Sunday, December 23, 2012

My Criteria for Judging Whether a Pattern of Behavior Should Be Judged as Potentially Indicative of 'Mental Illness'

I can understand that some people believe that to call a mental illness an "illness" is misleading, as they believe that there is not evidence of a physiological cause.  However, I think it is important to acknowledge that certain people fall into certain psychological patterns that are self-damaging.  And it is noticeable that:
1. The pattern consists of unusual behavior
2. The behavior is harmful to self, others, or both self and others
3. The behavior has a lot to do with some deeply-ingrained belief or propensity to believe
4. Even though only a minority of the population engages in such behavior, it is conducted by enough people for psychiatrists to notice a pattern.  That is, it's not confined to one person; there are multiple cases of it.
I think this raises the issue of what should or should not be considered an indication of mental illness.  First off, a behavior should not be considered a sign of mental illness just because it is unusual.  For instance, Albert Einstein wearing his hair the way that he did, was strange.  But I don't see how his having strange hair inflicted long-term damage on his life or happiness.  Therefore, Einstein having strange hair is not enough to be taken as a sign of mental illness.

Rather, I think that what makes a pattern a behavior a sign of mental illness is that it is severely damaging to others or at least to oneself.   However, I think a certain qualifier is in order.  If someone engages in a certain behavior, and this leads to his unhappiness primarily on account of other people disapproving of it, that is not sufficient for the behavior to be classified as a mental illness.

For instance, one might argue that Galileo invited great misery upon himself for publicly stating that the Earth revolves around the sun.  One might also say that, in terms of his social standing, he might have been better off if he never shared his knowledge.  Galileo speaking the scientific truth arguably did cause him great unhappiness, but the unhappiness was caused less by the behavior itself than by the social establishment's disapproval of it.  For instance, we can ask ourselves what effect Galileo's actions would have had in a society where everyone approved of him saying that the Earth revolved around the sun.  If everyone approved of Galileo's behavior, would it hurt him?  No.

Now, what of being gay?  Someone might argue that if someone publicly comes out as gay, that might cause him great unhappiness.  But that has more to do with widespread social disapproval of homosexuality than with homosexuality itself.  If someone came out as gay in a society where nobody disapproved of that, I don't think it would harm him.  Therefore, even though psychologists did classify homosexuality as a mental illness for most of the twentieth century, they were wrong to do so.

Therefore, I have this generalization:  a behavior does not indicate mental illness solely because it is unusual or because doing it openly would bring widespread social disapproval.  Rather, the behavior can properly be seen as an indication of mental illness if it is unusual and would bring harm to self or others even if everyone in society approved of it.

For example, what if, to relieve stress, I always got a blade and made cuts on my wrist?  Imagine, if you will, that nobody in society disapproves of this.  The fact of the matter is that even if everyone in society condoned it, my cutting myself would still pose a physical danger to me.  Therefore, self-cutting does deserve to be considered a psychologically disturbed behavior.

What if I purposely starved myself to become skeletally thin?   Even if everyone in society condoned it, the behavior would still be a physical danger to me.  Therefore, this, too, merits classification as a disturbed behavior.

Thus, I think these are the correct criteria for judging whether someone's actions might be indicative of mental illness:
1. The behavior is extremely dangerous to one's life or long-term well-being, or dangerous to the lives of others, and would be such even if everyone in society approved of it.

2. The behavior is unusual and practiced by a minority of the society's members, but still happens frequently enough for multiple cases of it to be documented.
Is it possible for an entire society to be mentally ill?  For instance, it was normal for Aztecs to believe that if they did not sacrifice someone -- ripping out his heart -- to appease supernatural forces, then the world would end.  That is a very harmful belief, and it caused much tragedy.  But as this belief was normal in that society, I do not think it was a sign of what is usually called mental illness; what I think it shows is that even very normal people are in danger of engaging in self-destructive actions when such actions become the social norms.

I think an entire society can become corrupted in a form of self-destruction; that is what happened to Germany under Hitler.  However, I think that is a phenomenon different from mental illnesses like self-cutting and self-starvation, which are difficult to make into social norms.