“In a world in which the self is constructed psychologically and in which the therapeutic is the ethical ideal, we should therefore expect the notion of good and bad, of what is appropriate and inappropriate behavior, to change accordingly.”– CARL TRUEMAN
During a panel discussion in October, Health Minister Ong Ye Kung said that youth mental health is an issue which “preoccupies” the Ministry of Health. Citing data from the World Health Organization and other data around the world, the Minister said that “we are seeing a higher incidence of mental health issues among young people”.
The impact of social media on youth mental health has also come under the spotlight with the Wall Street Journal’s recent revelation of Facebook’s internal research regarding the impact of Instagram on the mental health of teenage girls. Facebook has pushed back against the “mischaracterization” of the research, and argued that teenagers “report having both positive and negative experiences with social media”.
The issue of mental health does not just affect teenagers. Among those aged 18 years and above, a 2016 study by the Institute of Mental Health (IMH) (published in December 2018) found that 1 in 7 people in Singapore has experienced a mood, anxiety or alcohol use disorder in their lifetime. Compared with 2010 data, it found an increase in lifetime prevalence of mental illness from 12% to 13.9%.
The COVID-19 pandemic and its effects on the lives and livelihoods of people around the world have complicated the mental health landscape further. IMH found that between May 2020 and June 2021, about 13% of the general population reported experiencing depression or anxiety symptoms.
While increasing focus on mental health is generally welcome, we look at the possible excesses of its hype.
Can Focusing on Mental Health Ever Go Wrong?
The WHO defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.”
It is an essential component of a person’s overall health, and seeking to improve mental health through service interventions, community awareness and communal empathy is certainly a good thing.
However, we find the truism – too much of a good thing can be a bad thing – applicable here. An excessive and exclusive focus on mental health may be harmful to human flourishing in the long run, and overprotectiveness over matters of mental health may actually be counterproductive.
Human flourishing – and thus, ‘health’ in its fullest sense – is comprised of reaching the fullest potential in not just mental health, but all other aspects of a person’s physical, emotional, and spiritual make-up as well. Human beings are, after all, more than just their feelings or their mental faculties.
On the other hand, perspectives that focus excessively or exclusively on mental health risk promoting a reductionist view of human nature. These perspectives regard human beings as almost entirely comprised of the psychological ‘self’. In this paradigm of the elevated psychological ‘self’, human flourishing becomes preconditioned on a person feeling good, whereas making a person feel ‘bad’ is not just unpleasant, but perceived as deeply harmful and an attack against the person.
Carl Trueman writes in his book, The Rise and Triumph of the Modern Self: Cultural Amnesia, Expressive Individualism, and the Road to Sexual Revolution:
“In a world in which the self is constructed psychologically and in which the therapeutic is the ethical ideal, we should therefore expect the notion of good and bad, of what is appropriate and inappropriate behavior, to change accordingly. The notion of assault on the person comes not simply – or even perhaps primarily – a matter that involves damage to the body or to property; it becomes psychological, something that damages the inner self or hinders that sense of psychological well-being that lies at the heart of the therapeutic.”
Psychologising ‘Self’, and Politicising Identity
Once the identity (or the ‘self’) is psychologised, mental health is thrust into the world of fractious identity politics.
Political theorist Francis Fukuyama wrote about the “triumph of the therapeutic” within America and other liberal democracies in a recent book “Identity: Contemporary Identity Politics and the Struggle for Recognition“. The rise of this therapeutic model – where individual happiness depends on self-esteem, which is the by-product of recognition – “midwifed the birth of modern identity politics,” the struggle for the recognition of dignity in advanced liberal democracies. The result is the politicisation of mental health in the context of debates and divisions over right and wrong, good and evil, oppressor and oppressed, or culprit and victim.
Unfortunately, this mindset has manifested in Singapore in the discourse on identity. In a December 2020 opinion piece published in the Straits Times, the writer called racial stereotypes a form of “violence”. He argued that this was because stereotypes “damage and destroy what is integral yet invisible to the person – the sense of personality and self, of complexity and individuality”. This is certainly an esoteric definition of “violence”, which typically requires physical force, rather than harm to a person’s “invisible” sense of self and individuality. (See the previous Regardless article, “Speaking of Race, and Violence”)
Beyond race, sexuality and gender have been couched and politicised in terms of mental health. For this, we need look no further than two incidents that happened over the course of the past year.
Beyond the details of the incident, undergirding gender identity discourse is precisely this view that sees the ‘self’ in exclusively psychological terms – a radical departure from the hitherto commonplace understanding that the ‘self’ is a composite of body and soul.
The statement, “I am a man trapped in a woman’s body” is a profoundly metaphysical, even religious assertion that believes that the true ‘self’ is a disembodied mind, soul or spirit, whereas the body is merely a shell, cage or prison that traps the true ‘self’ within. Under this new anthropology, ‘transitioning sex’ is only appropriate because it seeks to align the person’s body to that person’s ‘true’ gender identity, thus promoting the person’s wellbeing.
