To speak of “mental health” is to make a category mistake. And it is to reify while substantializing a supposed ens, an alleged “thing” or “abstract something” when, in our direct experience, there is no such thing as mind. So, there’s no such thing as mental health and there’s no such thing as an entity called “mind.” Consequently, we should, in the very least, stop speaking of “mental health,” not the least because it’s obfuscating.
A Brief Story for Context
When I first moved to New York City in 2009, I came to care about a woman I met there. For some months, we had a delightful time together. After we got back from a trip to Central America, however, things quickly turned. We broke up. She feel into a deep sadness. She thought of killing herself.
Now during this process I didn’t think, “She’s bipolar, and she went from mania or hypomania (when I met her) to depression (around the time we broke up).” Nor did I think: “She’s having suicidal ideations.” No, quite simply I was there for her when she needed me. I wasn’t applying labels; I was instead showing concern as best I could.
I do not say that I was a moral saint, and that, frankly, is not the point of the story. I say only that starting with “not knowing” (Socrates) is often a condition of possibility for genuine care.
It’s these kind of stories, in any case, that animate my doubts about homo psychologicus and about the psychologization of our everyday discourses and of our ways of being.
I turn now to the argument.
To begin with, notice the lack of definitional clarity. (1) Here’s a standard definition of mental health from MentalHealth.gov: “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act.”
(2) And here’s a definition from an academic journal: “Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”
Definition (1) tells us nothing about what mental health is; it only suggests, in a spooky sense, that it “includes” A, B, and C and that it “does” this and that–namely, it is alleged to have “effects” on how we “think, feel, and act.” Definition (2) at least suggests that it’s a “state of well-being” and then goes on to specific what that entails yet that state of well-being surely can’t be identical to realizing talents, being productive (see, as usual, Total Work), and to “coping” with “modern society.” And where is there genuine community today? Such is a fiction at this stage in modern history.
Neither, however, really tells us, unequivocally, about what the essence of mental health is. What, truly, is it? This vagueness should give rise to doubts in us.
A Category Mistake
The body, of course, can get sick or can be injured. This we know and have no reason to doubt. But is mind (I worry about using “the” in front of mind because the definite pronoun implies that mind is a substance; more on this below) even subject to illness or injury?
“Yes, of course.” Be careful here: it’s not obvious that brain = mind, and trenchant disagreements in philosophy of mind should help us to see that physicalism, a way of reducing all that exists to the physical, may not be the correct doctrine.
If for the moment we assume that brain is not mind, then a brain injury is just that: a brain injury. While a brain injury will affect mental functioning (for there is a correlation between neural processes and mental states), I don’t see, a priori, why there’s any reason to say that mind is therefore “ill.” That is question begging!
But can mind be ill? That is, is it even subject to illness or to health? I don’t think so. To doubt this is not to doubt that there are some people who suffer, say, from schizophrenia–they do suffer! It is to doubt whether we do well to call such people “ill” or “sick.” Again, more question begging! Couldn’t we just as well say that someone who suffers from schizophrenia is experiencing a reality that is very unlike the one that many other people are experiencing? And isn’t it fair to say that seeing that someone is suffering “in some mental way” does not entail that said person is, ipso facto, sick? (If you are grieving, I don’t say that you are “mentally ill,” do I?)
I conclude that the very concepts of “mental health” and “mental illness” are category mistakes. What is more, we can get along just fine without thinking that there are these spooky “states” that correspond to “mental health” and “mental illness.” If you doubt what I’m saying, just go on and take an earnest look and see whether you can actually find something specific that corresponds to either. Go to your direct experience, not to the concepts you’ve inherited from the modern secular social order. What you find instead, I submit, is a flow of transient experiences of the kind described well by Buddhism and by other introspective practices.
Mind as Substance?
But even if the argument concerning category mistakes doesn’t convince you, consider this more basic one: there is no such “thing” as mind in the first place! And if there is no such “thing” as mind to begin with, then it immediately follows that there cannot be some attribute–health or illness–that can thus be attached to this non-thing. If there is no boat, then there certainly can’t be a mast that is the mast of this non-boat. Mind cannot be said to “possess” health or illness.
Ask yourself, “When I meditate, do I ever find (a) a container in which thoughts and feelings arise and/or (b) a theater in which thoughts and feelings appear?” Short answer: No!
This is quite simply because there is none! Minding just is thinking; minding is nothing but thinking; as such, minding is exhausted entirely in thinking. Minding just is feeling; minding is nothing but feeling; as such, minding is exhausted fully in feeling. And so on. A corollary is that minding occurs intermittently and therefore is subject to momentarily disappearance (as when Zen master Dogen says, “Mind and body drop off”).
It’s a mistake of Western philosophy (ens in Latin refers to “thing” or “thinghood” or “substance”) and of the English language to reify mind as we do. For when we do, we come to believe that mind = a container in which thoughts arise or that mind = a theater in which thoughts appear and through which they pass. But, in our own direct experience, we have absolutely no evidence to support this view. It is a phantasm.
Why This Discussion Matters
Why does this matter?
–First, because “a picture held us captive” (Wittgenstein): believing what is false does not allow us to readily examine our own experiences with a view to discovering the truth of the matter. What is really going on? Who am I, really?
–Second, because it’s become more and more common to state: “My mental health is suffering.” But that is unintelligible and it’s a dodge. It’s not your mental health that is suffering; it’s you who are suffering. Because mental health is not something you possess, it can’t be the subject of your inquiry (or the cause of your suffering).
–Third, because speaking and thinking in these terms secularizes life while presupposing the legitimacy of secularization: we can think only of “wellness,” “well-being,” and “functionality.” But what of God, truth, beauty, goodness, and holiness? What of eudaimonia (the good life)?
–Fourth, because “my mental health is suffering” distances the speaker first from himself and second from others: how can one get to know himself by beginning from such a starting point? How can one possibly get to know said speaker, in any emphatic way, when the inquiry into what that suffering is really about can’t even get under way? That statement is, in fact, a conversation stopper. The person is really implying: “I take myself to be a victim of some mysterious, spooky process, and I don’t really want to know what it is or why I’m really suffering, so I’m defaulting to soliciting your pity.”
And, fifth, because this language amounts to a cloud of obfuscation. It just doesn’t help in actual sensemaking.
The truth is that we don’t need secular concepts like “mental health” to accept that so and so is suffering or that I am suffering. In fact, such concepts may make us feel that John or Jane is actually quite other and therefore very separate from us. And that is sad.
How much simpler, and more straightforward, is it to say: “I am suffering. But I don’t know what my suffering really is, I don’t know where it comes from, and I don’t, actually, know who or what I am. I do not know myself.” Starting here could bring one not only to genuine humility but also, if all goes well, to immense insight. And, all the while, it should solicit genuine compassion, not mere ersatz empathy, from us as well as deep admiration for her courage.