In recommending that the “decay” of pain can be identified at an early stage and treated, Rosmarin points to the decay of a tooth. He draws an appropriate analogy to Dental Hygiene:
This approach is already practiced in many other areas of health care: It’s called prevention. The American Dental Association recommends that even individuals who aren’t at elevated risk of periodontal disease have dental well visits once or twice a year.
Preventive dentistry allows practitioners and patients to identify and deal with issues quickly and with minimal intervention. Cleaning teeth, checking gums for decay, and filling small cavities is better than waiting until it’s time for invasive and expensive procedures. such as a root canal. Preventive psychotherapy could work in a similar way. It could help people recognize and cope with smaller emotional concerns, before the onset of depression, panic disorder, obsessive-compulsive disorder, or another mental health problem.
At this point, I move beyond (and perhaps away from) Rosmarin. It is not just enough for the psychologist’s door to be open for the identification and treatment of pain. It is equally important to consider ways in which the pain is being defined and then treated. When pain is identified as a given of life, then it can become clean. A psychological process such as aspirationally-based psychotherapy can be engaged that leads to mending of the clean pain and to learning and subsequent growth (Menakem, 2017, pp. 19-20). The clean pain is metabolized (converted) by our body into a motivation for us to more deeply explore our own psyche and for reform of the setting in which we choose to live (Bergquist, 2020). Alternatively, when the pain in life is defined by a deficit model of psychopathy (as is the inclination of Rosmarin), then it is likely to become dirty. As a “mental illness”, pain is stigmatized and often never addressed (Lewis and Munzer, 2021). Treatment is avoided and the unprocessed dirty pain leads to shame and denial—thereby further exacerbating the pain and the trauma that precipitated the pain.
It is not just a matter of prevention (as an alternative to treatment). It is also the matter of empowerment and the modification of our often traumatizing, pain-inflicting and “crazy” environment. This is a key component of an Aspirational perspective. I have offered my own analogy (drawing on the work of Camara Phyllis Jones of the American Public Health Organization: Jones, et.al. 2009). I suggest that people standing on the edge of a cliff need not just be prevented from falling off the cliff (therefore requiring treatment and ameliorative services) (Bergquist, 2019; Bergquist, 2020e). They can be invited (and empowered) instead to move away from the cliff and find a new way to live their life.
