Abstract
In the previous chapter I presented a formal characterization of the concepts “positive health” and “positive mental health”. I also indicated that it is now possible to try to formulate a material definition of positive mental health. This will be the major task in this chapter.
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I have decided to use the term “acceptable” (health). Other candidates were “minimal”, “basic”, and “reasonable”.
This does not mean that we require that people do work, or want to work. What is required is the ability to work (in some occupation).
Most notably by Laing and Cooper.
The instrument is, of course, rather crude, but I hope my discussion will show that it is intuitively sound.
I say “partly” here since I will not be able to state all the requirements for having acceptable mental health.
Observe that we are not talking about intentionally expressing anger. A 7color-blind person might not have this “ability”.
Obviously acquiring here is not an activity.
Porn 1993, p. 296. Morriss 1987, p. 81.
Pöm 1993, Morriss 1987, Nordenfelt 1987, 1997.
Morriss 1987, p. 52.
Nordenfelt 1997.
Proprioception is a concept which might describe (at least) one aspect of body-awareness. According to Brian O’Shaughnessy the concept stands for a “specific mode of perception” which has to do with the person’s awareness of her own limbs and body (O’Shaughnessy 1995, p. 201). And The Oxford Companion to Philosophy states that proprioception “concerns stimuli arising within, and carrying information about, one’s own body: acceleration, position and orientation of one’s limbs” (Honderich 1995, p. 652).Even though O’Shaughnessy uses the word “awareness”, which implies that he sees proprioception as involving mental states (1 am not sure, however, that we should interpret this literally), it might be the case that proprioception does not refer to a mental ability at all. The description of proprioception in Norstedts Medicine (search word: “proprioception”) does not refer to any mental activity or state. Instead proprioception has to do with the “reaction of nerves to body movements and relation of information about movements to the brain”, and proprioceptive refers to “sensory impulses from the joints, muscles and tendons, which relate information about body movements to the brain”. Having “body-awareness” in this sense is more like having an auto-pilot controlling our body.
It is mainly found when discussing (manifest) neurological damage, and some striking examples are to be found in Sacks 1990, or in phenomenological writings, often in connection with the French phenomenologist Maurice Merleau-Ponty (1994). Still, the conception of body-awareness does appear in some other diagnoses in psychiatry. For instance, some schizophrenic patients have a fragmented or diffuse sense of the body. For a list of such mental disorders see Gelder et al. 1994, pp. 28–30. An interesting book devoted to related topics is The Body and the Self (Berm idez, Marcel, Naomi 1995 ).
From now on simply called “well-being” and “ill-being”.
The “mechanisms of defense” (repression, denial, projection etc.) discussed by Freud and others only seem to affect the memory of specific events or emotions, and might therefore not be seen as an impairment of memory in the ordinary sense of the word.
This is mainly derived from Baddeley 1994, pp. 281–301.
A thorough discussion about the philosophical problems pertaining to perception is beyond the scope of this book.
Some epistemic attitudes are believing, knowing, judging. Some philosophers claim that all perception is epistemic, that there are no uninterpreted sensations, others hold that some non-epistemic perceiving is possible.
Let me say here that the seeming circularity in these interpretations is indeed only seeming. The term “perceive” or “perception” is found both in the definiens and in the definiendum. However, it is the word “correct” which is defined, not perception itself.
As we shall see in chapter seven in order for misperceptions to be detrimental to the attainment of important goals they must be supported by delusions about reality. A rational person would most likely not take a mistaken perception for granted.
Mario Bunge suggests a few more (Bunge, 1987 ). The others he suggests, conceptual, methodological, ontological, valuational, are either only pertinent to science, or, I believe, can be subsumed under the three conceptions chosen here.
Jürgen Habermas and Mario Bunge hold similar views (Habermas 1981, Ingram 1987, Bunge 1987 ). A similar suggestion found in The Oxford Companion to Philosophy is that it is rational to adopt beliefs for appropriate reasons (Honderich, 1995). Lukes (1991) lists several similar claims.
Popper 1959. These ideas are developed by Bartley (1987). See also O’Donnehue and Vass 1996, pp. 310–314.
This is one aspect of what Bunge calls methodological rationality (Bunge 1987).
Taylor 1982.
