So What is Mental Health if it is all Contextual and External?

I will try to set out how I now see ‘mental health’ in the context of everyday living but when we include the changes that have occurred in modernity.  The way we now ‘talk about mental health’ becomes a modern phenomenon, which is probably something Foucault was saying many years ago in a different way.

(You will need to be patient until Points 18 and 25 though.  I hope I will be able to say this all much better when it comes time to put it into the new book.)

  1. In life there are always problems and conflicts, and almost all can be traced to scarcity of resources, if resources are thought of in a complex and nuanced way and not simplistically. Because most of our resources come through other people, most of our life problems arise in our social contexts. Most problems are interpersonal.
  2. For most of these problems and conflicts we have many ways to deal with them, or through sneaky strategies or just giving up on getting resources we can overcome the problems and keep on living about the same as before. So if their car breaks down, most people can arrange some solutions by getting it fixed or doing without a car for a while.
  3. There have always been serious problems, however, that people cannot deal with easily. If your land was attacked and the houses burned down and food supplies destroyed, this would be difficult in the extreme. You might die.  You might give up totally and die.  If in modern life there is a traumatic event of great magnitude, that shatters your ‘normal’ way of life, this can similarly make coping very difficult.
  4. In traditional kin-based communities there would still be a number of kin who would help you (if you also helped) to overcome these most difficult problems. There was almost always support.
  5. Although, in traditional kin-based communities if your problem involved going against the community and family in some way there was probably little other support and your chances would not be good for getting a solution.
  6. My key point here, however, is that for all these sorts of problems in old times, both big and small, people could observe obvious or salient contexts that led to the problems: drought, raiders from the north, floods, community members themselves with their cultural rules to follow, plagues, etc. You could mostly ‘see the enemy’. You knew where the problem lay.  Even in cases like a plague or drought, you could see what was happening in a concrete way, despite not having words to talk about how it came about.  You knew the people who were responsible for your troubles.
  7. This still occurs today when we have problems because our neighbors will not turn their music down, our land agent is demanding more money, our kids keep failing at school, our money does not pay for everything, we lose our credit cards, etc. We can observe the contexts in which these problems are arising quite easily and either solve the problem or be unhappy about things and keep complaining.  But life goes on.
  8. In all times, old and current, there would also have been some problems so bad and unsolvable that the people involved would just give up and stop behaving in any way that might serve to get things back on track as they had been. They might behave in ways that just served to escape the contexts and did not try to solve anything, or in ways that did not make sense if you believed the goal was to get back to how things were. These people have just given up, as it were, or begun acting strangely.
  9. In such cases, kin-based communities often kept people on and supported them still, so there would be a place for them still, or those people could have left that really bad situation to try and make up a new life elsewhere. They could go to the badlands, become a nun or ‘village idiot’, or run away to sea as a sailor or pirate.

