The Concept and Nature of Mental Sickness

There is no doubt that a good percentage of persons in our society would like to have information about mental sickness. Do not be embarrassed if you have such keen interest. I would not go into analyzing why you are so interested. Suffice it to say, that it is a common phenomenon among human beings to be excited about discussions on mental sickness. Despite this fascination on abnormal process there is yet little tolerance and less concern for the persons in whom such sicknesses occur. In our society today, the mentally sick people are stigmatized in ways that the physically ill persons are not. There is abundant research evidence that, in general, the public seems to fear and shun individuals deemed mentally sick. Such mentally sick people have always been set apart from others. More often than not they have been rejected, cast out, isolated, tortured, or destroyed by society. Then one may ask who is a mentally sick person? Perhaps asking more directly, what is mental sickness? I would be surprised if any psychiatrist or psychologist gives a straight forward answer to these questions, because a sentence definition of a mentally sick person or mental sickness does not exist. Except perhaps the definition goes this way; a mentally sick person is a person that is not mentally healthy. You can see that this definition is as controversial as it is incomplete since it has given rise to further questions. Thus, who is mentally healthy? And what is effective mental health? I think we may start from here, attempting to understand what is “bad – abnormal from our knowledge of what is good – normal.” A person is considered mentally healthy when his or her behaviour is appropriate within the context of his culture, and in relation to the person’s age, sex, social position and perhaps religion.

Such a person should have the ability to assume the responsibilities that a person of his or her age and intellectual and physical capacities should assume as well as carry them out. An effective mental health includes both emotional stability and maturity of character and a large capacity of frustration tolerance which gives the strength to withstand the strain and stress inherent in living in today’s society and mostly in the developing nations of the world where little or proletarian measures are taken to educate people in the vicinity without physical or psychological balance. As a matter of fact, sense of balance is the rule in mentally healthy persons. Such a person is well rounded, not one-sided. A sense of balance is one of the requirements for harmony with oneself and others, and for being at peace with oneself and the world. An effective mental health further implies the ability to judge reality accurately and to perceive things in terms of their long range rather than short term values. For a balanced healthy person, self perception and perception of others is realistic. An effective mental health as it relates to interpersonal relationships with other persons. Healthy persons have unconditional acceptance and positive regard to life as it is, which enables them to be more or less at peace with those to whom they relate and live with comfortably and spontaneously. The demand of effective mental health covers a wide range of behaviours such as, the presence of an affectionate conscience; being realistic and independent; while at the same time guided by a practical ethical code by which to live. Furthermore, it demands the satisfaction of needs such as hunger, thirst, sex, self-assertiveness, self-esteem, self control and self actualization in such a way that neither self nor other persons are hurt. The mentally healthy persons are guarded by their motivations. Their goals are realistic, personally and socially constructive; the means of reaching them are practical and attainable, and they are compatible with one another. Such individuals have adequate and spontaneous emotional expression and capacity for happiness and pleasure. It may be necessary to note that effective mental balance does not imply perfection, faultlessness, extreme happiness, or eminent success; it does not also imply impressive surface appearance which may be a faulty indicator of the true state of the individual’s personality; and it is absence of symptoms of psychological problems such as aggression, frustration, anxiety and guilt. There is no absolute condition in mental health. Having examined the qualities of mentally healthy persons, we can simply say that mental sickness is a deviation from this normal mental state. Since there is no absolute zero point in mental health, such a definition is unacceptable. Mental sickness is a state of mental and psychological imbalance. It is a condition of inner turmoil and discontent that result in behaviours that the society would label as abnormal, bizarre or deviant. People with severe mental sickness generally have confused, distorted perceptions of themselves and others. Frequently their interpersonal relationships are marked by severe strain or conflict. Such people often cause trouble for themselves as well as others within their environment. Sometimes they can be troublesome for the society as a whole. This view of mental sickness is a recent development. Before this modern concept of mental sickness, such related behaviours were attributed to possession of the mind and body by demons. Demons here refer to the invisible powers that were assumed to cause mental sickness. The only hope lay in preventing such spirits from entering one’s body. For once they gained entry; the process of driving them out was traumatic and more likely to result in death than a return to normal mental