Four Assumptive Worlds of Psychopathy V: The World of Mental Illness
What does all of this mean? We can turn back to our references regarding syntax in the first essay. Most Western languages are right branching (and reliant on active voice). This manner of syntactic structure tends to highlight internal locus of control: “the boy hit the ball”. The primary agent is the boy. The ball is secondary. “This crazy person is a sinner and deserves to be suffering!” “This prison keeps social deviants in chains!” Agency is clearly identified in both of these sentences: the crazy person and the prison. The first and third assumptive worlds are both very clear and consistent about the source of psychopathological behavior. An alternative agent has been identified in the case of our first assumptive world (Satan evil doings or God’s predestination plans); however, the agency is still clear and consistent.
When we turn to the second and fourth assumptive worlds there is less clarity and consistency. The primary agency is usually assumed to be some pathogen, genetic factor or injury—yet healthy practice and other preventative measures are still emphasized. We are victims of “mental illness”, but in some instances can do something to ameliorate or even prevent this illness. This ambiguity regarding etiology is exemplified in recent emphasis on determining the percent of mental illness (such as depression, by-polar disorders and schizophrenia) that can be attributed to generic predispositions (nature) rather than environmental factors of behavioral patterns (nurture).
The syntax itself reflects this ambiguity. We often say something like the following” “mental illness has afflicted this unfortunate person.” We focus on the pathology (schizophrenia or depression) rather than the person—a “schizophrenic” forfeits all other identifies. As we noted with regard to “stigmas” when entering the third assumptive world, the world of “mental illness” is filled with stigmatizing terminology: while we are trying to remove the blame from those “allected” with a mental illness, we also are inclined to believe that this is a permanent affliction that can be controlled with medications, but never “cured.” There is no healing grace coming from a benevolent God, nor any spiritual practices that bring about a rebalancing of the body’s energies, nor any release from prison or poverty. There is only a lifelong, isolating “affliction.”
The Categorization of “Mental Illness”
By defining psychopathology as a form of “illness”, leaders of a society and, in particular, leaders of the medical community, can provide a rationale for the belief that specific forms of psychopathy can readily be categorized (diagnosed) in a manner that leads to specific treatment strategies. If we can determine that a leg is broken, an appendix is burst, or a heart is malfunctioning, then we should also be able to identify specific maladies that are mental and/or emotional.
We should be able to differentiate between (and isolate) specific forms of psychopathology. In fact, we have done just this in the Western world. A formal categorization has been formulated by the American Psychiatric Association (not the American Psychological Association). This is the Diagnostic Statistical Manual—which is now in its fifth edition and is fundamental to the diagnosis and categorization of “mental illness.”