The performance "Homo", by Melania Olcina Yuguero. Photo: Juan Carlos Toledo

Forty years ago we started to popularize a new conception of mental disorders understood as syndromes (superimposed pathological signs), which disturb psychic functions (such as cognition, memory or will), associated with social dysfunctions (damage to the sphere of love, work and learning). . Reactions in line with cultural expectations, for example, in the face of events such as loss and bereavement, as well as political, religious and sexual behavior are not considered mental disorders. The reader may have noticed that this definition makes no reference to causality or suffering as criteria for saying that we are facing a disorder. This idea that disorders are statistical conventions helps to understand why between 1968 and 2015 we discovered 115 new mental disorders. The idea that mental illnesses are basically brain diseases, derived from the absence or reduction of neurotransmitters, such as serotonin or dopamine, which can be replaced with the correct medication, has tacitly infiltrated popular discourse. Gradually we got used to this theory of mental disorder as a kind of cerebral diabetes, a chronic disease that requires permanent medication, that has a genetic origin, that requires control and a certain education or food or body discipline. A sister theory was that chemical dependence requires a war on drugs and the discipline of abstinence, as illegal psychoactive substances generate brain dependence.   

The neuroscience findings are incredible and advance the understanding of behavior and emotion determinations. There is nothing wrong with them and no psychotherapeutic theory that would be justified should be indifferent to them. It so happens that along with the mental diabetes theory came a tremendously pernicious side effect: the view that mental illness is indifferent to how we talk about it. For this theory, the way we interpret and link the appearance of symptoms with our life, past or future, is nothing more than an epiphenomenon without etiological value. The theory of brain causes, ideologically exaggerated, gradually began to mock everything that was related to the subject's way of life, understood as a unity between language, desire and work, as a Freudian, anti-scientific heritage, dependent on the belief in conflicts. and other moral dispositions based on good faith and willpower. The discourse that differentially interpreted certain symptoms to the detriment of others (depression instead of mania, for example), the suffering narratives of the community or family members with whom one lives, the patient’s own version, his “place of speech” in the face of the disorder, have become epiphenomena that do not change the route of what we should do: educational correction of distorted thoughts and exact medication.

Forty years later, we woke up in the midst of a global mental health crisis, with rising suicide rates, massive medicalization, prescribed by non-psychiatrists and insufficient human resources or theoretical and clinical equipment to face the problem. This is the cost of disregarding culture as an instance that generates language mediations necessary for us to face suffering before it evolves into the formation of symptoms. This is the disservice of those who imagine that theater, literature, cinema and dance are for ideological and accessory entertainment, as the expansion and diversity of our cultural experience were not the central point to develop listening skills and protective skills in mental health. As if they didn't teach us how to suffer and reciprocally how to deal with suffering in the collective and individual context of caring for the self. The impoverishment of the ability to tell their own story, to understand the logic of their conflicts, to name the recurrence of their discomfort is not just a loss for the wealth of the spirit or for the formation of more sensitive personalities, it is an arrogant contempt. and an unreasonable waste of elementary means of basic mental health prophylaxis.


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