Wellness of the Mind by Nerissa Shaw
As a counsellor and also as a human being who desires to be happy, I think a great deal about mental health and what it actually means to be mentally well. The phrase ‘mental health’ is a part of modern language. It’s used all the time in lots of different situations from the medical profession to singer Lily Allen, in her track ‘Smile’, telling her ex that he ‘messed up her mental health’. But what is mental health really? What does it mean in relation to our everyday lives?
When is a person mentally ill?
The dictionary defines ‘mental’ as: ‘relating to the mind’ or ‘relating to disorders of the mind’, whereas ‘health’ is perhaps best defined as ‘a person’s mental or physical condition’.
So mental health then, is a statement about the wellness of someone’s mind. It isn’t however as simple as that! Mental health seems to take in other things – our state of contentment; whether or not we can derive pleasure from things; our relationship to others and to the world; our spiritual state; whether or not how we experience the world is in line with those around us or with societal ‘norms’.
And this is where the definition, for me, begins to blur. Am I mentally ‘unwell’ when I am grieving the loss of a loved-one or when a relationship of many years breaks down in a painful way? I am certainly not seeing the world as those around me might. I may feel that I might never recover from the pain; I may not be able to go about the daily business of work and play or I might find myself depressed or angry. Those around me not directly involved, however, will know that it is likely that I will recover, that my pain will heal and, that I will begin to take part in everyday life once again and that I will find a way to ‘come back’.
I suppose then, I am not mentally well when grieving – I am not ‘myself’ – but, in the situations I describe above, I am experiencing something that is a normal part of life – a defined process through which I must pass to recover. Of course, the journey of grief is different for everyone and the time it may take me to recover is not fixed but most people would probably agree that I do not, in these situations, have a mental illness.
To take another example, what if I am seeing or hearing things that others cannot? This state – perceiving reality as different to those around you – is known as Psychosis and it can be a very dangerous state for someone to be in. Usually they need emergency care from a medical professional. But, what if that person is hearing the voice of God or is having some kind of spiritual experience. Would we have put Jesus in a psychiatric unit if he were alive today? Was he ‘mentally ill’? Of course, you may not believe in Jesus and the Christian God so what about the experiences of a Shaman? The Shaman regularly experiences a different reality to those around him – the shaman sees and hears spirits all the time and will journey to other places, other worlds with other types of beings, to heal those in their community. Is this ‘mental illness’?
Clearly the boundaries between mental wellness and mental illness are not solid. They can vary culturally or according to circumstance. Everyone feels depressed sometimes, but when does depression become an ‘illness’?
A Counsellor’s Perspective
For me, as a counsellor, I might ask the following questions:
- How does the person feel about what is happening to them?
- Is the person a danger to themselves or to others?
- How is the person’s sense of self? Do they have a clear idea of their identity, of who they are? When they look to their ‘true voice’, what do they hear?
- Is the person able to take care of themselves on a day to day basis – eating, sleeping, washing and dressing?
- What do their family and friends think about the person’s state of mind?
- Who is supporting the person and how do they feel about that support?
- Are there things that the person looks forward to and derives pleasure from doing?
- How does the person feel about the future?
Of course, none of these in and of themselves can tell me everything about a person’s mental health. My role as a counsellor is not to ‘diagnose’ but to offer support and to help a person explore their difficulties but these questions taken together can really help to paint a picture of how a person is doing, where they are going and whether or not they are ‘well’.
But here I am attempting to answer the question about mental health by asking questions about what it is not. So, what factors contribute to a sense of mental wellness?
A personal perspective
There are various academic models of what makes a person mentally healthy but the following are my own thoughts on the matter very much based on my own experiences of being mentally ill and mentally healthy. I sometimes think of it as a checklist – if I am experiencing problems in any of these areas, it is time for me to ask myself if I need to take some action. Sometimes the answer is no – like the process of grieving, what I am feeling is based on events – I have a sense that I can get better on my own, that I just need time to process something. Other times, running through my ‘checklist’ tells me that something really isn’t right and perhaps I need to look for some help or make a plan about what to do.
When I am mentally healthy I
- have a strong sense of identity, of who I am and my place in the world;
- take any medication that I need to take to remain well;
- have good, reflective relationships with different people, family, friends and colleagues and the ability to be responsible for my side of that relationship;
- have an ability to navigate the basics of life, communicating with others, managing money, keep my ‘official’ paperwork up to date, remember birthdays, buying food and cooking for myself and my son; washing my clothes; keeping my house reasonably clean; walking my dog;
- have a sense of moving forward and of purpose, whether it be going to a job, creating something or thinking about a personal goal;
- take responsibility for my physical health – getting exercise and doing my best to eat and drink things that are good for me;
- feel a sense of connection with the natural world or to my personal spirituality;
- experience moments of contentment and peace when it’s OK to be alone with nothing to do and nowhere to go;
- don’t do things to excess – e.g. eat, drink alcohol, spend money, exercise or unreasonably restrict my food intake;
- have an awareness of what I am doing and why – that I am not getting stuck in old patterns or repeating old mistakes or, at least if I am, I am able to notice it and stop.
We know ourselves best
No-one does, or is, all these things all the time, nor would it be reasonable to expect them to be. We all let things drop and that is OK in my opinion – we’re not machines – and we all carry ‘wounds’ from our upbringing or from things that have happened to us. We all have different coping strategies too. But one way of looking after your own mental health, particularly if you have had mental health problems in the past, is to have a checklist like this of your own. Everybody is different, there is no one-size-fits-all model of mental wellness. In person-centred counselling we maintain that the client knows themselves best and knows what is best for them so, in some ways, you are the person best able to tell if you are mentally healthy.