Can we define mental health objectively?

The question of whether mental health can be defined objectively is dependent on a number of

notions: whether objectivity exists; what mental health is to be considered; and whether there are

prejudices inlaid within psychology that affect the categorisation of illnesses. This essay will critique

the notion of objectivity through analysing tenets and adherents of the anti-psychiatry movement in

addition to relying on mainstream sources regarding mental health and mental illnesses, like the

Diagnostic and Statistical Manuel of Mental Disorders. Ultimately, this essay will argue that mental

health cannot be defined objectively.

First and foremost, the notion of objectivity must be explored and critiqued: what is objectivity? Are

we capable of objectivity? Is objectivity itself an abstract concept that cannot be explained or

fulfilled? Fundamentally, humans are subject, not objects. Because of this, situating objectivity in a

subject is a disingenuous task that elicits no results. Humans possess agency, autonomy, and an

individualised consciousness, which muddies the metaphorical waters when analysing symptoms of

health and illness. Of course, a more simplistic argument regarding objectivity is sourced from

existentialist and phenomenological though: a table is easily denotable, but exists not as a shared

thought. A table one person conceptualises could be very different to a table another person

conceptualises. Essentially, shared meaning is diffuse and divergent; no objective table exists.

Considered to be the father of psychology and founder of psychoanalysis, Sigmund Freud theorised a

number of conjectures that influenced the descendents of psychology, so to speak (143). Freuds

psychology was situated in the unconscious, a realm of anxiety and drives, and Freuds

psychoanalytic theories were developed in order to explore the unconscious so as to cure patients of
their psychological afflictions. While Freud is undeniably influential in psychology, his work remains

controversial (145). Freuds analysis of psychosexuality is innately sexist, especially exemplified in

his codification of the Oedipus Complex, where women lack the phallus, which is the nexus of their

ill mental health. Furthermore, Freuds conceptualisation of the id, ego, and superego is rather dated,

with modern psychologists viewing the unconscious in less defined terms. If the father of psychology

can err in regards to the fundamentals of the human psyche, it then follows that further adherents of

the discipline can err too.

By analysing Freud and his work, it becomes apparent that while Freuds theories were

historically correct at the time, the progression of psychology has shown that there were historical

prejudices at the very core of his work, thus potentially detracting from successful psychological

intervention for women. Another rather light-hearted argument against Freuds objectivity is the use

of cocaine to treat mental ailments, something that seems rather beyond the pale in modern practice.

Essentially, psychology itself is not an objective system of thought and practice; it then follows that

the research that comes from psychology is not necessarily objective. For instance, it is argued that

Borderline Personality Disorder is a feminised version of Post-Traumatic Stress Disorder, in that the

symptoms are similar and women represent 75% of people with BPD. Although psychology as a

school of discipline has progressed since the proto-sexist views of Freud, there is still a degree of

sexism that is reflective of the patriarchal mores that exist in other disciplines. Hopefully, as humanity

progresses, a more objective objectivity can be ascertained and implemented, but the historicity of

psychology as a discipline underpins just how divergent notions of mental health and mental illness

can be.

The anti-psychiatry movement is a radical tendency within clinical psychiatry that rose to

prominence in the 1960s... highly critical of conventional methods of psychotherapy and questioned

the very existence of mental illness (Macey 2001:17). Essentially, the anti-psychiatry movement

argued that Mental illness was viewed not as a disease, but as a social label attached to certain

individuals by an alienated society and the psychiatrists who were its agents (Macey 2001:17). This

counterculture approach to mental health focussed on the historical contingencies that could
potentially define certain illnesses, like schizophrenia for example. By studying the historical

gradations of a certain illness, the fundamental symptoms could be seen as eradicable results of

societal prejudice or class warfare. The anti-psychiatry movement was firmly rooted in the

counterculture of the 60s, which is, in and of itself, a reflection of its own societal expectations,

contingencies, and prejudices. While it does seem counterintuitive to argue that the underlying basis

of this essay is subject to individual prejudices and inaccuracies, it is indeed an affirmation that the

gatekeepers and custodians of mental health can in fact be deluged and misinformed by their own

research, decrying any further notion of objectivity.

