A psychologist on the difficulty of defining mental illness and the necessity of treating it anyway.
Misery is inevitable, but we also have a sense that there can sometimes be too much of it. We don't want to eliminate misery; that seems somehow morally dubious and practically impossible. |
 | | Bráulio Amado |
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Throughout my training and career as a psychologist, I have been plagued by the worry of how to justify what I do professionally. The "psy disciplines," which encompass psychiatry and the varieties of psychotherapy, have always been subject to critique of their scientific and conceptual basis. Isn't professional mental health care just the most currently fashionable way of managing social deviance? Am I a sympathetic health professional or a regulatory arm of the state analogous to the police? The practical aspects of my training suggested to me that there is value in the provision of mental health care. I have met countless individuals whom the field seems to have helped, and I consider myself to have benefited from psychotherapy. |
But my engagement with philosophically oriented literature about the field never quite quelled the doubts I had about the basic underpinnings of what I do, which I wrote about in a recent guest essay. I spent a lot of time learning to identify the traits of mental disorders in order to pass a qualifying exam, but I never found a fully satisfactory definition of mental disorder. I have learned to identify instances when I feel I should refer someone to a psychiatrist for medication treatment, but I have never satisfied myself that I know the difference between depression and ordinary sadness. I have flip-flopped between the hope that I am treating serious illnesses and the worry that I am occupying a purely socially constructed role. |
Over time I have come to reconcile these apparently polarized positions in my head and to start letting go of the idea that my work needs to be entirely grounded in an unimpeachable set of scientific facts. The reality is that psychology is a practice that has to be both socially negotiated and informed by our best efforts at scientific inquiry and justification. On the face of it, this integration seems paradoxical. But I see it as a form of pragmatism that is indispensable for those working in my profession. |
| READ HUW'S FULL ESSAY HERE | | |
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