The mental terrain

This is based on an article I wrote for merton-l, on [95 Jan 20].

I beg leave to differ on some of the views of ``mental illness'' expressed here so far. From my own past experience (neurotic depression, anxiety neurosis, panic disorder, paranoid ideation and obsessive-compulsive disorder, all at the same time!) and from reading books and meeting people, and a lot of thought, partly introspective and partly extrospective, I have moved from believing in organic bases for most mental illness (biopsychiatry) to a functional basis, that is, the accumulated experience of the individual (including the experience passed onto them from their forebears).

It is interesting to note that much of the support for the biopsychiatric view of mental illness comes from the patients' parents, who are exonerated by it. Considerable resources are invested in the search for, for example, an organic cause of schizophrenia; this exonerates society from taking the blame; it gives a permanence to a diagnosis, and the impression that schizophrenia is inevitable for some people.

Some psychiatrists, disillusioned with the way they have seen patients treated, are now taking a very different, and more compassionate, view of mental illness; Masson and Breggin are leaders in this field, with the books ``Against Therapy'' and ``Toxic Psychiatry''; they focus particularly on the way traditional therapy is used to manipulate women into a subservient role.

In these views, conditions generally seen as `madness' are termed `psychospiritual overwhelm', and considered as a sane response to an insane world.

I have come to incline towards such views myself, and have been gradually forming my own model of cognition and affectivity.

In this model, I see the subjective mindscape (of thought and mood, combined -- I would find it hard to separate them; there are always links, often cycles of causal links) as being like a hilly countryside with places on it and roads between them. At each place where roads join, you can take a choice of which road you leave the junction on. Roads that lead down a slope are easier choices than the uphill ones, but depending on how energetic you feel, you may take a road that leads uphill.

If your energy is low, you will find yourself taking successive downhill choices, and at best going on level ground or gentle upgrades. Doing so, you naturally stumble into a valley (or pit), and then keep going round and round the sides of it, never getting back up onto the ridges.

Note that in this analogy, I am not using `valley' to mean a place in which you feel affectively low, but a place that it is easier to get into than out of; stuck in a rut. There can be feel-good valleys and feel-bad valleys; the common characteristic is that they are places you're likely to stay in. To describe these in a way which doesn't tangle with the use of the terms "high" and "low" to describe moods, colours may be helpful: so a black valley is a depressing cycle of thoughts and feelings, a green hill is pleasant freedom, a red cliff is where anger catapults you out of a valley.

The hills between the valleys, that you have to put some effort (blood, sweat, tears...) into climbing onto, are the places where you have a free choice of where to go -- you are up, and can move along the ridges from hills to hills, or can descend into a pleasant valley if you see one; but if you get tired, you're likely to start heading downhill again.

Very specific non-organic mental illness (such as individual phobias), to me, is usually a label for the state of being stuck in a small valley and unable to get out without help. The fewer other people are in that kind of valley, the crazier people regard you as being.

Helping people out of the black valleys

In this analogy, in depression, people are stuck in black valleys, in which the sides are too steep, and their strength of courage too limitied, for them to get out. It seems that many expect you to carry them out (or just carry them around; the former being co-dependence with some hope, and the latter hopeless co-dependent depression). However, the terrain is inside themselves, and no-one can carry them; attempts to do so can produce only an illusory change. The first approach to helping that I thought of is to strengthen, train and encourage them for their climb; another might be to show that the roads are not as steep as they seemed. Perhaps good cognitive therapy includes some of each of these approaches.

The adventurers

Now think of this mindscape, this land of moods, as having an overall topography of a land with an extinct volcanic crater in the middle... a ring of high rock that few can climb. Almost everybody in the land lives their whole life inside the crater; the walls are fearsome to climb, the rumoured land beyond them hardly spoken of (and then, only with the lights on).

Some people wander... some of vigorous mental activity... some have the vigour to wander up these cliffs of fascination, and down again beyond them into a land that many never see but all know must exist; a land ten thousand times more varied than that within the crater; they explore, they find new ruts, valleys and craters out there; if they can eventually find their way back to the crater and struggle back over its walls into the little land they once saw as the whole world, they return with tales that many will not have the understanding to believe; speaking tongues that others know not. They are feared; their strength is legendary; they have endured things that others would remain imprisoned to avoid facing. Their roadmap is larger; others do not know what to do with it.

Madness and genius and the cloister are all to be found in this land outside the crater; a cosy life absorbing that with which the media feed you lies within. Who, then, are the crazy ones?

I feel that the difference between genius and madness is that genius knows where reality is; it is, perhaps, madness with a saddle and bridle.

John C. G. Sturdy
[John's home] Last modified: Sun Jun 10 18:17:20 GMT Daylight Time 2007