Reasoning is sometimes divided into theoretical and practical reasoning. Audi (1989), for instance, holds that theoretical reasoning is connected with truth, whereas practical reasoning is connected with action. Both are important, but in everyday situations it is, of course, especially important to have the latter capacity.
Culver and Gert 1982, Taylor 1982, Lukes 1991, Bunge 1987. This is also an important aspect of Habermas’ conception of rationality. Habermas claims that the function of practical argument is to give arguments supporting beliefs underwriting decisions to act (Ingram 1987, p. 20 ).
For the falsificationist, that a belief is justified here means that the belief has not yet been falsified.
Evans 1993.
This is a version of “bounded” rationality. The problem is generally formulated thus: people have limited cognitive and other resources so it is only reasonable to require that people check beliefs that are of importance to them. Cherniak (1992) has an extensive discussion about this problem.
Chemiak 1992.
It would not make sense, for instance, to require that people should be able to calculate like a computer. The concepts discussed are concepts which appertain to human individuals.
However, I would like to qualify this claim. There can be a serious case of irrationality when it comes to goals. If the person believes that the goal will not make her happy (satisfy an important wish), it is irrational to strive for the goal. To clarify: it is irrational to strive for a goal that the person herself does not wish to reach. Remember here that happiness is wish-fulfillment.
There can of course be secondary goals to secondary goals, etc. Buying a house can make us happy, money would make it possible to buy a house, work gives us money, and education gives us work, etc. So a secondary goal can be “vital” in the sense that it leads to a goal that makes us happy. Note that the secondary goals might be unpleasant but necessary for reaching a vital goal, as when one goes to the dentist.
However, if a person always ends up unsatisfied with the goals she pursues we can question the rationality of the grounds on which she bases her judgment that the goals are worth pursuing.
One could argue that everything is problem-solving, even perception. Richard Mayer (1992), for example, uses thinking, problem-solving, and cognition as synonyms. I will not use such a broad notion since it blurs the distinction between useful mental concepts.
Mayer 1992.
Some problems might not even be attended to since they are too small to make a real difference.
Marie Jahoda, we saw, has a slightly different view. She is more interested in the process of problem-solving than the result or end-product. Jahoda discriminates four parts in problem-solving. The stages in this process are “awareness of the problem, followed by a consideration of means toward its solution, a decision for one or the other of the considered means, and finally the implementation of the decision” (Jahoda 1958, p. 63). It should be clear from what I said above that sometimes the fourth step is unnecessary since the problem might be an intellectual one. Even deciding (stage three) is sometimes not necessary since there might only be one solution and when you reach it you know that it is the right one.
These examples are from Greeno and Greeno & Simon but my source is once again Mayer 1992.
This quote and the following three are from Mayer 1992, pp. 6–7.
This seems to be closely related to autonomy. However, flexibility in this sense, it seems, is neither a necessary nor a sufficient condition for being autonomous. One can imagine a person who has made several autonomous choices about values and preferences but then does not change them, and a non-autonomous person who changes values and preferences (unreflectively) when the fashion in society changes.
Changing values and preferences can be seen as changing thinking in a limited area.
This is Rollo May’s primary condition, “bringing something new into existence” (May 1975, p. 39). May, however, makes a distinction between artificial and genuine art, thus making a distinction between ordinary people and true artists or scientists. This distinction will not be used here since I think that creativity is also a concept that can be used about everyday activities. May also argues that creativity represents “the
Mark here that knowledge means holding true justified beliefs. This requirement might be too strong. A lot of scientific “knowledge” has through creativity emerged out of false but justified beliefs.
This characteristic is part of Albert Rothenberg’s definition. Creativity is “the production of something that is both new and truly valuable” (Rothenberg 1990, p. 5). Rothenberg leaves out our third defining characteristic, the connection to older knowledge and experience. However, later he emphasizes the importance of training and hard work, even if he does not seem to make these features necessary conditions. He claims that “Creative people are professionals… They have undergone training and learning…” (ibid., p. 10 ).
p. 35. However, Nozick adds that creativity could be used for a negative purpose. Thus, this term is not a value term in the moral sense.
It could be objected that this definition excludes children from being creative. There are two possible responses to this objection. The first is to agree, and to suggest a separate definition for the “creativity” of children. The second is to argue that most children fulfill the requirements stated by the definition.
