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What is meant by "Non-Organic Mental Illness"? - by Malcolm Bowden

One of the most frequent criticisms made about the book "Breakdowns are good for you" (BAGFY) is the unacceptability that all "mental illnesses" are due to behavioural problems and are not a medical condition. It is generally felt that there must be some cases where a medical condition exists in order to explain a person's strange behaviour.

This aspect was considered in BAGFY but it seems that further clarification is called for - hence this paper. I will first examine the various categories that mental illnesses are usually classified under, and then describe precisely what we mean by "non-organic mental illness".

THE VARIOUS FORMS OF "MENTAL ILLNESS"

A. MEDICAL/ORGANIC CONDITIONS

(1) Brain Damage

This can easily be seen in those who have been involved in an accident that has physically damaged part of their brain. They may be unable to speak, move or think properly, from mild to severe cases.

(2) Strokes and birth problems.

The brain has been deprived of blood for a period such that in one or more sections the cells have died. In general, if the area is large, the cells do not usually replicate fully, and that part of the brain is effectively dead. However, such is the flexibility of the brain that other sections can be retrained to take over some or many of the functions that were performed by the dead section.

(3) Congenital maladies

The person is born with a brain that is malfunctioning. The most obvious example is that of Downe's syndrome babies, but spastics and other cases are well catalogued.

(4) Drug effects

There is no doubt that the brain is affected by drugs

(i) those prescribed by doctors which we will call medical drugs, and

(ii) those taken for "pleasure"; the illegal drugs such as heroin etc.

In the first case, few, if any, actually effect a "cure", such that after a course of such drugs, the patient can then stop them and thereafter be free of any symptoms. Usually, they are taken for very long periods and many for the rest of the patient's life. Such results can hardly be claimed as a "cure". They appear to act by simply deadening the patient's sensitivity in a specific area of his life, rather than "putting things right" in the brain.

There may be a case for prescribing anti-depressants for someone in deep depression such that they do not even communicate with others. Even this needs some examination in depth.

Regarding the second, what is more important is not the effects of the drugs, but the behavioural/mental attitude/peer culture of the person who felt so inadequate that he was prepared to take drugs. In BAGFY, (p. 135-8) Bill Gordon - an ex drug addict - points to the excitement and risk that they crave, which mundane living does not provide. Thus, it is a social weakness that is the root of their problem - not the drugs themselves. This is where counselling becomes important - which is most certainly dealing with a non-organic cause.

In summary - the organic/medical causes for mental states can be very easily diagnosed, even by laymen. All the above conditions are medical conditions about which there is no dispute. It is the blurring of such cases with those "mental illnesses" that we contend are NOT basically due to an organic malfunctioning.

B. NON MEDICAL CAUSES.

We would consider that those conditions that can be fully cured by good counselling - and there are many - CANNOT be due to a medical/organic condition. The counselling does not in the least way affect any part of the brain that is truly malfunctioning only the thought processes that go on inside what is basically a reasonably functioning brain. Counselling to change attitudes is an entirely non-organic process, and this distinction must be kept very clear in the reader's mind at all times. It is continually being made into a "grey area" and fudged to have it classified as a mental ILLNESS - i.e. as if it were organic in nature and therefore a medical condition requiring the expertise of a doctor (psychiatrist).

Once this distinction is kept clear, articles on the subject which slide ( a word deliberately chosen) from one approach (medical) to the second (counselling) can then be seen for what they are - moving the goal posts so that what are stated to be a medical condition are later treated by counselling, so that the latter is still assumed to be under the jurisdiction of the former.

A classic case of this is in an article on depression by a Christian psychiatrist, that appeared in the Evangelical Times (March 2003 p.17). In the second paragraph he reports a woman who said "Why didn't you tell me it was a physical illness?" and gives a few other examples. But by the fifth paragraph, he admits that it might be "perhaps even a personality disorder." and later admits "But when a person seems to be using depression to avoid clear Christian duties, what can be done?" So, we have now moved from medical to personality problems, and there is not the slightest attempt to explain how one can determine the difference between them. The rest of the article is on these non-medical lines only - cognitive behaviour therapy being suggested etc.

The cases we would consider to be non-organic range from tension (which we all experience), mild anxiety through depression and the "final" (and most challenging) example being schizophrenia. We deal very extensively with both these last two in BAGFY and will not repeat it all here. Suffice it to say that we give extensive evidence that people behaving in a schizophrenic manner (a carefully chosen phrase) have been fully cured in three separate American institutions without any recourse to drugs or any medical treatment whatsoever. These results were all entirely by training the people to take responsibility for their actions All these successful examples have been deliberately ignored by the psychiatric profession and correspondence with them reveals actual (or more likely feigned) ignorance of these proven cases. It is little wonder that BAGFY has been strongly opposed by orthodox Christian journals etc, as they undoubtedly have Christian psychiatrist friends to whom they turn for advice and reviews of BAGFY on this "specialist" subject.

We would also reaffirm that NO medical cause of schizophrenia has ever been discovered - only possible "links".

One area that there has always been seen as potentially providing a much needed cause of mental illness is that of genetics. Studies have shown that there is a tendency for certain psychiatric conditions to have a genetic "link", but they only demonstrate a "tendency". On 18 July 2003 in "Science" (p. 386-9 v301) a paper showed a link between two variations of a gene and depression. This was seized upon by popular newspapers and journals (e.g. New Scientist 26 July 2003 p.15) that implied that depression was largely due to a genetic condition.

However, a close examination of this paper (See separate article by this author "A Gene Link to Depression? - An Examination" - the next page on this website) showed that the gene was far from determining a person's reaction to problems. In fact, at low levels of incidents, the correlation was reversed. This was not even commented upon in the paper, which suggests that they ignored anything that would contradict the general desire to find a gene that "caused" depression. Any such "proof" that would exonerate their clients from guilt and responsibility is greatly longed for in the mental health and social services professions. The word "guilt" is regarded with absolute horror by the secular authorities, closely allied as it is with the Christian teaching they deeply despise.

This avoidance of responsibility is graphically described by Theodore Dalrymple in his book "Life at the Bottom: The Worldview that makes the Underclass." (Pub; Ivan R. Dee Chicago 2001). Dalrymple is a doctor in a London slum and works in a large hospital and a local prison. He is not dealing with "mental problems" as such, but all that he says fully supports our contention that many people deliberately use the "mental illness" cover to avoid working and taking responsibility for their lives - often very violent and criminal. He describes the way in which the public services aid and abet this approach which is a scandal in itself.

In summary - ALL those cases that can be cured by counselling alone are clearly non-medical and non-organic. It is essential to keep these two separate groups apart. Ultimately, the medical profession CANNOT deal MEDICALLY with problems that are due to antisocial behaviour, as the vast majority of cases that come for counselling require. Many involve marital and social breakdowns, and where is the medical or organic component of that? For those who still claim they do have a "medical" condition, are they accepting it and dealing with it in a mature Christian way - or using it to excuse their behaviour?

M. Bowden.

9 September 2003


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