The concept of mental health
Mental health
The concept of mental health refers to a certain emotional and social balance that enables a person to face life's challenges, maintain good relationships and make appropriate decisions. It does not mean that a person doesn’t have any problems, but rather that they have the ability to handle them in a healthy way. But what do we mean by “healthy”, “good” and “appropriate”? That is certainly a complex question.
Jacques-Alain Miller points out that the concept of mental health is defined by public order. When mental health is lost, then that order has been disturbed. Who determines what is healthy, good and appropriate is thus the public order: mental health workers, whether they are physicians, psychiatrists, clinical psychologists or social workers. Their goal is to reintegrate people into the social community so that they share similar standards of what is good and appropriate.
The DSM - 5
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) is a guide used by mental health workers to diagnose and classify psychological disorders. The DSM-5 sets out what is understood as more or less acceptable for each ailment or condition vis-à-vis public order.
Psychoanalysis and mental health
Psychoanalysts do not use any manual or guide to classify disorders. Nor do they provide services to improve mental health, since they are not mental health workers.
What psychoanalysts do is support the subject in their desire so they can work on their symptoms, whatever these may be. As a starting point, the analyst assumes that each patient is a little bit “unhealthy” with respect to any general category that may be applied to them.
This does not imply, however, that psychoanalytic treatment does not have a curative goal. Psychoanalysis has therapeutic effects. However, these are not produced by making the subject fit into a certain pattern of normality, but rather by employing what precisely does not fit as an orientation. This is what is most unique, precious and valuable in each patient who comes for a consultation. Furthermore, beyond mental aspects, psychoanalysis also considers the jouissance (enjoyment) of the body and the flesh, which condition the former, driving it a bit mad and leading the mind astray.
As Miller says, psychoanalysts don’t keep watch over their patients’ mental health, instead they welcome them as soon as they come through the door.