Does the mental/physical distinction make sense regarding health… or yoga?

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Lately “Mental Health” has been getting a lot of play. There’s a Mental Health Foundation page on facebook that promises to help you manage stress. I’ve been listening to some of the speakers on Recovery 2.0, an innovative conference on addiction and recovery organized and facilitated by Tommy Rosen. I even wrote a piece for Muse in the Valley during Canada’s “Bell Let’s Talk” week on how yoga helps me with PTSD. I recently had a Twitter convo with Ben King of Armor Down, discussing how he came to found this revolutionary organization for helping soldiers armor down after deployment.

So perhaps you’ll forgive me a moment of confused frustration with the term “Mental Health.” In Ancient Greece, there was no distinction between mental and physical health: activities benefitting and destroying your body were assumed to have corresponding effects for the person’s mental function and outlook, and visa versa. Sometime after the Enlightenment, when we stopped referring to “humors” to explain illness, we began to look at physical ailments as a class separate from purely “mental” ones. The shift was complete by the time Freud adopted the diagnosis of “hysteria” for his female patients suffering from a variety of symptoms. Though even he used physical images to describe what he surmised was causing his patients’ suffering, and much of it came down to disorders of the “nervous system,” these were used as a metaphorical correlates for the very distinctly physical system.

Regions of the brain affected by PTSD and stress.

Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia)

We currently prescribe drugs and investigate the impact of exercise, mindfulness and diet on depression, addiction and other “mental health” diagnoses, however it doesn’t seem that those suffering from these imbalances are accorded the same latitude as those affected by “cardiac health,” “metabolic health,” “musculo-skeletal health” or other health phenomenon. Which is strange. Because there’s an equal and growing recognition of the psychological effects of cardiac ill health, as well as all other forms of disease. Yet insurance coverage, work policies and social stigma persist regarding “mental” health.

Truth is, being sick can make you sad. Being sad can make you sick. Trauma sucks and has lasting results on the nervous, hormonal and cardiovascular systems, effects that can be mitigated and reversed through lifestyle choices like meditation, yoga, group therapy and, yes, medications. Depression is a physical illness, affecting  body chemistry in known ways. So, too with bipolar disorder and schizophrenia. The brain – hold on for the revelation – is part of the body. Whoa. I know, deep, huh?

No underestimating the profound effects of addiction, depression, PTSD, bipolar and schizophrenia here. Just questioning setting them aside as “mental.” There are two possible assumptions behind setting aside some illness as mental, so far as I can see:

  • A simple taxonomy of providers and research that allows specialists to group together for professional and training reasons. Emergency Professionals train together, as do Cardiology pros (surgeons, nurses, etc), as do Psych pros. 
  • A classification of some symptoms as originating from a different mechanism than physical ailments. Mental symptoms are caused by ideas, while physical ones are caused by electro-chemical reactions within the body on which we can have meaningful impact with diet, exercise, surgery and drugs. Symptoms caused by ideas skip this physical mechanism and are healed or helped by other ideas which similarly skip physical causation.

The first is really just practical. The second is really just false, as suggested by exercise and pharmacological suggestions for psychological symptoms and meditative help for cardiac ones. Clearly, if you’re having “the big one” or you’ve sawed your arm off, you have a certain range of therapy you must seek in a finite range of time. This speaks to acuity and profundity of the symptoms rather than their source, however. We know that surgical, pharmacological and electrical interventions are often nearly as  damaging as they are helpful: that’s why we approach, prescribe and consume with great caution. Only when the gain in quality strongly outweighs the loss in trauma and side effects is it wise to engage. In extreme and emergent situations, the gain of life over probable death or profound loss of function justifies using tools that operate rather immediately on a gross level instead of ones that cause change slowly while operating on processes that are less concentrated and longer range tests are required to detect.

As a yoga teacher (were you wondering what all this had to do with that? ;>), the basis of my practice is that breath, body and mind are different ways of referring to the same experience. The experience accessed through sensation, breath, feeling and thought is that of “me:” my identity, history, person, singularity or unity. In Western Philosophy, the fallacy represented by option two above (originating from a different mechanism) is called “The Mind-Body Problem.” It’s only a problem if you think they’re distinct. We can have useful discussions about whether one causes the other, or if one is created by but has no causative force on the other (epiphenomenalism), or if they are identical, but if you begin with an assumption that they’re different in kind, you land in a briar patch that no one in the history of philosophy – in East or West – has ever escaped.

Once you’ve accepted that all well-being and dis-ease have both molecular and emotional (which also have molecular) effects, it’s easier to see that just like cardiac health, mental health is a continuum. And the lifestyle choices we make that increase our well-being on one continuum, are likely to have effects on the other – whether those lifestyle choices are pharmacological, exercise or nutrition choices.

Would we lose anything by ditching the “mental” distinction for psychological specialty symptoms? Nothing except a freakishly outdated notion that ideas are caused by ideas which somehow magically skip concourse with our bodies and directly change our emotions… which are, er… um… wow, this could be embarrassing to admit, huh? Embodied. It’s one thing. Your mind and your body are different ways of relating the one irreplaceable experience of you, and your health is singularly important. All of it. All of you.

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