This philosophy is evident from the “Statement of Support for Transgender Students”, apparently signed by various individuals identifying themselves as “Teachers, Counsellors, Social Workers, Community & Youth Workers in Singapore”. The Statement cited “evidence” that “transgender youths face higher risks of depression and suicide when prevented from transitioning”, and called upon schools to refrain from interference with gender transition (either to withhold or hasten them). The Statement added, among other things, that: “As an act of care and respect, school leaders and staff should make efforts to respect the expressed gender of students who have trusted us enough to share their transgender identities.”
Likewise, on 30 June, the Singapore Psychological Society (SPS) forayed into the political when it criticised “conversion therapy” as “ineffective and harmful” in its post on social media. The caption to the post fully embraced the psychological ‘self’, and reads:
“As Pride Month draws to a close, SPS stands with every single person for their deepest “self” (ie who they deeply experience and identify themselves as) — and in particular, we honour the LGBTQ+ population who have suffered deeply, and who we deeply cherish just as they are.”
In the face of criticism, the SPS subsequently clarified in a statement that its “recommendation” only “applies to psychological practice in the treatment of our clients”, and the statement “does not seek to have any bearing over political or religious beliefs and practices”.
Potentially Harmful and Counterproductive
The kind of emotional reasoning – “I feel it, therefore it must be true” – embodied in much of the perspectives discussed above is ironically damaging to mental health and counterproductive, as the insight from the field of cognitive behavioural therapy (CBT) has shown. In short, CBT teaches that thoughts can shape feelings. Negative thoughts can shape negative feelings, and vice versa, to create a feedback loop of negativity that traps people in cycles of depression and anxiety. The reverse is also true.
Regardless of which side of the aisle one finds themselves on, characterising disagreement as psychological harm or branding political opponents as malicious enemies is a cognitive distortion that promotes greater feelings of negativity.
At times individuals may resort to such tribalistic behaviour, motivated by good intentions to protect mentally vulnerable persons. However, this may easily venture into a kind of overprotectiveness that is counterproductive and causes greater harm to mental health in the long run.
Apart from reducing human beings to their feelings or desires, the views above assume that anything that makes a person feel bad is wrong, immoral and harmful. In so doing, they effectively divide the world into a simplistic “us” (the good guys) versus “them” (the bad guys) on the basis of whether or not they affirm a person’s subjective sense of ‘self’ or identity.
Such thinking could easily usher in forms of political polarisation that have divided many societies elsewhere. As Greg Lukianoff and Jonathan Haidt wrote in their 2015 article, “The Coddling of the American Mind”:
“When the ideas, values, and speech of the other side are seen not just as wrong but as willfully aggressive toward innocent victims, it is hard to imagine the kind of mutual respect, negotiation, and compromise that are needed to make politics a positive-sum game.”
In February, then-Education Minister Lawrence Wong similarly foresaw this eventuality in the midst of the debate over the allegations brought by the transgender student against MOE. Rightfully, he cautioned that “gender identities have become bitterly contested sources of division in the culture wars in some Western societies”, and that “We should not import these culture wars into Singapore, or allow issues of gender identity to divide our society.”
A Better Way Forward: Mental Resilience
In the midst of the challenges to mental health, the temptation to coddle and overprotect – beyond legitimate care and comfort – is strong, but wrong. That temptation must be resisted. It is the societal equivalent of “helicopter parenting”, an unhealthy practice where parents swoop in to save their children from any kind of discomfort they might experience in life. This deprives the child of meaningful opportunities to develop the skills and abilities to face real challenges when they come.
Instead, what might a better way forward be?
We think it might be found in mental resilience.
An analogy from the arena of physical health might be useful here. When you fall sick and recover, your body develops a certain degree of immunity against that virus, developing antibodies and becoming more resilient against that virus. Vaccines are based on a similar logic, exposing your body to a weaker version of the virus in order to trigger an immune response.
Or in the words of Nietzsche, (and of Kelly Clarkson who sang years later), “What doesn’t kill you, makes you stronger.”
The same principles apply in the context of mental health.
Exposure to moderate levels of stress, anxiety, disagreements and conflict, and learning to resolve or overcome them can help to strengthen resilience or “immunity” to the mental health challenges that these present, apart from other benefits to personal growth. Over time, through increasing levels of exposure appropriate to the age and maturity of the individual, an individual can develop essential skills to thrive even under the most challenging of circumstances. It is a virtuous cycle.
Positive values and belief systems are also essential, such as perseverance, charity, compassion and integrity. As CBT teaches, one must avoid and reject cognitive distortions, such as emotional reasoning (“I feel, therefore it must be true”), catastrophising (“It is the end”), and overgeneralising (“I always fail”). It also includes rejecting the temptation to demonise others who disagree, or simplistic “us versus them” thinking.
On a governmental or societal level, a proper balance must be struck between stability and freedom. Government and society should not play “helicopter parent” to suppress each and every claimed form of risk to mental health, but should ensure a minimum level of stability, safety and security according to the societal context. To fail to do so would lead to the weaponisation of mental health as the one claim to rule them all. To that end, mental health professionals themselves ought not allow themselves to be made use of for ideological purposes.
Since the family is the basic building block of society, part of that stability must rest in having stable family units so that children can grow up in an environment of happiness, love, safety and understanding. It is, ultimately this bastion that gives children the freedom to explore the world while knowing that they a have a safe haven to return to in times of difficulty.