According to Dr. Allen Frances there are over 40 different definitions of mental health. Most definitions have the goal of defining what it means to be well and when we are sliding into mental illness. The idea among professionals is that if we have a good definition that will help with understanding and treating a particular condition.
The problem is that a definition is more than words, a definition can become clinical magic.
For years, I have sat with struggling parents who have cried as they described their child and said they need to know what is wrong with them. I see the agony in parents whose teenagers decide to drink and do drugs, have seemingly out of control behaviors, are disrespectful and belligerent, and make decisions that endanger their health.
I am in the helping profession because I enjoy being part of alleviating suffering. I help create opportunities for parents and youth to talk about their lives, their pain, their experience and their hopes. This can help but there is often a feeling that there must be more. Estimates are that in the substance abusing population, 80% are dealing with a mental illness. Some clients have a list of 6 or 7 disorders in their file. What I wonder when I look over the diagnoses is that even with the diagnosis, the life of the youth and family may not improve.
I think it is important that we ask ourselves whether suffering can be alleviated simply by defining what is wrong?
Many treatments do help but not because of a diagnosis or medication. Treatments often help because there is trust, understanding and kindness, supporting a family to communicate and listening to their hopes and needs along with assessment, diagnosis, strategies that help the multiple needs of a person (social, mental, emotional, spiritual, physical and the like), and in some cases medical treatment.
A diagnosis simply points to what is wrong, the deficit. What is often missed is the mental wealth that a person and their family still possess. I ask myself:
• What are they doing that is working?
• Where do family members show kindness to each other?
• How do they keep moving despite the crushing weight they are experiencing?
• When is the youth not using, using less or behaving (even a little) more appropriately?
• How is what a youth is experiencing a sensible response to their own pain or needs?
These are just a few examples of questions that make me realize there is more to a person than a definition or diagnosis. By defining and diagnosing a mental illness, our attention is on the illness and returning a person to health. At the same time we tend to miss the wealth of who that person is in spite of their substance use, depression, self injury, depression, desire to die and other behaviors.
My son and I have a ritual that we go through when we both get home (me from work, him from school). I ask him what was good about his day? He usually begins by listing 3 or 4 things that “sucked” about his day. With a little persistence on my part, he eventually can come up with a few things that at least went okay about his day. Finding and talking about the wealth of what is good about our day can be very hard especially when we are struggling. But it is a habit that creates the wealth that can make us well.
Keep it real