I’ve often been struck how strong is the conventional tendency to describe life in terms of illness and wellness. Now, on the level of physical illness, this can make great sense. However, I’m often left wondering, from a holistic and developmental perspective, whether it is quite so useful from a mind and awareness perspective.
I’ve recently been designing some material for a client and one of these has been on the subject of mental health. While it’s an area I’m personally very interested in, and in which I passionately care about making a difference, I’m also aware of how much the field is dominated by what is known as the medical model, as you might gather from the name. What is meant by the medical model in the talking therapies or even coaching is that the mind can be regarded as either “well” or “ill”: we’re married to it, whether in sickness or in health, so to speak. Thus, when you are sick, you can, we hope, be treated for it via some diagnosis.
This does have very often have great value for those with severe depression or anxiety, and approaches like CBT have proved to make a big difference for such people. That is undoubtedly useful. Yet, my my mind went, what about those of us with mild symptoms, probably a much bigger number? If you’re feeling down emotionally, then you’re mentally ill?
Somehow that didn’t feel right, but I can imagine that’s where people’s minds might go. Then up comes everybody’s image of mental illness, psychiatrists, men (usually) in white coats, drugs and the rest of it. Now I know that people who work in mental health are doing great work to de-stigmatise mental health, so that having depression, being prone to panic attacks, having a phobia, etc. are now regarded as “common mental health conditions”. See for example this publication by ACAS, a government body, or the great work done by people like MIND. It’s like saying it’s quite common now and really OK, not that that is how it feels for the sufferer. What people are trying to do it get the world to be more tolerant and accepting of mental illness. Great, I think. Very positive. So, why am I feeling ambivalent about the use of the “wellness-illness” terminology in matters relating to the mind?
I think it is partly the use of terminology that classifies people who are feeling for example depressed or anxious, a very significant number today, as “unwell” (8-12% of people suffer from depression, for example. It’s a very significant number). Classing people as unwell places people into a medical framework and into the realm of science, and therefore potentially drugs, and into a monolithic and allegedly objective way of understanding the mind such as can be widely found in these fields. Its defenders will for example argue strongly that in this way, the various psychological approaches to understanding the mind can be validated, such as by the use of RCT’s, Randomised Controlled Trials, and thus be described as “evidence-based”. That which has not been so validated is implicitly not OK. As a result models like CBT (Cognitive Behavioural Therapy) have become the main accepted practice in the UK National Health Service.
Thus the possibility of subjective experience, of my map of the world, of my perceptions, my life experience, my feelings, and of the inter-subjective interaction of two humans working together, and of what occurs between them and what is common to them at the essential level, if it is not deemed validated by science, in the form of RCT’s, has no validity. In one sense, this poses a good challenge for these other approaches, for example in the humanistic and transpersonal domains, to be more investigated by methods like RCT’s. Yet, it still leaves me questioning what is going on here.
I alluded just now to a monolithic approach, that something has validity only once it has been subjected to “scientific” analysis. Yet even in science, there are no certainties, only probabilities. A lot of the scientific vailidation for what is happening in the mind is due to the use of brain imaging and observation by another of how the brain behaves. Yet the mind and the brain are not the same thing, depending on your interpretation. There are those who regard the mind as the whole body at the cellular level (see “The Biology of Belief“, Bruce Lipton), if not well beyond it. According to Ken Wilber, the so-called “objective” approach is that of “flatland”, since it omits other perspectives. From a holistic perspective, there are also the domains of the “I” or subjective, and “we” or the inter-subjective (see “A Theory of Everything” and “Integral Spirituality“). In his “Integral” model, there are four domains in consciousness, or four “quadrants”: “I”, “We”, “It” and “Its”. The scientific approach only allows for the last two, hence Wilber’s use of the term “flatland”.
From a transpersonal perspective, for example, being depressed is a state of awareness, a limited state, a function of the ego, and not who we really are. However it is state from which there are potentially great learnings and growth. To label it as being “sick” is to devalue the experience. It is a journey to be gone through, out of which can come, for example, a powerful liberation. To be “well” is to set up some other state of being, one that can mask various strategies for living that, while we feel “well”, are actually every bit as dysfunctional and undermining of our potential. This is the great problem with trying to describe the state of “wellness”. It is every bit as fraught with loopholes. What does it consist of? Very often states of wellness are idealised descriptions, often set up for analytical purposes. We might feel “well” but continue to run our rackets and patterns that screw our lives up.
According to positive psychology, there is another approach needed, that which builds up a state of well-being (still the word “well”), and which needs to be learned, for the most part. However, there is more potential here, in that we can focus on what uplifts us, and thus learn to shift away from negativity.
However, this is where the scientific world gets stuck. What is the norm, against which everything is judged? Well, it is the state of wellness, we are told. But what is “well”? Well, pardon the pun, it seems it is an absence of “illness”.
From a transpersonal perspective, unity consciousness transcends both polarities of “illness” and “wellness”. Those who experience life as pure love and joy for example, “illness” and “wellness” are simply opposite polarities of the ego level of awareness. This is described in the work of Steve Taylor (see for example “Waking from Sleep“). At the ego level, we flip from one to the other, very much as the ACAS article says referrred to above (on page 4, if you download it). In their efforts to normalise mental illness, they are in danger of finding another way to justify the ego. In the awakened state, all this is transcended.
This subject, for me, is very much work in progress, and I expect to add to or alter this article over time as I explore it further. For the moment, it might pay to investigate the work of people like Richard House.