Theories of Mental Health and Mental Illness

By emphasizing pathology, we had tacitly accepted health as the absence of signs of pathology. If instead we emphasize normal development and healthy functioning, we adopt the view that pathology is deviation from health as nonfunction, dysfunction, or malfunction of natural processes. The pathology-centered approach brought an increasing tendency to consider all human mental function as essentially pathology, in greater or lesser degree, which often led us to spend a great deal of effort in working to cure aspects of healthy function. That is a terrible error. Instead, we can view mental health as a complicated but definitive functioning condition, discernible as having many elements of normal processes functioning well, with mental elements and factors that serve purposes we can understand. We then view health as those processes aiding us to adapt and function in personal and interpersonal life. This vantage promises to be increasingly fruitful and more useful than pathology-oriented study. The work presented in this blog has already brought knowledge for cure and prevention. Extension of the theory of health beyond the scope of emotion health may bring far more knowledge.
The "everyone is ill" belief leads to an industrial approach to mental health issues and all too frequently to a smug, condescending attitude toward patients. As one psychiatrist observed, "Every child should have a course of psychotherapy during adolescence." His belief that everyone is ill in some degree meant that he should treat everyone who came to him, to prevent catastrophic developments, or at least to make their lives healthier in some degree by removing pathology. From his illness-oriented approach, any least characteristic or element of any illness that he could note he declared to be sufficient basis for necessity of treatment.
From several of his former patients who eventually came to me, those elements of illness he detected would often have been better understood if they had been considered along a range of variation within healthy mental functioning. His approach had made healthy children into patients. Then they needed psychotherapy--to free them from being patients! His practice involved thousands of adolescents over at least three decades. His belief in the universal necessity for treatment gave him what could look like an uncanny diagnostic talent. He needed only to hear the name of an adolescent to know sincerely that the youngster should be under his care, usually in a hospital for thirty to sixty days, isolated from communication with parents (to break the parent-child bond and foster a healthy relationship with the therapist), all the while medicated with one or another psychotropic drug. Supposedly the child then could start anew to form good relationships with parents and family. The problems in that are obvious.