Do we really “have” mental illnesses?
April 27, 2014 25 Comments
Should we see our mental illnesses as parts of our genuine selves or as unwelcome, alien entities? I’d be very interested to hear your thoughts on this. Personally I’m open to persuasion.
The current norm is to say “I have depression” or “I have OCD”, as if something foreign has invaded from the outside, like a bacteria.
There are obvious reasons why this is a helpful way of phrasing things. By externalising the problem, stating that the illness is not a part of their real self, the person is absolved from any blame. Their character is instead seen as having been attacked by something they had no control over. This relieves stigma, lessens feeling of self doubt and in so many cases, is a vital part of recovery.
But is it always a good thing?
To be honest, it actually doesn’t make sense to me in the context of some physical health problems. To say you “have” heart failure, for instance, sounds strange. It’s the same heart you’ve always had, except now it isn’t working as well – what exactly have you acquired, except the symptoms of the failing organ?
The same query can be applied to mental illnesses. In some cases, might it make more sense to state the problem in the personal sense, for example, “I am depressed” or “I am someone who becomes psychotic”? After all, it’s the same brain in your head, just working differently. No virus has crept in, no tumour has appeared.
Does externalising the problem prevent some people getting better? Does believing the problem is an outside agent, over which we may have little control, make changing things harder sometimes? Perhaps for some people, recognising that their diagnoses are the result of complex interactions between the outside world and their own personal reactions to it would be more appropriate. Concluding that the illness forms a part of themselves that is as authentic as any other may be a more constructive step.
In the extreme form, if a mental illness is severe and unresponsive to all treatment, could externalising the problem lead to a feeling of being tortured by something foreign that cannot be expelled? Would coming to terms with the cause of suffering as part of oneself bring a relative sense of peace?
This, of course, is a very different stance to arguing that diagnoses themselves should be done away with. As in the heart failure example, the diagnosis can still be solid despite the fact that saying someone “has” it sounds inaccurate. It’s also very different to stating that people with mental illnesses are in some way to blame for them.
So, are mental illnesses things that people partially are, rather than things they get?