Self-Fulfilling Prophecies, Mental Health, and the Art of Manifesting Change

Are we all creators of our reality?

I have a confession to make. I am not perfect.

Glad we got that out of the way.

I don’t know it all. I make mistakes. Not everyone who comes to see me in clinical practice makes substantial improvements. Treatment failures exist.

As the new year unfolds, it naturally prompts a period of self-reflection.

At our center, we actively conduct outcome research, urging all our clinicians to reflect on cases that resulted in treatment dropouts and non-responders. I strongly believe in the value of this reflective practice for promoting professional growth. It serves as a space for learning from cases where our assistance didn't achieve the desired outcomes, offering insights that are just as crucial as those learned from successful interventions.

This process is both constructive and challenging, involving a deep reflection on cases where our support fell short. It requires a thorough examination of each step in our approach, a process that can be enlightening and, at times, uncomfortable. As I examined my personal case notes of these treatment dropouts & non-responders, I identified recurring themes that should not only inform new ideas but also have the potential to transform our perspectives on mental health, well-being, and navigating the pains and traumas of life.

Self-fulfilling Prophecies

According to Wikipedia, a self-fulfilling prophecy is a prediction that becomes true, at least in part, due to a person's belief or expectation that the prediction will come true. It's a specific case of the broader phenomenon of positive feedback loops and can lead to either negative or positive outcomes. The mere act of labeling someone or something can influence how the person or thing is perceived, creating a self-fulfilling prophecy.

This experience prompted me to contemplate the formidable influence of personal judgments, labels, and an individual's self-concept.

Are we creators of our own reality? Can that reality be influenced?

For instance, consider a scenario where someone believes they are “beyond help”. Unfortunately, this belief manifested in several cases where treatment progress was not observed. Upon closer examination, this notion of being beyond repair often unveiled core beliefs about themselves, such as "I am damaged" or "I am broken."

This belief seemed to bias most experiences in their life. My compassion, empathy, or even optimism was met with extreme skepticism, often dismissed as, "You have to act this way; it's your job."

Setbacks in life were interpreted as confirmation of their inherent damage, and emotions were judged as supposed evidence of a “mental illness”.

In romantic relationships and friendships, they were convinced of their inherent "unlovability," leading to seemingly unconscious patterns of self-sabotaging relationships, preemptively ending them before the possibility of rejection. This same behavior extended into the therapeutic relationship.

They clung to psychiatric labels as if these diagnoses validated their sense of brokenness, using them as evidence that they were incapable of living lives like others.

This perception became their reality AND they acted the part.

Dangers of Psychiatric Labels

Recently I had the pleasure of being a guest on Alex Clark's Spillover podcast. Her probing questions on psychiatric diagnoses, drugs, and our present culture were not only insightful but also sparked a captivating two-hour conversation. We dove deep into the controversial aspects of these topics, unraveling layers that often go unexplored.

During the episode, we explore the power of expectancy and the placebo response in antidepressant drug trials. However, from the title they chose and some comments I've read, it seems that the concept is still widely misunderstood. It's not about claiming that an antidepressant drug is an actual placebo. It’s a powerful psychoactive substance that acts on the brain. Instead, the key point is that when people were provided the placebo (dummy pill) in the drug trials, but believe they've received an actual antidepressant, they often experience similar improvements. This suggests that the perceived benefit of the drug is largely driven by the placebo effect.

My argument centered around the idea that those who show improvement while on the drug likely experience it not because of the drug itself, but rather due to their beliefs about themselves and their expectations of what the drug can achieve. Considering the potential for side effects and the risk of severe adverse reactions, I emphasized that any potential benefits from the drug may not outweigh the substantial negative consequences. You can watch the episode below:

One of my central arguments against the use of psychiatric diagnoses revolves around the deliberate distortion of these labels when presented to the general public. While conditions like mania can be observed and we can measure the weight of somebody who is anorexic, most psychiatric diagnoses are inadequately developed constructs lacking in both validity and reliability.

When someone declares they "have ADHD" or "Major Depressive Disorder," it's an idea constructed around their struggles rather than offering a meaningful understanding of the underlying reasons for their challenges. While these diagnostic labels may serve as somewhat useful heuristics to broadly categorize a state of "being," their oversimplification and potential misinterpretation of complex human experiences are causing lasting harm. This oversimplification is pushing individuals into the assumption that they possess a permanent medical condition necessitating medication—a drug that, more often than not, exacerbates their condition and negatively impacts their lives.

When individuals claim they "have" psychiatric diagnoses, the framing often parallels that of having a traditional medical condition, leading to a similar treatment approach – take this pill, follow this protocol. While most non-psychiatric medical conditions can be objectively identified, this level of clarity and precision is absent in psychiatric diagnoses, making the comparison less straightforward and the treatment process more nuanced.

Regrettably, in our present culture, when individuals latch onto a psychiatric diagnosis, it often leads them to believe that there is something inherently "diseased" about them. Statements like "My brain does not work like most people," "I AM biologically prone to being depressed," "I AM an anxious person and HAVE anxiety," or "I AM ADHD" reflect a deep identification with the diagnosis, shaping their self-perception.

This shift from experiencing challenges to embodying the condition can contribute to a sense of permanence and identity defined by the diagnosis, which does not accurately capture the complexity of individual experiences and their power to change.

When someone perceives themselves as "broken" or plagued by a "disease," the prevailing narrative pushes the idea that a cure lies in modern medical interventions. This widely embraced notion positions drugs as a pivotal aspect of healthcare. Those fervently embracing this concept become more susceptible to a placebo response, initially experiencing a mood boost after taking the drug (or a placebo) under the belief that it's rectifying an underlying "disease”.

