Shhh! Don’t Talk About Mental Health

The place where he felt emotions had been replaced by a black hole; it was where all emotions got sucked in, never to escape.

Nothing made him feel good. Nothing made him feel bad. Nothing made him feel.

Depression is one of the 297 mental disorders recognized by the American Psychological Association and one of over 300 recognized by the World Health Organization (WHO).

Psychology is the scientific study of human behaviour, emotions and thought (cognitive) processes.

The Greek thinker Hippocrates, in 400 BCE (after whom, a doctor takes his oath in the present day), was among the first people to try and change this perception. He said that mental illnesses were caused by biological factors rather than by spirits.

People who believed that the mind was the site of demonic possession, cut holes in the skulls of the mentally ill – a process called trephination.

There are many persons now living who can remember passing the gates of old Bethlem and hearing, as they passed, the cut of the lash and the screams of its victims. – Mary Lamb, a famous English writer who was suffering from a mental illness (1796)

history may be written by the victors but simply re-writing history, doesn’t make you victorious.

Lorenzo Salom who, along with other merchants and craftsmen, took the task of building the first psychiatric hospital in the western world.

Spain came to be known as the cradle of western psychiatry.

the first real Western psychiatric hospital was proposed in the humble streets of Valencia, Spain in the early 15th century and it was built by 1410. The hospital was named, The Hospital D’Innocents, Follcs I Orats (Hospital of The Innocents, The Insane and The Lunatics).

Religion, despite all the cruelties it had imposed on the mentally sick earlier, ended up being an antecedent to the first psychiatric hospital in the western world. History is full of similar instances where religious figures have used their God’s name for evil. Other people have used the name of the same God for kindness and service to mankind.

Atrocities have been committed in the name of God and continue to be as people fight over who has a better imaginary being.

It is time we started caring more about the people we can see right in front of us instead of fighting about beings that do not exist.

The idea of treatment of the mentally sick has its roots in the French revolution of 1789.

Philippe Pinel was born into a medical family on April 20, 1745 in the French township of Jonquières.

He moved to Toulouse at the age of 22 to study theology. There he came under the influence of Voltaire and other Enlightenment thinkers.

Rather than studying for the priesthood, he began studying medicine, and received a doctorate in 1773. Pinel moved to Paris five years later. He was refused permission to practice medicine in France’s capital because his medical degree was from a smaller university. He found means to earn a living in Paris, as a medical writer.

He looked at his patients as humans and not as possessed by devils or spirits. His contributions to the world of psychiatry are legendary. Some scholars go so far as to say that his work was on level with Newton’s equations to Science and Linnaeus to Taxonomy.

Pinel’s classification is considered the ancestor of the modern International Classification of Diseases, a classification directory that is maintained by the WHO and lists various criteria for diagnosing a mental disorder.

I have found my tyrant, and in his service I know no limits. My tyrant is Psychology. It has always been my distant, beckoning goal and now since I have hit upon the neuroses, it has come so much the nearer. – Sigmund Freud in a letter to Wilhelm Fliess, 1895

Freud was fascinated by the discovery that there were some sensations which went unnoticed by our consciousness. He believed that the consciousness was just one part of the human psyche while the major part of it was our unconscious mind. A concept he was the first to formalize.

The child is the father of the man. – William Wordsworth, 1802

Freud believed that as a child, there are many experiences which ultimately shape our personality and decide the kind of life one is going to lead in the future.

Moral treatment had spread like wildfire across Europe and America. The mentally sick were no longer chained but treated with compassion and trust.

There was a debate on whether the causes of mental illness were biological or psychological. At the very least, there was a consensus that they were not caused supernaturally.

Freud believed that mental illnesses were the manifestation of our unconscious urges and needs.

Freud believed that when the conscious mind is not given any time to repress the unconscious, it is easier to see its manifestations.

In the 1880s–90s, the term ‘melancholia’ was replaced by ‘depression’ by Adolf Meyer.

People have started using ‘depression’ as a transient mood or feeling instead of a disorder.

Sigmund Freud died via assisted suicide on 23 September 1939. Thus, the story of the most influential psychologist of all time came to an end.

