Many clinicians, particularly physicians, do not believe in it, despite growing evidence, including the effects of military service that has involved various chemical exposures and resulting effects common to many thousands of people. Lack of awareness is causing a great deal of suffering and loss of productivity.

5. Stigma

Stigma often occurs as a subtle that can derail psychotherapy, and that can affect people with neurological problems far more than they realize. But, for many clinicians, getting them to understand this is like trying to explain water to fish. Stigma has deep roots in our culture and in our psyches, and is causing many of us to make drastically bad decisions and endure harmful, but unnecessary levels of stress. My blog entry, “Gooble Gobble, One of Us, ADD, One of Us” touches on this.

The Challenge

What would your list be like? Can you challenge this? Will you take the challenge to learn how to better manage these issues?