The Importance of Social Health

“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.

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  1. You brought up a very provocative premise attached to PTSD. We do have a tendency to over medicate. We also have a tendency to want to rush to “normalcy,” especially when physical wounds are absent.

  2. Thank you for this post. I relate so much to this. I was not in the military and I have not seen combat. I did work in a prison and I have witnessed things that might be equated to combat. I was in a tight group where I felt like I belonged and had purpose. There was trust and a sense of honor and duty. When I left corrections and attempted to start a regular job my world fell apart. I no longer felt like I belonged, I was an outsider. The people I worked with saw this and used it as an opportunity to manipulate, intimidate and abuse me. Thank you for giving me a little more insight.

  3. Would it be too radical to suggest that collectively we are building a society unfit for humans? That leads us of course to ponder on what it really means to be human? The rapid rise in Mental Health Issues particularly amongst the young is a sad reflection on our current direction. Do we really need catastrophe after disaster, ethnic cleansing and persistent wars to wake us up to the reality that we’re going to hell in a hand cart? We are in the midst of a crisis of biblical proportions here in Europe yet for most “it’s business as usual.” Driving us mad and then labelling us with a “mental health issue.” Is it not the sensitive sane person who is driven mad by the insensitive insane predominating culture of politics=money=power=dominance?

    Thanks Steve, keep them coming you inspire me to speak out and bypass my tendancy to become a passive bystander in a world where my perspective seems at odds with the paradigm surrounding me.

  4. Steve (Dr. Rose): WOW! This post blows me away. I minored in sociology as an undergraduate and still see my day-to-day world through a sociological lens. In particular, I find myself constantly searching for solutions within our society for mental health and wellbeing. “If this were different / that were different…” I think, turning the problem over and over in my mind. Thank you for the introduction to Fromm’s ideas. A question for you: what call to action would you urge people to who believe that society needs to reform to promote mental wellbeing? The only things I feel I can do are take action in my day-to-day life, and blog. But I often feel frustrated, wishing there was more I could do. Thanks!

    1. Thank you for this wonderful comment! I’m glad you appreciate the sociological lens. I wish I could provide a clearer call to action for individuals, but I can’t think of anything beyond empathy and the golden rule. Seeing the world through the eyes of others and treating others the way you want to be treated seems to be a way individuals can create healthier societies.

      1. Thanks for the response! Empathy is certainly key. I hope it’s a skill we foster in all societies throughout the world. For some reason it seems that empathy is only an important value in some parts of life, such as kindergarten (haha), or in some occupations, such as counseling. I think it should be a ubiquitous value throughout all parts of life.

  5. Good post, but you stop short of defining what a “healthy society” might look like. I contend only a sicko society would send its citizens to all these wars in the first place. These conflicts can only occur because citizens passively allow the tax collectors to direct their so much of their money and lives to destructive ends.

    No wonder vets have so much trouble re-entering society. The bonding that occurs between fellow soldiers in war could also occur in more productive shared goals. I think of plays and concerts, where each player participates in a common goal that enriches everyone involved.

    1. You are right. I stopped short of defining the ideal society because that gets into the realm of politics. I tried to keep a sociological perspective in this post because the attributes of an ideal society can be realized through both right-wing politics as well as left-wing politics.

      1. I agree and would add that for me, an ideal society would supersede all notions of “left” and “right” polarizations. I think an ideal society would celebrate the individual’s unique qualities and potential for contributions to the greater whole.

        The idea that competition is good, for instance, is deeply entrenched. But competition in school, sports, business, or war pits individuals (and teams) against each other, creating winners and losers. How can I feel truly good about winning when someone else must lose?

        For me, winning means maximizing potential such that it is a beacon to others to do the same. I wish no less for society, but the current environment stifles the spirit of initiative. It also pits individuals and groups against each other to the point where they lose the sense of community and shared concerns.

  6. Mental health is not clear cut… My grandma, mom, and sister have varying degrees of mental illness. Normal has to be put in context… for each of them, because they have their own differences… Social stigmas do not make it easier as they try to heal and live..

  7. You might be interested in “Community resilience: Lessons derived from Gilo under fire,” by Dr. Michael Ganor and Yuli Ben-Lavy, in the Journal of Jewish Communal Service, Winter/Spring 2003, p105.

  8. Edward Tick, with whom I imagine you are familiar from your work, has also emphasized the need for society to step up to the plate, as it were, in aiding veterans with readjustment into society and either avoiding PTSD altogether or at least minimizing to some extent its effects. I can also attest, as a civilian posted twice to Afghanistan, that the readjustment to civilian society can be brutal. To this day, six years after returning home, a grocery store is still daunting. On my way home from my second deployment I had to return through London, England, and had some time on my hands. I had always wanted to visit the British Museum and did. Despite the amazing collection and the material I desperately wanted to soak up, I lasted only one hour before I had to leave. It’s hard to explain, but the reality is I couldn’t do it, I couldn’t handle the relative affluence, the peace and quiet, the slow movement of the visitors, the lack of any sense of danger. The readjustment factor is real and, at some level, survives beyond coming home. Thanks.

    1. Thank you for sharing your experience. This is something I’ve come across many times throughout my interviews with veterans. I also very much enjoy Edward Tick’s book on war and the soul. He does a very good job explaining the role of society. Are you from Ottawa? What role are you currently working in?

      1. Steve, sorry for the delay in responding. I am from Ottawa and normally work with the Directorate of History and Heritage at the Department of National Defence. However, I’ve been on leave from my position since November 2015. Ken

      2. Steve, sorry for the delay in responding. I am from Ottawa and normally work with the Directorate of History and Heritage at the Department of National Defence. However, I’ve been on leave from my position since November 2015. Ken

  9. I encountered a European who told me they often considered the mentally ill to be otherwise enabled. Those that were not violent were considered bell-weathers in spiritual matters.

  10. I believe that certain occupations accept those with a mental health issue more than others. It is hard to adjust to “normal” society after being inpatient where everyone accepts the differences.

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