chapter  37
The causes of mental and emotional distress are environmental, social and to do with power and powerlessness. The medicalisation of distress is an error
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Amongst person-centred thinkers, there is a widespread and increasing view that the causes of emotional and mental distress are not intrinsic, interpersonal and a response to relationships with signi®cant others but that their origin is social and/or environmental. Also, there is an assumption that `madness' is socially de®ned and that social and political circumstances at the very least contribute to mental distress and are possibly (or even likely to be) causal. There is also a belief that the imbalance and abuse of power relate to mental ill-health and that it is only if power in all its aspects is openly addressed can therapy be successful. For example, Proctor (2002: 3) is clear that `there is much evidence to associate the likelihood of suffering from psychological distress with the individual's position in society with respect to structural power'. She (pp. 3±4) shows how women are more likely than men to be diagnosed with a range of disorders and that working class people are as a whole overrepresented in the mental health services. Similarly, Sanders (2006a: 33) states that there is growing evidence that psychological distress has social, not biological, causes. He goes as far as to say that there is no such thing as mental illness and (pp. 33±35) makes a strong, evidenced argument against what he calls `biological psychiatry', that is psychiatry based on a diagnosis±treatment±cure model for speci®c `disorders' such as schizophrenia and depression.