In the not-so-distant past, if you became sick there was a high likelihood that your moral character would be called into question. Physical illness, in all its mystery, was often attributed to some sort of supernatural punishment for sins. And since, in the course of normal human life, it is quite common for people to become ill; various political, religious, and social institutions have at various times found it convenient to use this phenomenon as evidence of the truth of their moral philosophy.
Did one of your family members contract an incurable virus while others were spared? Clearly there was some reason. Perhaps it was because they did not attend a religious service that everyone else did? Perhaps they attracted evil spirits that made them sick by not adhering to social customs? Or, in recent decades, perhaps they contracted AIDS as some kind of punishment for being gay? This moralization of illness, from the superstitious to the supercilious, adds insult to injury in a literal sense.
It is comforting to believe that in the modern world we have matured beyond the point of assigning moral judgment to the appearance of physical illness. As much as this is true it is largely thanks to the advancement of a scientific understanding about the nature of the body and illness. Health care has become, for better or worse, a more scientific field. The benefits are plain to see. The drawbacks are, naturally, slightly less obvious, but can be seen most clearly in the field of mental health.
Until very recently it was standard practice to lock the mentally ill in prison-like cells, treat them with violent procedures and programs, and generally make them social outcasts. To this day the mentally ill are often treated with neglect, suspicion, and resentment. But mental illness is not a rare occurrence. According to the National Alliance on Mental Illness, roughly 19 percent of the American population suffers from some type of mental illness each year. About 4 percent suffers from debilitating mental illnesses, like schizophrenia. So why is there so much stigma around mental illness?
Dr. David B. Feldman, writing in Psychology Today, states that mental illness is diagnosed very differently from physical illness. Mental illnesses are primarily diagnosed according to the symptoms they present, whereas physical illnesses are diagnosed according to (testable) biological causes. In short, mental illness is harder to diagnose, and the diagnoses when they are made are less descriptive of actual illness and more of a collection of symptoms.
This has led to heated debate over whether mental illnesses should be considered “real” at all. Of course, the symptoms are real, but are they the result of something like a disease where pathogens invade the body? Or is mental illness more like a bad habit? If we cannot verifiably discover biological causes for mental illnesses, then how do we treat them? Are cognitive and behavioral therapies our only options? And even if we do discover biological underpinning of mental illness, where does the patient — the person, him or herself — fit into the healing process?
The biggest difference between mental and physical illness is, obviously, that we cannot test and treat the mind in the same way we do the body. The body is tangible, observable, and relatively predictable. The mind is, essentially, very different. It is intangible, unobservable, and infinitely complex.