What exactly is mental illness?
I asked myself this question after unsuccessfully attempting, for a second time, to complete a degree in Psychology. Several concepts I encountered during the course puzzled me; one main concept being the method of diagnosing mental ailments by determining the most suitable label. For me, the particular requisite course was based on using a textbook guideline to categorize an individual and their symptoms and from there, determine course of action and treatment.
Certainly I'm no expert, seeing that I resigned from the institution. This is by no means a reflection of the quality of education available at the institution. It was at the time, the actions of a young woman seeking to discover herself: the way she is and not the way she thought she ought to be.
One major concern of mine during the short-lived participation in the program was, What if this man or woman was incorrectly categorized? For me this was an unthinkable sin, as the unsuspecting psychologist and the more-often-than-not resistant patient would have ventured on a road leading not to recovery, but to a worsened state that could have even led to the demise of a career or worse, a life!
Another concern I had was, What if this so-called ailment has yet to be defined and neatly categorized?. I do not believe for one minute that mankind has discovered all there is to know and thus, the probability still exists that the guiding manuals are inadequate. Again, this unthinkable notion led me to think that there must be something inherently wrong with this fixed method of diagnosis.
A paradigm, according to the Oxford Dictionary, is:
..a typical example or model to be replicated or followed..
The process of diagnosing a mental illness, as taught through the educational systems, is in fact establishing a model to be replicated, a paradigm.
However, can we function without this and any other paradigms? As well, shouldn't paradigms be simply a guideline, a malleable framework?
Permit me to construct a ridiculous analogy.
If soil was a paradigm, a model, a framework within which plants are grown, should the paradigm soil be inflexible? Soil is soil in a context where it is in a field, seeds are planted within and crops are expected to flourish with the rights additives. The same soil becomes something else entirely when prominently seen on the beautiful white garment of a three-year-old child. Can it continue to be viewed as the paradigm labeled soil in this alternate context?
Continuing the analogy..
Let us examine diagnosing mental illness called Autism.
According to the Diagnostic and Statistical Manual of Mental Disorders [ DSM IV], the characteristics of Autism include:
(A) qualitative impairment in social interaction, as manifested by at least two of the following:
1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, _..
4. lack of social or emotional reciprocity __
This is one of many guidelines into determining a possible diagnosis of Autism. Upon close inspection, one finds language that can only be deemed subjective:
appropriate, marked impairment, lack, qualitative
Who determines what is appropriate, lacking, or even marked? Can any two psychologists come to the same conclusions without having similar experiences, nurturing and education? Can we therefore assume that all persons diagnosed with Autism are in fact Autistic?
A further challenge to the paradigms that are models for diagnosing mental illness:
Can it be possible that there are persons who are born with certain physiological and neurological uniqueness that determines the way they communicate, develop and even form relationships? If this is an undiscovered way of being for these special people, should the approach be to diagnosis and treat an illness or should it be to find a way to communicate and relate to such persons, thereby bridging an obvious gap?
Within these paradigms, the models whereby mental illness is diagnosed, we see issues of subjectivity and lack of quantitative guidelines. Why then is it reinforced as an inflexible framework? From my experience, any attempt to submit answers to examination questions that contradict or suggest other interpretations outside the taught model would be met with a failing grade. Is this not reinforcing the notion that paradigms are inflexible and immovable?
I believe there is a useful place for every paradigm. I also believe that, like soil on the white garment of a beautiful child, it can be misplaced, damaging and unfortunate. How can we know the difference is an entirely different matter!
Photo Credit To Berkersfield Now
Tina Mowatt is a freelance contributor to MNI Alive