For an evolutionary conceptualization of Mental Health

Abstract

The epistemological problem of the demarcation criterion (between what is and is not a mental illness), far from being an esoteric one, is one of the most central and fundamental problems of Psychopathology. Throughout a bumpy and time-consuming course of millennia of documented history, various forms of conceptualizing illness and mental illness succeeded each other, from the supernatural tradition up to, in the specific case of the latter, the ubiquitous DSM, nowadays imposed as the official classification of psychiatric disorders. However, no form has so far been truly satisfactory for the discrimination and characterization of such disorders. Not even the DSM, after all a kind of glossary built on statistically validated consensus, which in essence translates the leadership (or even the hegemonic power) of American pragmatism into Psychiatry and Psychology, and which in founded on debatable assumptions, in particularly the assumption that the different diagnostic entities it defines have a natural and universal underlying reality.

It is necessary to continue the journey. A journey initiated by Karl Jaspers, regarding the understanding (and not a mere description) of the phenomena in question. A journey that will only make sense if we seek to better understand the natural realities that may exist, when they exist, underlying psychiatric disorders; and also seeking at the same time to recognize what parts of the definitions of such disorders are culturally defined; and finally also trying to articulate the different orders of factors (natural and social) that, together, will form a new conceptualization of illness and mental illness. That is, looking, on the one hand, to know the natural functioning of the psychological mechanisms, such as have been “programmed” or “designed” by the evolution of our species; on the other hand, looking to know which environmental conditions (social, cultural, etc.) trigger those necessarily contextual mechanisms in a dysfunctional manner; and finally, incorporating this knowledge into the cultural values that have defined, over the centuries and civilizations, deviant behaviors that are considered to be mental illness. Such a conceptualization, of an evolutionary nature, may finally bring a solution to the fundamental problem of defining demarcation criteria (between what is and what is not a mental illness) that will allow us to find adequate and satisfactory explanations for understanding of the psychiatric phenomena.