This is a chapter of a blog that advises how to stay in good health, be happy and live long. Most such books concentrate on normal health (i.e., a life without illness). Is that all there is?
What about a happier life; a life without worries or troubles, a life in full maturity and wisdom, a life of the spirit that does not fear death?
In our sections on physical illnesses the emphasis was to diagnose or prevent in order to restore normal health. The reason for that is that in physical illness there is a sharp line dividing wellness and illness. Not so with mental illnesses. With physical illness, for example, one either has measles or does not. But depression, schizophrenia, the personality disorders? A little of one, or a lot of the other? That is the problem that has tormented psychiatrists and patients for years.
Most mental illnesses are not hard and fast diagnoses, not based on tests but on syndromes, check off lists, facets of a patient’s history. And so-called diagnoses like depression are conditions of long-standing that one never really cures like measles is cured. So the diagnostician has to content self with diagnosing a state and changing it for the better or preventing a change for worse, analog rather than digital.
And with mental illness we must consider states of happiness, resilience, moods, the period of life and historical factors and the culture one lives in. Many persons consult a psychiatrist not simply to make a diagnosis or treat an illness but to feel happier and be more successful in their life. They want to know if they are mentally normal. In other areas of Medicine to be normal healthy is to be without disease but this is not so in mental illness. Of course if you have schizophrenia you have an illness and go for a cure. But what if you are just short-tempered and it is harming your life. Ideally a psychiatrist ought to be able to improve that. It gets us to What is mental health? Traditionally in healthcare, normality is the absence of illness. In statistics it is Average. Statistically, the average total cholesterol is 198 mg% but health-wise that is high and may lead to premature coronary artery disease. And what is mentally normal for a person? Surprisingly, a mental status test may tell us that Adolf Hitler was mentally normal: no schizophrenia, no clinical depression, etc. Yet by all agreement he was the moral monster of the 20th century.
The criteria for mental good health are still under discussion but the following points should be be considered.
Normality in a statistical sense; what is usual and what unusual? Normality in a digital vs in an analog sense? Digitally one either has, for example, schizophrenia or not; in an analog sense one has more or less of the schizophrenic condition (the schizophrenia spectrum). Until recently digital was the way to go.
Looked at in a digital sense, a physical diagnosis like peptic ulcer is digital: you either have it, or not, 1 or 0.
Until fairly recently psychiatrists were using the average statistical model to try to diagnose and it does not work well. As suggested, mental illnesses do not lend themselves to traditional physical diagnoses. You never really get cured of anything: you just get better or worse
In the 1960s came the first change; certain research psychiatrists, now my type psychoanalysts (See Chapter 9.33) suggested that mentally healthy normal individuals should be in touch with their own identity and their own feelings; that they should be oriented toward the future; that their psyches should be oriented toward life and provide resistance to stress (have resilience); and also that they should possess autonomy and recognize what suits their needs; should perceive reality without distortion and possess empathy; should be masters of their environment - able to work to love and to play and to be efficient in problem solving; and should pass through stages of maturity successfully as suggested by Erik Erikson. A good review of the latest answer to What is good mental health, which can be found in the 2nd chapter of Kaplan & Sadok`s Synopsis of Psychiatry, 11th edition and now 12th Ed. It is worth several reads to get ideas for what is mentally healthy.
To read next chapter now, click on 9.26 Behavior As Control - BF Skinner & Behaviori...
The End (until next update). Note the above hypertext may not work. In that case go back to Homepage, descending table of chapters and there to Notebooks 9 and click on Chapter 9.26.
26 Behavior - Reward, Motivation, Addiction
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