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Deconstructing "mental health" & "mental illness"

Updated: Nov 21, 2020

  • Opening points

    • We are deconstructing the idea of "mental health" and "mental illness".

    • We are not negating, minimizing, or romanticizing the reality of suffering. Suffering is real. The interpretation of suffering as “mental illness” is a choice we make as a society based on many factors.

    • Holding these two together—deconstructing the idea/framework plus acknowledging and finding a way to alleviate suffering—is difficult given where we are as a society, because the latter currently depends on our established framework. What I am trying to do is explore whether there is a better framework.

    • The change in perspective and education I’m suggesting is not one that can happen overnight. If you are under the care of a professional or have a care plan established, please do not make sudden changes based on what you learn here. Rather, if you find this meaningful, discuss this with those who you trust and are knowledgeable, including a professional.

  • Why do we interpret certain kinds of suffering as “mental illness”?

    • Our society does not understand the mind well. Many interpretations and practices for exploring the mind are not part of our educational systems. This leads to a lack of insight and sometimes helplessness when faced with unusual and painful behavior/experiences. This is then interpreted as illness.

    • Our society is not consistently compassionate, so applying a label of "illness" helps us to understand there is something significant happening and that deserves compassion. We should not need to label suffering as illness to express compassion. This is more a commentary on our society than on suffering.

    • Medicalizing suffering as illness supports the practice and industry of diagnosing and treating suffering.

  • Stigma

    • We create the interpretation of “mental illness” then try to de-stigmatize “mental illness”. There are reasons for the stigma. One is because there is a lack of understanding of the mind leading to helplessness and fear in the general public, which in turn creates distance and a lack of compassion. Another is the lack of societal and political will to address lifestyle factors (homelessness, economic injustice, hunger, racism, sexism, etc) that create mental trauma. This again creates distance, fear, and a lack of compassion. One solution for the stigma is for professionals and educators to simply to go beyond the phrase "mental illness" and associated diagnostic labels. Instead, simply use the descriptive words that those who are experiencing difficulties are using. It is not the labels themselves that are the problem. It's their vagueness and the resulting confusion that is allowed to proliferate. So we need to go beyond these labels until clarity sets in.

    • "Mental health" sounds better than "mental illness" because nobody likes the word illness, yet "mental health" it is just as vague. "Mental health" movements say we must take care of ourselves, but they generally fail to say the most important points: "We don't know what the mind is. We need to find out. Here is our plan to find out more." There is a lack of awareness of the problem and lack of accountability to hold ourselves to a higher standard of knowledge. Good intentions must be informed by insight. The existence of a vague entity called "mental health" ensures the persistence of a vague entity called "mental illness".

    • Deconstructing these non-medical concepts can unmask feelings of hopelessness, fear, anger, and even violence, both on the part of those suffering and on the part of professionals because it threatens the feeling of having ground beneath our feet. It threatens the idea that we know what is happening. But we can know more if we look more closely. The situation is not hopeless.

  • Reminder: Suffering is real. We have to find the best ways to address it. The interpretation of suffering as “mental illness” is a choice we make as a society based on many factors.

  • My mind went through an integrating process that began in my twenties. The sense of identity and the sense of body and mind became more fluid. Key factors that worked for me during the integration process:

    • Was part of a tradition and culture that said that the integration that was happening was a key, important event in the journey of a human being.

    • Had close contact with someone who had been through a similar process and had, in a sense, seen it all before.

    • Made changes in lifestyle such as food, spending time in nature.

    • As a physician, I understood the implications of the modern lack of understanding of mind-body perspectives, criteria for diagnoses, and so on. As a result, I was able to hold multiple worldviews together and communicate according to the level of understanding of the person front of me.

  • Key factors that worked against me

    • Neither I nor the society around me fully understood what was happening and what was needed. If we did, I think there would be a kind of sabbatical built-in to our societal structures to allow the process of integration to continue, followed by a period of re-integration into societal life, where new insights are valued and applied to societal systems.

    • I had a framework, yet didn’t have detailed understanding of the process of integration and the relationships between the First and Second Minds.

  • Why are "mental health" and "mental illness" not primarily medical realities?

    • They are culture-dependent and education-dependent. (This is the case for non-psychiatric illness as well, however the expertise of biomedical science is in biology and physicality, not mind.)

      • In some cases, "mental illness" in one culture may be not be an illness in another culture.

      • If our education about the mind were better and we addressed societal problems, many kinds of suffering would not become "illness".

    • Both "mental health" and "mental illness" refer to the mind, but we don’t know what or where the mind is. What if I, as an emergency physician, diagnosed someone with a "kidney infection", yet could not tell them what the kidney is or where the kidney is?

  • The beginning of a solution

    • Ask:

    • Does the general public need the phrases "mental health" and "mental illness" if we have deeper insight into the mind, if we find there is hope through discovering meaning, and if we are compassionate?

      • Are we doing our very best to mine the knowledge from other cultures and translate and map that knowledge to our understanding?

      • Are we willing to admit what we do not know so that we can learn?

  • If you are overwhelmed:

    • Know that experiences can be painful and difficult and still carry some meaning. Many find that discovering this meaning helps to heal.

    • Know that others have had similar experiences and made it through to new levels of insight and function.

    • Know that there are practices that can help to develop insight and stability. However, these are unique to every person and situation. A practice that helps one person may make the situation more difficult to manage for another.

    • Ask for help from a friend, someone who has been through something similar and is doing well, and/or a professional.

    • Know there can be a role for medication to facilitate this process.

  • If you are not overwhelmed:

    • Invest in self-education, and if possible, public communication. Understanding the mind comes from being willing to explore one's own experience, recognizing one's thoughts, emotions, and history, recognizing the Second Mind, recognizing a more complete anatomy of the human being, understanding the basics of philosophy of mind, and ongoing introspection reconciled with action.

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