Mental! Who are you calling mental

The very use of the word ‘mental’ in mental health is pretty screwed up - do you agree?  Why not ‘emotional health’? In 1960, Thomas Szasz published ‘The Myth of Mental Illness’ a controversial paper that rang alarm bells throughout psychiatry circles.  Szasz argued that mental illness is a damaging myth, and had no established foundation in biological pathology. 

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In fact, he argued that the concept of mental illness takes away the human responsibility, and what has been labelled as ‘mental illness’, is actually the “human problem with living”.  Szasz was criticised of course, and his views have been dismissed by the American Medical Association, American Psychiatric Association, and the National Institute of Mental Health.

However, Szasz recognised the very real human struggle with how we should live.  He acknowledged that we struggle to attain “our place in the sun”, that we struggle to attain “peace of mind”, and that “we have problems in living”.  He strives to remind us not to mistake medicine with magic, and to look at the bigger picture .  Perhaps it would be wise for us to approach mental health with the current and trendy “dis-ease” label rather than disease.  I mean, the reality is most of us feel dis-ease most of the time. That is the essence of anxiety, a lack of ease. 

Dr Tom Insel, in an inspiring Ted talk, proposes that we need to rethink mental disorders as brain disorders. Not as the usual codswallop that we have been told regarding a chemical imbalance in the brain. Insel proposes that the brain is an organ of surreal complexity, and that we are only just beginning to understand it. In mind illness's such as depression, anxiety, OCD or PTSD, there are differences in circuitry, unlike brain disorders such as Alzheimers, or Huntington's Disease, where there is a malfunctioning part of the cortex. These mind illnesses are just like a traffic jam within the circulatory system. Dr Insel suggests that we could compare it to the heart where you may have a heart attack (the brain equivalent being Alzheimer's, Huntingtons) vs an arrhythmia ( the brain equivalent being depression, OCD, PTSD).

An illness of the mind may be a case of a mind stuck in traffic (or in rumination and suffering), and we can break through with the right tools. And when we are assessed for mental illness, we are compared to what is 'normal'. There is no normal when it comes to mental health. In fact, ‘The Myth of Optimality in Clinical Neuroscience’ was a study published in 2018, from Yale University Psychology Department, debunking “normal”.

It was concluded in this study, that despite popular belief, there is no universally optimal profile of brain functioning. And it gets better when they state “we propose that, instead of examining behaviours in isolation, psychiatric illnesses can be best understood through the study of domains of functioning and associated [complex] patterns of variation across distributed brain systems”.

What this means is that attempting to define people due to divergence from a psychological model, is a really sad way of disempowering said person. That person will never be able to connect with their true self, as their true self is not considered normal.

We may go to a doctor with symptoms of anxiety, and then we are assessed in a linear, one size fits all approach, while the world is inherently wide-ranging, and in a “constant state of flux.” This is not to say that if we are suffering we shouldn’t seek help from a caring physician, but I would argue that the care sought should be integrated, as opposed to simply prescriptive.

 

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