Defining "Mental Health"?

Hello Prof Dalke,

I know for my life telling my stories in therapy, etc., have been helpful for releasing past hurts, etc., and I have learned that there is a place and a time to tell them.  This reminds me of a story I wrote last Fall semester that hit on some personal issues...and then I felt as though I could not write for months later. Was this helpful? I can see now that it was though the timing was a bit off. And it may just be that a text that one find's very hard to digest is reassuring for another. I used to obsessively read books on concentration camps when I was a child/teen.  The more detail, the better. And, though these stories I read were horrible...they taught me of courage and bravery and many other concepts that I needed to learn.

Just a thought.

Meredith

"He then points out that all of our studying, probing and doctoring actually changes people, for we do not exist in a vacuum."

I like the idea of "making people up" and the concept that individual people together influence their culture/society but that activity can in turn change the individuals and so on back and forth. I like concrete examples and one (maybe) that came to mind... why do people who hear voices, those with schizophrenia or what have you, often have hallucinations of a negative nature? One suggestion is that historically most people who heard voices did not neccessarily have negative/threatening/violent ones, and that cultural judgements about hearing voices has biased hallucinations.

"what of people who do benefit, personally, from a paradigm that does empower them to see "illness" as being something they "have" and not who they are?"

I don't think a particular "model" of anything has to be entirely rejected, if there are aspects of it that "work" I think they can be incorporated into a new "model". As Professor Gibbs said in class, many of her clients like thinking about their "condition" as biologically based and that helps them acheive whatever their goals in therapy may be. But it still begs the question, would those people who are empowered by thinking in terms of "illness" feel disempowered to begin with in a new/better model of mental health? If yes, then feeling empowered by thinking in terms of "illness" would seem appropriate. But maybe they could end up feeling more empowered by a new/better model? I think a goal for a new model of mental health would be for all to feel as empowered as possible in the first place and then act from there. I think maybe we have to examine what purpose thinking of something as an illness, not a part of who they are, serves. For my personal experiences of depression, thinking it of an "illness" has been helpful in so far that it releases some of the responsibility and allowed me to look at my experience more objectively and in a way understand it better. On the other hand, thinking of it as an "illness" makes me feel powerless and feel like it has "happened to" me.

So, I guess my conclusion for right now is that because we've acknowledged that individuals are so diverse, on a number of parameters, we can't get caught up in trying to make too broad of generalizations, as there will always seem to be exceptions and unique contexts to consider.

Sarah, thank you for bringing up Gestalt theory (which I have no understanding of beyond what wikipedia just told me, but sounds very interesting!). Perhaps wikipedia's summary is not exactly correct, but from what it says, it actually appears to be very in line with (my understanding of) professor Grobstein's definition of mental health.

To quote the all-powerful wikipedia on Gestalt therapy:

"The client learns to become aware of what they are doing psychologically and how they can change it. By becoming aware of and transforming their process they develop self acceptance and the ability to experience more in the "now" without so much interference from baggage of the past. The objective of Gestalt therapy, in addition to helping the client overcome symptoms, is to enable him or her to become more fully and creatively alive and to be free from the blocks and unfinished issues that may diminish optimum satisfaction, fulfillment, and growth."

The end goal of Gestaltian therapy thus seems to very much be saying what I interpret Professor Grobstein to be defining mental health as: the ability to perceive of one's own condition and how one can change it.

(I am unsure whether I think one needs to only be aware of how one's situation could be changed, or needs to actually be changing it, in order to be mentally healthy - thoughts?)

Anyway, while I do really like the self-understanding/evolution theory of mental health, and I'd be happy to call it the first step one takes when deciding if someone is "mentally healthy", I worry that in many cases asking this question wont get us very far. Is a child with bi-polar disorder who is threatening the lives of his family members one moment and crying in their laps the next impaired in being able to understand his own condition and how to change it? YES. Now what?

I think the challenge put forth in Culture as Disability, and by the self-understanding/evolution definition of mental health is a very worthy cause that must be addressed, but I also think if we put forth ALL our efforts towards changing cultural norms so there is no longer "mental illness" and "mental deficiencies", we are going to not give "help" to a lot of people who may need it in a more "traditional" mental illness kind of way.

