Mental Health Philosophy: You are mattering

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Mental Health, Mental Health Philosophy, Philosophy, Psychology

Understanding Mental Disorders

May 18, 2026

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How do we understand Mental Disorder?

Psychology, Rationality, and Mental Health Explained

How We Understand Mental Disorders

It might seem obvious now, but what we take as evident and maybe even self-evident, this view upon ourselves and others, is not so sure. It seems likely then that when we are suffering mentally, the issue is that we are having the experiencing of being not sure, and often having various reactions to that uncomfortable state.

This post is getting into the idea and the substance of mental issues. We’re getting into something different than the quick fix; this isn’t “ways to manage your mental disorder”. This is more about what is actually happening.

By the way, as the whole of my mental health posts will attest, this blog discusses the conditions that must be met if indeed we are involved with mental health, which can help a person overcome their issues.

However, the comments and discussion in this post and my blog in general are not intended to treat any mental issue. Please reach out to a mental health professional if you are in crisis or are seeking help.

If you live in Colorado, you can reach out to me at agencymatters.org.

Orientation and the Nature of Mental Health

The maxim of mental health is this: if a person can become aware of what is actually happening, then they will naturally be able to solve their own problem.

This is factual, not theoretical. It is a matter of how we understand the situation of ourselves. In other words, when we are managing our mental health symptoms, we are effectively solving our own problem because we have understood what the issue is. The question is not about opinions, but is more about how we are oriented upon things.

In this way, orientation concerns mental health, wherein psychology gains its focus upon problems. This is not to say that mental health is positive and negative, that one is better than the other or one is right and the other is wrong. Such orientation upon things misses the mental health itself, as I say, the object of mental health, for the sake of being subject to the modern world. This is mental health: that psychology works to miss what is happening to be more concerned with how the problem appears. It is not wrong or bad necessarily; it simply presents the condition of mental health.

What are mental disorders?

Today we are getting into mental disorders.

There is a basic experiential issue has been around since the beginning of modern psychology. It is not simply how to identify a specific mental issue. The more precise rendering of this is what is the threshold at which a psychological problem becomes able to be pronounced?

At first glance, it might seem that a history of science might be the first place to look, or a critical philosophical archeology. Nonetheless, when being involved with mental health and issues, the very first place we look is the person herself. We couple that with the question of why would a person identify their experience as problematic? And this means the manner by which the experience of the person is informing the themselves that there is a problem that they cannot overcome.

The Medical Model of Psychology and Mental Health

This is where mental health diverges from the psychological version. Psychology assumes there are common problems, disorders and diseases that exist which afflict a person’s mind that have the same nosological quality as physical problems. The person is experiencing a phenomenon that appears to exist through human beings in general, rather than a problem that the person itself is experiencing. In the realm of mental health, us clinicians, we call this the medical model. There are multitudinous problems with the medical model for mental health which I won’t get into here (check out some of my earlier posts).

Much of my effort as a clinician (from a philosophical stand point, not a specifically interventional standpoint) it to disrupt the belief in the medical model, but not in the way that the medical model approves of, which is to argue about why it is failing or bad.

The medical model does not approve of (at least) not strongly implying that something is wrong or bad, so this in itself offends modern medicine. My discussion of mental health in my posts, papers, and books, take to approach that arguing against psychology merely reifies that psychology is accurate; indeed, this kind of argument is the source, foundation, and teleology of psychology. Mental health does not participate in psychological problems in this specific way because it tends to aim toward a contradiction of hopelessness. Mental health is more correctly so because it aligned definitionally and in by the facts with what we actually do in contrast to what we hope or wish what we do is aligned with, whereby it is more accurate to say that the problems participate in mental health. Mental disorders are part of mental health because to be focused and oriented upon the problems of mental issues compromise mental health itself. Mental health is less a result of fixing a mental issue than what is happening in that we are dealing with a mental problem.

We find this repeated in history.

Addiction, Alcoholism, and the Origins of Modern Therapy

There is a great example of the problem of what constitutes a medical disease around addiction. For a very long time, doctors thought that alcoholism (and addiction) was a disease, but they could never figure out how or why is occurs in the physical body. For sure there was a problem because everyone around the person was complaining of it. But no one really knew what to do about it. Prior to the early 20^th century, all they really could do was lock them up away from alcohol, talk to them, try some things, give them belladonna and other chemicals, shock them with electricity, and so forth, let them go, and hope —which is pretty much what we still do, but with (hopefully) a little more confidence about effective remedies. But no one had any idea just what the problem actually was, why these people could not stay away from drink, nor why they went back to it.