For of what account are truth and love when life itself has ceased to seem desirable? – Clifford Whittingham Beers

The First International Conference of Mental Hygiene was held in London in 1948, but by the time it ended the term ‘mental hygiene’ found itself replaced by the modern word, ‘mental health.’

Beers was not a psychiatrist or a doctor in any sense of the word. However, he was highly honoured by psychiatric associations across the USA. The state of mental health we see today is based on a large contribution from Clifford Beers’ work.

Mental health today is interwoven with Psychology. It is believed that only two types of people are talking about mental health (1) those who have a background in Psychology or (2) those who have suffered from a mental illness themselves.

Psychology, in comparison to Physics or Chemistry, is a young science. It is not an exact science and is open to different definitions of a concept as time passes. Physics, on the other hand is much more precise. You can predict the trajectory and landing position of a ball if you know the value of certain variables. In Psychology, you cannot always predict how a person thinks or will respond to a situation.

Ask yourself, “Why have there been so may wars throughout history?” A feminist might say that it is because of men who are always greedy for more power. An atheist may say that it is due to every religion’s inherent call for violence. A Marxist may say that it is due to capitalism. And an Indian may say that it is because of white imperialism.

The biggest mistake of past centuries in teaching has been to treat all students as if they were variants of the same individual and thus, to feel justified in teaching them all the same subjects the same way (Howard Gardner in Siegel & Shaughnessy, 1994).

Intelligence is the ability to achieve one’s goals in life, given one’s sociocultural context by capitalizing on strengths and correcting or compensating for weaknesses in order to adapt to, shape, and select environments, and through a combination of analytical, creative, and practical abilities. – (Sternberg, 2005)

The work of the associationists was followed by Willhelm Wundt. He was credited with establishing Psychology as a scientific discipline in 1879.

Structuralism played a very important role in the growth of the discipline of Psychology. It acted as an anchor that could be criticized and used to develop new theories and ideas.

The functionalists led to the formation of the American Psychological Association under the leadership of G. Stanley Hall (1892). They found the weight of the great Charles Darwin (1857) behind their thoughts.

When it was discovered that organisms can be conditioned or ‘taught’ to learn certain behaviours, the school of behaviourism really took off. They produced the concept of conditioning and dominated the field of Psychology for most of the 20th century.

Freud proposed that a child is shaped by their sexual needs and based on whether these needs are fulfilled or not determine the child’s personality.

Abraham Maslow came forth like a shining light. He said that Psychology had focussed on the ill for too long and needed to focus on what the healthy could achieve. He, along with Carl Rogers, set up a new school of psychology called Humanism.

Humanists were focused on fulfilling the potential of a human being and achieving the pinnacle of life.

At the time of this book’s writing (2019), Psychology is mostly focused on Positive Psychology (an offshoot of the humanist school) and Neuropsychology.

Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community (WHO, 2001).

Resilience and emotional intelligence are the two most important concepts needed to form a mentally healthy society in my opinion.

The in-group is the group of people we relate to. It is the group we find comfort in and where we can express ourselves. The in-group is almost always considered the morally righteous one.

The out-group is the ‘other’ people. It is the group that has people who either do not talk about the issue in question or differ in opinion.

An argument is not there to be won; it is there so that all the people involved can learn.

Emotional intelligence is an idea that is only 30-years-old at the most. It was proposed by Peter Salovey, but the most influential work on it was done by Daniel Goleman who released his book Emotional Intelligence in 1995.

Goleman said that emotional intelligence is the ability to sense emotions that have not been conveyed verbally and respond to them appropriately.

If youngsters are taught about and encouraged to improve their EQ, we would make a major move towards an emotionally-healthy society.

Emotions are one of the many things that make us human and if we focus on wiping them out, we end up losing a part of ourselves.

Mental health is defined as a state of psychological and social well-being in which every individual can cope with the normal stresses of life, can label and express their emotions accurately and can process information rationally and realistically.

neurology is considered the study of the brain (the hardware) and psychology is seen as the study of the mind (the software).

Chemistry and Physics are known to be interlinked, but there has been no amalgamation of the two over centuries. In the same way, neurology and psychology are expected to continue as two separate but interlinked disciplines.

scepticism is the first step to improvement.

