The Etiology of “Mental Illness”
As I noted in the first essay, words do seem to matter in the social construction of reality. They matter in terms of both semantics (meaning of words) and syntax (ordering of words). In embracing the term “mental illness” most contemporary societies are creating an important and powerful new construct: psychopathology is in most instances a form of illness (like cancer or diabetes) that is caused by some physical pathogen, genetic defect or injury to the body (and in particular to the brain). This shift to a focus on something other than spiritual aberration or social deviance is certainly to be commended as a way of looking for sources outside the church or penal code. Furthermore, this fourth assumptive world has produced very detailed and scientifically based descriptions of how mental illness is produced. Certainly, most societies are doing a much better job of “curing” psychopathologies under the banner of this fourth assumptive world than was the case with either the spiritual or societal worlds.
In recent years, we are even seeing an interesting and often productive interplay between the second world (especially the Asian version) and the fourth world. Often under the title of “complementary” medicine, we see the use of meditation, mindfulness and yoga practices being “prescribed” by medical doctors and physicians for their patients who are struggling with emotional and mental problems. While this complementary (and complimentary) relationship often does not include acceptance in Western medicine of the Asian assumptions about the sources of psychopathology, there is ample use of the health-inducting practices and treatment strategies that arisen from the etiologies assumed by this Asian world. I would also note that the word “complementary” may be very important here.
In my own previous co-authored book on medical cultures (Who is Wounding the Healers) (Bergquist, Guest and Rooney, 2004), we pointed out that the term “alternative” was being used for many years to describe a cluster of medical and nonmedical concepts and practices that were posed in contradiction to the accepted (allopathic) medical concepts and practices. It was assumed that these “alternative” perspectives were to be corrective on or even replacements for the dominant medical theories and practices. A somewhat unholy alliance was established late in the 20th Century that enabled alternative practices and practitioners (at least in the United States and Canada) to be accepted (with some reservations) within the fold of established medicine—thereby enabling practitioners to receive compensation from an insurance company or government rather than relying on direct payment from the customer (“patient”). Unfortunately, payment for this admission to the medical community was an abandonment of the term “alternative” and acceptance of the term “complementary” (suggesting that these alternative practices are to still be considered secondary to traditional allopathic medical principles and practices). Yes, words do matter.
