The Totality of Mental Health Practice

In this article, I intend to explore my premise of influence on defining mental health. The argument I make regarding mental health practice is fundamentally related to health as its defined extensively in my previous article: Defining health, purpose, and the meaning of life.  

These articles are long, due to the process of identifying and addressing the role of philosophy and underlying assumptions throughout; which is unavoidable without giving vague, broad, meaningless, definitions. Vague definitions can be easily be found elsewhere, such as “to help you achieve your full potential.” The definition I argue is: 

The totality of mental health practice is adjusting what has our focus.

This article will address what value there is in trying to attempt a definition at all, as well as what underlying assumptions must be addressed to make any concrete definition of mental health. 

Why I Write 

These articles are not a short and easy read meant for receiving high views. I do not believe my writing of these articles shall fix cultures problems, for I have come to believe through extensive reading, that most, if not all of healthcare’s answers and solutions are right outside the front door, lining the shelves of libraries, and waiting for the Grandchildren to visit.  

To address this topic, I will attempt to be grounded in evidence; which is to use a heuristic approach throughout these articles. The idea is, rather than holing myself up and writing a book, that at best would only be read by America’s already literate elite, I will write here, and take action now. 

As for my motive, I am writing several in-depth articles for these reasons: 

  • To motivate myself to learn, and then reflect on the progress 
  • To organize what I learn coherently for family and friends 
  • To facilitate discussion among peers in order to weigh and evaluate the evidence 
  • To refine my understanding as I try to make positive health behavior appealing to others 

This article is influenced by the current state of America, though attempting to use universal concepts.  It should be noted however, that comparing healthcare problems internationally, is really in colloquial terms “comparing apples to oranges.” There are countries in great poverty with poor mental health nationally. There are also countries in poverty, by industrialized standards, with much greater reports of happiness and life satisfaction. There are countries with high average and overall socioeconomic status, with poor mental health, and also the opposite (Buettner, 2017; Helliwell et al., 2017). Some argue, such as Dr. Stephen Ilardi (TEDxEmory, 2013) that depression is a “disease of civilization”, similar to diabetes. While divisive, Ilardi takes strong to the nurture end of the nature vs. nurture debate calling depression a “disease of lifestyle.” However, this cannot necessarily be generalized to all mental health disorders. Though I think there may be some truth to this, I argue that the correlation is not the whole of the causation. As Wiking argues in his book Lykke (2017), “health and well-being should be separated.”

The challenge I see is this; there is “all talk and not enough action regarding health, particularly in America. I do not necessarily mean that metaphorically. Quite literally, depression and sedentary activity are on such a rise, that a literal lack of action is a good part of the problem. I don’t say this to condemn people, but to recognize this; bills need to be paid, kids fed, houses cleaned, groceries to be picked up, jobs to be attended, and relationships to be fulfilled.  

Introduction 

It seems that mental health is related to life as we experience it; which is quite subjective. Reasonably so, since the inception of psychology as a science, there is no shortage of perspectives of what we must do to achieve or maintain mental health. It is difficult then, to make any suggestion of what mental health practice is, without being incredibly vague. Presumably, in a vague way, therapy is to “help us reach our full potential” or “make us better” or “healthier” or “happier.” Truly, any attempt to narrow down or describe mental health and the practice of it, in anyway, is to come into disagreement with some theory, philosophy, psychologist, or field of thought, eventually.  

Freud argued that we had a will to pleasure. The philosopher Nietzsche, argued that humans had the will to power, which influenced Alfred Adler’s break in direction from Freud. Frankl Argued we had a will to meaning. I would argue, that Maslow’s Hierarchy of Needs could be described as a will towards self-actualization. Yet at the basic level, they each are influenced by an underlying assumption; that humans have a will at all. Somewhere, there is someone who would argue there is no will, such as the extreme behaviorist.

Then I might say, there is no doubt, at least the perceived experience of will. If not for you, than I speak for myself in truth. Yet in regards to the other will to [fill in the blank]; each of those concepts involve a will to change. From a pragmatic perspective, there is something fundamental in the human; that a percieved will exists. This may best be captured by Williams James’ 1892 written explanation: 

“The fundamental Fact. – the first and foremost concrete fact which everyone will affirm to belong to his inner experience is the fact that consciousness of some sort goes on. ‘States of mind’ succeed each other in him.” (James, 1984). 

Returning to a pragmatically influenced approach, and with the understanding of what positive mental health should be, as I have previously argued, I shall resume from that standpoint, what positive mental health practice is.  Which as I stated at the beginning of this article:

The totality of mental health practice is adjusting what has our focus.

