What is health?

An upcoming psychoanalytic conference in my town will be addressing the challenging question,"What is mental health?" This will be answered from a psychoanalytic perspective, presumably, which will shed some light on the matter, no doubt, but is likely to be somewhat unidimensional, because of the monochromatically psychoanalytic perspective. Cognitive and behavioral psychologists might define it quite differently, and biologically oriented folks would have their own viewpoint too.

As a homeopath and partisan of bio-energetic healing modalities, I thought a more broad view of health itself would be valuable to the discussion of what mental health is. After all, isn't mental health a subset of health?

In tackling this question, I started with the homeopathic answers proferred by Hahnemann, but quickly bumped up against a number of unsettling questions. First, we tend to assume that the physically sick person is not healthy, but what of the physically well person? Are they by definition healthy? For those with mental illness, the answer seems simple enough - of course not, they have an illness that affects their mind or their brain, whichever you please. But this seems a bit narrow still. Is the sum total of human function a matter of mind and body? And what about those who have been derogatorily referred to as the "worried well" or "neurotic"
individuals. Do they have "mental illness" or is this some type of non-illness problem?

Let's consider the individual who engages in criminal or abusive behavior. They appear to have a moral defect, as they do not seem to feel guilty about their behavior. Or perhaps they are just impulsive. Is lack of morality an illness? What about poor impulse control?

What about those well adapted folks on Wall St. who scammed poor America and our government into wrecking our economy? Is greed or perfidy an illness? Or is it just an example of healthy capitalism (caveat emptor!)?

Some of us may be quite well adjusted in some ways, with no clear mental or physical illness, but have greatly troubled relationships, that cause us a great deal of stress. Is stress an illness? How about relational difficulties. Does being healthy mean you should have harmonious and successful relationships, or does this go too far?

Then there are those of us who seem to get along apparantly quite well, but who live what Kierkegaard describes as "lives of quiet desperation." These individuals seem to be spiritually adrift. They may include hedonists and materialists, or those for whom what Hahnemann termed in the Organon "the higher purposes of our existence" are irrelevant. Is it necessary to have some type of spiritual vibrancy in one's life to be healthy? Is there such a thing as spiritual health?

In many religions, a high premium is placed on altruism or giving to and sympathy for others. Does this mean that those who give more are more virtuous? Is there such a thing as healthy selflessness? What about healthy selfishness, as Ayn Rand (and Neitzsche) proposed. Is being virtuous a sign of health? It seems easier to regard lack of virtue -- i.e., miscreancy, turpitude and subterfuge for example as signs of illness. It is not uncommon for one to hear those who commit horrible crimes referred to as "sick." But does this mean philanthropists are necessarily morally healthier than the rest of us?

Many of these questions have no easy answers, of course, but the point is that our definition of health can be as broad as we would like it to be, and it can easily be too narrow. It may include, along with what I have already mentioned, namely, physical health, mental health, interpersonal health , moral health, and spiritual health, any number of the following:

Creative health. Isn't being a creative individual a healthy thing, and being dull and unimaginative a sign of our failed human capabilities?

Social and community health. In that we are social creatures, isn't it a necessity for us to be connected to our neighbors and community, with which we share an interdependent relationship?

Economic health. Can we truly be healthy if we are poor? Isn't poverty a sign that we have not succeeded in the basic biological function of self-sustenance?

Environmental health. How can we be considered healthy if we are constantly destroying the world which gives us life? To thoughtlessly pollute and defile the earth, and undermine the earth's livability for our descendants if not us seems to be manifestly against the interests of our health.

Mental health might be broken down into various components: there is cognitive health, which itself can be dissected into various capabilities, such as verbal reasoning, mathematical reasoning, spatial conceptualization, executive function, problem solving and abstract reasoning.There might also be categories for emotional health, perspective taking (also known as ego functioning), flexible thinking, empathic abilities, the ability to separate emotion from thought, or to recognize emotional reasoning in oneself, and verbal and non-verbal communications skills. One might leave a space for intuitive capabilities as well.

This leaves us with a potentially colossal list of parameters to track in our patients. When someone comes in with a sore throat or sleep problems, should we be looking for signs of ill health in all of these areas? The answer is probably that there just isn't time. But it is useful, as we get to know our patients as individuals a bit better, and those of us who do primary care, or have long term treatments with our patients will get to know our patients quite well, that there are multiple realms of health. And when our treatment is truly helpful, as deep healing sometimes can be, we are apt to see improvements in all of these realms.

It is also worth thinking about, as we try to "educate" our children, that just teaching the curriculum created in most of our schools is just a small part of what we should be doing to mold our children into healthy, vibrant, and successful adults. There is a moral, spiritual, social, interpersonal, emotional, community, and global developmental process going on along with the cognitive development, upon which we put so much emphasis. And intangible as these developmental processes may be, we as adults neglect them at the peril of our children. A roof over their heads, good food, clothes and reading, writing and arithmetic are only the platforms from which are children are launched into lives potentially rich and deep, or poor, shallow and riddled with the subtle or sometimes not so subtle stigmata of ill health.