I am a freelance science journalist and I have previously written for The Guardian, BBC, National Geographic, Gizmodo, Wired, and more. I am passionate about all things science, health, and the mind, and I was particularly interested in this topic because , given my job, it is important to me to explore how we talk about our minds and why that’s important. I wanted to learn how to better communicate the science surrounding mental health, without watering it down to be something it is not.
Talking about mental health is, thankfully, no longer taboo for many slices of the population in the Western world — “my therapist said” is a staple of the conversation during drinks with friends, and social media will consistently suggest a variety of content asking to regularly “check in with your inner child” or coping mechanisms and attachment styles. For a large swath of people who weren’t privy to these conversations beforehand, this norm-shift represents a welcome breath of fresh air. For some scholars, however, the ubiquity of this conversation about mental health could be doing more harm than good to our mental health.
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I’ve long wondered what people from different cultures, or from different moments in history, experience and understand of their own mental health. If there’s different ways of calling a mental condition, does it change what people feel from it? If there’s no way of calling it at all, is that better or worse? This is especially true when I travel, and I’m confronted with completely different ways of describing feelings and emotions in various languages. Many romantic languages use metaphors and similes in their everyday life, and those help people feel things more when, say, they’re reading a poem: is it the same for talking about mental health?
On a person to person level, this newfound openness in talking about the status of our mental health has given many people a freedom to express themselves they previously didn’t have, reducing stigma and breaking down barriers. For many, having greater access to information about mental health conditions, and getting accustomed to the very labels and names professionally attributed to classes of symptoms, has helped people make sense of what they are going through and find some resolution — that feeling of if it has a name it’s not all in my head, it’s real, and something can probably be done about it. Not to mention, atop of clarity, classification and diagnosis, even if not professional, can provide community and help people find others who might be feeling the same way.
These are just three of the reasons why this new age of mental health awareness has fundamentally changed the lives of many, but even just because we’re well past the season of having to convince ourselves that mental health is important, which is great, because if you’re spending all your time just trying to convince people something is important, you’re losing time where you could be doing something about it right now.
Yet, so much talking about subject matters which initially only belonged in the realms of neuroscience, psychiatry and psychology has the potential to become fundamentally unscientific, and conceivably harmful. That is especially true for our newfound tendency to give and receive diagnosis according to what we briefly skimmed over in our phones while on our toilets this morning.
“I feel like it’s been useful in some respects, but that there’s been some collateral damage or side effects,” Lucy Foulkes, a psychologist at University College London and author of Losing Our Minds: The Challenge of Defining Mental Illness, told me when I interviewed her for this article. Foulkes notes that if promotion of the idea that mental health problems are common, and that they are things that should have names, doesn’t come with the necessary kind of depth of information, people will start interpreting common experiences and emotions as psychiatric disorders when they aren’t. “When actually they’re just sort of part of daily living, and that’s not to dismiss them, but my worry is more that the people frame them as being medical problems and that is unhelpful.” It’s unhelpful for people who perhaps don’t have these disorders, because they might end up overpathologizing themselves and feeling even more of a mental burden for this new condition they’ve self-diagnosed with.
“If you’re not aware of the concept of anxiety disorders, then you’re not going to label yourself as having one, or interpret your experiences through that framework. So, the language that we have is really, really important for understanding our psychological experiences, definitely. And the current cultural trend is to interpret pretty much anything negative as a mental health problem or a mental disorder.” Not to mention, it’s also unhelpful for the people that do have disorders, because it devalues the real, vivid impact of their condition. It also skews who gets to have access to therapy, treatment, or medication.
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On a long term level, some scholars believe that throwing around all of this diagnostic psychological terminology and calling it ours can, in turn, cause changes in society. This is known as the Looping Effect, and it was coined by Canadian philosopher Ian Hacking: “classificatory practices induce reactions in the members of the human kind by enabling new intentional ways of being and acting,” this research paper describes.
“There’s these psychological descriptions circulating in common parlance and people take them up, and these descriptions and classifications can provoke changes in our understanding of ourselves,” Jeff Sugarman, a psychologist of selfhood at Simon Fraser University, told me when I interviewed him for this article. Then, in turn, people start to react to their new understandings of themselves and they develop more behaviors to fit in with these descriptions, once again making changes to the descriptions, notes Sugarman, and it becomes a recurrent cycle. This phenomenon is also heavily rooted in the politics of society too. Neoliberalism has reshaped what it is to be a healthy person, or what success means or what happiness means, according to Sugarman, and these too have become parts of the psychological descriptions by which we understand ourselves.
For Kai Ruggeri, a professor of Health Policy and Management at Columbia University, this wishy-washiness of mental health discourse now also opens two more, major, negative possibilities.
One, that the concept of mental health becomes co-opted by big corporations undermining and instrumentalizing it in order to ultimately take it away from, say, their employees. “When you have this watering down where it’s like, ‘take a wellness break, walk around, get 15 minutes of fresh air.’
Those are nice things nobody’s saying they’re not, but they’re not core mental health. They’re not addressing your reason for living,” Ruggeri told me when I interviewed him for this article. Ruggeri notes that this big-biz shorthand for mental health is, ultimately, not addressing the bigger questions: do you have good positive interactions with people? Do you have the ability to achieve the things you need to achieve in a day? “Organizations can pat themselves on the back and say, look, we, you know, we did it,” Ruggeri says. “But all those other things are just superficial things.”
Two, that long term national policy is harmed in the meantime, since policymakers miss out on recognizing the fundamental elements of mental health and therefore opportunities for good policy on it.
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Much of the responsibility moving forward now is in the hands of educators in providing depth to the conversation. “It’s not necessarily anyone’s fault because someone often might just be learning it from someone else using it in a term,” says Foulkes. “I think the issue is that the lack of depth like that we’ve promoted the idea that there is such a thing as [a specific mental disorder] but not necessarily fully promoted information about what it really is.”
In fact, the debate on whether how we talk about mental health changes the way we experience mental health has been around for as long as the notion of mind and self have existed. The scientific jury is still out on how to label mental illnesses and the pros and cons of doing it in the first place — this is especially true because, with the advancements of science, many of the descriptions of the diagnosis stretch, bend and morph over time in order to encapsulate new information scholars come across through research.
According to Foulkes, that’s exactly where one of the solutions to this paradigm lies — being open and transparent, and educating the general public, that a lot of this is much deeper and messier than it seems, even for the experts. “Things are messy, and we need to talk about the fact that [mental health] is on a spectrum and the fact that no one can quite agree when disorder begins, and that some people disagree about whether you should ever use the term ‘disorder.’ I actually think it’s useful to be honest about that,” says Foulkes.
Still, maybe this initial phase of extreme popularization of therapy speech and the mental health discourse needed to happen, to break down some existing barriers, and now it’s just a matter of reigning it back in. “It may well have been that this was the first necessary stage and we now need to refine it from here, or sort of slightly change course a bit.”