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Is It Real or Really Just in Your Head?

September 21, 2017

Did you know that emotions like to anchor themselves in life events?

However, some emotions that while coinciding with a life event or experience, are actually independent of that experience or at least felt disproportionate to the experience. Hence, not all emotions are truly anchored in a life event or experience and in some cases, people may actually construct a version of a life event to try and make sense of an emotion. Emotions seek to have external justification.

This is the nature of mental illness – we try to make sense of our feelings in view of what is happening in our life, yet the feeling may be more internally or biologically determined than by an outside stimulus. The feeling may actually be quite independent of a life event or experience.

Hence we distinguish between endogenous and exogenous contributions to mental illness.

If endogenous, the depression, anxiety or other disturbances are more biologically determined even if one tries to make sense of the feeling by attributing it to an experience.

It is just that you don’t have to have experienced serious life events to have an endogenously determined mental illness. To add, there is a good likelihood that a close relative, (parent, grandparent, sibling, aunt, uncle, cousin) also has the same or similar mental illness.

If exogenous, then the issues are truly tied to external events, such as loss of a loved one, abuse, neglect, etc.

It may also be the case that both endogenous and exogenous issues are at play.

To further complicate matters, significant negative life experiences (trauma) or less serious but ongoing negative life events can alter the brain to then evoke biological changes to create a longer lasting endogenous mental illness.

This is so important to understand and determine as it affects treatment: Endogenous, exogenous, or both and to what degree?

It can mean the difference in the kind of medication that may be helpful and the duration for using medication. It can also mean the difference in terms of the type of counseling that will be most helpful.

That is why assessment before treatment is so important. We seek to understand and determine the appropriate diagnosis and the degree to which factors involved are biologically determined or the result of certain events or experiences – or both.

I am Gary Direnfeld and I am a social worker. Check out all my services and then call me if you need help with a personal issue, mental health concern, child behavior or relationship, divorce or separation issue or even help growing your practice. I am available in person and by Skype.

Gary Direnfeld, MSW, RSW

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Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert in social work, marital and family therapy, child development, parent-child relations and custody and access matters. Gary is the host of the TV reality show, Newlywed, Nearly Dead, parenting columnist for the Hamilton Spectator and author of Marriage Rescue: Overcoming the ten deadly sins in failing relationships. Gary maintains a private practice in Dundas and Georgina Ontario, providing a range of services for people in distress. He speaks at conferences and workshops throughout North America. He consults to mental health professionals as well as to mediators and collaborative law professionals about good practice as well as building their practice.

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