Defining Mental Health and Illness

This brief overview of the psychology of mental health and illness contrasts and compares the three primary views from which therapies occur; the psycho functional view, the psycho medical view, and the psycho visual view. In essence, these three views comprise the three ways health professionals define mental health and illness.

Currently, the perspectives from which mental health professionals address and explore peoples' levels of health and illness can be roughly divided into two broad categories.

In the first category, the "medical / symptoms" model, health is defined by the absence of symptoms; illness, by the presence of symptoms.

In the second category, the "functional / dysfunctional" model, health is defined by the ability to function at what are perceived to be the reference norms for a particular group. Illness is then defined as the inability to function at these perceived norms.

Presently, a third category is emerging. In this third category, the "visual / blocked" model, health is defined as an unblocked ability to picture choices on the screen of one's mind. Illness is defined as the inability to picture these choices.

On what is this third perspective based? On the hypothesis that the root of illness is neither the symptoms nor the dysfunction present but rather, that illness stems directly from people's blocked abilities to visualize their choices. Literally.

It is further hypothesized that these blocked visual abilities are the actual root cause of both the symptoms and the dysfunction present, the literal a priori nature of mental health and mental illness.

And the assumption beneath these hypotheses?

That beneath all symptoms and dysfunction, there is a preverbal visual essence which, in nature, and in effect, precedes all mental and emotional processes. More over, that by directly addressing these preverbal visual aspects of peoples' inner lives, that therapists can bypass people's conscious and unconscious defenses.

Can this hypothesis be true? Can peoples' blocked visual abilities to picture their choices be the actual root cause of all mental health symptoms and dysfunction? Admittedly, this is a radical hypothesis. None the less, strong evidence exists for this hypothesis being true.

Exploring this hypothesis will be the goal of this brief article.

A First Look at the "Three Perspectives"

For the rest of this article, we will refer to these three perspectives, or views, as, [1] the "psycho functional " perspective, [2] the "psycho medical " perspective, and [3] the "psycho visual" perspective. How do these three perspectives differ? To see, let's look at how health professionals from these three perspectives would look at a common personal problem, say, "low self confidence at work."

To do this, let's set up what might be a typical situation wherein this condition could exist.

Let's say we have a forty-five year old man who works for a fortune 500 company. More over, let's say this man has, for years, managed an information services department in one of this company's regional offices, an office in which he has been managing some forty to fifty employees.

Let's also say that this man has been working for this company for going on twenty five years. However, despite the fact that there have been many opportunities for advancement beyond his present level, he has repeatedly been passed by and has never complained.

How might mental health professionals from each of these three categories see this man's situation?

the Psycho Functional View

Psycho functional therapists would probably begin therapy by looking at how well this man functions at work. To do this, they might ask him things like how he manages his time or how he communicates to his boss or coworkers.

Eventually, of course, the therapy would uncover the inevitable flaws in this person's life skills. Why? Because all people have these kinds of functional flaws. Even so, the therapy would see what it had uncovered as having made progress and would then define these functional flaws as this man's problem; his "dysfunction."

What would happen next? In all likelihood, the therapist would focus on exploring these flaws. How? By asking this man things like "how he has done," "what he has learned," or "how he has felt" about how he has done over the course of his life, paying particular attention, of course, to the times in which he did not function well.

Along these lines, the health professional might ask, "Was there ever a time when you managed your time well or did you always have trouble managing your time?" Or, "Can you ever remember being able to get along with a boss well? Or "Did you always shy away from your peers?"

Other typical questions might be, "What do you believe about how people advance?" or "What do you think limits your thinking with regard to you, yourself, advancing?" Or, "How does it feel to have been passed by so many times when you know, all too well, that you have deserved to advance?"

The essence of these questions, of course, represents the second half of the present bias toward the cognitive-behavioral therapies. In other words, these questions typify the behavioral entry into the therapeutic process and ask, "How does what have learned in life about how people advance or about how people get along affect your behavior?"

The therapist's goal? To improve the man's functioning by eliminating his "dysfunctional behaviors."

And the assumed outcome?

That if his "dysfunctional behaviors" were eliminated, that he would be more likely to advance. And that by achieving his rightful place in his life, that he would, indeed, feel more confident and be happier.

Would he?

Yes and no. We'll address the two conflicting sides of these assumptions in a moment.

the Psycho Medical View

So how would the approach of psycho medical therapists differ from those who use the psycho functional approach?

Psycho medical therapists would probably begin therapy by looking at any symptoms present. Thus, they might look at this man's low self worth, chronic feelings of depression, feelings of inadequacy, and feelings of self doubt. They would then explore these symptoms in a historical context, looking for some "origin" or "cause" for these painful feelings, in all likelihood, some childhood event to which to attribute these feelings.

In order to do this, they might ask this man things like, "How did your parents treat you when you felt down about school?" or "How did your father feel about his career?" Or, "Did anyone in your childhood encourage you to do better?" or "Did your father ever advance in his career?"

Other therapists in this category might ask things like, "How did you feel about your father's career or about the fact that your mother did not work?" Or, "Did you ever feel anyone appreciated you for who you were?" "Did anyone, in fact, ever really know you?"

