N.B. This essay is based around the effects of long term developmental trauma and those who survive it.

We learn that through the process of living that one must accept and own their decisions no matter what the consequences. That is one of the unchangeable characteristics of the process that we call living.

As one gets older we learn to make better decisions based on experience and learned behaviour. There are many others factors that influence our choices. Morality plays very large role as do too, unconscious data retention and emotional states. We all have made decisions which are not really important, things like “What to eat for dinner?”, “Do these shoes fit nicely?”

Also we have made life changing choices. “Will I marry this person?”  “Should I take and keep what is not mine?” “Will I decide for someone else how whether they care for me or not?”

The majority of folk make trivial and life changing decisions with a focus that is rational and hopefully even minded. The best descriptor would be “Normal People”

And now before anyone gets all “high fallutin’” , there is a normal! Its parameters are very broad and cover a lot of behaviours, thinking processes and physical states of being. Ask someone who lives with a chronic disorder or illness if there is a normal. You will find there must be, otherwise there can be no differential diagnoses of any kind, through a process of rational assessment. For example- Cancer is not the norm for any living creature. We treat it so a normal existence may once again be the status quo.

Are you aware that there is a population of folk who must attempt to make rational decisions with an irrational mind? Like everyone else, this population must live with and accept the outcomes of their choices. Unfortunately a significant percentage of these choices are not in their own, (or anyone else’s) best interest.

Imagine if you will,

A man of forty years of age has been chronically acute in his lack of mental health for the majority of his life. He tries very hard to be a good person and has very firm views on what is acceptable behavior and what is not. Often the standards are unattainable and mostly applied to themselves rather than any else

Unfortunately for him, he is heavily influenced by his upbringing and also the state of his mind, which is often irrational or disordered. He must live within his community and therefore must at least learn to mirror back a mask of normality. Masking is one of the most important skills a person with a mental illness must perfect. One must appear to be untouched by the chaos that runs rampart in the mind and also the physiological aspects of existence. Too, he must perfect the outward façade of decision making. He will need to rationalise his decisions when challenged on the basis of such. So with masking in place, he makes what he believes as the right choice in any given situation. As is often the case, that decision has an effect on the lives of the people around him. Those people he knows and those he doesn’t. That is often, one of the biggest stumbling blocks for an irrational mind. How not only to make a decision which he can rationalise but one that stands up to testing of logic if questioned by some else. And whether the person themselves can live with the natural consequences for themselves and others who make be effected by the process. Having a strong moral centre this person has to be sure that any fallout for the choice is not a negative one.

He is not always and sometimes not often, successful. And the price paid is truly and very often confusing and damaging.

But what are the options?

Anyone with any real dignity left, can’t and won’t take the easy option and simply fob off the blame, onto their mental health condition. In fact almost anyone who isn’t sociopathic or border line disordered, will often take the wrap for poor choices that do not belong them. This is learned behaviour, a survival mechanism and is a very sticky trap.

With appropriate treatment and therapeutic support these issues around decision making can have significantly   improved outcomes.

The only real barrier to this is the actual availability of these treatments and therapies. To improve outcomes and consequences and therefore improve the quality of the decision making, takes an almost disproportionate level of effort and time. Not to mention the dollars needed to make this happen.

So I ask you, when will the difficult and complicated and indeed complex, lives of people who have undergone prolonged and intrinsically damaging developmental trauma, be a priority when treating the population of people with a mental illness?

I ask this because like so many others, I suffer the rational consequences of irrational decisions made with a non-volitional, irrational, mind. We could definitely use some effective and easily available therapeutic and clinical support.

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