I have taken a position in my individual and collaborative writings the need to highlight and focus on innate resiliency and capacity for adaptation to different life circumstances that we all face. It is a part of our biological and psycho-social-spiritual evolutionary process to make the best of our present reality of our existence, whatever they may be. Circumstances, situations, individual, and collective approaches may vary and social change and culture and our evolving knowledge base that is available. Adverse life experiences or “Dukha,” as Budha would say, is part of our human, or organism’s life experiences, and reflected in our knowledge of nature along with intense awareness of Uncertainty that confront our conscious living existence. No matter how “disabled” a person may present, he or she has the innate capacity for optimal adaptation that is present, and individual and social therapeutic approaches may need to focus how to promote that capacity, with compensatory support services, which may involve a variety of interventions involving biological, psychological, and social approaches of different degree based on client’s own and significant other people’s (involved with client) perceived needs of benefits. No one formula will fit all and needs to be individualized, that is where the challenge for a clinical service provider in engaging in mutually agreed upon strategy with the consumer-client.
Iatragenic effects or negative side effect issue are not only associated with a given intervention, biological or psychological, there is also potential for counter-recovery by fostering identification with the “illness dependent persona” that any ongoing “treatment process” entails, as it may take away client’s inner search for his or her best adaptation and sense of “wellbeing.” Too much focus on “what is wrong,” or “what negative experiences that may or may not have happened in one’s past history, may outlast the benefit beyond a point of, promoting one’s perpetual “obsession” with the past neglecting the use of positive redirection and capacity to make the best of one’s present life circumstances. After all, from a Reality Perspective, the present moment or reality of living experience that we all face, where past is gone, and future is partially can be predicted, but mostly Unknown. I do acknowledge the importance of advocacy for social policy change with emerging new knowledge base for mental health or for any other social situation, as well as need to address personal grievances for what has been done “wrong,” and ensure societal responsibility to protect future “wrong doings,” but it may be important for a practicing clinician to compartmentalize these processes, and focus on what one can do best to promote recovery within one’s discipline identified professional role, whatever they may be. How to promote capacity and engagement in various “positive redirection” activities, some of which are referred by Brian, and build in “compensatory support” (including therapeutic prompt) in the individual’s personal and social life and the “milieu environment” and collaboration with significant others in client’s life will no doubt involve thoughtful reflection and challenge to service clinicians. Approaching one’s role in some defined ways in terms of what is “possible” and what is not, given one’s unique roles and functions, may help to navigate the process to a mutual understanding and satisfaction for client and client service providers. Peer support roles for both clients and clinicians are important component to this process.
To balance the perspective, it would be helpful to cite any studies that may also show positive changes in genetic expressions and epigenetic effects across generations demonstrating “positive” effects of psycho-social and environmental factors, so research can identify what positive psycho-social factors that one should value and foster.
The other issue would be demonstration of reversibility of negative effects through psycho-social interventions, as that is also an important focus of interest to many members of ISPS types of organization, who engage in using and advocating for the psycho-social perspective, while “reversibility” research on biological and genetic interventions will be most appealing to people who have identifications with that discipline perspective.
My sense is that biological and genetic research in some ways mirror physics and astronomy, where knowledge will always be expanding, but will always be limited by the fact that much will remain Unknown and Unknowable, a simile to the assumption that approximately only 4% of known matter in the Universe is knowable, 96% of all in the Universe consists of Dark Matter and Dark Energy and remain invisible to the human mind, and possibly knowable to some extent by limited indirect evidence.
Nevertheless, it is exciting for the human mind to continuously explore and expand our knowledge base, and our associated conscious ever expanding experience in the process of discovering new intricacies of interrelated connections among physical, biological, psycho-social, and existential-spiritual Realities.