What would that be that goes beyond the stigmas, labels and trends in so-called “mental health” ?
Take first the WHO phrase “mental health”: “a state of well-being in which each individual develops his or her potential, can cope with the stresses of life, can work productively and fruitfully, and can contribute something to his or her community.” “. This appears in the WHO speeches as a point that organizes and arranges what would be well-being and a good way of living in the order of the logic of the universal, that for all.
The constant repetition in the media of this proposition slips the idea that “mental health” had a consistent and obvious definition. Nevertheless, This definition has not been rigorous but rather, it appears on the side of the ideal and as an operator of functions that emerge from it.
It was René Leriche who put into play the classic definition of health from the side of medicine: “health is life in the silence of the organs.” It is this definition of the word “health” that has effects in the field of the psi and the social – encompassing the public, the institutional, the governmental – and it is from there that it takes its first function. The main effect has been the construction of the public health domain as the function that takes charge of eradicating all those ways of living psychological discomfort to silence them.
At the same time, it could be established that there would be a diseased organ as the cause of psychological suffering – proper terrain for the positioning of neurosciences and medicalization.
Let’s add another effect. Anything that does not fit the definition of mental health will be taken as something that by definition will not be healthy. It is here where the articulation with the great vademecums, books and manuals with lists of signs in a descriptive logic that locate and form fields of pathological pictures is presented.
The social implications of this perspective
The diagnosis appears as the great label for classifying disorders and diseases -terms also imported from medicine- that encompass a series of features to establish a clinical picture with a scientific basis, that is, under a positive model. The ICD-11 and the DSM-5 have a history within the classification of mental illnesses defined in this way. And, finally, these are the ones that serve as a guide for public health policies – the great trend in mental health – and the implementation of universal treatment protocols according to the established diagnosis.
An example
Owen is an autistic boy. His parents narrate the difficulties they had in relation to his son since, from a very young age, he began to show all the signs of autism spectrum disorder. The absence of language in his son was the main difficulty in establishing any bond with him.
His parents began to lose hope that their son would be able to speak after trying universal methods and protocols applied without success as treatment for their son. Owen’s father narrates that, on Owen’s brother Walt’s ninth birthday, he and his wife throw him a small party with their school friends. When the party ends, the children leave and Walt is left sitting at a table looking sad.
Owen sees this scene and heads to the kitchen where his parents were. He stands in front of them and suddenly, out of nowhere, says, “Walter doesn’t want to grow up like Mowgli or Peter Pan.” The parents are shocked. It was the first time they heard their son speak. His father narrates that this was not just any phrase, but a complex phrase, a complex thought that showed that there was much more to Owen than what simple observation could detect. And then his father realizes something: His son Owen uses phrases from Disney movies to understand the world in which he lives.
That night, Owen’s father heads to Owen’s bedroom. He notices that his son is sitting on the bed with a Disney book in his hands. Next to his bed, on the floor, the father sees a puppet of Iago – the pet of the villain Jafar, characters from the Aladdin movie. He takes it with one hand and covers his head with a sheet so Owen won’t see him. In this way only Iago’s puppet appears in Owen’s sight. The father begins to imitate Iago’s tone of voice and says to his son when he returns to see him: “Owen, Owen, how does it feel to be you?” Owen replies, “Not very well because I don’t have any friends.” Owen’s father contains his excitement at hearing his son speak and stays in character. And he says to Owen as he continues to imitate Iago’s voice: “Well, well. Owen, when did you and I start being such good friends?” And Owen responds: “When I watched Aladdin, you made me laugh.” Then he has a conversation through Iago for a minute. It was the first conversation I had with Owen.
It is at this point that the parents make a bet. They They decide to stop seeing what the specialists who had treated their son considered an obsession -watch Walt Disney movies repeatedly- and take it as a tool to communicate with your child. Current psychiatry considers these repetitive behaviors and interests as elements that should be eliminated. According to the manuals, these behaviors must be eliminated since they isolate the person and do not allow them to expand their world. That is the universal treatment protocol. Parents, then, decide to implement elements taken from Disney phrases and characters to create situations in which their child can grasp the words that he already knows. Little by little, your child begins to gain vocabulary.
In addition, he begins to emerge from what is classically known as “autistic encapsulation.” His parents realize that these “obsessions” of words and phrases from Disney movies constitute one of Owen’s most unique passions. Thus, they turn them into tools with which your child can invent his own medium, tailored to him, with which to communicate and establish a social bond with the people around him. The uniqueness of Owen’s interests was what brought him out of his autistic confinement.
Concluding
This little story of a case of autism has teaching value for a professional in the mental health field. It is in this small vignette where we can point out what is lost in universal definitions and that is often excluded within clinical practice: the uniqueness of the person who is there as a patient. It is here that the horizon of a “beyond” of mental health appears, the horizon where stigmas subside, labels fade and respect for the uniqueness of each patient emerges.
It is about putting into practice in clinical praxis the commitment to the singularity of the case at the very center of its foundation. And this is not a simple formalization or case tool. It is an ethic in everyday life with our patients.
Author: Patricio Moreno Parra, winner of the First Essay Contest proposed by the Superar Psychology Center regarding the 35 years of its operation and World Mental Health Day.
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