I may be wrong, I accept that.  

But, if a truth exists at all in my statement, I can only benefit from being wrong in order to learn what is right.

Where I stand is, that there must be some objective truth out there. There must be some objective truth, as to what is “best” for us as a collective and/or for us as individuals. I believe that any psychology or mental health theory, is merely an attempt at discerning that truth, but that truth remains regardless. I am more interested in describing the theme I find most pertinent to share, that I argue, all mental health practices attempt to accomplish whether they agree or not. 

To make one final point clear, I do not believe I truly argue for a new definition of health, but rather, for using modern language to better define that truth which has always existed. Certainly, there has been examples of wide-spread health as well as understandings of health, centuries before our time. Even in many places today, as the National Geographic Fellow Dan Buettner (2017) has described in his book Thrive, great health often exists with traditional understandings.  

I would argue there to be an objective truth underlying what health is, in relation to the human condition, that has always remained the same. If I use any words, it’s only in an effort to translate, using modern day language, a reality that existed before my time.  

The 3-point thesis statement defining health that I argued in my last article, is listed below: 

  1. The meaning of life may be unique for everyone, but finding it is the same.
  2. Meaning in life is found through purpose, which is defined by the act of a person to focus on priority.  
  3. The practice of focusing on priority, also defines purpose, which is where we will find our meaning. 

To review a few key points from my previous article: 

  • I also believe, mental health is directly and fully related to purpose. Positive mental health is the ability to pursue purpose. Negative mental health, is any barrier that prevents that pursuit; and that pursuit being comprised of the ability to focus on one’s priorities. 
  • Rather, mental health is the ability to focus on priority, which is in many other terms, to “live and pursue”, “goal-oriented”, “self-directed”, “purpose-driven”, “meaningful lives.” Mental health, is to know purpose, not happiness.
  • I shall argue, our mental health is mutually related to life as we experience it, and is determined by where our focus is placed. Changing where our focus is directed, is the act of prioritization. Therefore, positive mental health behavior, is taking any action to focus on positive priorities.

Existentialism: Hasn’t This Already Been Done? 

One could argue, my statements reflect a therapeutic approach similar to Existentialism. I did make several references to Viktor Frankl and his form of existential therapy known as Logotherapy. Another modern-day derivative is Meaning Therapy; which emphasizes meaning in well-being while including many contemporary mental health practices such as positive psychology and cognitive-behavioral therapy (Wong, 2014). I have disagreements with keystone existential philosophers, though my disagreements divulge into opinion more than worth noting here. The primary issue remains, that much to be debated is “all talk and not enough action”; as for the validity of there being a problem at all, I will later address that in this article. 

While what I argue may be related to forms of Existentialism in value of meaning and purpose; I would also argue, that while meaning and purpose may be the primary determinants of health, they are not necessarily the primary determinants of health-in-practice 

Put another way, Existentialism may be the ends, but is itself not enough of the means.  

Put yet another way, knowing meaning (existentialism) may help you find motivation to wash the dishes or pay the bills, but often these tasks need to take place before one could ever come to closure and fulfillment in discovering meaning in their life. 

That is what occupational therapy also contributes beautifully as a profession, to health-in-practice. I am biased to include my own profession. Occupational therapy recognizes, it is also through the engagement in everyday tasks that we will find our meaning, and not necessarily through guided talk therapy and activity alone (AOTA, 2014). While other forms of therapy may have their purpose in certain instances, I argue a two-fold truth exists. A top-down understanding and recognition of meaning and purpose motivates us to complete our every-day tasks; but also, a bottom-up engagement in every-day tasks, also helps us find meaning and purpose. 

A Purposeful Digression: What is The Problem? 

It could be said, that I ought to be careful in making any conclusions here. That to define health, purpose, the meaning of life, and therefore the role of any health practitioner, is too large a subject for a young novice like myself to address. That by publishing such descriptions and conjectures, I could mislead people, especially if I promote my material. 

My credentials are not the most extensive. However, I do have a high enough education (Masters of Occupational Therapy, Bachelors in General Studies, Minor in Psychology), to have an educated opinion from a scientific stand point that: A variety of influential experts disagree on key aspects of healthcare.  

