On 7 June 2023, the Lyceum Institute held a Philosophical Happy Hour discussing the nature of “mental health” and why it has become so problematic in the 21st century. While the conversation ranged across many topics—isolation, technology, dualism, abuse of medicines, the pathologizing of every difficulty—two themes caught my attention. These Happy Hour discussions are open to the public.
Note that this presentation proceeds in a manner open-ended and dialectic, even as it takes a definitive position.
1. Introduction: Seeking Definitions
If there were but one complaint that I could lodge against the scientific discipline of psychology (and the practical extension of it in psychiatry and therapy), it is this: you have no good causal definition of “mental health”. Mind you, there are many other just complaints, but this, I think, is principal among them all, for the failure to provision (or accept) a good definition of mental health leaves one incapable of pursuing it.
To be clear, it is not as though the psychological professions have no definitions of mental health; only that those they have—or, to be fair, the most prominently-displayed among them, as I will not pretend to have exhaustive knowledge of the field—are not good definitions. To look at the Center for Disease Control and Prevention,[1] the statement closest to a definition I could find is this: “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices.” Comparably, the World Health Organization gives as a definition: “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.”
Operative in both definitions is the word “well-being”. This, of course, says more vaguely what is said by “health”—such vagueness being quite problematic, given the role assigned to the word, “well-being”, in each definition. The CDC further differentiates this “well-being” by “emotional, psychological, and social”; the WHO by the various things it enables people to do. Neither differentiation is helpful. The CDC’s specification seems oddly redundant (are not emotions something that belongs to the psyche?). The WHO’s checklist may include key indicators, but this hardly constitutes a positive definition of what mental health is. Indeed, neither definition gives us anything like a formal or final cause. One could say, instead, that both are merely nominal definitions. Such may be safer in an age lacking common first principles (a kind of “metaphysical pluralism”), but nominalism quickly gives way to motivations other than the discovery of truth or the promotion of the common good.
This radical deficiency is, of course, disastrous. Despite a proliferation of “mental health professionals” in recent decades, the strength of our sanity seems only to wane, day by day. I would not hesitate to identify the imprecision and vagueness of our definitions and our conception of what constitutes “mental health” to be a key cause (by absence) of this weakening sanity. But, even further, I question whether the very concept of “mental health” itself is not a fundamentally misbegotten notion. In back of this questioning I have also a yet-deeper concern over beliefs prevalent in medicine—and the broader conception of “health”, treated mechanistically so often as it is—but here, we will focus specifically on the application of “health” to the “mental”.
For, indeed: what do we mean by “mental”? What is “the mind”? To many, including those within psychology and its related fields, this question has not been answered. Worse, for many of that many, the question either cannot or does not need to be answered. The rationale for such positions (functionally the same), is that one can treat mental illness solely on the basis of the external indicators, such as social well-being or the ability to cope with stress and work; thus, we can adjudicate the mental healthiness of an individual not by anything formal or intrinsic to that individual, but by their perceptible relations to others and the social norms of the day.
In contrast to these deleterious positions, I would like here to suggest that the truth represented only obliquely by the phrase “mental health” can better be grasped through the concepts of order and nobility.
2. The Concept of “Mental Health”
Before proceeding into these positive conceptions, however, allow me a few paragraphs to expound on the shortcomings of the phrase “mental health”. There are two principal and interrelated problems that I see. The first is contingent upon the present conventional understanding of health, such that the idea of “health” broadly considered suffers a mechanistic interpretation. The second both promotes and is exacerbated by this mechanicism: namely, that the separation of “mental health” from “health” generally at the very least implies a kind of dualism, and quite often compounds that dualism into a position of radical incoherence.