(I apologize for my overuse of quotation marks. I am wary of all adjectives and nouns after our discussion Monday night. And also for not really giving any conclusions in this post - the ideas are still unclear in my mind!)

I don't know that I'd want to consider things thought of now as an "illness" (depression, schizophrenia, etc.) as a "different type of normal", but instead maybe as... "natural", something to be acknowledged as normal to happen? A different type of normal might suggest that someone is content being that way permanently, I don't think most people with depression feel that way. But what about also acknowledging some of the positive aspects (creativity for some, new perspectives after "recovery"), etc. "Illness" would seem to ignore those things.

The issue of those terms and Gestalt therapy is interesting. I feel them to be positive, especially evolve, evolving would never imply being complete in anyway. And never having to be complete would take the pressure off of being "normal". I do like the goal of awareness, and self-reflection, as a therapeutic process. But that only seems like the first step... what can you do with that awareness but change (perspectives, attitudes, actions, understandings, etc.)?

"Deciding what "mental health' is, and when to "cross the border" have always been and will always be questions that have no "objective" answer, questions that one has always had to answer and will always have to answer "subjectively," ie in awareness that there is no "god's eye" view, and that one is always acting out of, and testing, one's current understanding.  "

I think that what Professor Grobstein said above (which I quoted) is true: where is the line drawn? What are the parameters of mental illness? Who decides who is sick and who is well? Those questions are complicated and hard to answer, and in our largely imperfect attempts to do so we've created decidedly faulty tools (like the DSM) and made clear mistakes along the way (like including homosexuality IN the DSM). Still, that is the goal of "getting things less wrong," isn't it? To recognize that there are mistakes, and to try and improve on them?

Because I do think there are ways in which mental illness and physical illness are akin to one another, and though they may very well not be analogous, I also think that in class we ignored the fact that a lot of physical illnesses also have many causes, some which are not always that clear. Many people with heart disease are genetically pre-disposed, some don't excersize enough, some smoke, lots have a combination of the four (and other) factors at work ... And some of those people will die of heart attacks, and some will catch it earlier and take treatment that will (likely, though certainly not necessarily work), and some may experience physical ailments ... But even more, there are still gradations in "healthy" hearts. My blood pressure is fine,  but I doubt I have the perfect heart ... So, some doctor somewhere has made a relative chouce about what a healthy heart does and doesn't look like.

In mental health, the structure is not drastically different than that, and just because we don't know exactly how to treat something doesn't mean there is no treatment. (If the big issue with disease is that it can cause physical harm and/or death, then the risks of psychological disease are not dissimilar ... ) 

I’ve made a 180 degree turn from my original ‘biological illness’ view of mental health and illness. I think my attempt to explain mental health fits within the 4 criteria above...

Perhaps mental health is just a method of thinking and interpreting, which facilitates personal happiness.

For example, I’m writing my opinion on this website, and someone disagrees with me. If I were to have 'mental health', I interpret the disagreement as an opportunity to learn another viewpoint and to change or defend my own. I would be happy and excited by the intellectual stimulation. On the other hand, I could have a 'mental unhealth' and interpret the disagreement as an attack against me and my intelligence - in which case, I would be upset.

Mental 'unhealth' isn't neccesarily wrong. In fact, it may be right sometimes. Perhaps having 'mental health' is naive sometimes...

Here is my current definition of mental health.  I look forward to changing it Monday...

To echo Yona, the only thing that I can say with any certainty right now is that a mentally healthy person should be capable of behaviors that sustain life.

Following this,  I agree with the idea that it's easier to define mental health in terms of what it's not.  I believe that we all basically experience the same emotions/symptoms.  "Mentally ill" people just experience symptoms of greater frequency or magnitude.  But then you run into the problem of where do you draw the line... 

Finally, I'm wary of any definition that references societal norms.  Phrases like "able to contribute" and "productive member" leave me with an unsatisfied feeling.

A mentally healthy person should be able to perform tasks necessary for sustaining life (be they hygeienic, health-related, social, etc.) without posing a danger to his or her self, or to others. One should be able to derive *some* pleasure from even the banalities of life, and should have self-sustainable mechanisms in place for dealing with challenges and disturbances that arise as a byproduct of the human condition.