Psychologists are trained and paid to treat mental illness. But what does that really mean? For that matter, when it comes to the mind, what does the word illness really mean? For the average John or Jane to go to therapy, must they be mentally ill? And regardless of what’s being treated, what is meant by the word treatment?
There’s a lot of meaning to unpack from the questions above, so let’s start unpacking. First of all, one does not need to be mentally ill in order to seek or benefit from psychotherapy. In fact, most people who attend therapy are technically not ill. The unvarnished truth behind that misconception is this: Health insurers only pay healthcare providers to treat patients who are ill, not to help people recover or cope with suffering in the absence of illness. The profession copes with this quandary by pathologizing the everyday emotional suffering of crises, traumas, stress, conflicts, and anxieties, most of which have nothing to do with illness.
Mental illnesses are real though. For many different reasons, the brain’s electrochemical balance can become disturbed to the point of causing serious pathology. Incapacitating anxieties, depression, rage, mood swings, addictions, delusional beliefs, auditory or visual hallucinations, lack of behavioral control, are all symptoms of real mental illness. Such symptoms of disease need to be cured if possible or, at a minimum, controlled. Nevertheless, these diseases are not amenable to being healed. Curing and healing are entirely different processes utilized for entirely different conditions. So let’s do some more unpacking.
To cure means to control or eliminate a disease that disrupts the healthy functioning of an individual’s body, mind, or behavior. To heal means to make whole that which has been broken. Both curing and healing improve people’s health, though in entirely different ways. This is true for both physiological and psychological health conditions, as will be explained.
If a patient has a sinus infection, a physician can cure this disease with medication. Because there is nothing broken or damaged, a sinus infection requires no healing. If a patient has a broken bone, a physician can heal that condition, yet there is no disease to be cured. When it comes to physical health conditions, the distinctions between curing and healing are clearly understood.
But how are we to comprehend the distinctions between psychological conditions that call for curing versus healing? What makes this more challenging is that many disturbances of the mind are subjective in nature, in contrast to the objective disturbances of the body. A physician can see a broken bone on an x-ray, detect an infection through visual inspection, or identify a cancer through blood work, etc. But when it comes to mental illnesses, psychologists have few objective tests for proving the existence of a psychopathology. Most of what we diagnose is based on the self-report of the people we treat. Even though the causes of psychological distress are varied, what most of those causes have in common is that they are invisible and unprovable. This ambiguity makes it difficult for psychologists to discern if a condition needs to be cured or treated.
Before proceeding further down the path of differentiating between curing and healing, the following fact should be noted: Mainstream psychology never uses the words “heal” or “healing,” and it has no model whatsoever for healing what ails the mind. Did I mention that we have a lot of unpacking to do?
The simple explanation for why psychology does not address the concept or process of healing is due to its strict reliance on the dictates of science. Science is incapable of recognizing anything about the mind that can become broken. An individual’s brain can be broken through injury (thereby causing some form of mental illness), but the primary treatment for that injury would fall into the hands of a neurosurgeon to repair a damaged brain, not a psychologist to cure the mind. The brain is an objective, physiological entity that houses the subjective, psychological mind. Without being able to see anything broken within the mind, there is nothing recognizable to heal. Nonetheless, the mind does require healing and it is entirely capable of being healed.
Perhaps you’ve heard the allegory about a man looking for lost keys at night by exclusively searching the area beneath a lamppost. A passerby asks if he is certain that the keys were lost beneath the lamppost, and the man replies that this would be the only area where they could possibly be found. Similarly, when it comes to the mind, there are realities that lie outside the lamppost of scientific detection. There are, in fact, parts of the mind that can become broken, most often in the absence of mental illness.
Sooner or later, everyone’s hearts break. Likewise, people suffer from broken spirits, trust, faith, will, confidence, and self esteem. Everyone also suffers from internal conflicts, evidenced when one part of their nature behaves in ways that another part judges harshly. Can you recognize how each of these conditions might create intense psychological distress to the point where you might need professional assistance? These are common examples of psychological harm that are not pathological. None of these conditions can be cured. Instead, each is an example of psychological harm in need of restoration.
There are countless ways in which human beings become deeply conflicted, divided, and damaged, none of which can be scientifically measured or cured. Such is the nature of the human heart and the subconscious mind, the two “places” where healing is needed most.
From the earliest days of psychoanalysis (some 140 years ago), pioneers in the field recognized that the mind is made up of different parts that suffer from conflict with one another. Most people are familiar with Freud’s theory that neurosis was caused by the rational Ego’s failure to successfully mediate the conflicts between a harshly controlling Superego and a dangerously primitive Id. The term “intrapsychic conflict” acknowledges that the human mind is comprised of different parts that can fail to get along with one another. If fact, the relationships between different parts of the mind can become broken, just are relationships within a family can become broken.
When a troubled family or couple seeks therapy, the therapist does not identify either as diseased. There may be high levels of dysfunction and distress, but that may be entirely due to their failure to manage their relationship conflicts in healthy ways. Again, these are not conditions that require a cure. Conflicted and broken relationships require a process of healing in order to restore a degree of wholeness that has been lost or compromised. This exact same principle applies to the nature and needs of a troubled mind. When the conflicts between different parts of the mind (referred to as subpersonalities) are severe, those relationships need to be healed.
There have been numerous psychological models of subpersonalities developed since the dawn of psychotherapy. Psychosynthesis (Assagioli), Transactional Analysis (Berne), Gestalt Therapy (Perls), Transpersonal psychology (Wilber), and Voice Dialogue (Rowan and Rowan) are well-known examples. Today’s prevailing model for treating conflicted subpersonalities is Richard Schwartz’s Internal Family Systems (IFS), a model embodying an extensive catalogue of subpersonalities. Treatments that focus on repairing and/or improving the relationships between divided people and/or divided subpersonalities fall into the realm of healing.
The American Psychological Association, arbiter of mainstream (i.e. Western) psychology, requires empirical evidence in order to confer legitimacy to treatment interventions. The problem is, how does one gather empirical (objective) evidence of damaged relationships between invisible subpersonalities? Because we lack the means to do so, we are prevented from discussing the potential for healing. It’s not as though psychologists lack the ability to heal the psychological dysfunctions created by relationship conflict, it’s merely that we can’t identify an empirical foundation for doing so.
It is deeply problematic that psychology has failed to recognize the need for a model for healing the human mind. Doing so would not replace our current model for curing mental illness. Rather, a model of healing would complement and expand our paradigm for understanding and improving mental health.
The nature of the mind is too complex and vast to assume it can all be understood using the lamppost of empirical science. While it remains critical for science to guide and support our treatment interventions, it is equally important that science not prevent us from developing the healing treatments that real people require. Psychology must therefore evolve in order to accommodate the vital need.