The Biggest Problem in Mental Health Treatment – Monica Cassani

The biggest problem in mental health treatment

Click on the above link to visit Monica’s extremely valuable resource base at for this post – which accords with how we make sense of our work at this service:-

‘The biggest problem in mental health treatment is the idea that anybody need be treated at all. What people really need is a safe space to be who and what they are. Once people are in a safe place they simply need to be supported in trusting their own process. When this is done right everybody’s path is going to look radically different.’

Yes, just so. Thank you, Monica. This is such a simple truth, and one so little seen or acknowledged. Even in the supposedly person-centred world, most therapists will ‘yes, but’ such a statement, introducing borders at which point – without adequate evidence or a thought-out/felt-out basis – they bring in the language of ‘mental health’ and psychiatry. This perpetuates a system which tends to make people into objects, to be done to and known better than. That system mostly fails to meet people as they need to be met, and at worst causes extraordinary harm, as Monica says. The writer has been practising since 2006, has worked with many people with fat psychiatric files in their pasts/presents – and has not yet experienced any apparent edges to Monica’s ethos.

The writer carries a vision of a 24/7 ‘safe space’, which she would like to participate in creating – somewhere people could choose to come and stay for a little or a longer time. The ‘safe space’ is a mixture of physical (a comfortable, welcoming, nurturing environment – more nest than clinic) and relational (the availability of loving human relationship characterised by the core conditions).  It would include other beings – because often people can connect with a creature, when they feel too burned in human relationship to risk it – space to connect with the natural world, a mix of private, withdrawing space and space for relationship/community. It would offer a structure forming around flow and radiating outward from the person – not imposed externally – founded in respect for personhood and diversity, and a sense of trust in each other and in that flow.

There are many who come through our doors who are wanting and needing more support than we are set up to offer or able to offer. Their reality is often that we are what they have – because the ‘mental health system’ alternatives are not available, or tried and found wanting, or not wanted. So they – and we – do our best with what is available. Therapy is a process of support to each person in finding the many and diverse paths to their unique well-being – and the well being of one always tends towards serving us all, as Carl Rogers noticed decades ago. Monica speaks of these paths at the end of her post. Each person will uncover them for themselves, with the support that is needed. No-one else can know what they will look like.

The power of the human spirit to turn a little of what is needed into enough, a lot, abundance…however slowly and painfully…never fails to evoke our wonder and respect, although also anger, activism – it does not need to be this hard. We could structure our cultures to provide multiple sources of the safety, support and respect for personhood which Monica describes.

‘Authority over others is violence.’

Yes, and we do not need it. All any of us need is adequate support in accessing, encountering and living through our own personhood and sovereignty. A sense of the sacred – however conceptualized – in ourselves, each other, in all life, each moment and each act.

Thank you, Monica, for all you do. The Soundcloud talk included in Monica’s post is a hugely worthwhile listen.

Palace Gate Counselling Service, Exeter

Counselling in Exeter since 1994

This entry was posted in abuse, actualizing tendency, autonomy, client as 'expert', community, consent, core conditions, cultural questions, diversity, empathy, empowerment, encounter, equality, ethics, external locus, flow, growth, healing, interconnection & belonging, internal locus of evaluation, love, medical model, Monica Cassani, non-conforming, non-directive counselling, objectification, Palace Gate Counselling Service, paradigm shift, person centred, political, power and powerlessness, presence, psychiatric abuse, psychiatry, relationship, resilience, self, therapeutic growth, therapeutic relationship, transformation, trauma, trust, unconditional positive regard, values & principles, violence, vulnerability, working with clients and tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

2 Responses to The Biggest Problem in Mental Health Treatment – Monica Cassani

  1. thank you! lovely and insightful comments…so much appreciated!

    • And thank you for all you offer. It’s supportive and enriching to connect with others who seem to be seeing a similar picture, outside of the mainstream perspectives that predominate in the therapy world (often with coercive pressures of one kind or another behind them). Have personally learned and received an immense amount through you, and I am grateful. Lindsey

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