How Should We Define ‘Mental Illness’?

The term ‘mental illness’ has a way of sounding so alien, cold and severe that it may – despite our  best intentions – leave us struggling to understand what could be really going on for sufferers (who might at times include us).

A useful way to think of the term is to imagine that it involves a form of negative thinking that would be familiar to most people but that is here distinctive principally because of its relentlessness and restrictiveness. Like all of us, mentally unwell people feel anxiety; like all of us, they know self-hatred, paranoia and shame. But unlike all of us, this is the sum total of what they experience. What would – for a well person – be a momentary thought, a fleeting apprehension, a passing perspective forms the basis of their whole self-assessment and outlook. They are gripped where most of us are merely touched. They cannot take a break, they cannot look at things from another angle or give themselves and existence the benefit of the doubt. Every morning, they wake up haunted by the same appalling notions: that they have done something irredeemably wrong, that they are irrevocably ugly, that they are comprehensively hateful, that there are enemies everywhere who are are right now plotting against them, that they are going to come to an awful end. 

All of us will think these sort of things sometimes, especially when we are tired. But a healthy mind has a vigorous way of ushering in new, redemptive concepts, sometimes within seconds. A gentle kindly creativity is applied to dilemmas and pains: yes, there might be a mistake but it doesn’t have to be the end; not everyone might be a friend but can there really be enemies everywhere? Perhaps one isn’t the most beautiful person, but one has a right to take a place among others. 

We might define mental illness as a failure in the capacity to be kind to oneself. The mentally ill person tyrannically creates an internal theatre in which there is no room for forgiveness, no gentleness to self, no ability to move on, no capacity to introduce less vindictive concepts; no ray of light. The slightest benevolent idea has to be – according to a silent law – ruthlessly strangled at birth. 

This gives us a clue as to the likely cause of this form of suffering: a deficit of love, a lack of a sufficient early experience of close-up attention, calm, sweetness, hopefulness and sympathy to enable one to dissolve the perils and doubts of adult life. The mentally ill person is at some level treating themselves the way they were formerly treated by others. Their self-laceration is a version of the whipping they received at the hands of former care-giver or parent. They hate themselves as they were hated.

Such a diagnosis points us logically to a solution: a reparative kind of love, delivered often enough, intensely enough, reliably enough, convincingly enough, that it eventually stands a chance of piercing through the defences of cruelty and put up a plausible opposition to the chorus of inner voices of doom and revulsion – a love that might come from a partner, a friend, a therapist or a still robust enough part of the sufferer’s own mind. 

We begin to work our way out of the cavern of mental illness when we can take on board the particularity and unfairness of our self-punishing ways – and allow ourselves to trust in the possibility of a kindness to ourselves that we have until now been too stricken and scared ever to tolerate.