To top that, prominent and primary resources such as certain government websites, list outright, wrong healthcare information as it is presented by primary works of scientific-evidence (which I would love to tell you about in person). I most certainly, am not the most qualified, and most certainly, have a great lot to learn. This is to say, you should not take my word as 100% accurate, as I do not either, nor anyone elses. What you should do, is question, as I have. It is no conspiracy that American “common sense” is not working. Why do I believe things are not working in America as is? 

  • Epidemically increasing rates of mental illness (SAMHSA, 2017) 
  • Epidemically increasing rates of chronic conditions (CDC, 2017) 
  • The world’s highest healthcare cost per person, and still increasing (Keehan, 2016) 
  • Current decreasing rates of life expectancy (Tinker, 2017) 
  • And decreasing rates of life satisfaction? (Helliwell, Layard, & Sachs, 2017) 

You may come to your own conclusions.  

I will not list directly, sources of wrong information; for that is one possible way to get sued (defamation). I will throughout the upcoming series of articles address topics with specifics. I will form my opinion, but will list sources, and direct information, to make easy, the follow-up of references to my sources.  

Why That Digression Was Needed 

I must first ask: 

  • What then is the purpose of writing and producing opinion?  
  • Is there not enough medical models and theories currently in existence?  
  • Is not, my argument for health being defined by purpose only simply “another way” to look at things? 

Simply; the answers to health are simple, and the ‘mainstream’ says it’s complicated. I must make my effort. 

When I first begin writing on this website, I wanted to systematically address mental health topics like mindfulness, coping skills, goal setting, and the like. In the process, I found myself questioning my own beliefs and returning to the literature and evidence. What I found, was continuously diverting opinions and arguments, though seemingly similar conclusions. I found it difficult to promote these practices without knowing how it fits in mental health as a whole. I then sought to address the fundamental paradigms (perspectives), guiding what health is. This led me to writing my previous article.  

In addition to my earlier stated thesis statement, there is an underlying philosophical belief guiding this writing. At some point, one has to ask themselves which they believe; Does an objective or relative truth exist? In fact, I’d argue, regardless of whether you think you know an answer, your actions are already influenced by your perspective of that question.  

This relates to mental health practice because as I will argue, mental health practices can only attempt to use fundamental truths of humans, to address their needs. Truths such as, the idea we are conscious beings. I will take a stance to stay, that psychology is the primary and most closely related practice, to addressing our mental health. Defining psychology is then worth-while, as well as its primary field of thought. Because ultimately, I’d argue that any mental health practice that works, fits into agreement with some type of universal truth. 

 

Psychology Defined 

Definition of Psychology: scientific discipline that studies mental states and processes and behaviour in humans and other animals. 

While there are most likely fans of some scientist, philosopher, or thinker, who might argue that undue credit is given to their name of choice, one of the most prominent names given to the “outset” of defining psychology as an independent and specific field of study in America, was William James. For William James, along with Wilhelm Wundt of England, are listed in the Britannica as being the primary influences. 

William James created a consolidated manual, a manifesto of sorts, that was pivotal in establishing the “what is psychology.” James’ book Psychology: a Briefer Course (1984) first published in 1892, remains an incredibly relevant book to read in modern times. While maybe certain topics, modern science has come to disagree with, more can be said about the fundamental accuracies in his book. These accuracies deserve an article of their own; such as his discussion of habit as it relates to willpower; which current leading opinions and scientific evidence, appears to be completing a 180-degree return back to James’ description, reflected in modern times by the works of those like Baumiester in his book Willpower (Baumeister & Tierney, 2011). However, I attempt to hold value in William James approach to writing known as Pragmatism. If I were to put pragmatism into my own words it would be: Some type of truth exists in the things that work 

In mental health, I would argue; some type of truth exists in the mental health practices that work. For example, most modern-day evidence as described by influential researchers, scientists, doctors, and journalists, agree that; Diets don’t work (Cambell & Jacobson, 2013; Mann, 2015, Pollan, 2008; Spector, 2015; Wansink, 2007).  I used dieting as an example due to the link (not causation necessarily) between nutrition and eating habits, with our mental health. 

However, many people do find that a diet did work for them. A pragmatic conclusion would be: “something worked, so some truth exists about what worked.” Maybe that truth is, for some people in some situations, they are motivated to change their habits because of attempting a diet. The point being, rather than focusing on dieting being wrong or right, a pragmatic approach is interested in what worked. 