The primary notion behind the anti-psychiatry movement is that psychiatry and psychology

are not historically devoid and subject to societal norms; rather, psychiatry and psychology intersect

with history, politics, and culture and that symptoms of mental illnesses are not necessarily situated

within an individual, but are responses to the society one lives in. Of course, this is not to say that a

bad breakup or poor financial situation cannot stimulate symptoms of mental illness; rather, the

conditions of society engender such responses by its very nature. If this premise is true, then different

cultures would have different notions of health and illness, similar to Foucaults premise about the

non-existence of homosexuality until the 19th century. While the actual expressions and symptoms

may be similar, if not the same, healthy modes of mentality are divergent in cultures, even

dichotomised in country and city in Australia.

Michel Foucault, an seminal philosopher and historian, articulated a history of mental illness in works

like Folie et deraison (Madness and Civilisation), Naissance de la clinque (Birth of the Clinic), and

LHistoire de la sexualitie (The History of Sexuality), fundamental works in structuralist disciplines

that analyse the historical notions that changed views on mental health, sexuality, and psychology and

psychiatry. Perhaps the most integral theory that Foucault posited was how madness was constructed:

socially constructed by a wide variety of discourses that give rise to collective attitudes or mentalities

defining insanity (134). For Foucault, mental illness is not necessarily innate, in that discursive

attitudes can establish modes of psychology that determines certain societal outliers as being

expressions of illness. Similar to certain mental illness, Foucault argued that homosexuality did not
exist until the 19th century; rather, same-sex relationships and activities occurred, but were known by

different names and encircled by different ideas (149). Analogously, the symptoms of schizophrenia,

for example, may have existed in 30AD but could have been considered the result of a demon or an

expression of prophecy. Essentially, symptoms A and B may be the same centuries apart, but the

conclusion could be C or D or E. Again, illness is subject to historical contingencies with ingrained

prejudices and societal discourses underpinning any attempt at diagnosis.

Furthermore, Foucault postulates that knowledge is a form of power, allowing those with a

certain power-knowledge to articulate the parameters of speech, thought, and behaviour, similar to the

Marxist notion of base and superstructure. Essentially, Marx argues that those who control the

economic base can control the societal superstructure, like culture, religion, and morality. In this

sense, the gatekeepers of psychology can control the fluxes of knowledge, giving them a degree of

power over the realm of mental health and illness: Like the confessor or the priest, the psychoanalyst

or psychiatrist who asks his patient to say what he desires is establishing a relationship of power and

control (134). Therefore, those with power-knowledge, replete with their singular prejudices and

theories, determine what is healthy and what is deviant. Objectivity, then, is situated within those with

power-knowledge. In any Western society, power is generally situated in men, the middle-class, the

white, and the heterosexual. Objectivity is not at all objective, but the discursive notion of objectivity

is. Objectivity, in and of itself, is historically contingent and established by an exclusive group of

individuals.

Ultimately, objectivity as a concept or framework does not exist, shown through historical and

theoretical examples. Although objectivity is touted as a clinical advantage, the intersection of

politics, culture, and history which eliminates objectivity allows for a broader and more

progressive view of mental health and mental illness. Whether concepts of mental health are slowly

progressing to an endgame of pure objectivity is unforeseeable, but regarding mental health as an

objective notion is fundamentally unsound. By embracing historical contingencies and discursive

methods, psychology and psychiatry can process statements and ideologies viewed as objective into

sound and balanced treatments.

Macey, D, 2001, Dictionary of Critical Theory, Penguin Books, London.

Rabinow, P, 1991, The Foucault Reader: An Introduction to Foucaults Thought, Penguin Books,

London.

Horrocks, C. & Jevtic, Z 2004, Foucault: A Graphic Guide, Gutenberg Press, Malta.

Gunderson, J.G. 2009, Borderline Personality Disorder: A Clinical Guide, American Psychiatric

Publishing, Arlington.