From Chemical Imbalance to Power Imbalance: A Macropsychology Perspective on Mental Health

We need radically to change how we think about mental health and psychological well-being. The idea that our more distressing emotions are nothing more than the symptoms of physical disease, which can then be treated like any other medical pathology, is pervasive and seductive. But it is also profoundly flawed, scientifically incorrect, unhelpful and, ultimately, inhumane. To find a solution to the very real problems facing our mental health services – and, of course, the people who use them – we must move away from the ‘disease model’, which assumes that emotional distress is merely a symptom of biological illness, and instead embrace a psychological and social approach to mental health and well-being. We should stop thinking about ‘abnormality’, ‘disorder’ and ‘illness’ and instead offer humane and effective responses to what are understandable and normal psychological reactions. We should therefore replace ‘diagnoses’ with straightforward descriptions of our problems, radically reduce use of medication and use it pragmatically rather than presenting it as a ‘cure’. Instead, we need to understand how each one of us has learned to make sense of the world and tailor help to our unique and complex needs. We need to offer care rather than coercion; to fight for social justice, equity and fundamental human rights; and to establish the social prerequisites for genuine mental health and well-being. This would frame mental health – our psychological well-being – as a social and psychological, not medical, phenomenon. And this is a macropsychological perspective; it would also place our psychological well-being, rightly, in the context of politics, social justice, equity and human rights.