Monthly Archives: September 2021

Why the Term ‘Mental Illness’ is Unhealthy

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Forget most of what you have been told. We have been poorly informed by the disease model of mental healthcare and influenced by mental health stigma. Mental illness is not abnormal nor the consequence of the subject’s behavior, and there’s a clear demarcation between neurotic and psychotic. Even the term mental illness is problematic. Its negative perspectives and implications promulgate perceptions of incompetence, unworthiness, and undesirability. It is the dominant source of stigma, shame, and self-denigration. Realistically, we cannot eliminate the term from current models of healthcare; efforts to amend the language are promising but inadequate.  

One only needs the American Psychological Association’s[1] definition of neurosis to comprehend the mental health community’s pathographic focus. The 90-word overview contains the following descriptors: distressing, irrational, obsessive, compulsive, dissociative, depressive, exaggerated, unconscious, conflicts, anxiety, and disorders

The word mental defines a person or their behavior as extreme or illogical. In adolescence, anyone unpopular or different was a mental case or a retard. The urban dictionary defines mental as someone silly or stupid. It is often associated with violent or divisive behavior. Add the word illness or disorder and we have the public stereotype of someone dangerous and unpredictable who cannot fend for themselves and should be isolated. 

To the early civilizations, mental illnesses were the domain of supernatural forces and demonic possession. Hippocrates and diagnosticians of the 19th century favored the humours (bodily liquids). Lunar influence, sorcery, and witchcraft are timeless culprits. In the early 20th century, it was somatogenic. The biological approach argues that mental disorders are related to the brain’s physical structure and functioning. The pharmacological approach promotes it as an imbalance in brain chemistry. The first Diagnostic and Statistical Manual of Mental Disorders (1952) leaned heavily on environmental and biological causes. 

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The term physiological disorder distances itself from the hostility of mental illness but even that is inadequate, as is psychophysiological or the Bio-Psycho-Socio-Spiritual model. A disorder is the consequence of the simultaneous mutual interaction of mind, body, spirit, and emotions – a complementary condition which, in lesser severity, is discomfort. Obviously, we are concerned with pathology here and not the state of someone’s appearance or our son’s bedroom. In such cases, we would have to prefix disorder and illness with a complementary clarification – preferably not mental.

Disorders and discomforts can result in functional impairment which interferes with or limits one or more major life activities. Both are what used to be called neuroses, and both are correctible through the same basic processes. It’s a matter of severity. Discomfort is a condition that impacts our quality of life; a disorder is a diagnosable condition that impacts our quality of life. The disease model of mental healthcare labels the latter a mental illness or disorder. 

Dysfunction is not abnormal but a natural consequence of human development. A recent article in Scientific American speculates they are so common almost everyone will develop at least one diagnosable disorder at some point in their life.[2] There is nothing abnormal or unusual about them. They are normal facets of human development – evidence of our humanness.  

There are two types of disorders: neuroses and psychoses. When someone sees, hears, or responds to things that are not actual, they are experiencing a psychotic episode. 3% of Americans have or will experience a psychotic episode in their lives, and less than 1% have a psychotic disorder. The rest of us are neurotic. Everyone has moderate-and-above levels of anxiety, stress, and depression. We are all disordered to some extent. 

Research shows that 89% of disorder onset happens in adolescents due to heredity or experienced detachment, exploitation, and or neglect. In rare cases of narcissism and PTSD where onset happens later in life, the susceptibility originates in childhood due to some physical, emotional, or sexual disturbance. 

Anything that interferes with a child’s social development is detrimental to adolescent and adult emotional health. Childhood/adolescent abuse is a generic term to describe a broad spectrum of experiences that interfere with optimal physical, cognitive, emotional, and social development. It could be hereditary, environmental, or due to some traumatic experience. The cumulative evidence that childhood and adolescent occasions and events are the primary causal factor in lifetime emotional instability has been well-established. 

Any number of things are instrumental. Our parents were over-controlling or did not provide emotional validation. Perhaps we were subjected to bullying or come from a broken home. We must recognize that it is never our fault and possibly no one is intentionally responsible. A toddler who senses abandonment when a parent is preoccupied can develop emotional issues

Those who believe a disorder results from some behavior or is god’s punishment for sin are misinformed. Behaviors later in life may impact the severity but they are not responsible for the neurosis itself. We are not accountable for the cards we have been dealt; we are responsible for how we play the hand. We cannot be held accountable for our disorder. We did not make it happen; it happened to you. 

We are not our disorder; we are someone who has a disorder. The current pathographic process considers diagnosis over the individual. In groups, we learn to personify the disorder to distinguish it from the individual, so that the symptoms are appropriately assigned. A person who breaks his leg does not become the broken limb; she or he is an individual with a broken leg. 

Carl Roger’s study of the cooperation of human system components to maintain physiological equilibrium produced the word complementarity to define simultaneous mutual interaction. All human system components work in concert; they cannot function alone. Integrality describes the inter-cooperation of the human system, environment, and social fields. A disorder is not biologic, hygienic, neurochemical, or psychogenic. It is a collaboration of these, and other approaches administered by the simultaneous collaboration of the mind, body, spirit, and emotions.

There is no legitimate argument against mind-body collaboration in disease and wellness. Spirit is both the core and fluid character qualities of an individual, emotion is the expression of those qualities, both in collaboration with and responsive to mind and body.

Eliminating the prefix mental will help alleviate the deficit and diagnosis focus of the healthcare system. Changing negative and hostile language to embrace a positive dialogue of acceptance and appreciation will open the floodgates to new perspectives and positively impact the subject’s self-beliefs and image, leading to more disclosure, discussion, and recovery-remission. The self-denigrating aspects of shame will dissipate; mental health stigma becomes less threatening. The concentration on character strengths and attributes, propagated by humanism, positive psychology, and other wellness-focused alliances, will encourage accountability and foster self-reliance, leading to a confident and energized social identity. 

SAMHSA defines mental illness as a “diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria” that can “result in functional impairment which substantially interferes with or limits one or more major life activities.” This ‘defective’ emphasis has been the overriding psychiatric perspective for over a century. By the 1952 publication of DSM-1, the focus had drifted from pathology (the science of the causes and effects of diseases) to pathography (the breakdown of an individual’s problems, categorizing them to facilitate diagnosis). Pathography is the history of an individual’s suffering, focusing on a disease model of human behavior, whereas wellness models emphasize the positive aspects of human functioning. 

Undoubtedly, this sociological model conflicts with moral models that claim disorders are onset controllable, and the disordered are to blame for their symptoms, or that mental illness is God’s punishment for immoral behavior. Again, it is crucial to recognize we are not responsible for our disorder. Playing the blame game only distracts from the solution: What are we going to do about it?

[1] APA Dictionary of Psychology. (2020.) Neurosis. American Psychological Association. https://dictionary.apa.org/neurosis

[2] Reuben, A., & Schaefer, J. (2017). Mental Illness Is Far More Common Than We Knew. Scientific American. Retrieved from https://blogs.scientificamerican.com/observations/mental-illness-is- 798 far-more-common-than-we-knew

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