Surveying the vast literature on mental illness I have learned that there are many competing viewpoints about the origins of mental illness and proposed cures. In both the academic community and public debate, the relative validity of these perspectives is contested. The different perspectives can be broadly classified in terms of four distinct models: biomedical, psychological, social, and spiritual.
Biomedical
Mental illness arises due to chemical imbalances in the brain. Healing can occur through treatment with appropriate drugs. With the development of new drugs, such as
SSRIs, in the last thirty years, this has become widely used by psychiatrists and medical doctors. There is no doubt that many people, including myself, have benefited significantly from these drugs. Unsurprisingly, big pharma strongly pushes this point of view. However, drug treatment is not always successful and it is debated whether such drugs are over-prescribed. Even among psychiatrists, the biomedical model is contested because it ignores thinking patterns and the social interactions of the patient. Recently, the New York Times had op-ed articles by a doctor and a patient contesting this model.
Mental Illness Isn’t All in Your Head
Lisa Pryor
It’s Not Just a Chemical Imbalance
Thinking of my mental illness as preordained missed many of the causes of — and solutions to — my emotional suffering.
Kelli María Korducki
Psychological
Mental illness arises due to negative thought patterns.
Healing can occur through psychotherapy.
Freud drew an analogy with grief over the death of a loved one to argue that depression arose due to the patient turning their anger inward about losing an ideal object.
Cognitive behaviour therapy seeks to train the patient to think in more positive ways.
Other approaches focus on past trauma and/or unresolved conflicts, particularly from childhood.
Mindfulness uses meditation exercises to help the patient learn to control their thoughts.
Many people, including myself, have benefited from this approach. However, there are many people for which this approach is ineffective, particularly without medication.
Social
People are social beings. When they are isolated from true community mental illness results. One of the first advocates of the social model was
Emile Durkheim, one of the founders of sociology. He
found suicide rates varied significantly between different social groups, and argued that this was related to the levels of social integration felt by individuals.
A recent popular advocate of the social model is Johan Harari, in
Lost Connections.
The best treatment for patients is to help them establish meaningful relationships in the context of a community.
Marxist
In capitalism, people are defined by their jobs, by their relationship to the ``means of production'', the technology that is at the heart of the economy. As a result, they are alienated from one another, from nature, and from meaningful work. The solution is political and economic: revolution leading to a socialist economy where workers own and control the ``means of production.''
Spiritual
The most extreme form of this model is that mental illness arises due to demon possession. Healing can occur through prayer, particularly exorcism. Advocates will point to accounts in the Gospels such as
Jesus healing the demoniac. A milder form of this model is that mental illness arises due to the sin or lack of faith of the individual. The solution is repentance and faith. There is no doubt that substance addictions and abuse are bad for mental health.
Studies also show that forgiving others is beneficial for mental health.
These competing models raise fundamental questions such as
What really defines a human person?
How do you define human well-being?
Is a human essentially biological (biochemical and genetic), mental, social, political/economic, or spiritual? These models for mental illness tend to each assume an extreme reductionistic view of the essential character of a person.
However, Jesus seems to have had a more integrated view. He said people should love God with all their heart, mind, soul, and strength. He is not presenting a partition of a person, but saying a person is a complex unity of emotions, brain, spirit, and body. Furthermore, the incarnation is about God taking on a human body. Jesus promises his followers will be resurrected with him: not disembodied souls, but rather bodies.
Rather than seeing that one of the models as being mutually exclusive I see that they all have strengths and weaknesses. Individuals are complex and diverse and they live in diverse contexts. Hence, causes and solutions for mental health may vary significantly.
This week I am giving a talk on Jesus and Mental Health for
Jesus week at UQ. More to follow.