This first problem consists in the predominance of a background mechanistic conception about the whole world. At the heart of this conception, as applied to health generally, is the belief that “health” follows from the correct kinds of efficient cause operating on properly-disposed matter, and that these two alone give a sufficient causal explanation for what is meant by “health”. The limited but precise and impressive success in treating many conditions of the body following this conception has led to the concept’s entirely unsuitable extension to the so-called “mental”. In other words: the mechanistic conception, though inaccurate in identifying the health of the body as such, has resulted in many efficacious treatments. However, it is entirely unsuitable to the treatment of problems of a psychological nature. It may and sometimes does genuinely treat of the symptoms of such a problem, and, in treating of those symptoms may even allow for a correction of the root problem—but incidentally, as it were, thereby confusing those who believe it sufficient and accurate in treating of all psychological difficulties.
Bridging this and the second problem of dualism runs the notion that “health” is an instrumental good of “the self”. In some ways, of course, this is true, as it pertains to the body. If “physical health” may be broadly (and provisionally) defined as “the right disposition of the organic body for the sake of the animal’s characteristic activities”, then “health” does, in a certain way, serve as an instrument—or rather, describes the condition of the instruments, namely, the organs through which we operate.[2] But, even granting more extreme instrumentalist vies of the body, does the mechanistic conception of “health” result in an extension of this instrumentality to the “mental”? In other words: if the health of the body is “for the good of the ‘self’”, then what is “mental health” for?
Thus, to identify the second problem, that of dualism: the notion of the body as merely an instrument suggests that the person and his or her body are not a unity, but, rather, that the body is a possession of the person.[3] But, although the word “dualism” suggests a simple duality—the physical and the mental—we can see with a little reflection how much more complex the problem is in fact. Ordinarily, that is, one suspects most dualisms of simply treating the body as an instrument and the mental as the personal self to whom that instrument belongs. But with the mechanistic appropriation of “mental health”, the mental too becomes an instrument. For thus “mental health” becomes something that one has—and we describe mental health problems as hurdles that the person has to overcome, and so on. Holding that the body is a possession, an instrument, we strive after physical health as a right functioning of that instrument. So, too—implicitly, unconsciously—the mind comes to be held likewise as a possession and an instrument in need of being well-tuned in order to perform as we wish it would.
Often, and paradoxically, this particular twist in dualistic thinking goes hand-in-hand with materialism: believing, for instance, that all our psychological experience is constituted neurologically—such that our “mental health” difficulties arise principally if not exclusively from physically-explicable (and resoluble) disorders in the brain—one becomes a de facto dualist. For we experience a will and a desire to be something other than what is neurologically constituted (and all the flaws located therein). Even if one maintains materialism as true, accepting this opposition must mean that some part of the brain—the part with which we identify—constitutes something distinct in its identity from the flawed parts. Thus, the self becomes divided, again and again, part against part, with no resolution to any sense of a whole.
Finally, even if one were to post this standing of part against part, of the “true self” as only a part of one’s material whole as merely illusory—as though any identity of the self apart from the material consists in naught but epiphenomena—then one would be forced to accept that our manner of experience is entirely other than what the things purportedly-experienced themselves are in fact. Such is a one-way street to solipsism.
3. Psychological Order
By contrast, we here propose that the psychological, or at the very least what we conventionally if vaguely designate by that term, is both distinct from the corporeal but also inseparable from the physical.[4] This too might, prima facie, appear paradoxical. But it must be known that not all distinctions are of two wholly different beings. Certainly, my hand is a part of me; but I am not my hand. Likewise, the psyche is the intrinsic principle of my body, but it is not my body itself.[5] Moreover, the activities of the psyche are not limited to those which are strictly constrained to the corporeal, but are able to exceed that corporeality. I’ll not dive into this here (such being a more difficult and engaged topic—covered, not incidentally, in the Thomistic Psychology: A Retrieval seminar) but simply posit these points as true in order to arrive at the main point of this essay: namely that, in brief, these psychological activities are relational, and consist in a being-towards objects understood under lights irreducible to the corporeal.