The effectiveness of a mental health practice then, has more to do with its relation to “some type of truth” in the human condition, than to modern medicine and science. Modern medicine and science is for the purpose of discovering those truths for literature and practice, despite that those truths may have been practiced and known for centuries. William James would argue, psychology as a science was meant to find these truths. In his book, he defined psychology using another academics description stated below as: 

The definition of psychology may be best given in the words of Professor Ladd, as the description and explanation of states of consciousness as such. By states of consciousness are meant such things as sensations, desires, emotions, cognitions, reasonings, decisions, volitions, and the like (James, 1984). 

How this relates to pragmatism and defining mental health, is the attempt at objective pursuit of truth and understanding. It’s a style of writing that I will attempt to represent. This is why I take time to digress, as I did above. That in my search for truth, in my effort to share my believed understandings, I too, want you to both question for yourself and consider the fundamental truths that may exist.  

To return to what mental health practice is, I must make a few basic observations: 

  • Some mental health practices seem to work,  
  • some don’t,  
  • some, work better than others for different people. 
  • There is a wide variety of mental health practices. 
  • Still, there must be some universal truths regarding what will work better. 

Conclusion

It is here I return to my 3-point thesis statement regarding the meaning of life being related to health, which is defined by the ability to pursue purpose by focusing on priority. I do not argue this is a new way of looking at things, but the beginning attempts by a well-read novice (myself), to seek out the universal truths in mental health. That in relation to mental health practices, these truths converge on the human’s ability to focus.  Which is why I argue:

The totality of mental health practice adjusting what has our focus.

It is this focus, which I will address and explore in my next article, as well as provide specific examples. This focus I will argue, is fundamental to all mental health practices. 

References

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy. 68(Suppl. 1), S1-S48: http://dx.doi.org//10.5014/ajot2014.682006 

Baumeister, R. F., & Tierney, J. (2012). Willpower: Rediscovering the greatest human strength. Penguin. 

Buettner, D. (2010). Thrive: Finding happiness the blue zones way. National Geographic Books. 

Center for Disease Control and Prevention. (2017, 28 June). Chronic disease overview [webpage]. Retrieved from https://www.cdc.gov/chronicdisease/overview/index.htm  

Campbell, T. C., & Jacobson, H. (2013). Whole: rethinking the science of nutrition. BenBella Books. 

Helliwell, J., Layard, R., & Sachs, J. (2017.) World happiness report. Retrieved from http://worldhapiness.report/ed/2017/ 

James, W. (1984). Psychology, briefer course (Vol. 14). Harvard University Press. 

Keehan, S. P., Poisal, J. A., Cuckler, G. A., Sisko, A. M., Smith, S. D., Madison, A. J., … & Lizonitz, J. M. (2016). National health expenditure projections, 2015–25: economy, prices, and aging expected to shape spending and enrollment. Health Affairs, 35(8), 1522-1531. 

Mann, T. (2015). Secrets from the Eating Lab. New York: HarperCollins. 

Pollan, M. (2008). In defense of food: An eater’s manifesto. Penguin. 

Psychology. 2018. In Britannica.com. Retrieved February 13, 2018, from https://www.britannica.com/science/psychology  

SAMHSA (2017, Sept 9). Key substance use and mental health indicators in the united states: Results from the 2016 national survey on drug use and health. Retrieved from https://store.samhsa.gov/product/Key-Substance-Use-and-Mental-Health-Indicators-in-the-United-States-/SMA17-5044  

Spector, T. (2015). The Diet Myth: The real science behind what we eat. Hachette UK. 

TEDxEmory. (2013). Stephen Ilardi: Depression is a disease of civilization [Video file]. Retrieved from https://youtu.be/drv3BP0Fdi8 

Tinker, B. (2017, 21 December). US life expectancy drops for a second year in a row. Retrieved from https://www.cnn.com/2017/12/21/health/us-life-expectancy-study/index.html 

Wansink, B. (2007). Mindless eating: Why we eat more than we think. Bantam. 

Wiking, M. (2017). The Little Book of Lykke: The Secrets of the World’s Happiest People. HarperCollins.

William James. 2018. In Britannica.com. Retrieved February 13, 2018, from https://www.britannica.com/biography/William-James 

Wong, P. T. P. (2014). Meaning in life. In A. C. Michalos (Ed.), Encyclopedia of quality of life and well-being research (pp. 3894-3898). New York, NY: Springer. 

 

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One Reply to “The Totality of Mental Health Practice”

  1. Interesting definition and idea. Obviously a lot of thought and effort went into this – nice work. Do you think though, that sometimes we need to help people even have a focus (depression, anxiety, hopelessness) or sometimes (as with overcoming addiction) we need to help them maintain their focus?

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