Sunday, July 17, 2011

What is Mental Illness and What is the Cure?

You might be surprised that definitions can be very elusive. We tend to think of depression, for example, as a form of mental illness. However, it is widely recognized that the depressed see reality and also themselves more accurately that do the “normal.” Psychologist Shelley Taylor (Positive Illusions) writes,

• Normal people exaggerate how competent and well liked they are. Depressed people do not. Normal people remember their past behavior with a rosy glow. Depressed people are more even-handed…On virtually every point on which normal people show enhanced self-regard, illusions of control, and unrealistic visions of the future, depressed people fail to show the same biases. (p.214)

Perhaps pain and depression shouldn’t be regarded as illnesses if they enable us to get a better hold of reality? Interestingly, once the psychological torment passes, self delusion returns. Taylor confesses,

• When depressed people are no longer depressed, they show the same self-enhancing biases and illusions as non-depressed people. (p.223)

This truth leaves us with an uncomfortable choice – Do we define mental illness in terms of (1) freedom from painful symptomology, but also having a host of self-delusions or (2) freedom from self-delusions, but not from painful symptomology? Neither choice is very appealing. Should we instead define “mental illness” in terms of what is “normal?” Martin Gross raises significant questions about the “normal” criterion:

• The individual…has been falsely taught that he lives in a continuum between normality and insanity, the common aberration called “neurosis” in between…We imagine – and are subtly told by the Society’s professionals – that there is an ideal, virtually anxiety-free paradigm from which we somehow deviate. (The Psychological Society, 325)

This raises the question about normalcy. Is it an unattainable goal that makes us feel like failures? Gross argues that our definitions of the “normal” are arbitrary and culture-dependent. Our psychotherapeutic norms reflect our culture. Therefore, what is “normal” in one culture, might be considered pathological in another. For example, in many more traditional cultures, sexual inhibition is considered a good thing, especially for women. Modesty is a virtue. However, in Western culture, getting what you want, right now – satisfying yourself – is a virtue.

Likewise, in Eastern cultures, submission to one’s elders is the norm, along with putting the interests of the family above one’s own. Duty, therefore, is the higher virtue. In the West, inhibition of personal desires and welfare is considered neurotic. Peter Kramer, the famous promoter of Prozac, explained one of his “success stories” this way. One of his clients, a single mother, was very “repressed.” Instead of dating, she devoted herself exclusively to her children. However, once on Prozac, she experienced less anxiety about leaving her children and began to date, leaving her children with the baby sitter.

Is this a success story or merely an accommodation to the values of our Western culture? Gross is understandably disturbed by the philosophical tyranny of our psychological culture:

• In establishing such a model [of normalcy], which exists only in psychological fantasy…the society serves as its own neurotic-producing stimulus [hinting that those who don’t fit in are not normal]. It forces millions to perceive their individuality – the very essence of human normality – as a psychological disturbance. (325)

Consequently, many have been influenced to think that they are pathological and need to change. If they are overly anxious about their children, there is something the matter with them. Of course, it’s more difficult to live with anxiety, but anxiety might pay dividends in other ways, perhaps in terms of better care for the children and the household, and even personal fulfillment.

If normalcy is merely a reflection of our social prejudices, must we throw out this concept entirely? I don’t think so. I think that the Biblical definition enables us to understand ourselves and the plight of others. What is normal is sin and self-delusion:

• "There is no one righteous, not even one; there is no one who understands, no one who seeks God. All have turned away, they have together become worthless; there is no one who does good, not even one." (Romans 3:10-12)

This levels the playing field. We’re all in the same leaky boat. If anything is normal, it is sin, and its effect upon the mind is powerful: “For sin…deceived me, and…put me to death” (Romans 7:11). Consequently, we are self-deluded, and whatever we do, we rationalize (Proverbs 21:2). Why? Because our conscience is a powerful alarm which painfully alerts us when we sin! We then have two choices. We can confess our sins to our loving and forgiving Savior, or we can deny or rationalize them away. Denial – a hardening and a refusal to see – is the beginning of self-delusion. Everything that follows – the positive affirmations and achievements – serves to cover up the foundational problem, un-confessed sin.

What then is the cure for our negative symptomology. Confession and repentance, of course! Yes, there are other ways to reduce symptomology. There are drugs, social supports, and even success, but these are no more than band aids, since they fail to address the underlying problem and leave the underlying condition festering.

We are moral and relational creatures. When our primary relationships are undermined, popping a drug isn’t the most appropriate response. We have to address the real problem, if it is at all possible. The same is true with our relationship with our Creator. We may be unwilling or unable to recognize this, but this relationship has been broken and needs repaired (Romans 1:18-32).

When instead we pursue pleasure, popularity, prestige, or power to cover the brokenness, we hurt ourselves. When we harden our heart against our sin and God, we also harden it against life and other relationships. We’re all a mess, not just those deemed “neurotic” by society.

While we can define “physical health’ to our satisfaction, defining “mental health” is an entirely different matter. It is not a matter of maximizing pleasure as secular culture seems to imply. It is a metaphysical question requiring a metaphysical answer. The answer involves taking into account moral absolutes and ultimate meaning, and these can only come from God. In his lecture to the Athenian philosophers, Paul affirmed the God-centricity of our existence:

• “'For in him we live and move and have our being.' As some of your own poets have said, 'We are his offspring.'” (Acts 17:28-31)

When we deny this fact, we deny much of our fullness as human beings.

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