Since “mental illness” refers to illness of the mind, it should go without saying that we must understand and define the mind. We have not yet done this in medical science. Our medical understanding of the mind is not on par with our medical understanding of, for example, the heart.
The phrase "mental illness" has become part of our vernacular because it represents something real that we experience: suffering and difficulty, which touch the human soul like few other experiences can. Specifically, the phrase includes suffering that is due to beliefs, thoughts, perceptions, and emotions. The challenge is that many if not all people experience suffering due to their beliefs, thoughts, perceptions, or emotions. Some experience it for longer periods and some for shorter periods. Some experience it more frequently and some less frequently. Some experience it more intensely and some less intensely. When we look at this question closely, we see that the thresholds of how we define mental illness and impairment are primarily social determinations rather than medical determinations.
Because the mind is traditionally linked with subjectivity, it is notoriously difficult to reach a consensus on what range it covers. Science, philosophy, spirituality, religion and direct personal experience have much to say about the mind, and all may be valid from their frames of reference. So perhaps the best place for us to start collectively is to simply say We don’t know what the mind is. What we know is only our range of the mind.
We don’t know what the mind is.
This is the starting point of all learning, and of all possibilities. This places great responsibility on you and me as members of an educated society. We are the ones who collectively help shed light on the boundaries of mental health and illness, based on our experience of the ranges of the mind.
What if the mind is more than beliefs, thoughts, perceptions, and emotions? What if the mind is both within and around the body? What if our perceptions and concepts of "objects" as such are essentially mental in nature? All of this is possible as well as consistent with science when we change our philosophical outlook. This new outlook would shed new light on our understanding of mental health and illness, including the interpretation of words like delusion and hallucination.
Rich, ancient philosophical traditions have investigated such questions in depth and left a trail of breadcrumbs that any diligent mind can follow, but we have so far failed to mine this knowledge to inform medicine and psychiatry. What I've seen is that there is often a rush to defend established notions of “mental illness” and “mental health” with the goal of helping others, assuming our definitions are benign and questioning them is somehow denying or minimizing the suffering of others. On the contrary, it is precisely because there is so much suffering that we must investigate different avenues and reconsider unexamined notions. Otherwise, we allow our ignorance to shape us rather than our knowledge.
Investigating such philosophies is not enough. We also have to get the basics right, beginning from childhood. The basics include expressing and sharing our emotions, and recognizing that there is no such thing as a “normal" person apart from a mathematical average. If we do this effectively, starting with making an example of the way we live, we will find that our insight into the mind increases. This is how we open the door.
So whether you’re an expert or a lay person, a person with an advanced degree or no degree, a person who meditates or doesn’t meditate, it is you who helps us define mental health and illness based on the range of your experience of mind.
We don’t know what the mind is. Let’s find out.