Mental health interventions have evolved drastically over the past few years. From institutionalisation and physical restraints; the likes of straight jackets, handcuffs, and chains


By Mertha Mo Nyamande

Mental Health Interventions have evolved drastically over the past few years. From institutionalisation and physical restraints; the likes of straight jackets, handcuffs, chains, etc) to chemical restraints with the likes of CPZ or chlorpromazine as a rapid tranquilisers.


The more modern interventions favour atypical medications with little to no side effects, and talking therapies more than the restraining types.

The main talking therapies are Cognitive Behavioral Therapy-based, which have also evolved from behavioural therapies to cognitive therapies and now a combination of the two. The behavioral therapies focused only on the behaviours that were exhibited by the individuals.

The cognitive therapies recognised that for a behaviour to occur, there is a driving force behind it, which is the cognitions.

This is what gave rise to the Cognitive Behavioral Therapies that works on the premise that whatever is exhibited, there is a set of thought patterns behind it and therefore if we can identify the thinking and change the thinking, we can change the behaviour.

The dilemma with this modality is that human beings are creatures of a habit, and thereby formulaic approaches can be problematic. We tend to replicate things over time to the point that whatever thinking we use in most of our activities is something that has been there for a long time and almost became ingrained to the point that it has become our normal, however abnormal or disruptive they may be.


What is normal is essentially what is repeated over time and acceptable by our peers and societies. So, when someone approaches anyone to say whatever they are doing is not normal, who decides what is?

Often, it is the outsiders that come into an environment and judge the practices in which they enter by comparing it with their own normalised.

As such, the colonizers brought different practices to what was considered normal by our ancestors and were influential enough to convince them that their ways were better and more normal.

Centuries later, we are still trying to find our way through these new ways of doing things, most of which still do not make sense to our people, yet we still try to follow them anyways.

This creates what is referred to in the psychological circles as dissonance, were doing what we have been taught does not make us feel or achieve what we think they should.

Therefore, the interventions like CBT aim to undo or unlearn the lessons that have been taught that have proven unhelpful and particularly painful to one’s ways of being, in order to re-train different ways that work better.

We only consider them less effective or not good if the individual or communities practicing their struggle to make them work. So, it may create even more difficulties to do things differently, yet again, until they become commonplace and normal and less confusing as new habits.

Our parents would have been taught and learnt different ways of doing things, ways that may have worked at the time when they grew up, but we find that applying some of those ways today, would create chaos, yet somehow, we do it anyway as a sign of respecting their “culture”. Culture though is practicing that work at a particular time, and these change with time and as new information is received.

According to Maya Angelou, people always do the best they can, although that may not seem so to others observing, and they always do better when they know better.



The dilemma is that at times, when we know better, yet struggle to change our habits, this is what mental issues stem from.

While the traditional dressing in animal skin hides worked well in the 18th century, they would become inappropriate in today’s world, and so should some if not most of the other practices associated with those times, yet somehow certain aspects are allowed to die off while others are fought to stay.

The dilemma with the change is also associated more with the practices, than with the principles that the practices sought to satisfy, for if we understood the principle, it would be a lot easier to amend the practices in line with the principles.

Most of what is considered mental health issues are things that challenge one’s beliefs in ways that question and in some cases threatens their sense of being, their identity, a concept known as moral injury.

While we may also try to quieten the pain of these injuries with tablets, other substances that numb or escape into work, football, sex, TV, the internet or other fantasy spaces that distract us by distancing us from our pains.

These vices subsequently become addictions that can become problematic for us to function in ways that are expected of us without causing difficulties.

Therefore, whatever the interventions that we sought to utilise, they ought to focus or be based on a focus on principles more than various practices of culture across the geographical expanse.




Psychotherapist Mertha Mo Nyamande @













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