Mental health, then and now

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Mental health demonstrates a wide bifurcation between Western and other worldviews.

The ancient Greeks, lending their day-to-day language to the writers of the New Testament, had simple terms that undergirded simple ideas. There were such things as ‘unclean spirits.’ People could be bothered by these unclean spirits and could thus be ‘demonized’.

When Jesus came along, he was able to wear this worldview effortlessly. He spoke on occasion to evil spirits within a person; they spoke to him, usually calling out curses; he cast them out; the patient recovered. It’s worth remembering that Jesus also ‘rebuked’ fevers and indeed ‘rebuked’ the wind and the waves. But as regards ‘unclean spirits’ he didn’t feel a need to update the ancient worldview; he operated successfully within it.

Western medicine has, I think, turfed out this worldview entirely, even though plenty of people still hear voices, voices that tell them to do evil things, and even though some people would self-diagnose as ‘demonized.’

Once I was on a conference call with a sick and very damaged person (he had been tortured). The leader of the call asked if anyone was in the room with him. The answer? No-one, he said, except the demon who watched him all the time and never left him.

Essentially, I think (and this is not my subject) quite a few Western-trained mental health workers would think the person self-diagnosing as ‘demonized’ was actually deluded and deceived and essentially, misdiagnosed. (I don’t want to downplay, though, the tenderness and skill with which some people within Western diagnostic traditions will nevertheless work with such a patient.)

There are plenty of fine reasons for this Western stance. Unfortunately (and I am very hestitant here because it really isn’t my subject), Western mental health is still in my view rather primitive. I wonder if it isn’t, in fact, roughly where Western physical medicine was about 300 years ago–dogmatic, authoritative, ineffective, its practice centred around humours, bleeding, and leeches.

How often are the mentally ill cured? I do not know. To what extent is mental illness itself a metaphor– in the sense that we sort-of know what physical illness is and (by way of metaphor), describe other things wrong with humans as ‘mental illness’? Are we medicalising something that isn’t an illness? For example the widely-cited Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has a new entry called ‘Prolonged Grief Disorder’. This in effect medicalizes people who suffer bereavement for longer than might be considered normal. I don’t know enough to critique this properly, but at least on the face of it it seems odd to give a medical label to someone who’s taking a long time to move on. If you can’t pull your socks up in a decent amount of time, DSM-V seems to say, there must be something medically wrong with you and you need a psychiatrist. I am not entirely sure that I am happy with this, nor that it is right to use phrases like ‘mental health epidemic’ when more and more stuff like this is unearthed. ‘Mental health terminology epidemic’ might be equally fair. The wave of sadness and depression that is passing through the country, is, of course, not doubted, just (arguably) not properly diagnosed and even if the diagnosis is right, isn’t being ‘cured’. Or isn’t being cured all that much. People are still suffering and sad, which is the real scandal. People are still plagued with voices and terrors.

This circles back to the bifurcated worldview. It would be fine to disparage and move on from the ancient worldview if the modern worldview wasn’t, in itself, so frequently ineffective and disappointing.

Wouldn’t it?

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