Nordenfelt 1987, p. 82.
Some sensations are not feelings, visual sensations for example.
Anguish is a classic existentialist suggestion of a general mood that all humans experience from time to time (see Sartre).
Just to give some examples: love, hope, happiness, joy, gladness, delight, pleasure, contentment, compassion, sympathy, lust, admiration, respect, anger, sadness, sorrow, grief, contempt, scorn, pity, self-pity, self-contempt, despair, remorse, distress, hate, envy, jealousy, misery, woe, disgust, repugnance, powerlessness, fear, dread, gratitude, nostalgia, loneliness.
Here are some other candidates: well-being, calmness, harmony, bliss, comfort, anguish, weariness, depression, apathy, downheartedness. They all have to lack direction or object in order to belong to this category. However, it might be argued that there are no true moods, that these feelings are all best seen as emotions where the object of the emotion is hidden, or not obvious.
Greenberg, Rice and Elliot 1993, p. viii.
Even if we do admit the relatedness between cognitions and emotions it is, of course, useful to be able to distinguish between these aspects of mind.
Green 1992.
We see here that the emotion includes a cognitive feature, beliefs. Thus, this model excludes the possibility of upholding a dichotomy between emotions and cognition. It might, of course, still be possible to uphold it between moods and cognition.
We have to keep in mind that we are not requiring that the person actually can exhibit emotions, just that she can experience them.
Since happiness is the emotion that tells us that a goal is vital to us, it is obviously important to be able to experience this emotion. Without it, it would be hard for the individual to choose a course in life. I don’t believe that the desires by themselves can do that, since they can be mistaken. It seems to me that the subjective feeling is what tells us if the wish we have concerns a vital goal.
The wish, of course, stays the same (that the wife is faithful).
An elaboration of these thoughts about empathy can be found in Tengland 2001b.
Ottosson 1995, p. 499. 65 DSM-IV, p. 661.
I will in this section still use the word “know”, but in this special sense.
The importance of an aspect like knowing what mental state one is in, being able to become self-aware, seems to me to be too self-evident to discuss.
However, this might be less true of bodily needs than of mental needs. For instance, the body has certain needs for vitamins, but not knowing most of these needs would not count as not having self-knowledge. With many bodily needs the only way to know them is through scientific research. This, of course, goes for some mental needs too. It is likely, however, that in order to stay healthy the person has to have some apprehension of certain basic bodily needs. And we might require that people have acquired some knowledge about what science says about nutrition.
Note that these beliefs do not have to be justified, so self-confidence is not having self-knowledge. Of course, as we shall see in the next chapter, self-confidence might be counterproductive as regards health, if the beliefs are not realistic.
Nordenfelt 1994.
Ibid., p. 20. Nordenfelt later adds that in order to be autonomous one must also have the possibility of deciding not to, and have the opportunity not to, perform actions. Furthermore, Nordenfelt adds, a person acting under threat is not fully autonomous even though the person, in one sense, has the ability and opportunity to decide which action to perform.
Any combination of these four kinds of impairment of autonomy is, of course, also possible.
One reason Nordenfelt has for choosing such a broad notion of autonomy is that to him it does not make sense to talk about making choices that one believes cannot be acted upon.
The physical ability to act is not relevant here.
Dworkin 1988. I will ignore the fact that Dworkin has written papers where he holds ideas slightly different from the ones presented here.
Dworkin 1988, p. 20.
For his arguments see 1988, pp. 15–17.
There are, of course, plenty of examples where both kinds of information are included in the same utterance
Someone might claim that I am making too much of the difference between cognitive and non-cognitive information. It might be said that all affective information involves cognitive aspects, and that all cognitive utterances have affective content. I agree to some extent, even though I find it obvious that some statements involve much more affective content than others.
In practice, however, it is probably not possible to separate verbal and non-verbal communication; they complement each other.
I leave it to psychologists, psychotherapists, and psychiatrists to come up with empirical theories of people’s vital goals.
Damasio 1994.
I have chosen to discuss an artist since few kinds of work, in general, can be as isolated as this one.
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Tengland, PA. (2001). An Analysis and a Quasi-Empirical Investigation of Some Mental Abilities. In: Mental Health. International Library of Ethics, Law, and the New Medicine, vol 9. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-2237-7_6
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