Necessity is the mother of invention and people had to get creative.

In the early 20^th century, the organization we know as Alcoholic Anonymous came up with the best version of help for the time, which remains a widely accepted standard for a why and how of addiction. Many doctors even back then pondered that there was some sort of moral component, or moral failure, that was occurring for these people. However unsatisfactory this might seem to scientists, though, basically the idea was that people suffering from alcoholism didn’t want to stop because of some underlying pathology that had to do with interacting with other people.

The astonishing success of AA’s approach is founded (arguably) in this focus on morality. Founded in the notion of personal powerlessness, their famous 12-Steps says outright and first the solution must be for the person in fact to find a power that will solve their problem, which originally for AA was God. Later, because of the problem with (arguably again) the male-centered, Christian notion of God and its brand of moral imperative of the method to help other alcoholics, the ‘power greater than myself’ morphed into ‘the group of alcoholics’, which is indeed and essentially a power that is not the individual person; the person can vest their interests in gaining power over the drinking problem in the group. AA’s version of the ‘disease’ of alcoholism is one of a failure of moral willpower, and the solution to it is to give up one’s sense of self-righteousness. It has and continues to work very well for many, many people across the world.

One could argue that this was the beginning of therapy as we know it. If Sigmund Freud realized letting a person talk freely about their issues tended to help the person to get over their issue, then we might say that there is no real ‘disease’ beyond the one of how a person finds themselves within a semantic correlation of understanding how a defined problem equates with a defined solution, and we might then take the model of AA and its 12-Steps as the first model for all subsequent theories of intervention generally in this regard.

The effectiveness of AA’s ontological, phenomenological correlation showed us that it doesn’t matter as much what the correlation is but that it should resonate enough with a person sufficiently that the person effectively solves their own problem by thinking a certain way, doing the things, and so on. This is what mental disorders turn upon, namely, the activity of subjective correlations called psychological theories on one hand, and phenomenology on the other.

Carl Rogers and Person-Centered Therapy

The first scientific philosophical organization of this explicit idea was made by Carl Rojers. Before his breakthrough, psychological help for mental issues was still firmly in the medical-physical model, which included institutionalization, coercive treatments, and moralized diagnosis. Instead of back-linking the person to a prior science, he linked mental health to the person first, to how their experience is such. Indeed, his person-centered therapy is the foundational teaching for all counseling theories of intervention. Therapeutic help and healing as a return to the non-pathologized state of being human.

…but this does not mean pathology is wrong, even while it could be incorrect in its assumptiomns…

Science, Brain Disease, and Mental Health

This is not to say there is no such things mental disorder or disease, by the way. For the scientific community, at least, the issues of moral will was just begging the question of causality. Science, as a useful method, is never content with simply what works; it is focused on discovering why a method works. It is oddly, though, it does not feel (science, indeed, is supposed to not feel) it should find out why its own method of correlating problem to solution works (My work exposes this larger phenomenological Correlation.). Nonetheless, it has criteria of what constitutes a disease from a medical standpoint. Within this orientation of ontological correlation, one criterion that often holds a lot of weight for the status of a scientifically valid disease is the underlying mechanism. We might say this is gold standard of disease; a physical structure is very good support for the title of ‘disease’. Generally speaking, the rest of the criteria falls into one category, consensus. But the point we are discussing in not about this model per se. Rather it is about how psychology functions and how mental health does not need to meet psychological criteria to be effective, that psychology does indeed meet mental health criterion, which is to say, about what mental disorders actually are.

As to alcoholism, the main point of contention was how to treat people with the problem. There seemed to be no medically viable way of successfully treating it, and it was thought that finding a physical mechanism would help significantly with how to treat it. Whereas prior to the early 21st century the disease idea of alcoholism was mainly about semantic consensus, the big shift and the final validation came when the physical structure was identified: substance disorders are a brain disease (see The Reward Pathway). The issue for us here, though, is that it does not explain how people can suddenly ‘recover’ from the disease. If the addiction disease has something to do with neurological structures and chemistry, then how do people suddenly stop using and have no further problem with controlling their use?

