Saturday 16 April 2011

I return to pondering the question what is mental illness?

I have no good answer. At least nothing elegant nor concise nor complete.

The dual continua model of distress and psychopathology separated into two dimensions is just the beginning of a confusing journey.

Biology and course are essential to the application of the paradigm of medical illness. This are is deeply confusing because it's not really a medical illness but behaviour, emotions and consciousness can have biological cause and presence.

Disability covers real and not real (mental) illnesses. Where I see the weakness in thinking is to focus on treatment and homogenousiation of indiviudals. A diagnosis enacts treatment to make a person normal. So do treatments in physical medicine but here lies the funky bit. Blindless is a right and is normal. The blind are a part of society and the day when people try to eradicate the blind, with the best of intentions, there will be people like me fighting for their right to exist. The blind and those with other physical disabilities are normal. I sound cold and heartless because there exists a social disability. But changes in society and individuals to make us more accepting of each other and our differences means this disablility lessons but the type of individual or human being, I chose the term phenotype, survives.

Sadness, mood swings, psychosis and other pathologised symptoms may also have a purpose for the individual and greater societty. Love or hate religion it has influenced the course of human development. Every nation has had religion inextricably linked to its history. It is the creation of psychosis in my opinion and it was the old mental health system.

I admit a perspective which sees psychiatry as having usurped religion when spiritual and religious explanations won't do. Now that we have science...

The new dogma is most useless in mental health because the very foundations of the use of science are flawed. Psychiatry is fundamentally the study and implementation of treatments for psychopathology. Illness. Little research is done in the area of psychosanaology. The study of wellness of the mind (whatever that nebulous concept means).

Few published papers look into wellness or are considered in psychiatric manuals and the general recommendations for treatment. It is all still to change the phenotype and reduce the experience.

I would love to think psychiatry is the study of the human condition. I was that was what mental health was all about. The change in language is about a change in concepts. It's to move away from illness and medical thinking. It's to understand that there's a spectrum of colours in the human condition and life experiences (and probably more) which turn genotypes into phenotypes.

That's the science. What we chose to do with 'abhorrent' or 'deviant' or 'abnormal' or normal phenotypes that are disadvantaged by a malformed modern Western society (3 perjoratives for mental illness and one way which I like to think) is about something different at the moment.

Biological proof was not required when psychiatry was incieved. Social labels and the proof of being outcast were what were the informal, unwritten diagnostic criteria. Religion offers one explanation for these vagries in human behaviour but as it waned society had no reason to show acceptance. The asylum system housed the rejected and outcast. There was no diagnosis but rejection from society to live out a life incarcerated in one of the old leper colonies.

The medical paradigm was applied later but doctors are still honest in their textbooks.

And still I have no answer!

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"