Position One: Curing Mental Illness
If I have an “illness” I can seek a “cure.” If I seek a cure I am likely to—since pills cure so many things—look for the magic bullet of a pill. If I am “sick” you can’t blame me or expect me to be responsible for my behavior. I do what I do because I am “sick.” And because I am sick, it means someone should take care of me, because that is what people do when someone is sick, right?
A “medical” model of mental illness inherently searches for a biological cause. And there are certainly biological causes of mental illness like syphilitic lesions, UTIs, basal ganglia cell inflammation (for which little testing is done), meningitis, and certain parasites that cause symptoms of the things we call mental illness. Treating these biological illnesses requires less expensive diagnostics and allows care to follow the current medical paradigm. Ask the woman who wrote Brain on Fire. She’s a great example. Or the women who were chronically suicidal and later found to have a parasite found in cat feces transmitted by cleaning cat litter. For each of these, being a “patient” with a bona fide biologically based condition would be very comforting. Get the body right, and the symptoms (should) disappear.
Even when the cause of a mental health diagnosis isn’t biological, but is behavior learned in the context of specific settings, naming the challenge as a disease may help the diagnosed person make sense of experience. However, a “patient” can also become a scapegoat – everyone else is behaving badly, but I have a diagnosis, so they put the spotlight on the person with the diagnosis. Your behaviors are understood in the context of “It’s your illness…” or “Might this be because of your history?” or “Well you can’t trust what SHE says.” Seeing challenges behaviors as the inevitable result of an “illness” becomes a “Catch-22” that makes healing nearly impossible. And over time with the insistence of how “sick” one is, it becomes easy to believe it. The shame and judgment are easy to internalize, and it becomes easy to believe less of oneself. Even if you believe more of yourself than others do, the scarlet letter is there, and the risks of having the knowledge of your “condition” used as a weapon in relationships, work, faith, communities and healthcare is present.
Are there patterns of connections in the brain that make thinking, feeling, and acting in ways that most others do difficult if not nearly impossible? Of course. Can medication help people feel better and have the room to think, feel, and act differently—can it help adjust those patterns? Of course. Does learning to transform challenge thoughts and behaviors require developing a sense of self, personal agency, learning to say no and deal with the flak that comes? Absolutely. And that is something at which we are less than proficient.
Position Two: Improving Mental Health
Everyone can improve mental health—think about personal and professional development, self-improvement, and the many programs and labels people apply to efforts to change their thoughts, feelings, and actions in ways that make it easier for them to fit in, relate, grow and succeed. And, truthfully, when you begin to think about how specific behavior is helpful (without copping an attitude about the other person’s behavior!) and consciously choose to believe people are doing the best they can… well, the world changes. Everyone has some degree of mental health that can be improved.
Strategies to improve mental health are available to everyone. They require no diagnosis. They only require identifying something one defines as “better,” or “healthier,” finding a model, and practicing different thoughts, feelings, actions. Every athlete, musician, actor, physician—everyone—practices something to perfection. Change the target, change the practice, change the outcome.
Unlike curing a disease, improving mental health is a stigma-free process. It gives a person power in the process: instead of a patient or consumer, you’re the person who pays the caregiver’s salary, directly or indirectly. You’re the person who has a right to health and who is paying the other person to help you develop it. It’s a learning process instead of a curative process. Learning is the work of life. Learning liberates the diagnosed person from the shame and stigma of disease in order to look at “what happened” and to create a different way of being.
Please join me on Facebook to discuss mental health and this thing some people call mental illness.