operations. The modern view of mental sickness is based on the medical model in which mental disorder is viewed as a result of physical illness or being similar to physical basis or cause for mental sickness and that the cause can be treated. This view, while promoting the concept that mental problem is a disease rather than a form of maladjustment, has brought about an emphasis on hospitalization and drug treatment of mental sickness. Because many physical diseases are contagious, there is a tendency to believe also that the association with the mentally sick people or a bite from them could bring about mental sickness. There is however a growing concern in recent times about viewing mental sickness from a medical model perspective. According to Zimbardo and Ruch (1975), the medical model accounts for the major advances in the study and treatment of mental sickness but on the other hand misguided both research and possible solutions to the problems. They however outlined the main features of the application of a medical model to mental sickness as follows: (a) Mental sickness is symptomatic of an underlying disease. (b) Overt symptoms are signs of internal psychological states and processes. (c) The ultimate cause of mental sickness will be found in genetic, biochemical, and organic malfunctioning; (d) The present illness is the manifestations of the individuals prior history of trauma, deprivation and variables related to poor mental health care. (e) Sharp distinctions are seen between the behaviours of a mentally sick person and a mentally healthy person. (f) Treatment involves hospitalization and medical intervention designed to rid the sick person of the disease, to cure the illness that rages within. (Zimbardo & Ruch 1975). The critiques of the medical model argue that the major dangers of accepting the medical model as a way of viewing mental sickness is the overemphasis on the “sick person” rather than the environment in which he functions. It is oriented towards past origins of disease, rather than towards current conditions that may be maintaining the abnormal behaviours. It assumes that the mentally sick person must be isolated to some extent, taking a passive role as a patient in the treatment process presided over by medical experts. The medical model assumes that even when all symptoms disappear following treatment, the patient is not necessarily cured, since symptoms are but the visible tip of the inner lying component of mental sickness. A mental patient whose disease symptoms are no longer present is described as having the disease in remission which implies that though not yet in the open it may break forth at any time. If we condemn the medical model as the true concept of mental sickness, then what is the alternative view? The following questions may be of help. Is madness a diagnosable disease in the tissues of individuals? Is mental sickness like beauties which exists only in the eyes of the beholders, or does it really exist only independent of social evaluation and the observer’s cultural bias? Some attempts to answer these questions may clearly challenge the very foundations of modern psychiatry. All the same, I make bold to say that I share the views of psychologists of behaviourist orientation to assert: (a) that the phenomenon termed mental sickness is better viewed as a deviance rather than disease; (b) that mental sickness is not an entity in the same way as cancer, malaria or tuberculosis, but is rather a subjective label or metaphor applied to some people by other people to infer states and processes that are not directly observable; (c) that it is the socially, economically, politically powerless people who are more likely to be labeled mentally ill than the powerful ones, even if they display identical behaviours; (d) that madness is a product of the individual’s interaction with and adjustment to his or her social environment, with its conflicting demands, unreasonable rules, and pathological relationships fostered in the family, schools, work place or other situations. In physical illness there is a clear, agreed upon, unusual measurable signs of disease (for example, Malaria Parasite). But mental sickness is present when some say it is. So mental illness is established not by physical realities but by social ones. In this case, it is behaviour that is observed and not tissue, and someone has to evaluate the behaviour and judge whether it is pathological. From recent investigations so far, some nations of the world generally consider individuals mentally sick on the basis of each or a combination of the following: 1. If they are under psychiatric care 2. When respectable and significant members of the society agree that the behaviour represents the phenomenon termed mental illness; 3. If a psychiatrist or clinical psychologist makes a diagnosis of mental sickness; 4. When scores on a psychological test deviates from the standards or norms of behaviours designated as normal; 5. When such persons declare themselves to be mentally sick either explicitly or through expressed feeling of unhappiness, anxiety and inadequacy; 6. When they behave publicly in such ways as to call attention to their behaviours as deviating from standards accepted by the majority of others in the society. The diagnosis of an individual’s behaviour as mental sickness carries with it a number of consequences; it makes us perceive behaviour as sick, something to be eliminated rather than understood; it gives public agencies (health and social welfare units) the right to confronting; and it causes these people (mentally sick person) to define themselves as rule breakers and undesirables, and allows them to fulfill that label.