“Mental health cannot be defined in terms of the ‘adjustment’ of the individual to his society, but, on the contrary… must be defined in terms of the adjustment of society to the needs of man” —Erich Fromm
The conversation around mental health has often centered on stigma. As mentioned in my previous post, this is a good thing because it encourages an accepting environment for individuals who are suffering.
In this post, I want to emphasize that beyond interpersonal stigma, our social environments have a tremendous power over our mental health. A poor social environment can trigger mental health issues, while a strong social environment can promote mental flourishing. Instead of just treating individuals, we need to diagnose and treat the health of our societies and the organizations that compose them.
Societies are like living organisms, institutions and organizations are the organs, and individuals are the cells that compose the organs. Each level functions in an interdependent relation with others on it’s level. For example, societies interact with other societies, just as our bodies interact with other bodies; organizations interact with other organizations, just as our bodily organs interact; and individuals interact with other individuals, just as our cells interact.
In addition, each level functions in an interdependent relation with each of the other levels: societies are affected by organizational and individual effort, just as our bodies are affected by the function of our organs and cells; organizations are affected by societal arrangements and individual interactions, just as our bodies impact the function of our organs and arrangement of our cells; and individuals are affected by societal pressures and organizational patterns, just as our cells are affected by the way we treat our bodies and the function of our organs.
Unhealthy societies, like ill bodies, may contaminate other societies, disrupt the optimal function of organizations, and hinder the development of healthy individuals. But what should define a “healthy” society?
In The Sane Society, Erich Fromm advocates a radical approach to mental health that goes against mainstream psychiatry. He argues that the psychiatric approach to mental health assumes the problem is the individual’s inability to adapt to their environment, neglecting the fact that the social environment might itself be the problem. This occurs when our social environments are out of sync with our needs as human beings—similar to the way we can’t blame our cells for not growing when we are not receiving the proper nutrients.
According to Fromm human beings have the following needs: “the need for relatedness, transcendence, rootedness, the need for a sense of identity and the need for a frame of orientation and devotion.” An expansion on these themes in the work of Victor Frankl can be found in my post on finding meaning and purpose.
Fromm’s approach to mental health is radical since it targets the root causes of many existentially oriented mental health concerns: the human need to meaningfully connect with others. Loneliness is one of the most dangerous states. Shame-inducing stigma and our superficial relations resulting from the constant need to market ourselves perpetuates the failure to connect.
The problem with mental health defined as mere ‘adjustment’ is that the psychiatrist may be working to help individuals adjust to an unhealthy social condition. Over-prescribed psychiatric drugs merely work to keep the unhealthy social condition in tact by numbing the individual to its detrimental psychological effects. This is comparable to constantly taking painkillers for a sore muscle resulting from poor posture. Rather than fixing the structural problem, the drug helps keep it in tact. Although this is a valuable critique of over-prescribing, I am still aware of the usefulness of psychiatric drugs, particularly for neurochemical imbalances.
Fromm’s diagnosis of contemporary culture is poignant, particularly in light of recent discussions of military veterans in transition to civilian life. In his book, What It Is Like To Go To War, Karl Marlantes says, expecting veterans to simply ‘adjust’ to civilian life “is akin to asking Saint John of the cross to be happy flipping burgers at McDonald’s after he’s left the monastery.” Leaving a closely bonded combat unit and entering into the individualistic consumer culture of Western society places the veteran in a situation where they lose their sense of belonging.
In the combat unit the individual courageously commits oneself to a group, working for the collective goal. Although the individuals in the unit may face intense suffering, they maintain resilience so long as their psychological need for relatedness, transcendence, rootedness, a sense of identity, and a frame of orientation and devotion are met by virtue of their position within the unit.
Upon transition to civilian life, this psychologically protective social structure dissolves and the individual may be left feeling isolated due to the culture shock. After the intensely collective and profoundly transforming experience of combat, simply expecting veterans to ‘adjust’ upon return is to neglect that civilian life itself may be the source of many of the psychological problems faced by veterans.
Now that mental health awareness is gaining traction, we also need to consider the vital role of social health. Ending the stigma is just one aspect of a healthy social environment. We also need to consider how interdependent relations within and between each level of society may contribute to or detract from a sense of relatedness, transcendence, rootedness, and a sense of identity.