The essence of these questions, of course, represents the first half of the present bias in psychotherapy; the bias toward the cognitive-behavioral model. In essence, these questions typify the cognitive entry into the primary therapeutic process and ask, what did you learn during your lifetime about "self-confidence?" And what did you feel about what you learned?

And the therapist's goal?

To reshape and restructure this man's inner thoughts and feelings so as to relieve him of his feelings of low self confidence. Said in other words, the therapist's goal would be to eliminate this man's "symptoms."

Of course, the assumption underlying this goal would be that by eliminating this man's symptoms, and of course, by uncovering their source, that this man's life would improve.

So would it? Again, yes and no. More on this in a moment.

and ...

the Combined View - the "Cognitive Behavioral" View

Before offering an example of the third perspective, the visual / blocked perspective, allow me to state that I, in no way see these two brief descriptions as the only way therapists practice these two perspectives. Nor do I mean to imply these two views are distinctly separate from each other; ergo, the currently common label which identifies them as "cognitive-behavior" therapies.

I also do not mean to imply that these two views are limited to "talk therapies." Thus, these same two perspectives underlie pretty much every current therapy, from experiential therapies like psycho drama to the more esoteric approaches such as EMDR and Emotional Freedom Techniques.

But aren't the therapies I've just named, visually oriented therapies?

Yes they are. And as visually oriented therapies, they do offer very powerful avenues to healing. However, even the briefest of exposures to these types of therapies will reveal that their underlying nature is based on these same two assumptions about mental health and illness, that illness stems from either symptoms or dysfunction, and that health stems from either the lack of symptoms or from the presence of healthy functioning or both.

the Psycho Visual View

Now let's take a look at the third perspective, the visual / blocked perspective. How would a psycho visual therapist approach this man's problem?

Psycho Visual therapists would begin therapy by visually exploring this man's ability to envision scenes related to his work environment. The goal? To divide his inner life into two piles; one, the things he is able to envision, and two, the things he is not able to envision.

Examples of questions which might be used are, "Can you ever see yourself advancing and at the same time, still feeling insecure?" or "Can you picture yourself in five years in a more adventurous career, such as financial planning?"

Now rather than detail the rest of the process here, please know, the story I've just briefly told you is a real one. Further, the man I've just described actually exists and is one whom I personally was able to help.

Did he change?

Yes. In fact, far from being unable to advance, he now practices what is surely one of the more risky of financial careers; he practices as a financial planner, confidently and with a real passion.

And how did this happen? You'll find a link to his story at the end of this article. You can read it and judge for yourself.

Real Life Examples of "Illness"
from the Three Psychological Views

Now what you'll find above are some brief examples of how these three views define mental illness. What you'll see, of course, are some examples of problems many people have. Thus, these examples are more the kinds of problems us normal folks have rather then being problems of the more serious kind.

Even so, these brief examples very clearly demonstrate how differently therapists from these three schools of thought define health and illness.

Real Life Examples of "Illness Healed" (health restored)
from the Three Psychological Views

What you'll find above now are some brief examples of what these three views would define as having healed these illnesses. Again, these examples are how many people define healing. Thus, these examples are more those of us normal folks than of the more serious mental conditions.

Even so, these examples clearly show very how differently therapists from these three schools of thought would know they have "restored heath" to these people.

The point is, the first two views define health as being able to function, even at an improved level, and / or being symptom free. And while psycho visual therapists see these two things as significant, in and of themselves, they are not seen as indicators that any healing has occurred.

So does define "healing?"

Only one thing: the effortless ability to picture the alternatives while in the named life situation.

Thus, unless these people can easily visualize the problem scene, even when they no longer feel the symptoms, this in not seen as health. Nor is being able to function, even at a higher level.

So what is all this based on? To be honest, the answer would take a whole article in and of itself. However, to get a brief look at this answer, I've taken these three views and placed them within the Layers of Aloneness, the personality theory on which we Emergence Practitioners base our work and our lives.

To see this then, take a look at the diagram, and the brief explanation, I've placed below.

Using the Layers of Aloneness to See How these Three Views Relate

Finally, here is the structure of personality which underlies these three views. Clearly, all three views are interrelated.

In essence, then, the Psycho Functional View is outer most view. This view is comprised of the outer four layers of personality, which are usually the easiest layers to identify and see even when things get tough.

The Psycho Medical View is then comprised of the middle two layers of personality, Layers 5 and 6; "symptoms" and "blocks." Thus, while these two layers are sometimes easily seen, seeing them usually takes more effort, except for when things get really bad.

Lastly, the Psycho Visual View is comprised of the inner four layers of personality. Seeing these layers almost always requires much effort, which is why most people never get to know these sides of themselves. Why? Because seeing these parts of our natures requires much effort and much suffering.

Having said this, can you now see how, by knowing how these three views relate, it is easy why we use the inner four layers to define illness and healing? Why? Because even when people make changes to both the outer four layers and to the middle two layers, there still remain the root causes of people illnesses. Which is why things like serious meditation practices, such as the practice of Zen Buddhism, often do help people to heal at incredibly deep levels. These practices actually reach these four inner layers.

And the story I promised you, the one in which the man I described at the beginning of the article healed his blocks in and around advancement? It's called "Brian's Story," and you'll find it at the other end of this link.

As always, should you have any questions, please do write and I'll be happy to elaborate. And to listen to you too.

Warmly,

Steven