A commitment to a possible 'beyond' in mental health: the singularity

What would that be beyond stigmas, labels and trends in so-called "mental health"?

Let us first take the WHO phrase "mental health": "a state of well-being in which each individual develops his potential, you can cope with the stresses of life, you can work productively and fruitfully, and you can contribute something to your community". This appears in the speeches of the WHO as a point that organizes and arranges what would be well-being and the good way of living in the order of the logic of the universal, for all.

The constant repetition in the media of this proposition slips the idea that "mental health" had a consistent and evident definition. Nevertheless, this definition has not been rigorous, but rather, it appears on the side of the ideal and as an operator of functions that derive from it.

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An incomplete way of understanding mental health

It was René Leriche who brought into play the classic definition of health from the medical side: “health is life in the silence of the organs”. It is this definition of the word "health" that has effects in the field of the psi and the social. -covering the public, the institutional, the governmental- and it is from there where he takes his first function. The main effect has been the construction of the domain of public health

as the function that takes charge of eradicating all those ways of living psychic discomfortto silence them.

In parallel, it could be located that there would be a diseased organ as the cause of mental suffering -proper terrain for the positioning of neurosciences and medicalization-.

Let's add another effect. Anything that does not fit the definition of mental health will be taken as something that by definition will not be healthy. It is here where the articulation with the great vademecums, books and manuals with lists of signs in a descriptive logic that situate and form fields of pathological pictures is presented.

The social implications of this perspective

Diagnosis appears as the great classification label for disorders and diseases -terms also imported from medicine- that encompass a series of traits to establish a scientifically based clinical picture, that is, under a positive model. The ICD-11 and the DSM-5 have a history within the classification of mental illnesses thus defined. And, finally, it is these that serve as a guide for public health policies - the great tendency of the mental health- and the implementation of universal treatment protocols according to the diagnosis established.

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An example

Owen is an autistic boy. His parents narrate the difficulties they had in relation to his son since, from a very young age, he began to show all the signs of autism spectrum disorder. The absence of language in his son was the main difficulty in establishing a bond with him.

His parents began to lose hope that his son could access the word after trying unsuccessfully applied universal methods and protocols as a treatment for his son. Owen's father narrates that, on Owen's brother Walt's ninth birthday, he and his wife throw him a small party with their school friends. When the party ends, the children leave and Walt sits at a table looking sad.

Owen sees this scene and goes to the kitchen where his parents were. He stands in front of them and suddenly out of nowhere he says, "Walter doesn't want to grow up like Mowgli or Peter Pan." Parents are stunned. It was the first time they had heard his son speak. His father narrates that this was not just any phrase, but a complex phrase, of a complex thought that showed that there was much more to Owen than what simple observation could detect. And then his father realizes something: his son Owen uses the phrases from Disney movies to understand the world in which he lives.

That night, Owen's father heads to Owen's bedroom. He observes that his son is sitting on the bed with a Disney book in his hands. Next to his bed, on the floor, the father sees a puppet of Iago - the mascot of the villain Jafar, characters from the Aladdin movie. He takes it in one hand and pulls a sheet over his head so Owen doesn't see him. In this way, only the puppet of Iago appears in Owen's view. The father begins to imitate Iago's tone of voice and says to his son when he turns to see him: "Owen, Owen, how does it feel to be you?" Owen replies, "Not very well because I don't have any friends." Owen's father contains his excitement at hearing his son speak and stays in character. And he says to Owen as he continues to imitate Iago's voice, “Okay, okay. Owen, when did you and I start to be such good friends? And Owen replies: "When I saw Aladdin, you made me laugh." So he has a conversation through Iago for a minute. It was the first conversation she had with Owen.

It is at this point that parents make a bet. They decide to stop seeing what the specialists who had treated their son considered an obsession -repeatedly watch Walt Disney movies- and take it as a tool to be able to communicate with his son. Current psychiatry considers these repetitive behaviors and interests as elements that should be eliminated. According to the manuals, these behaviors must be eliminated since they isolate the person and do not allow them to expand their world. That is the universal protocol of a treatment. The parents, then, decide to implement elements taken from Disney phrases and characters to set up situations in which their son can capture the words he already knows. Little by little, your child begins to gain vocabulary.

In addition, he begins to come out of what is classically known as "autistic encapsulation." His parents realize that these "obsessions" of words, phrases from Disney movies constitute one of Owen's most unique passions. Thus, they turn them into tools with which your child can invent his own medium, tailored to him, with which to communicate and establish a social bond with the people around him. The uniqueness of Owen's interests was what broke him out of his autistic lockdown.

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concluding

This little story of an autism case has teaching value for a professional in the mental health field. It is in this little vignette where we can point out what is lost in universal definitions and what is often excluded within clinical practice: the singularity of the person who is there as patient. It is here where the horizon of a "beyond" mental health appears, the horizon where stigmas give way, labels fade and respect for the uniqueness of each patient emerges.

It is about putting into practice in clinical praxis the commitment to the singularity of the case in the very center of its foundation. And this is not a simple formalization or case tool. It is an ethic in the day to day with our patients.

Author: Patricio Moreno Parra, winner of the First Essay Contest proposed by the Superar Psychology Center for the 35th anniversary of its operation and World Mental Health Day.