Freedom to Change: Examining the Extreme Perspectives of Mental Illness

Existential therapists frequently encounter the ultimate questions of freedom and change, deliberating on how much of each is actually possible. The clients who see them often find themselves trapped between two opposing world-views: one is the philosophical, based on the belief, espoused by existential philosopher Jean-Paul Sartre, that humans are responsible for their own destinies, and the other is the pseudo-scientific, mainstream one, which posits that individuals struggling with mental illness can’t help themselves.

Both constitute extreme perspectives, which tend to be held by conservatives and liberals, respectively. In the sphere of social, economic, and mental health challenges, conservatives have a “pick himself up by the bootstrap” mentality, which minimizes, or even negates, environmental effects and biological/psychological constraints. To them, man is essentially nothing but pure free-will; all he has to do is want something badly enough and then somehow create the inner-drive to achieve it: that simple.

Liberals, on the other hand, tend to take a more scientific approach to humanity’s plight, conceiving of mental illness in its proper context of genetic and environmental influence, accepting man’s inevitable, existential limitations, which have always been a part of his existence. Unfortunately, whereas, conservatives tend to be too optimistic about the resilience, liberals are too pessimistic, infantilizing those struggling with mental illness and precluding them from psychological development.

The biological and sociological models of mental illness merely (and I don’t mean to devalue their significance) explain the roots of our ailments, without exploring the possibility of individual growth. Because a model explains how something arises doesn’t mean that it proves a predetermined existence. If that were the case, psychotherapy, or any form of self-exploration and improvement, would become irreverent and obsolete. Thus, the tug of war between both sides seems silly; in a sense, both of them are right. As with most aspects of life, the answer is to be found within the middle.

Interestingly, although it seemed that Sartre was terrified of freedom, some part of him had to have also longed for its existence. For, what was so evident to his colleague and partner, Simone de Beauvoir, eluded him. Dr. Skye Cleary writes:

For Beauvoir, we are free, but we are also thrown into contexts where we don’t always have the freedom to choose. This is very different from Jean-Paul Sartre’s emphasis on radical freedom; by his lights, any attempt to blame our situation for our predicament is a denial of freedom – a form of bad faith… This is where Beauvoir’s nuanced point about situation reaches its climax. Yes, we’re free, but it is always freedom in situation. Our freedom is violated when we’re in situations that close down the possibility of choosing into an open future. Those who are stuck in ignorance or oppressive situations are robbed of their freedom.

His dichotomous thinking pervades present-day conservative desires: we want there to be a divine plan, yet also wish to be free. And with respect to mental illness, we prefer to think of it as an obstacle rather than an immovable object, which can be incredibly helpful, but within reason. The conservative side fails in its unwillingness to acknowledge the hardship involved in becoming healthy, refusing to accept that one can’t just want to want to get better and then instantly heal; life will not allow it! As much as Sartre’s suck it up attitude can be helpful in moderation, when pushed to its extreme form, it can create irreparable damage by persuading someone that she’s to blame for her emotional state because she refuses to make herself happy.

However, decades of research indicates that mental illness is treatable, and its treatment is predicated on the notion of its malleability, which in itself entails freedom. One can’t simply make oneself happy, but he can take the necessary steps to a healthier life through psychotherapy and psychiatric intervention. So, although man isn’t condemned to freedom, he isn’t condemned to a determined existence, either.

Much like with the nature-nurture debate, which ended with a synthetic understanding of what makes us who we are, the debate around whether or not mental illness is within one’s control ends similarly. Our environments and our genetic compositions dictate our lives to a vast degree, but they can’t take away our freedom to choose how to live, not fully. Our mental ailments are not our faults, but they are our responsibilities; and treatment is often a long, and sometimes brutally difficult, road. Even though we can’t just pick ourselves up when we’re down, like a mixture of Sisyphus and a phoenix, we can begin to push our burdens up a steep and rugged hill until we have transformed ourselves into the archetypal heroes that we read about as children.

Freedom, in the way that Sartre conceived it, isn’t meaningful; for, what’s so special about someone who can easily overcome her struggle? The hero’s journey only becomes significant through the trials placed in front of her, which are often both biological and environmental in their natures. And, that’s what psychotherapy means to me: the exhilaration of witnessing an individual push back against her burden, leaving the shackles and chains of her former self behind. For, like with Sisyphus, they go tumbling down from the mountain top once she reaches its summit, but unlike him, she isn’t ordered to climb back down to retrieve them and begin all over again.

See you all tomorrow.

Buh-bye.