This is one support for why psychology is a part of mental health, rather than the reverse. Simply speaking, mental health recognizes the limits of psychological science while the science does not, and more often limits the way people perceive what is actually happening for a person suffering. Mental disease is a one-direction way of comprehending what is happening, but what is happening is that this one-way of understanding is indeed one that is involved with a number of ways.

The Vagueness of Mental Disease

One hundred and fifty or so years ago learned physicians had difficulty in telling the difference between epilepsyand hysteria. Never mind right now the social commentary on the patriarchal history of the problem that they called hysteria, and for a moment try to set aside what we think we know now. My point is that when we remove the labels that seem so common place and sensible, and step outside out modern medical knowledge of physiology and its one-direction, efficient cause model of why (its ontological apology for its methodological truncation) it is difficult to tell the difference between someone having an epileptic seizure, someone having a panic attack, someone acting ‘crazy’, or yelling and flailing about or saying nonsensical things. It becomes very confusing if you don’t have a ready-made ideal to place upon the instance because the variations of appearance and presentations are near infinite. If we remove the categories through which we are seeing what has already been defined for us to understand and thus see, it just looks like a group of people suffering from the same malady, doing the ‘same thing’, and likely responding to the ‘same thing’, which at root is really just them behaving in a way that makes others feel uncomfortable. We are prone to see ‘insanity’ and ‘reactivity’ where there really is rational adaptation and response, for example.

Nevertheless, for sure categories are helpful and useful. Today we have continued that tradition of labeling, and with the rise of social media, this manner of taking social talk and identifying personal problems has solidified the phenomenological method. Of course, this has always been the case, but now we are able to see if play out right in front of us more overtly than ever before —and we are able to become more privy to the help it can provide as well as the problems it aggravates and multiplies. Its kind of ridiculous; mental health is so prominent in our social discourse that it almost seems like it would be a problem if a person was not working on their mental health. So it seems appropriate that we might want to know what exactly are people doing and what they are encountering when they are working on their mental health.

How example, are people experiencing anxiety? What is that? Is it a physiological state or a mental state? Is it problematic or not? How could we know? What is thus mental disorder I am saying I have?

Anxiety, Rationality, and Irrationality

In the most basic and unsophisticated way, the fundamental issue of how we know if we are experiencing a mental issue occurs at the break between what we typically identify as rational and irrational. In therapy, this is what we are sorting out regardless of the way we talk about it; namely, do I think I am being irrational? Is this a problem? Why? Negative self-self, for example, can be understood as an internal response to not being able to reconcile what I’m thinking with what I think I am supposed to think, which is a different way of saying that I feel that I am being irrational —in whatever way that appears, whether what actions I’m doing or how I think my life is supposed to be, or what have you.

On the other side of it though, is that the problem is not simply that someone is behaving erratically (whether inside or outside) like psychology would want us to believe in its assessment something irrational is happening (even if we contextualize it as a rational response, i.e., that the person is being irrational as a rational response somehow). Psychology is the scientific activity formed out of the reaction of a group of people who did not like this kind of behavior and did not know what to do about it, and the external behavior means that there is an internal problem. The issues is nearly comical if it were not so devastating for the person; psychology is taking the external expression as indicating an internal issue, and this issue is taken to be solvable from something that is outside of the person. Then as well, the person herself is having some sort of problem that is likewise coming now upon a reflection of itself in that the clinician of psychologist is telling the person if not simply reifying the problem by the fact that such a clinician exists, that they have an internal problem. The person is left with a problem where the only solution is to not have to be responsible for their condition. Indeed, so much of psychological science is based on the establishment of that agential condition of helplessness; even while the person is able to help themselves, they can only do it by— do I hear echoes of AA ? —effectively admitting they are powerless against the problem, that their internal condition is itself defective and disordered. Psychology is involved with the problem and rejects mental health in its contextualizing everything as psychological. In Mental Health Philosophy we call this ontological move redundant.

In this strict social perspective of things, the psychological perspective, it is that their (psycholgy’s) concept of things failed to incorporate the behavior of the person back into the group concept and so it has to take charge. Another way of saying this philosophically is that the person did not correlate to the proper ontology, or the way the group conceived of things for what a person is supposed to do could not encounter the person behaving in whatever way, e.g. physical actions or speech actions, as they are. The person must have a psychological disorder. If it could then rectify the discrepancy there would be no problem because the person’s behavior would necessarily correlate with what the world is supposed to be, that is, ontologically. This is all to show the threshold of this for the modern world occurs where rationality fails. For every possible definition that can be put forth, this is what we call irrational (unless we make another psychological argument about what should be, that is, ontologically).

