I have more recently come to respect the idea of mental illness. It does seem possible that we can become involved and even stuck in lasting patterns of deeply destructive thought, behaviour or realities. It also seems possible that pharmacological support for such difficulty can be helpful. Furthermore, I must confess that I have even become aware that many people might willingly embrace the illness labels that they are given by professionals.
For instance, understanding relatively destructive and habitual sexual behaviour as a “sexual addiction” might help in gaining some sense of control over it, avoiding the behaviour in future and encouraging support from partners in dealing with the behaviour. Similarly, the understanding of oneself as “bipolar” might help to finally acknowledge deeply destructive aspects of ones life, gain a sense of “ok, this is what I am suffering from and why I was capable of this”, and help one take predictable steps towards avoiding, or at least coping with, such difficulty in future. Do such categories have any fabric of truth woven into them? Can ones character be said to have a “pathological” structure to it? Although I have learned not to dismiss ideas of pathology and psychiatry altogether, what if the answer to these questions is less important than the practical implications of such illness based understandings? What if the most important question was not whether mental illness exists or not, but: “When do the professional practices associated with diagnostic categories have constructive or destructive implications for those struggling with such experiences?”
Kenneth Gergen (1998) speaks critically of the psychologist as heroic scientist who is supposedly able to step outside everyday influences and “carve truth from nature”. From this position we can measure, predict and treat what people bring to us (a position arguably taken from medicine). You tell me a story about your experience, from this story I identify symptoms, these symptoms lead me to a diagnosis and from this I base my “treatment” of you. You bring me an experience and from it I carve out what is wrong with it. Your pathos allows me my heroism. My treatment of you relies less on your own interpretations and more on professional versions of you. And so, what happens to your personal power, your knowledge and your own versions of your life when you sometimes take on a medicalised category in attempting to understand your difficulty?
In other words, along with my respect for the idea of mental illness come cautioning questions: How does the idea of “mental illness” contribute to peoples’ experiences of themselves, in both positive and negative ways? Does it lead to a sense of empowerment, value and sense of control over ones life? There is growing concern that medical approaches to peoples experiences lead to a loss of personal narrative (Roberts, 2000) – the potentially interesting and elaborate stories I have for myself are replaced by a more generic and limited clinical one.
In conclusion, in many circumstances it might be important to acknowledge “mental illness” but the ways in which this mental illness is acknowledged has significant implications for the position from which we can try and deal with it. A new psychology attempts to provide a different experience of illness by viewing the illness as something acting upon us (and the people around us) rather than something that is an intrinsic part of us.
Gergen, K. J. (1998). The Ordinary, the Original and the Believable in Psychology’s Construction of the Person. In B. Bayer and J. Shotter (Eds.) Reconstructing the psychological subject. London: Sage.
Roberts, G.A. (2000). Narrative and severe mental illness: what place do stories have in an evidence based world? Advances in Psychiatric Treatment, vol6, pp 432-441.