What is ‘mental’ about ‘mental illness’?

There was no mention of ‘mental illness’ in Nellie Bly’s ‘Ten Days in the Mad-House’ (1887).

Although she does not name the illness for which she was diagnosed, it was ‘hysteria’, an affliction doctors ascribed especially to young, independent and assertive women. It was often regarded as short-hand for sexual voraciousness. Rather obviously, then, hysteria involved the entire body, not just the ‘mental’ bit.

Nor was she admitted to a ‘mental hospital’. She was admitted to Blackwell’s Island Insane Asylum. No room for ambiguity there. The asylum in those days was an unhappy marriage of a prison and a hospital. The insane were on the inside and the sane were on the outside.

Notwithstanding the title of David Rosenhan’s ‘On Being Sane in Insane Places’ (1973), he and his fellow pseudo-patients walked into the categorizing arms of the Diagnostic and Statistical Manual (1968) of the American Psychiatric Association. No binary divisions here, but 182 ‘disorders’. (There are a lot more now). One pseudo-patient was categorized as manic-depressive and the rest as schizophrenic. All bona fide ‘mental’ illnesses.

They were admitted and detained in what were variously described as psychiatric or mental hospitals.

So what had happened between the 1880s and the 1970s for the ‘mental’ to break free of its bodily moorings?

Some preliminary points.

The counterpart of ‘mental’ is physical, which, in this case, means bodily or somatic. There are ‘real’ illnesses and there are intangible ‘mental’ illnesses.

And within the ‘mind’ of the mentally ill there is an imbalance between cognition and emotion—as in ‘he killed himself because the balance of his mind was disturbed’. People are mad or mentally ill because their behaviour is uncontrolled by reason or judgment. Treatment focuses on how best to recalibrate this disturbed balance, using psychotherapy and/or psychopharmacology.

But as anyone who has been diagnosed with a mental illness knows, it effects every fibre of your being, including most of your organs and limbs. It’s not just the bit above your shoulders that’s a problem.

And as anyone socially connected with a mentally-ill person knows only too well, all who come into contact with this person get to be affected too. For example, a depressed person is a black hole of negative energy, draining the life out their nearest and dearest. Not since the days of Newton has there been such an example of action-at-a-distance.

Mental illness is simultaneously mental, somatic and social. Running between these levels is the emotional. Perhaps we should be speaking of emotional rather than mental health?

In fact, the causation may run in both directions.

Consider the possibility that the mentally-ill embody social ills, in the same way that canaries down mines detected gas by dying. Perhaps mental illness is a rational response to mad social situations. If that were so, we’re doing the equivalent of resuscitating canaries and sending them back down the mine.

Like the fool in Shakespeare’s plays, perhaps the ‘mad’ are the only ones who get to speak the truth.

One thought on “What is ‘mental’ about ‘mental illness’?

  1. daveicrewcut says:

    In Chapter one of Healing the soul in the age of the brain, Dr. Frattaroli argues that modern day psychiatry focuses on mental illness as a product of the brain and neglects our inner life; the essence of humanity; our soul if you will. His is an interesting perspective, and one which would concur that mental illness is simultaneously mental, physical, social and emotional. Frattaroli (2001) suggests that in order to understand the ‘mental’ piece of mental illness, one has to understand that a person’s inner experience is not “a particular geographic locale, … , or social setting, or even a particular physical body but an indefinable inner place- the place where experiencing happens”. Frattaroli refers to this place as the soul.; that indefinable whole that integrates processes happening at four different levels- body, brain, mind and spirit. Many psychiatrists may disagree- what is the place where experiencing happens? Why the brain of course.

    Frattaroli views the current approach to treating mental illness as dehumanizing; ignoring the uniqueness and meaning of one’s inner experiences, focusing instead on the neurobiological process in the brain. As he suggests, and I happen to agree, even though medication is often beneficial in the treatment of mental illness, “it is never a sufficient treatment for an inner crisis of the soul”. The word psychiatry comes from the Greek words psyche and iatreia.

    psyche [Greek psyche life, spirit, soul, self; akin to Greek psychein to breathe, blow] 1a : the vital principle of corporeal matter that is a distinct mental or spiritual entity coextensive with but independent of body or soma : SOUL, SELF, PERSONALITY… 1b : the specialized cognitive, conative and affective aspects of a psychosomatic unity : MIND; specif : the totality of the id, ego, and superego including both conscious and unconscious components
    -iatry [from the Greek iatreia art or action of healing, from iatros physi_cian] : medical treatment : healing

    Based on his, Frattaroli’s view that psychiatry means ‘healing the soul’ is supported. Sadly, I agree with him that the medical model of much current psychiatric practice, ignores this and view all of our conscious experience as simply a by product of the way our brain is wired. By doing so, the value of the therapeutic relationship that is formed as a part of the psychotherapy process, is diminished or dismissed.

    It is interesting that Frattaroli disagrees that Descartes ‘created’ the mind-body problem with his separation of the mind and body; the thinking mind as the center of consciousness and spirituality and the physical body as operating under the same mechanical laws that govern machines and animals. Nonetheless, he does concede that Cartesian dualism has “inadvertently reinforced a somewhat schizophrenic tendency in our human nature to avoid the unsettling awareness of inner conflict by divorcing our mental life from the experience of the body” (2002, np). This has resulted in a self-alienating trend wehre we define ourselves by what we think and perceive rather than by what we feel. He contends that “we have lost the moral compass that used to be provided by our awareness of inner conflict… we have lost touch with our emotions and with our sense of the soul altogether”.

    Alas, the more we deny our inner conflict, the more it tends to assert itself in the form of psychiatric symptoms. Written over 10 years ago, I would suggest that this position is ever more reflective of today’s reality.

    Long before Descartes, healing the soul was regarded as a key to balancing the rest of the body. Early philosophers such as Socrates and Aristotle realized that the mind, body, and soul had to be treated together and encouraged the medical community to practice holistic care. We would do great justice to those suffering from mental illness if we embraced this perspective.

    Frattaroli, E. (2002). Healing the soul in the age of the brain: Becoming conscious in an unconscious world. New York, NY: Penguin Books. Retrieved from http://serendip.brynmawr.edu/sci_cult/psychoneuro/panel03/frattaroli.html

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s