Szaszian idea that raising mental health awareness could lead to a situation where we diagnose daily life and every personality quirk or up and down in life is termed a disorder.

make sure that our enthusiasm to increase the reach of mental healthcare does not put us in a position where being normal is looked down upon, and where every life struggle is an illness.

Twenty-five percent of the human population suffers from a mental disorder at some point of their life.

Having a debate or even a discussion with anyone who has an open mind and is open to criticism, is a pleasure everyone must experience in their life.

In general, humans unconsciously differentiate people on the basis of arbitrary differences.

Cognitive dissonance is a feeling brought about when the perceptions we hold are challenged by conflicting information.

In the long term, people who self-medicate need increasingly larger amounts of alcohol or other substances to obtain the required level of dopamine to feel the psychological benefits.

The one thing people turn to in tough times for salvation, ends up being their damnation.

Throughout history, those who have tried to bridge a gap between two different groups of people has been scrutinized. These differences may be small or large. There is always a resistance to assimilating and accepting new people.

It is imperative that we become a part of the mainstream and continue to maintain our ideological diversity.

First they ignore you, then they laugh at you, then they fight you and then you win.

We do not promise that a mentally-healthy population will never be sad or feel like crying. Neither do we say that mental illnesses will be wiped from existence. We propose neither apocalypse nor utopia in the future. What we propose is that we will live in a world where people are more in touch with themselves and the people around them.

A future where a person is not identified with their illness; where visiting a psychiatrist does not cause a commotion in their community.

India is, in the most simplistic terms, a country of contradictions. It is home to the richest man in Asia as well as a large share of the world’s poorest people.

It has been rightly said that whatever you can say rightly about India, the opposite of it is equally valid (Robinson, quoted by Sen, 2005).

Dr. Bhimrao Ambedkar, the Father of the Indian Constitution gave a very apt warning in 1949 about the future of the country. He said India is now a land where equality exists in law but not in practice.

Regardless of what the uniting factor is, we always like to belong. This is something that is considered as part of a collectivist culture that is endowed in us over centuries. In countries like the USA or the UK, the culture is more focused on the individual instead of the group.

The identity of the self in these countries is given more importance and achieving personal goals is considered more important than reaching the goals of the community. This culture is called an individualistic culture.

In India, a sincere, honest and friendly personality is considered ‘good,’ whereas in the USA, someone who is assertive and strong, traits important for competitive success, are considered superior.

Just as psychological processes exert fundamental influences on culture, so too does culture exert fundamental influences on basic psychological processes. (Lehman & Schaller, 2004)

India was known as the Golden Bird in olden times. In the present, the Golden Bird has dulled. She does not exude brightness and confidence like it did. The Golden Bird has lost her shine.

There is a lot of explicit stigma associated with visiting a psychiatrist. A survey conducted by psychiatrists on 924 people showed that most of them did not even consider psychiatrists for consultation or treatment of mental illness (Zeiger, 2017). People just do not want to visit psychiatrists.

Students believed that psychiatrists are respected less in society unlike their non-psychiatric peers.

Diffusion of responsibility is truly a beautiful thing. Most students believed that there need to be more psychiatrists, but very few of them chose to be one.

The social stigma attached to being a psychiatrist is immense. It is somehow considered that psychiatrists are ‘crazy.’ The belief that only the ‘crazy’ treat other ‘crazy’ people is simply not true. We do not expect neurologists to have a brain problem and neither do we think our dentists have teeth filled with cavities.

Between 2005 to 2015, the number of suicides citing unemployment as a reason grew by 2000% in Madhya Pradesh, India. The number was at 29 in 2005, but 579 in 2015 according to the National Criminal Record Bureau. (It is interesting in itself that the records for suicide are stored at the crime bureau. Until 2018, suicide was legally a crime in India.)

Prof. Nand Kumar is a man who started Psychological First Aid for prisoners in Tihar Jail, that is first time in India and the second in the world.

In that moment, he felt like he was alive. In that moment, he felt like he mattered. In that moment, he felt. That one moment of emotional arousal and social support was all he needed to turn things around.

Twelve days later, he launched his blog at www.knightofsteel.com, as an homage to the superheroes who had made him stay alive until then.