In reality, with no genuine correction or addressing of root problems, the person becomes trapped in the unending loop that characterizes modern mental health care. The declaration "I AM mentally ill" becomes an accepted truth, cementing it as their unfortunate reality. Others respond accordingly, treating them as if they are inherently unwell.

Thus, a distorted reality is manufactured and maintained.

This perception becomes their reality AND they act the part.

An idea manifesting itself into behavior.

This should not be a revelation. Everything begins as an idea.

“I AM ADHD”

If you believe you “have ADHD” you most certainly will. Since sustaining focus and attention are complex cognitive tasks and everyone will struggle to maintain focus and attention on non-stimulating or boring tasks (often daily) you would be prone to viewing this as disordered, further exacerbating your struggle in the moment and externalizing the solution. This has now become you.

In truth, attention is a skill that can be cultivated. I presume you were never informed of that; after all, it doesn't appear to contribute to drug sales.

What about persistent challenges that result in functional impairment at work, school, or in daily life? Certainly, these can be genuine issues, but attributing them to "having ADHD" is a just a lie sold to us. In fact, transforming a fictitious illness into a perceived reality hinders the exploration of genuine reasons behind someone's struggles with focus and concentration.

Could it be related to sleep deprivation, a learning disability, overall poor health, pervasive worry, trauma reactions, parenting dynamics, lack of discipline, nutrient deficiencies, malnutrition, or even some environmental toxicity? Perhaps it's linked to a past head injury, insufficient exercise, excessive phone use, drug use, drug reactions, anxiety, or an undiagnosed medical condition? Perhaps it's the environment itself that poses the challenge. Forcing someone inherently active and inclined to work with their hands into a classroom demanding you remember 19th-century history facts might be the issue, not ADHD.

You get the point.

This faux diagnosis not only obstructs a thorough investigation into the legitimate causes of genuine impairment but has also shaped a new reality where the go-to solution is generally stimulant drugs. Unfortunately, this approach has become a gateway into the mental health system, as reactions to these drugs frequently lead to additional diagnoses.

The idea of ADHD (or any diagnosis) becomes their reality and they act the part.

We Are Creators of Reality

Let me clarify- I am not suggesting everything is in your head. We live in a world with legitimate challenges such as war, poverty, abuse, drug addiction, food scarcity, and widespread suffering. Life is stressful!

I want to emphasize that I'm not undermining these very real struggles. Depression is real and the impact of anxiety and fear can indeed be crippling. Post-traumatic stress is a legitimate public health concern, with untreated cases potentially persisting for a lifetime.

Now, let's go back to my initial point and revisit those instances where treatment didn't succeed: it's not about those individuals enduring more severe trauma or having inherently more severe conditions compared to the treatment successes. No- these were not the people who were TRULY mentally ill, and the ones who seemingly benefit from psychiatry.

Not surprisingly, that wasn't the defining factor at all. Instead, what became apparent was their attachment to an IDEA of themselves as mentally ill acting as the catalyst. Interestingly, most, if not all, of those treatment failures had been fully exposed to psychiatric propaganda previously and had either been on or attempted many drugs.

When this person deeply believed they were beyond help, fundamentally broken, my efforts to offer optimism, attention, care, and empathy were met with strong resistance. Interventions to address the root issues, bring about lifestyle changes, and acquire new skills were dismissed. Even attempts to break self-destructive relational patterns faced unyielding resistance, creating a sense of stagnation at every turn.

With an unwavering belief in their "mental illness," a conviction reinforced by doctors, family, friends, and society, the only solution was a drug. They were ill, broken… beyond repair. This perception was further cemented by the frequent occurrence of multiple psychiatric drugs failing to yield meaningful change—a prevalent issue. The only apparent course of action became managing this perceived "illness." Given my staunch rejection of this viewpoint, it was only a matter of time before the therapy failed.

I compared these cases with those who've truly thrived in therapy. They bought into a powerful IDEA: to break free from the chains of their existing reality, they must actively cultivate new experiences. The open-mindedness of these individuals to such an approach opens the door wide for transformative change. Challenges aren't setbacks; they're viewed as opportunities to learn, with a resolute understanding that personal history doesn't dictate their future. They embrace the notion of not just adapting but actively creating a new life, fully aware of their inherent power to do so. And over time, they sculpt their own narratives through purposeful, new experiences.

Behavior change is a focus and a catalyst to new experiences. This is how new learning is created, an expansion of consciousness.

Now, when it comes to attributing their improvement, the reasons are as varied as the individuals themselves. Some attribute it to a revamped lifestyle involving diet and exercise; for others, it's the dawn of a new love or friendships. Trauma therapy can be perceived as the necessary impetus for getting “unstuck” from their past. A new commitment to faith, a religious community or spirituality can be attributed as the reason.

What was the difference? What was the key ingredient in the therapy:

Did a particular adherence to a diet or exercise routine make the difference?

Was love the saving grace?

Did trauma therapy spark a resurrection?

Was it the therapeutic relationship?

Or did Jesus save their life?

It doesn’t necessarily matter.

Their perception becomes their reality AND they act the part.

We're all architects of our lives, shaping the tangible outcomes of our choices. Choices such as diet, exercise, and lifestyle not only impact our health but also play a significant role in shaping how we feel.

Love isn't just a sentiment; it's a potent force that not only shapes but enriches relationships—some might argue, the very essence of life itself. Processing trauma isn't merely a therapeutic exercise; it's a conduit for post-traumatic growth, a powerful transformation from suffering to wisdom. A revitalized sense of faith doesn't just provide solace; it infuses suffering with meaning and prompts a radical reevaluation of life's purpose from entirely new vantage points.

The bottom line: what they forged became their new reality, ignited by a powerful idea.

Much like the idea of being mentally ill.

Happy New Year to Everyone!

Be mindful what you are creating.