Let us therefore distinguish between the psyche as the principle of our whole being and the “psychological” as a descriptor used in designating those activities of the psyche which are not corporeally-constrained but rather relational in their constitution. Anything constituted in its own proper being as intentional (by which is meant not “purposive” but “being-towards”), in other words, deserves the name of “psychological”: thus, activities of cognition and emotion or appetite. These intentional activities, as it has been noted by a few particularly keen-minded individuals, are irreducibly triadic. That’s a rather complex phrase to unpack. Suffice it here only to say: they are realities that cannot consist merely in the efficient causation of one agent or instrument on another matter or recipient, but which exist together as a certain whole always constituted by no fewer than three distinct parts.[6] Remove any part, and you destroy the whole—destroying the whole, you change the other parts, too.
There are things that happen to us, that happen to and within our bodies, that may affect our psyches but which are merely dyadic—like one billiard ball hitting another (although much more multifaceted and complex in the case of the human organism)—and there are things that happen to us and things that we do, things that are psychological, which are always triadic: things like knowing, and loving, desiring and hating, wondering, and anything that involves the presence in or to your mind in a way quite different than anything which comes to be present in your body. Our lives are constituted from more than merely those experiences of which we are conscious—but it is through consciousness that we know ourselves and effect control and order in our lives. Thus, it is easy to see how one can reduce the self to these psychological activities and their consequents. But such would be a mistake, for a little reflection upon those psychological actions shows how dependent they are upon those dyadically-constituted and pre-conscious realities.
The myriad psychological activities in which we engage can be distinguished by the various kinds of objects towards which they are intentionally oriented. Seeing light differentiated into colors differs from hearing the vibrations of motors and the chirping of birds, while knowing that five times six equals thirty is quite something other than loving your wife. Distinguishing precisely the kinds of objects towards which we are intentionally oriented—and sorting out the complex ways in which they may intertwine in our experience—would take quite some time (and has already been well-done in the Aristotelian-Scholastic tradition). Briefly, however, we can generically enumerate what we call the external senses, internal or perceptual senses, the appetitive (or somewhat more broadly, cathectic) faculties, and the intellect and will.
Across all these diverse faculties which we possess for engaging in such triadic action, however, there exist three important commonalities: one, that each has some proper and fitting object for the kind of triadic action in which it is involved; two, that, although there is a proper object, the complex interaction of these faculties means that we can relate to any of these objects in ways which are unfitting for us; and, three, that not only within each faculty but also through their relations to one another, we form habits of relating to our objects. The malleability of these habits are what allow us to be better or worse in the way that we live, in the way that we exercise our conscious living. Therein we achieve, approach, deviate from, or destroy our psychological “well-being”: the right order that obtains between our faculties.
Or to put this otherwise, the possession of a right and fitting psychological order—what is sought after but missed by the phrase “mental health”—consists in the correct proportioning of these facultative habits both to their objects and to one another. We must love the right things, rightly understood, in the right degree, and we must engender this love habitually. We must not be consumed by cathectic habits of anger or lust. We must know the truth—and, moreover, be able to perceive it, and especially to perceive the truth about the good in the world that we inhabit.
Unfortunately, today, the standard criteria and practices of “mental health” are ordered instead toward the myopic and self-focused. It neither perceives nor promotes an awareness, let alone any “treatment”, of what are essentially triadic and intentional disorders, but rather attempts various subjective adjustments. Being so-inwardly focused, what most of all has been lost is the sense of right-ordering towards what is noble. Indeed, by contrast, it seems that while admiration for noble acts continues, behaving nobly is seen by most persons as unduly-burdensome. This belief, I think, is the fundamental cause of much psychological disorder.
4. Habituating a Noble Soul
The word “noble” may conjure images of wealthy men riding in carriages, French or English aristocracy (or perhaps an oligarchy)—mansions and riches and so on. Students of chemistry make think of gases or metals—of elements often found resistant to change. Or it may evoke the thought of selfless and praiseworthy deeds, of chivalric action, of high aspirations. For those familiar with the thought of Plato and Aristotle, it brings to mind virtue, of course, but also the beautiful: for the same word, καλόν (kalon), often is translated into English as both “noble” and “beautiful”.