Now enters modernity…

  1. This is difficult to get across sometimes, but we are now living in a world of social relationships and economic contexts that has never happened before. We are in the process of making up new ways of living and surviving. We cannot claim that we are doing things based on what our ancestors did because the world has totally changed from anything that has gone before.  There are no precedents and our old ways of living cannot be used.
  2. Since the beginning of the 1800s or so people have been living in social and economic contexts in which the majority of people they deal with, interact with, or spend time with, are strangers. Strangers have special properties not just because we have little commitment to them initially and so little real responsibility to them, but also because they in turn have no commitment to our family and friends, so they cannot even be held responsible by other people in our life.
  3. So most of what we do is now shaped by people we do not know, have little consequence or responsibility to, and our families and friends do not know them either. Humans have never been in these social contexts before and we are still making up how we can handle all this.  This has come about through our new economic system.
  4. For the present discussion, the point is that we now have enormous shaping pressures on us from a myriad of strangers and structures in modern society, people we do not know and who do not have any real commitment to us. Moreover, they are not concrete and observable in the way that our real communities and families were observable and concrete. They are abstract in actual practical terms.
  5. Around the 1800s, then, people started getting pressures, stresses and problems that were shaped in contexts by people they could not see and who might not be an actual person in any event.  Kafka did a good job in an artistic way of portraying some of these amorphous forces that can block us.  We cannot pin-point them but they are very real.
  6. There are two other historical events that I have argued are related to these changes in social and economic contexts from modernity.   First, around the turn of the 1900s, sociologists began describing the pressures and shaping in modern society by ‘generalized others’. Those amorphous pressures that now control our behavior to a large extent.
  7. Second, during these same times we see the development of the new psychology and psychiatry disciples, which are now there to deal with people who have problems and issues for which there are no obvious or salient contexts.  This is what is new.  Some people now cannot deal with their lives and there is no obvious or observable problem context, such as local economic woes, drought, a noisy neighbor, etc. There are similarly people who cannot cope or find solutions at all and start behaving in ways that are no longer trying to resolve things, ways that look ‘crazy’ or ‘maladaptive’ and we again cannot see any obvious context for this.
  8. But what is different now is that the contexts leading to these strange ways of behaving can no longer be seen, even by psychologists (those who just sit in their offices at least). They are now vaguely thought of as due to ‘societal’ pressures, ‘familial’ pressure, or said to originate ‘inside’ people as either brain problems or else a brand new invented category—‘psychological’ problems.  Now we see bio-socio-psychological…
  9. Here, finally, we come to ‘mental health’. In the way I have outlined, we can see that ‘mental health’ issues are just extensions of any other behaviors and ways of life, just conflicts around people and resources, but the term is now invented for modern situations in which there is no observable ‘problem person’ or context to deal with, there are only ‘generalized others’ as the problems but they are virtual, and the ways of totally escaping and giving up are more difficult and have more impact.
  10. This is why I have said before that psychology can be characterized as a discipline which deals with the dumping ground of problems in people’s lives for which there is no easily observed contexts that are bringing the problems about.  But they are problems created by modernity, neo-capitalism, and our current way of life, even though saying this does not make them any less painful.  But it might give us clues to help in new ways.
  11. The third historical change is that we now have two big, common, new sets of symptomatic behaviors which are called ‘generalized depression’ and ‘generalized anxiety’. Almost everyone in modernity suffers from these amorphous pressures and stresses from the very nature of our social relationships now, but there is no easily seen ‘enemy’ to tackle (sometimes labeled abstractly the as ‘black dog’).
  12. Those who cannot continue to cope with this pressure are now labelled as having ‘mental health’ issues.  Some just succumb, while others behave in ‘strange’ ways.  These have always been the options but now we cannot see what leads to this.
  13. So the key difference for a contextual view is that people do not ‘have’ depression or anxiety disorders; instead, they are living in modern contexts which are depressive or anxiety-inducing in ways that have not occurred in human history before. They are not coping well with the new, modern unobservable conflicts.
  14. We have only been led to think of these as existing ‘inside of us’ because they are coming from generalized contexts which have arisen from the capitalist, modern world with its preponderance of stranger relationships which have little interpersonal commitment or responsibility. We know there are pressures and stresses, and we know our behavioral options get severely blocked, but we cannot observe the source of these in a concrete way.
  15. We cannot easily observe the nature of these pressures, stresses and blockers, not because we are observing badly, but because they are new and they are generalized and abstract to talk about. So people who suffer most badly from these contexts are not poor observers, weak or stupid, they are trying to live in maladaptive contexts which do not show their faces and which provide no easy solutions, and for which we have no precedents to follow.
  16. So to answer my original question, I see ‘mental health’ issues as a recently named phenomenon arising from changes in social relationships through changes in the economic context of modernity (roughly called neo-capitalism). The links between these are real. They appear different to other life problems (about noisy neighbors and lapsed rent payments) only because they arise from contexts spread across a whole society of strangers working together but giving no individual commitments or help.
  17. Historically, because these maladaptive contexts could not be seen they were attributed to events ‘inside’ us and conflicts between unconscious and ego, and the like, and called ‘mental” issues—a term that only indicates their difficult to observe external contexts rather than revealing a secret new location.
  18. They are solvable problems and conflicts, however, but they must be seen in the broader context that our social and economic relationships are no longer nurturing good environments for most people, and people can no longer resolve their conflicts easily in the modern world.
  19. People do not ‘have mental illness’; people live, and have lived, in environments that do not support healthy behaviors”.  We now have some brand-new unhealthy environments.
  20. And such difficult conflicts have been faced by artists of all times, such as Kafka, who tried to warn and help us: “That’s not to say that great authors, great artists, are all ill, however sublimely, or that one’s looking for a sign of neurosis or psychosis like a secret in their work, the hidden code of their work. They’re not ill; on the contrary, they’re a rather special kind of doctor.” (Gilles Deleuze, 1995)
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