“Doctor, what is your end game? Up to now I have been passively going to therapists like a bump on a log and now I am sitting here in front of you. I want to get well! I believe I can get well! I want to know how listening to you will get me on a path to well-being. I want to feel good and be free of all you doctors. I know a person who was psychotic…. he heard voices, had delusions and fantasies. He really tripped out at times and would ‘wake up’ in a hospital. He tried to kill himself. He spent over 15years heavily medicated and still his psychotic manic episodes ended him up in mental hospitals. He spent years talking to therapists like you and doped up on meds, but now he is free…. free from doctors, meds, hospitals, padded cells and he no longer goes ‘schizo’. I want to be free. How is your therapy going to get me there? How will I know if I am getting well? What am I doing wrong? How are you going to help me change so I don’t ever have to see the likes of you again?! Sorry, but that is how I feel.”
Evolution has established a cognitive/physical/emotional correlation such that emotions provide consciousness with an awareness of the health and well-being of the body’s physiology and biochemistry. A useful definition of mental illness is the inability of a person to respond constructively to emotional signals. Individuals feel or perceive emotions and normally respond to their emotional guidance system by creating and accentuating cognitive activities that bring about positive feeling emotions. Negative emotions are a driving impetus to create new and different cognitive activities that bring about a healthy, good-feeling emotional response. If feelings are skewing negative, this is the brain’s signal to cognitively reconstruct this negative stimulus or to get off this subject entirely and refocus the mind and its activities onto something that brings a positive emotional response. The objective is to keep the mind and its cognitive powers of perception, recognition, conception, reasoning, and imagination – along with the body’s capacity of actualization – continually reaching for better cognitive activities and thus, for the good feeling emotional responses indicative of a healthy physiological biochemistry.
Within the concept of emotional guidance is the cognitive construct of want and desire: more precisely, the pleasure one feels when perceiving and cogitating upon obtaining and having that which is wanted and desired. The foundation of a psychotherapy rehabilitation that asks, “What do you want?” reaches through to activate the core of our evolved DNA that creates pain when hungry and pleasure with fulfillment. The beginning of healing starts with reaffirming and strengthening the cognitive neural networks of an individual’s objects of desire and wanting, and, their correlative emotional feelings of pleasure.
“What do you want?” is a question that brings about an emotionally negative response if the patient is dwelling within the cognitive constructs of the ‘not wanted’ or ‘lack of’ that which is actually desired. Our evolutionary reflexes are to move consciousness into cognitive activities of ‘that which is wanted’ and to how to attain it. The therapist’s role is to aid in their patient’s understanding of this process and to train and develop his/her cognitive skills necessary to pivot cognitive activity from that which is ‘not wanted’ to cognitive activity of that which is ‘wanted’…. from feeling bad to feeling good. Emotions are the guiding light regarding the success or lack of success in this change of focus within cognition. Neuroplasticity of the brain means that everybody has the capacity to realize a new and more beneficial reality because the brain can rewire itself and create new circuits of understanding and alternative healthy behavior.
Therapy based on the symbiosis between cognition and emotions reaffirms an evolved biological guidance system where emotions are used to evaluate cognitive behaviors. In stark contrast to ‘emotional regulation’, with this approach emotions are not ‘regulated’ but are used instead to regulate, that is, to guide cognitive behaviors. Also, in this context, emotions are not viewed as ‘out of control’ nor is there a concept of ‘emotional disorder.’ On the contrary, it is the cognitive mind that is ‘out of control’ and the therapeutic process addresses instead, a ‘cognitive disorder.’ Deviant emotional perceptions are reflections of this aberrant cognitive behavior. The emotions are not treated as dysfunctional but, rather, are understood as very functional, in that they are bringing to consciousness the dysfunctional aspect within the mind’s cognitive activities that is creating the aberrant biochemical physiology we are perceiving as emotions. It is these irregularities in cognitive behavior that need to be addressed. Emotions are but the messenger.
It is the symbiotic nature of cognition and consciousness that enables a person to ferret out that which is wanted from within that which is not wanted. This nature also enables a person to acknowledge that which is not wanted (or focus on the lack of what is wanted) from within that which is wanted. Cognition and consciousness have a basic biological function to maintain a healthy and vital physiological biochemistry. Emotions have a function. Emotions bring an awareness to consciousness of the health, or lack thereof, of cognitive activities. Feeling good correlates with a healthy biochemistry and feeling bad correlates with an unhealthy biochemistry. Psychological and pharmaceutical therapy must honor these functions. Mental ‘illnesses’ arise when healthy responses to the emotional system are absent and the individual does not have the mental/emotional capacity, agility, or wisdom to respond to his/her emotional guidance in a natural and healthy manner to ‘get his/her mind off the hot stove’.
The goal and practice of psychological rehabilitation is to utilize the brain’s power of neuroplasticity and to develop within a person the mental agility and reflexes to constructively respond to his or her emotional guidance system. At first, these steps may simply go from painful emotions to less painful emotions, but eventually, with the development of new habits and skills of mental agility, the steps will be from feeling emotionally good to feeling emotionally even better. The presence of these skills is the presence of mental health and well-being and the ability to lead a ‘normal’ life.