The Mental Condition Of Psychiatry

I wonder if we will eventually get to a place where we make no distinction between mental and physical illnesses, at least not in the way we do now.

In this New York Times article the idea is put forward that addictions should still be treated as brain problem, but a "physical" one. This also plays into an overall growing ability to accept the idea that what we now label mental illness is really no different from those things we now see separately as physical problems. One other example is something called Body Integrity Identity Disorder (BIID). This is where a person perceives a body part as superfluous, often asking that it be surgically removed. Research is showing this to be a condition that can be physically pinpointed to specific parts of the brain, not just an ambiguous "mental" disorder.

From an atheistic point of view, this makes perfect sense. We are only our bodies, but we have a range of reactions available to us that are expressed depending on the environment (social and physical) in which we find ourselves. That's basically it. We are who we are with no separate anything to be seen as a non-physical place we can approach alone.

Alternatively, for those who believe in things like a soul--something separate and independent from the body--the idea that it can be treated on its own supports the current psychiatric "mental" model. The mind is not physical, in this view, at least not identifiably so. To address the mind, it needs to be seen through a different lens than we see the body, in this view.

However, if there is no separate homunculus creature to be targeted--as an atheist would likely agree is the case--the approach to what we know see as solely a mental condition is seriously flawed. Maybe this is the reason why so many approaches to problems with a psychiatric tool set result in old behaviors returning fairly quickly, if they ever get altered in the first place. With a flawed premise, anywhere someone goes from there isn't going to be a rousing success.

This seems to be something not too far from assertions made by Thomas Szasz since the '60s. He has been marginalized by a good deal of the psychiatric profession, but I think he deserves some new attention. In essence, he claimed that what we label as mental illness is not scientific, it's social. Behaviors we, as a society, find distasteful or annoying we label as a mental disorder, even when a person has no physical injury or illness. It's an arbitrary line not verifiable universally. A set of behaviors in one culture seen as deviant could very well be prized in another. There's no way to draw a line other than the culture in which the behavior exists.

Between physical conditions we claim are purely "mental," and behaviors we label as non-physical "mental" problems, our view of our brains seems to be totally screwed up. We need to come up with a model that does away with the idea of a non-physical item within the human body where a treatment can be aimed--it doesn't exist. Shooting at a target that's not there will eventually hit something, but the resulting impact will not generally be useful or something that's expected.