Seeing Mental Health as Increasing Adaptation
The limitations of pathological thinking
Mental health is often seen under a binary system of judgment, where one’s mental life is either positive or negative, good or bad, healthy or unhealthy. A person is considered mentally healthy, according to the World Health Organization (WHO), when they are able to contribute to their respective social role without detriment to self or others by coping with life stressors. A mental lack of health is where pathology comes in, notably defined by the DSM-5 as the identification of a subset of a person’s total actions that lead to negative consequences in one or more areas of their life.
This binary frame of reference leads to all sorts of peculiar and unhelpful conclusions, with even further unhelpful incentives regarding how one looks at mental health pathologies or diagnoses.
If you don’t meet the criteria for a pathology, does this, therefore, mean that you’re mentally healthy? Admittedly, one professional I know considers diagnosis as falling under the rubric of “they likely met criteria at some point, so give them a label,” but this simply undermines the already problematic state of the scientific basis of mental health care, so it is not a tactic I agree with. One can see the poor incentive there, though, since mental health care is contingent on being unhealthy in the pathological sense, it becomes an easy rationalization to identify the behavior needed to check the boxes.
As an aside, for all the conspiratorial talk of doctors and so-called “Big Pharma” not wanting people to actually ever get healthy, it is, in fact, the broader mental health care system that is built on the notion of people never getting healthy, at least in the sense of no longer being pathologically diagnosed. I have lost count of the number of clinicians who take pride in the number of clients they’ve had for years if not decades. The underlying, and frankly often stated, so there is at least some honesty going on, the assumption in this life-long care is that a person’s pathology is who they are, with the continued, often weekly, intervention of talk therapy being a way to inoculate against a supposedly inevitable reoccurrence. That this thinking, including several other assumptions it includes, may, in fact, contribute to a lack of resiliency and flexibility that creates the supposed need for continued care is rarely considered and, in my experience, seen as almost sacrilege.
While the stigma associated with mental illness has dropped considerably over the last few decades, this seems to have only furthered the incentive for thinking in terms of the binary, healthy or unhealthy. Further, the lack of stigma and the perpetuation of mental health care as being life-long fits quite nicely into treating people as cogs or pieces in a societal machine.
Pieces of a Larger Machine
As Erich Fromm, in his “The Revolution of Hope” notes:
“The ‘megamachine’ is the totally organized and homogenized social system in which society as such functions like a machine and men like its parts. This kind of organization by total coordination, by ‘the constant increase of order, power, predictability and above all control…’ will find its fullest expression with the help of modern technology, in the future of the technological society.”
Fromm wrote that in 1968. I can only imagine, with shuddering certainty, what he would say about our world of generative AI, mobile devices, and data centers.
A tool or machine has a particular function. If it doesn’t do what it’s supposed to do, then it’s considered broken, and repair is needed. Washing machines and stoves, depending on one’s socio-economic status, are considered in need of either repair or replacement when they no longer function in a prescribed way. The problem of applying such thinking to mental life is more than just a knee-jerk protest of revulsion that “we’re not a machine.” Such protests hide us from bigger truths because they’re not fully honest.
When the direct comparison equating a person with an industrial tool is made, we recoil and shout something about a soul or an equivalent. Still, we often live our everyday lives thinking precisely this way, just not so blatantly. Take, for instance, the very wording of “she’s broken” or “he has a screw loose.” Both are references to a mechanistic perspective concerning mental life. The point in these metaphorical judgments is not simply word games; they support a particular way of looking at our lives.
Take one step outward and begin seeing psychologists as repair people, spare parts as psychotropic medication (made even worse by the oft-repeated and yet still false chemical imbalance theory concerning pathology), and return policies as in-patient treatment centers. The comparisons are not without some faults, as all metaphorical connections are, but consider for a moment how much the internal revulsion has to do with attempting to avoid the brutal truth of how often we view the world through this technological lens.
Seeing people and mental health as industrial appliances breaking down and needing fixing is ultimately a failure of inverting the causal relationship. Appliances and tools are designed for particular tasks in particular contexts. They’re singularly focused. This is why “multi-tools” are helpful. They provide multiple options in a single device to meet multiple contexts. Humans are not focused in a similarly singular way. They’re adaptive bio-environmental interactive organisms. We exist in reciprocal manifestation relationships, shifting and changing in a co-creative connection with the external environment. We are fundamentally embodied, embedded, and relational creatures, embodied in the gene-controlled biology that nature has evolutionarily provided, embedded in various historical and societal influences, and relationally determining how to define ourselves and the possibilities of our future.
Health as an Adaptive Possibility
Mental life is not a round peg seeking a round hole; it’s an adaptive organism with individualized degrees of potential change, which psychological literature calls “resilience" and Acceptance and Commitment Therapy (ACT) refers to as psychological flexibility. Seeing mental life this way, through the lens of an adaptive relationship, has consequences.
Mental adaptation is contingent upon two reciprocally linked and mutually manifesting organisms: the mind (felt as personal experience) and the multiplicity of environments each mind is nested within.
The extent of adaptability is based on the disposition of the two organisms, e.g., the degree of potential change. Sometimes, an environment is so rigid that it does not allow for much variation in being met (prisons and internment camps are examples). In contrast, at other times, a person’s mind is so rigid that even in an environment that allows for great variety in behavior, few of those potentials can manifest (brain damage and ideological dogmatism are examples).
All intervention attempts will affect both organizational perspectives (environment and mind). In other words, a person shifts a mental paradigm, resulting in an increased potential for different behaviors to emerge; the behavior happens, and the environment shifts according to its own set of potentials. Think of a new level of training or having returned from a particularly great weekend trip. Your behavior and the reactions of those around you have shifted with you according to their potential, leading to a cascade of changes in the various environments. Often, these situations are met with the curiously banal pronouncement of “You seem different."
In any of that formulation, is there a hint of brokenness? Of illness? Do you need repair by a prognosticating expert? We don’t like being referred to as machines, but we often deal with our difficulties precisely through that metaphorical construct. Changing how we look at our mental lives is more than the wording; it’s about shifting our view of how we interact with our environments from a one-to-one cause/effect relationship to a spectrum-within-spectrum cascading effect along multiple interconnected relationships. This doesn’t mean removing all drugs. It does mean acknowledging that we do not live our lives alone, not ever. This doesn’t mean removing all psychology professionals. It does mean noting that when we feel stuck, the “answer” may be as much in our communities and the environments we haven’t explored fully.
Being stuck isn’t a pathology. It’s a lull in imagination waiting for a challenging inspiration. Who decides what is or isn’t an inspiration? You do.