What is Mental Health and Mental Illness?

What is Mental Health and Mental Illness?

by Joe Tarantolo, M.D.


What is “mental health”?

What is “mental illness”?

No, I don’t like the terms either.

Let’s narrow it down some. How does one define health since the advent of "Humanism"? I’m defining humanism as simply the philosophical position that MAN IS THE MEASURE OF ALL THINGS. It is that position contrary to religious ideas that God defines what is right, and humans follow.

A few hundred years ago, health, in western culture, would most likely be, at least in part, a religious question. That’s for another time to consider since many patients do present with religious and biblical issues: "I am a messenger of God," "The Virgin Mary is a lover of mine," "God has chosen me," "My family has disowned me for marrying a----," etc.
 
The current psychiatric orthodoxy as reflected in the Diagnostic and Statistical Manual of Mental Disorders (DSM) gives us illnesses and diseases defined by committee.
Except for the dementias, there is no scientific way of making these diagnoses. For the most part, and at best, what the committee defines are arbitrary clusters of symptoms: anxiety, depression, panic attacks, bulimia, psychoses, personality features, etc.
 
So, the DSM does a good job of describing hundreds of SYMPTOMS, and these are symptoms of alleged mental illness because the committees say so. Okay. If they are the symptoms, then what is the illness? That is the challenge I propose to my colleagues.
 
I will give my very simple definition of mental health. It is THE CAPACITY TO SUFFER! And mental illness is the flight from suffering. The DSM simply lists the in- numerable ways to avoid suffering. Whether it is the psychotic flight , vomiting  food to keep oneself pretty, panic instead  of facing fear, dissociating, etc.
 
So, colleagues, what is your simple definition? What is mental health and mental illness?


Dr. Tarantolo is a graduate of Mt. Sinai Medical School and a board-certified psychiatrist. He has been in practice for more than three decades on Capitol Hill in Washington, D.C., where his practice is dedicated to psychotherapy and helping patients withdraw from psychiatric drugs. Dr. Tarantolo has helped hundreds of patients come off psychiatric drugs through individual and group psychotherapy, herbal remedies, meditation, nutrition, and spiritual counseling.

7 Comments

  • Joe, In addition to sick and dysfunctional, I wonder if you would also state that all of the USA mass shooters are possessed, evil, cursed, wicked, and crazy. To me, all of these descriptions fall into the same category of meaninglessness. Much like the terms religious and spiritual, these words seem to have as many interpretations/definitions as there are individuals and so I think they only serve to increase confusion. Is any individual who breaks a law sick or dysfunctional in your opinion? I thought a main principle behind ISEPP is that a mentality or thought process can not literally become ill, diseased, sick, or dysfunctional— which is why so much work is put into exposing the absurdity and dangers in adopting a medical model approach to human experience. I thought ISEPP as an organization wanted to abandon the medical model— but is there then an effort to extract from it the idea that certain thoughts or behaviors make someone sick, ill, diseased, dysfunctional, defective, or disabled? Perhaps you intended to express metaphorical sickness or dysfunction in your most recent comment. If so, I would politely suggest not doing so as it creates confusion (at least my own! : ) If you meant literal sickness or dysfunction, how do you determine that? For whatever it’s worth to those reading this, whenever I now run across the term mental illness, I am increasingly aware that I’m most likely about to hear or read something aligned with the medicalized/DSM approach to life. I especially urge professionals to fully abandon attempts to redefine unhelpful descriptors like mentally ill, sick, dysfunctional, mad, crazy, defective, disabled, diseased in reference to thoughts and behaviors as I think they only add to the continuation of almost complete societal confusion surrounding the human experience. Looking forward to more conversation.

  • Harry Stack Sullivan ( 1892-1949), the originator of "interpersonal psychiatry" did not use the term "mental illness". He might say there were dysfunctional relationships. He had great success with young schizophrenic men (cure rate >80%), eschewed drugging ( except, perhaps a bit of brandy for sleep), would never use ECT and thought autopsies performed at St Elizabeths Hospital in Wash DC established that schizophrenia was not an organic illness. Surely, failed love relationships, sexual, familial, social, had to be grieved. I think he would agree with me that all of the USA mass shooters are sick/dysfunctional. Repeatedly we see through the insights of reporters reporting the lives of these killers did not have successful interpersonal relationships and did not know how to mend their relationships.They do not grieve, a first step in healing, but lashed out violently.

  • I like the definition of mental health as the capacity to suffer and of mental illness as the flight from suffering. One of the mistakes of our mental health system is the focus on symptoms and the belief that we help people by extinguishing symptoms. The symptoms have to do with our lives and concerns we have about our lives and ourselves. We can help people by encouraging them and helping them to spend some time with their symptoms, understanding them, what is their message, what are they doing there. We can help people learn how to suffer. Suffering tells us what is important, what we care about, what we want, how we contribute to our suffering. I can appreciate the desire to feel good in the long run. But, in order to feel good in the long run, we must learn how to feel bad in the short run. I used to tell my patients: : If I could give you one gift, it would be the ability to feel bad, just to feel bad, to sit with feeling bad and to learn its lessons.

