A bet on a possible “beyond” in mental health: singularity

What would that be? beyond the stigmas, labels and trends of so-called “mental health”?

First, consider the WHO term ‘mental health’: ‘a state of well-being in which each individual develops his or her potential, can cope with the stresses of life, can work productively and successfully, and can bring something to his community. This appears in the speeches of the WHO as a point that organizes and ranks what would be well-being and good living in the order of the logic of the universal, for everyone.

The constant repetition in the media of this proposition undermines the idea that “mental health” has a coherent and obvious definition. However, this definition was not rigorousbut it appears rather on the side of the ideal and as an operator of the functions that flow from it.

An incomplete way of understanding mental health

It was René Leriche who brought into play the classic definition of health from the medical side: “health is life in the silence of the organs”. It is this definition of the word “health” which has effects in the field of the psyche and the social – covering the public, the institutional, the governmental – and it is from there that it draws its primary function. The main effect has been the construction of the public health field as the function that is in charge of eradicating all these ways of experiencing psychological discomfortto silence them.

At the same time, one could argue that there would be a diseased organ as the cause of psychic suffering -just ground for the positioning of neurosciences and medicalization-.

Let’s add another effect. Anything that does not fit the definition of mental health will be considered something that, by definition, will not be healthy. This is where the articulation with the great vademecum, books and manuals with lists of signs is presented in a descriptive logic that identifies and forms fields of pathological images.

The social implications of this perspective

Diagnosis appears as the great classification label for disorders and diseases -terms also imported from medicine- which group together a series of traits that make it possible to establish a clinical picture with a scientific basis, that is to say under a positive model. The ICD-11 and DSM-5 have a history in the classification of mental illnesses thus defined. And, finally, they are the ones who guide public health policies – the big trend in mental health – and the implementation of universal care protocols based on the established diagnosis.

An example

Owen is an autistic boy. His parents recount the difficulties they had in relation to their son since, from an early age, he began to show all the signs of an autism spectrum disorder. His son’s lack of language was the main difficulty in being able to establish a relationship with him.

His parents began to lose hope that their son could access speech after trying universal methods and protocols applied unsuccessfully as a treatment for his son. Owen’s father relates that, on Owen’s brother Walt’s ninth birthday, he and his wife threw him a small party with their classmates. When the party is over, the children leave and Walt remains seated at a table with a look of tristeza.

Owen sees this scene and goes to the kitchen where his parents were. He stands in front of them and suddenly, out of nowhere, he says, “Walter doesn’t want to grow up like Mowgli or Peter Pan.” The parents are amazed. It was the first time they had heard his son speak. His father says it was not just any sentence, but a complex sentence, of complex thought that showed that there was much more to Owen than mere observation could detect. And there, his father realizes something: son Owen uses phrases from Disney movies to understand the world in which he lives

That night, Owen’s father comes to Owen’s room. He notices his son is sitting on his leg with a Disney book in his hands. Next to his leg, on the floor, the father approaches a puppet of Iago – the mascot of the villainous Jafar, characters from the movie Aladdin. He takes it with one hand and covers his head with a sheet so Owen doesn’t see it. This way, only Iago’s puppet appears in Owen’s view. The father begins to imitate Iago’s tone and says to his son when he returns to see him, “Owen, Owen, how does it feel to be you?” Owen responds, “No muy bien porque no tengo amigos.” Owen’s father contains his emotion upon hearing his son speak and stays in character. And he said to Owen, mimicking Iago’s voice, “Good, good. Owen, when did you and I start being such good friends?” And Owen replies, “When I saw Aladdin, you made me laugh.” He has a conversation through Iago for a while. minute. It was the first conversation I had with Owen.

This is when the parents make a bet. their they decide to stop seeing what the specialists who had treated their son considered an obsession -repeatedly watch Walt Disney films- and take it as a tool to be able to communicate with your child. Today’s psychiatry considers these repetitive behaviors and interests to be eliminated. According to the manuals, these behaviors must be eliminated because they isolate the person and do not let him expand his world. It is the universal protocol of a treatment. Parents then decide to implement elements taken from Disney phrases and characters to set up situations in which their child can grasp the words he already knows. Little by little, your son begins to acquire vocabulary.

Moreover, it begins to emerge from what is classically called “autistic encapsulation”. His parents realize that these “obsessions” for the words, the phrases of the Disney films constitute one of Owen’s most singular passions. Thus, they transform them into tools with which your child can invent a medium of their own, tailor-made, with which to communicate and establish a social connection with the people around them. It was the singularity of Owen’s interests that brought him out of his autistic confinement.


This little story of a case of autism has educational value for a professional in the field of mental health. It is in this small vignette that we can underline what is lost in universal definitions and which is often excluded from clinical practice: the uniqueness of the person who is there as a patient. This is where the horizon of a “beyond” mental health appears, the horizon where stigmas fade, labels disappear and respect for the uniqueness of each patient emerges.

It is a question of materializing in clinical practice the attachment to the singularity of the case at the very heart of its foundation. And it is not a mere formalization or case tool. This is a daily ethic with our patients.

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