Now, I don’t intend to get into a deep phenomenological discussion of the type made famous by William Barrett in his book The Irrational Man (1990), where human beings are not primarily rational creatures living in a fully intelligible universe, that instead, existence is marked by uncertainty, freedom, anxiety, and the struggle to create meaning. That is all good and well, but what does that really mean? What meaning am I being free or am anxious to create if I believe the meaning of the argument Barrett is making? Have I not made a meaning that I was completely unaware of being responsible for making? But all that is for the deeper discussions of conventional philosophy.

What Psychology Means by Rational Thinking

In terms of Mental Health Philosophy, simply put, psychologically, the term ‘rational’ usually means thinking or acting in a way that is based on evidence, goal-directed, coherent, and open to correction, and what we often refer to as an ability to check reality. By this standard we are not making arguments about what everything is or should be (which is where Barret positions himself). Instead, the tack is while there might be a tendency for some to argue that being rational is the same as using one’s thinking, i.e., their cognitive ability, in contrast to letting one’s emotions determine their actions, here irrational does not simply mean emotional but usually means thinking or acting in a way that is inconsistent, biased, poorly calibrated to evidence, or self-defeating. The difference is intentionally subtle. Rationality is not so much the absence of emotion as the ability to align belief and action with reality, reasons, and goals. Irrationality is when that alignment breaks down, in other words, irrational is when cognition does not use emotions correctly according to social norms— otherwise one would always be rational.

The question of mental health is less oriented by the rational philosophical theories of psyche and its social involvement. As a clinician involved with the therapeutic help for a person, for sure, I do assess whether they can meaningfully participate in their own treatment, which is arguably a social contract, but I do not try to place them in a psychological category rational or irrational unless I am doing paperwork for insurance reimbursement, involved with some court hearing, or if the client or some responsible party for the person is interested in some sort of assessment of rationality.

Mental Health Beyond Rationality

In this respect, the very idea of psychological or phenomenological rationality is suspect and is therefore better viewed for its particular kind of use rather than authority. This is key: it is useful, but it does not extend into a criterion for whether a person is mentally healthy or not. In social reality it can; for example, in a court setting there has to be a way to assign responsibility and compensation. My contention, however, and in reference to the modern psychological definitions, is that people in general must be considered irrational, since the measure of aligning intention to goal with reference to emotional states is nearly entirely subjective and beyond the instrument of psychology to measure with any accuracy. Simply believing and asserting one’s rationality is just a proposal for the sake of social assessment; what one actually is, or the quality of one’s own thinking as being rational has no basis to reference itself internally, which accounts for the fact that various people can get in arguments over who is more rational, but also can account for internal conflict. In other words, I have no reason to assert to myself that I am rational if I am OK and have no reason to prove it someone else. I’d say that is the basic definition of mental health, what psychology could call confidence, self-esteem, or what we lump into the notion of well-being. The psychological catch, however, is that the purpose instilled in those notions is not based in the person but the group; with the benefit of doubt for best intentions, its purpose is measuring the various behavioral correlations to the expression of ‘self-esteem’, or ‘I feel confident’, and the like. For instance, “do I feel confident?” is, itself, a confident affirmation of oneself unrecognized, its purpose is measurement, not the state of confidence. We could even say that by the very question the person has ‘missed themselves’ such that that self-reflective question is really an expression of longing to be with one’s Self. Regardless of the theoretical connotations, in the end, only the person herself has an inkling of whether their stated goal is linked to their emotional states, and besides, the interpretation of just what this means is always rendered by the person, good or bad. Interestingly enough, whether a person achieves their stated goal likely has little to do with self-confidence or esteem, since a person could be quite mentally healthy and not care about measures of achieving any goals, personal or otherwise. This question, i.e., the measure of correlation between psychological instrument and psychological condition or individual phenomenology and an internal subjective world, however, is taken up in my other works. For now, we simply recognize when it comes to mental health the rational ideal is at best prone to contradiction —and this can create problems where none exist.

