The idea of psychological well being – and much more so its converse of psychological sickness – has turn into ubiquitous within the trendy West, and it deserves severe examination by philosophers. Many, in all probability most, cultures wouldn’t acknowledge the declare {that a} thoughts that sees demons or refuses to talk or commits suicide is in a situation analogous to a physique with a fever or a damaged limb.
The concept of psychological well being and sickness is the central concept within the psychological method that we sometimes consult with because the medical mannequin. The time period “medical mannequin”, in its most elementary sense, implies that one approaches a given area of human endeavour within the method related to medication: that area could then be thought of part of medication, or just analogous to it. I consider the time period was coined by R.D. Laing, the outstanding critic of psychiatry, and so it usually takes on a damaging solid, for the appliance of particular facets of recent medication in areas the place it’s inappropriate to take action.
It doesn’t must, although. Until we reject trendy medication in its entirety (which might be a silly concept), we’re going to settle for some facets of the medical mannequin for not less than the follow of drugs itself. Trendy medication has achieved an incredible deal, even in its utility to phenomena of the thoughts: antipsychotics and antidepressants should not cure-alls by any means, however for an incredible many individuals, their psychological lives are a lot improved because of these medicines.
Furthermore, the time period “medical mannequin” is used, and I feel rightly used, to explain sure philosophical approaches from lengthy earlier than the rise of recent medication. The medical mannequin as we all know it was definitely a shift from earlier Western methods of viewing dangerous psychological abnormalities, typically thought to be sin or as demonic possession. However it is vital that medical fashions of the thoughts as such should not a contemporary Western invention.
Think about the Buddhist 4 Noble Truths, usually said within the one-word summaries of dukkha, samudaya, nirodha, magga: struggling, origin, cessation, path out. These 4 may describe the parts of medical follow: prognosis, etiology, prognosis, therapy. In each medication and the Buddhist dhamma, one identifies the fundamental downside, its trigger, its future course, and what to do about it. And I’m hardly the primary to watch this similarity. The commentary doesn’t simply present up in lots of Western introductions to Buddhism; it was made by Buddhaghosa, the preeminent Theravāda thinker, himself. He proclaims that “the reality of struggling is just like the illness, the reality of origin is just like the illness’s trigger, the reality of cessation is just like the aid of the illness, and the reality of path is like the drugs.” (Visuddhimagga 512.8-9)
Buddhaghosa, then, explicitly treats a core instructing of the dhamma as analogous to medication. We’ve got a medical mannequin for our mentally prompted struggling and the way to get out of it. And Buddhaghosa is hardly alone on this. An article by Albrecht Wezler (Indologica Taurinensia 12 (1984)) goes into marvelous element on how this fourfold mannequin exhibits up not solely in Buddhist texts however in medical literature (the Caraka Saṃhita) and non-Buddhist philosophical texts just like the Yoga Bhāṣya and Nyāya Bhāṣya. Intriguingly, although, Wezler notes that the 4 Noble Truths are the earliest attested type of this mannequin: that’s, it seems in them earlier than the medical literature. So it could possibly be that slightly than Buddhist therapy of the thoughts being initially modelled on Indian medication, it was vice versa.
Nor was the concept of a medical mannequin unknown within the West. The Hellenistic philosophers (the Stoics, Epicureans, and Skeptics), referred to their philosophies as therapeia, the Greek phrase for medical care, and the basis of our trendy phrase remedy. Thus Martha Nussbaum entitled her glorious guide on these thinkers The Remedy of Need. In it, she exhibits how the Hellenistics believed that we’re in some important manner sick, and philosophy provided a manner of treating it.
The Hellenistics and Indians didn’t mannequin their philosophical paths on trendy experimentally primarily based medication, however they did see the paths as analogous to medication nonetheless. There stays one large distinction from the fashionable medical mannequin of psychological well being, although. And that’s that the 4 Noble Truths are a prognosis, etiology, prognosis and therapy of the regular human situation. That can also be how the Hellenistics seen their philosophical remedy: it may gain advantage everybody. The fashionable medical mannequin, against this, has seen “psychological well being” because the regular state of being. And, it appears to me, that’s what it will get unsuitable!
Even when utilized to bodily well being, there’s something just a little unusual concerning the phrase “well being” getting used as a binary: you’re wholesome or sick. As one goes by means of one’s forties and fifties and the day by day medicines one takes for minor troubles start so as to add up, it’s onerous to see the divide being so clear-cut. Absolutely well being is extra of a continuum. However even when one can settle for {that a} typical twentysomething is bodily “wholesome”, it’s nonetheless not so clear how that time period can apply to the thoughts.
Martin Seligman based the flourishing area of positive psychology out of frustration with this method. Psychology had historically seen itself as “curing” the “sick”: taking you from an uncommon state during which you had a “dysfunction” into a standard state of “well being”. However when Seligman, a lifelong “grouch”, noticed that his five-year-old daughter had performed extra work on bettering her temper than he had as a skilled psychologist, he realized one thing was unsuitable. One could possibly be completely “mentally wholesome”, on Twentieth-century psychology’s mannequin, and nonetheless be depressing – or nonetheless be a jerk.
It is for that reason {that a} stigma has lengthy been hooked up to seeing a therapist: to take action was to point that you just have been “loopy”. It appears that evidently as of late the stigma is diminishing – many present pop songs point out seeing a therapist – and I feel that could be a great point. The power to speak out one’s psychological issues and discover options is efficacious for many if not all folks, not simply “loopy” ones. However the “loopy” view of remedy is the logical conclusion of a mannequin that views psychological well being as regular, and “psychological sickness” as a deviation from that norm: a mannequin that divides the world into regular folks and loopy folks. The classical Buddhist mannequin is way wiser when it tells us: we’re all loopy. A few of us are simply crazier than others.
Cross-posted at the Indian Philosophy Blog.