  • These phrases are excellent exmples of what RD Laing called, "mystifications". If by mental we mean intangible, lived meaning then there is some possbility of significance in the category, but it is conflated with "neuro" and "cognition" way too much to be helpful. Then mental as neuro becomes a physical pathogen and mental as cognitive becomes distorted thinking. Neither are experessions of soul pain as lived meaning. Then there is the problem of illness and health as they are markers of an obvious gnostic hierarchical supremacism in a rank ordered ideology that polarizes health and illness, with illness being "bad" and health being "good". Psychopathology, however, means "speech of the suffering and joyful (pathos) soul". This is not hierarchicalizaed. Pathos as passion means BOTH suffering and joy. Our psychopathology is how we take up our suffering and joy, ALL of us, albeit in unique (or ontic) ways. Diagnosis needs to move away from taxonomy all together and stay descriptive of ways of being in the world as pathow, that is to say, to discern the "formal indications" (Heidegger) of how one particulalry lives out ontological givens in pathetic ways, and heed Michel Henry's sense that Life is invisible (not objectifiable or categoried), though lived in suffering and joy.

  • I think mental illness and mental health are merely terms we’ve gotten used to saying and hearing that don’t actually carry any meaning when unpacked. These terms were coined by humans to simplify and judge human experience when it is anything but simple. I wonder why we do we not say someone has thought illness, or imagination illness, or idea illness, or even dream illness. How is the term mental illness any different from these nonsensical options? Also, what human has any meaningful authority to label any specific thought or mentality of another as ill? To me, the use of the terms mental illness or mental health is lazy and misguided at best, and judgmental, harmful, and cruel at worst. I don’t think work needs to be put into defining these terms, but rather into abandoning them. What about the idea that each human is unique and that a thought cannot be literally ill or sick? I wonder what may happen if we focus on that as a starting point as we work to understand each other. I appreciate the new blog and conversation!

  • This is the critical question. What do we mean by mental health and mental illness? But, it is not enough to define those terms, it is also very important to make sure the definitions are not misleading – and at present, they are in a very dangerous way. The conventional definition straddles a fence between medicine and morality, giving mental health professions the authority to judge personal and individual choices and forcing compliance with ill-defined appropriate ways of living. So, unless we answer this question and come up with some rough agreement on a definition, any subsequent discussion about the matter is moot. My definition first starts out by abandoning any medical or illness implication. That which is left is about one's willingness to suffer and yet still trudge forward through that suffering. I differ somewhat from Dr. Tarantolo's idea in that I don't think it is the capacity to suffer, per se, but the willingness to do so, given the extreme difficulty involved. My focus on the willingness and not capacity is in line with my rejection of the medical model, along with its implied ideas of defect, deficiency, dysfunction, or disease in the person that is essentially an alien element with its own agency. Thusly, environmental context and our subsequent emotional responses thereto, provide the rationale for action, they don't dictate or prevent action. This is why we have never been able to find a true pathological biomarker that can be used to diagnose mental illness, or the absence of that biomarker to diagnose mental health. Ironically, when true pathological biomarkers have been found, the problem leaves the realm of mental illness and enters the realm of physical illness, notwithstanding categories such as Alzheimer's, substance intoxication, and breathing related sleep disorders remaining in the DSM as a testament to psychiatry's resistance to this. It makes no sense to call something a mental illness merely because the physiological defects result in mental and behavioral symptoms. But, that is exactly what is going on in today's world, not surprisingly as a marketing strategy to make sure there are sufficient "illnesses" for psychiatry to handle. So, coming up with a starting definition of mental health and mental illness is very important. However, I have a more basic idea that might help us. Let's start thinking about new terms to use other than "mental health" and "mental illness." Let's take the illness and medical themes out of the matter from the very beginning.

  • As someone who was a long-time member of ISEPP and a former psychiatric consumer, I am familiar with mental health professionals engaging in heated debates questioning the existence of mental illness, confused as to what mental health is and even questioning what the mind is. From a layperson's perspective, I think it is important for professionals speaking out to comprehend the general public and our mass media considers mental illness does exist and basically it is the politically correct term for thoughts, behaviors, moods, actions, feeling, cognition etc. that appear different and might otherwise be referred to in derogatory terms like crazy, insane, nuts, etc. Our lawmakers, along with many involved in advocacy, also seem to be pretty much convinced that not only does mental illness exist, but it is a public safety issue. Many of our school/mass shooters are considered to be mentally ill people. I think the general public pretty much understands mental health is a state of being that can be impacted in many ways. A person who is stable, balanced, able to function in life without the assistance of a psychology professional, is considered by most as being in a state of good mental health. People who are customers of psychology professionals are usually considered by most to have mental health problems. The Diagnostic and Statistical Manual of Mental Disorders is just a continuation of what has always existed between psychology professionals and their customers, basically just labels for the customer's problems. Historically, psychology professionals have always tried to categorize humans with various differences using terms like idiots, fools, simpletons and feebleminded. Psychology professionals need a classification system to provide services. The DSM is just an instruction manual, created out of statistics, not precision. The DSM does include categories of disorders that are caused by medical conditions and substances, unfortunately, most medical professionals don't bother testing and treating the known underlying causes of many mental disorders. Perhaps this could be fact checked.

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