Discussion of the noble could—and likely should—receive a whole treatise. In the provisional manner of a short essay such as this, however, we can give it only a heuristic description: nobility, as a characteristic of the human soul, consists in the willingness to endure suffering and to make sacrifices for the greater good. When the concept of “the good” becomes increasingly self-centered, self-focused, and myopically ordered to individual benefit and “well-being”—when a materialistically-presuppositive individualism becomes the norm—undertaking the actions indicative of a noble soul appears, indeed, unduly-burdensome. Mind you, this is far from claiming that “mental health” and the many very real struggles had today reduce, simply, to “being selfish”. The causes of psychological disorder are many.
But all of these causes are exacerbated when the individuals constituting the society fold in upon themselves, and direct their action primarily not at the common but solely the individual good. This often-unconscious selfishness—taken not as a moral flaw but as a given of human nature—undermines the whole society; it frays the threads, the relations, that hold us together. It leaves us lonely, even surrounded by others, for it saddles each and every one of us with the burden of an entire universe.
Contrariwise, what today we need are habits of the noble soul. That is, we need habits that order us toward a good irreducible to ourselves: goods that are truly common. When we pursue such goods, there is a converse resultance in ourselves: that is, we become ennobled by seeking noble ends. This ennobling of our souls helps rectify the psychological order. We are swayed less by distractions, temptations, more enabled to suffer anxieties and worries, if we know that our endurance of them may help contribute to a true and lasting good—that truly it serves a purpose beyond the satisfactions of the self.
5. Conclusion: Nobility and Rectitude
What conclusion can we reach, in so short a composition? Nothing too immediately useful. But for now suffice it only to say: our society is not well. Focus on “mental well-being” has failed to produce it. Rather, it has resulted in fragility. Fear, anxiety, anger, despair—consequences of waning hope in the possibility of attaining a meaningful good, for we have only an atrophied and distant sense of the noble—and thus, fall into psychological disorder of countless and increasingly complexified kinds. Pulling any thread of the knot in which we have tangled ourselves seems only to tighten it. What leaves the knot tied, most of all, is the unwillingness to keep at it; to give up; to slide into a palliative care.
But our situation is not hopeless; indeed, there is no knot that cannot be untied, with diligence, patience—strong, dexterous fingers—and recognition that our suffering, our struggle, serves a purpose beyond mere self-satisfaction.
[1] When did they add “Prevention”? I just noticed this and find it disturbing. Perhaps it has always been there. Perhaps I should always have been disturbed.
[2] That is, the body is not an instrument as such, but has parts which are used instrumentally for the good of the whole person. But this proves a topic more complex to demonstrate in full than would here be appropriate.
[3] The widespread tacit acceptance of this philosophical position appears, for instance, in the common mantra of “it’s my body, it’s my choice”—the implication being that one’s choice and one’s body are separate; that the latter possesses an absolute dominion over the former.
[4] That is, inseparable by nature. Death and the question of the afterlife can only be understood as exceeding our experimental verification—thus, we can infer justly that an afterlife is necessarily fitting to what we as human beings are, but the reality of that afterlife exceeds our ability here and now to know with any certitude.
[5] Cf. Aristotle c.330bc: Περὶ Ψυχῆς, (On the Soul) book 2, c.1.
[6] For an introductory consideration of this triadic nature of the psychological, consider the 1989 lecture by Walker Percy titled, “The Fateful Rift: The San Andres Fault in the Modern Mind”. This can be watched online here: https://www.c-span.org/video/?7788-1/san-andreas-fault-modern-mind or read in Signposts in a Strange Land. One can also listen to a colloquium by Dr. Kirk Kanzelberger on “Mending the Fateful Rift” in our 2020 colloquium series. A more in-depth treatment by Percy can be found in his “Delta Factor” article, printed in The Message in the Bottle.