The Foundations of Mental Disorder

It is all too easy and commonplace to look to the failures of clinical therapy methods of intervention, surmise that there is a physiological culprit at work undermining the therapy and the particular personal-social, ethical-empirical alignment (ontological theory), and delegate the cause and accorded task to a manipulation of neurochemistry. This is not to say, though, that we are being complacent or neglectful. Yet it might show us the limits of our conceptions for how to think of problems and solutions; thinking ‘out of the box’ is just as often only good enough to delegate the problem to ‘outside of my scope’. It is but a small and simple step to take that few of us find, in this way, to see that psychological use value is in mental health. There could very well be a neurochemical situation that can be manipulated which will help the person; the difference of orienting in mental health is the awareness of what is actually involved in such a referral.

To discover what we are really talking about here, we can take a very basic example from the beginnings of the modern science of psychiatry. It was once thought (perhaps it still is) that sanity was aligned with using thinking correctly, which is to say, using it at all. Insanity, or community reported erratic behavior, was automatically figured to be due to an absence, inability, or failure of rationality. Then on the other side of it, people nonetheless behaving in such a way irrationally was explained reasonably as behavior determined by behavioral conditions; the modification of behavior was the point which supported sanity. The two complimentary ideas, born of Enlightened Reason this formed the apologetic basis of all scientific efforts about the mind or psyche, and basically the assumption since as been correlated to this maxim. This is so much the case that every new theory of intervention is based on the fact that a person is, at root, thinking and feeling, and that the problem is around what they are thinking, as thinking is the basis of behaviors. Regardless of what semantic framing we dress it up in, they all are concerned with control of a person’s behavior through manipulating their cognition or way of thinking, and underneath this is a basic premise that emotions need to be controlled because if left uncontrolled it leads to irrational behavior, i.e., socially problematic behavior.

Diagnosis, Identity, and Mental Health

So, we have come round to the classification of mental disorders. I would imagine that most people involved with mental health do not see the person or themselves beyond their diagnosis. It is true that a potential exists, both good and bad, in a person identifying themselves as having a mental disorder, such as “I have ADHD”. But as well, likely some of the problem of the personal experience of mental issue is that the person herself is unable to see themselves as not problematic. We might give lip service to the idea that a person is not their diagnosis —which I believe is helpful everywhere —but I would wager that most of us see the diagnosis as a sort of parasite or cancer that has attached itself to or growth upon a person, and that these disorders are things which are common across people and can be identified by certain behavioral identifiers. From there one person may have sympathy upon the other person because they has a mental disease. I get behind Doctor Gabor Mate’s goto for most problems we call mental disorders: they are relational first.

Why Mental Disorders Are Difficult to Define

When it comes down to it, it can be difficult to tell in the witnessing of a mental issue just what is going on. Is it anxiety, depression, Borderline Personality Disorder, or Bipolar? We know but we don’t know. But even if we do know, it could change without us recognizing it, which unfortunately is what all to often happens. Very few if any will be able to actually find what is common between any observations of two or more people designate to a diagnostic class beyond that people report similar things, and use similar words to describe what they are suffering from. For sure there is comfort and help in community, but often enough it can aggravate the problem because people begin to drink the cool-aid, so to speak. Physical measures might not not help much either; for example, there is no physical experience of anxiety that equates to a disorder across the board. For many if not most people, anxiety, or feeling anxious, is no more a disorder any more than being cold or hot is a disorder but we have no way to tell because science just does not encounter those people who are anxious but are doing fine because its measures are being based on an assumption that the term-descriptor has occurred before the person so the person must be complying to the discursive determinate. There is no reason to say anxiety is a problem if it is not experienced as a problem, and whether it is a problem is nearly inseparable the social determinates of behavioral norms, which include what language we use to describe ourselves and experience. I lean and root for the individual but also, when we really begin to look at what is happening, it is indeed the individual that is finding their own solutions all the time, even if it is believing they have a disorder as the solution they have found.

That is the irony of this whole thing, that You. Are mattering.

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About this blog

Essays in mental health philosophy—less “tips,” more why things work (or don’t). I look at the first principles under therapy, psychiatry, psychology, and everyday life, and occasionally share notes from papers and books-in-progress.

This space stands alongside—not inside—my counseling practice. If you’re seeking therapy in Colorado, there’s a link in the footer.

About the author

Lance Kair, LPC, blends philosophy, mindfulness, and counseling to help clients find agency, meaning, fulfillment, and healing through deep understanding, self-awareness, and compassionate therapeutic collaboration.

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