Wellness, bootstraps, and gurus: the new toxic mental health cheerleaders.

Toxic positivity, the sunny side up mindset that has a dark side

Recently on twitter, a follower tweeted about their severe mental illness and the evidence-based treatments that they had found beneficial. It was a poignant and modest thread, written with great candour and vulnerability, and had clearly resonated with many other mental health patients who replied with affirmative responses, suggesting that for many, the tweet had evoked a ‘me too’ resonance with them.

However, one of the responses particularly struck me. The reply did not acknowledge the personal experience in the original tweet, nor did they wish the tweeter well in their continuing recovery. Instead, they immediately suggested that the person should have tried to get out of bed earlier, go for a daily run, eat healthy food, and ditch their meds. Just for good measure, they also recommended they should have tried a yoga class.

I like to imagine that the person who wrote the reply meant well, and genuinely believed that, if only the original tweeter could go back in time, they might have benefited so much from this wholesome (if pedestrian) post hoc advice, and would never have needed to see a psychiatrist or take prescribed medication. When challenged gently about their apparently high minded attitude, they responded with ‘it worked for me’.

Well intentioned advice, perhaps, but also unsolicited, unhelpful, and coming from a single authority (“Because I say so”).

To me, the brief message in the reply reflected a school of thought in psychology which advocates that people with mental illness should steer clear of conventional evidence-based treatments and should instead seek alternative approaches to relieve their ‘distress’.

Proponents of this view usually denigrate evidence-based practice and express a ‘life is tough, get over it’ view of mental illness, or what I call the ‘bootstraps method’. Rather than use the term ‘mental illness’, they prefer to talk about normal suffering/distress caused by social and economic pressures and power imbalances.

To anyone who has a history of mental illness (in my own case, adolescent psychosis and its prelude and aftermath), the positive Pollyannas do not motivate, cheer, or give hope. Instead, their cloying, syrupy, unsinkable buoyancy translates into a shutting down and silencing narrative that, to the recipient, feels a lot like shaming and gaslighting. It’s the bootcamp coach whose ‘in your face’ exhortations come with a serious case of psychological halitosis.

Three types of toxic positivity: 1) Wellness toxicity, 2) Bootstraps toxicity, and 3) Guru toxicity.

Wellness Toxicity promotes the idea that if we only looked after ourselves a bit better, we can dodge mental illness entirely.

Adherents of this view tend to thrust a litany of salutary ideas at us which, as in the example above, are usually unsolicited, and come with a strong whiff of privilege and ableism. Firm favourites tend to be the very dog-eared suggestion, ‘Have you tried mindfulness?’, often accompanied by suggestions such as:

Have a bath

Drink some tea

Go for a run

Try these supplements (including an I/V drip of vitamins (as you relax on your white leather sofa, overlooking the California coastline)

Meditate

Join a hot yoga class

Dry brush your skin followed by an infrared sauna

Eat a diet consisting of line caught wild salmon, Paleo foods, fasting, raw food, green goop, or perhaps even a cocktail of your own urine.

The aim of Wellness Toxicity is to take your health and then sell it back to you, primarily by suggesting remarkably mundane and/or expensive suggestions that would be out of reach for most people with serious mental health conditions.

Bootstraps Toxicity is a popular social media trope among mental health professionals who have drifted away from the governance of regulated mental health services and created a brand that depends on persuading vulnerable people that they know what’s best for them. It can also be found among motley academic philosophers, cult-church members, and lay tweeters who enjoy reminiscing about the past hardship they claim to have suffered and how it made them stronger.

You may find them writing books with titles that suggest suffering is its own superpower source of strength, and/or advising us that if we haven’t yet gotten to the root of our problems, we just aren’t working hard enough. Think Nietsche mixed with your worst nightmare PE teacher and add a dash of EST training.

Bootstraps Toxicity can also come in various guises, and often presents as a supportive but tough love cheerleader who has our backs. We simply need to buck up, follow the Nike approach, and ‘just do it’!

Bootstrappers often say to us:

‘If therapy isn’t painful, it isn’t working’

‘Push through the pain/depression/fear/inertia and you’ll be a hero’

‘Your fear is a superpower, man, tap into it!’

‘Your tears are the best detox ever!’

‘You need to dig deeper to get to the root of your issues. Keep digging!’ (deeper into your pockets).

Bootstrap cheerleaders keep you captive with exhortations that breaking down is by far the best thing that ever happened to you, and they are going to accelerate the process with a psychological or spiritual bootcamp which, once they’ve finished with you, will leave you so relieved that you'll be swimming in serotonin.

Guru Toxicity may appeal to those of us who can remember the ‘70s, when emerging alternative psychological therapies declared that mental illness is simply a myth or a imaginary construct, created by psychiatry and its puppeteers at Big Pharma and, oh by the way, our suffering is really a spiritual, meaningful, or even normal experience that simply reflects the crazy world we find ourselves in. It isn’t an illness, it’s a response to the capitalist system and societal power structures that insidiously impact on our instinctive search for meaning.

According to advocates of Guru Toxicity, our behaviour is simply an unconventional and misunderstood expression of our resistance to these pressures. They lure us onto a path that they, and only they, can lead us along to find true spiritual meaning and a sense of wholeness and healing from our fractured self.

They know best, and their approach requires that we submit ourselves to their control, gradually steering us further and further away from established (evidence based) treatments.

Guru Toxicity comes in plausible sounding guises, which may sound progressive and modern, but are usually found among some of the most unscrupulous therapists around. Like bootstraps toxicity, its leading lights encourage a deep dive into our psyches, our childhoods, our parenting, our birth circumstances, and even our previous lives.

If you can’t recall having ever suffered trauma, don’t worry, they will keep excavating til they find it, or may even create some for you, via:

Re-birthing

Trauma Therapy

Psychedelics

Past Life Regression

Cult pyramid schemes promising transformation by battling immortal evil aliens

Usually only available from private psychotherapists (and away from pesky professional regulators, bearing in mind that anyone at all can call themselves a psychotherapist or counsellor) they steer the vulnerable away from doctors, clinicians, and even their own families, and into a range of treatments that demand no evidence of efficacy or safety and rely upon the individual’s vulnerability, need for direction, and desire for an identifiable, reductionist, answer to complex problems.

Toxic positivity is inherently stigmatising and ableist

All three forms of Toxicity can present together, in varying combinations. All three tend to seduce the patient with a message of ‘trust me, I’m not a (real) doctor’.

Toxic positivity dismisses any sense of trust that the individual might have in themselves, with the soothing suggestion that there is nothing wrong with them (except that they require hours of expensive quackery that can only be provided by the particular therapy master).

These alternative approaches are dangerous.

They try to instil the vulnerable person with the view that the concept of mental illness is a taboo, a make believe concept, akin to fairy tales or Santa Claus. They reject and invalidate the value of the individual’s own lived experience, and seek to reset and redefine even the deepest suffering, including psychosis, as normal, cathartic, reactions.

By removing the familiar (albeit dry and uncharismatic) terminology of medicine, they shut down the conversation, and with it the risk of dissent, hesitation, or doubt by the person who entrusts their most precious possession, their mind, to the new Psych-Sherpa.

If you are not grateful and happy that the true nature of your difficulties has finally been identified by this single, powerful, therapist, then you are at fault, you haven’t yet understood, and you will need to work even harder to get to the root of your difficulty by trusting someone who is ultimately leading you away from effective care and into a reeking swamp of pseudoscience.