Mental health and social policy

Paper presented to the World Federation of Mental Health Biennial Conference Melbourne 21-26 February 2003

By   Dr Graham R Little PhD AFNZIM

Executive summary
Summary of mental health policy proposals
Introduction
A prescriptive definition of mental health
Mental health and spiritual well-being
The nature of psychological dysfunction

Mental illness, insanity, psychological dysfunction and mental health

Executive summary

This summary is of the overall system of thought within which this approach to mental health is developed. As with such a summary, the positions are stated, with no attempt to argue any point. For the arguments please refer to the prior papers.

1. Following Popper, thought exists in the universe independent of people; that being so, it ought to be possible to model its structure.
   • The analysis of perception and of how ideas come to be and the relation of the idea to the object the idea represents leads to a model of knowledge, in particular scientific knowledge.
   • The immediate and ultimate effects of W. Ross Ashby map onto scientific knowledge and are argued to be a model for such knowledge.
2. The model leads immediately to separation of a variable and its value. The model proposes that scientific theories must consist of variables and relations between them. Then any particular instance is described by inserting the values of the variables into the theory. Any and all valid theories of psychology can and must follow this pattern.
3. Causality emerges as the analysis of the variables and relations between them that describes the mechanisms: plus the starting point. So for Aè B, as A causes B, means we know the mechanism whereby A becomes B, and we know the start point such that once the variables are at that point, then B occurs (this including the understanding of the environment such that there is no C likely to interfere in the mechanism of AB).
4. This epistemological analysis alone leads to the idea of two quite distinct ways in which any theory of psychology could malfunction: namely failing of the mechanisms, and adoption of variables falling outside any socially ‘normal’ range. These are definitions of mental illness (best described as neural disorder) and insanity (conduct beyond the range that socially and usually legally sanctioned).
5. From the epistemology arises guidelines for conceptualization and creation of theories, by applying these rules to the system ‘personç è environment’ is created the process model of psychology, with several crucial features.
• The model is based upon core variables of Emotion, Thought, attention, and brain structures (physiological pathways of the flow of energy in the brain and neural system).
• The system exhibits complex multiplicity, with the core variables integrated with specific circumstances into quite independent systems called mental sets.
• All Thought emerges with the same status as regards the model, so that the model does not differentiate between values, ideas, concepts, morals, attitudes or beliefs. Differentiation relates to the individual person as described by the values of the variables, and cannot be described by the model. The overall system of Thought is described as a person’s worldview. Everyone has a unique worldview, but there are strong common elements arising from common social/cultural history.
• Self and I are described by the system, but are emergent properties of the system. That is, self does not exist in a new embryo or in the infant in the womb at the point of full cell differentiation: self and I are emergent aspects described by the system, they are not structural features. Each person evolves their unique self, this, the core of their unique consciousness.
• A key aspect of the model is the ‘sequences’, that is the order in which certain neural events occur and the consequential exhibiting/experiencing of mood and conduct. The only manner of the person managing these sequences is via conceptualization of the sequence and alternatives and practicing the preferred sequence using self-control and self-management techniques.
• All accepted aspects of psychology are described and explained by the model.
6. The model in operation shows the person shifting between mental sets each relative to the changing circumstances within which they find themselves, at the conceptual level of the mechanism, of neurons and brain structures, I call this the psychic flow. Some of the psychic flow is habitual, some deliberate.
7. At the psychological and behavioral conceptual level, the psychic flow represents the shifts and changes in mood and conduct. It is this aspect of flow that gives rise to the name ‘process’ model as describing the processes or processing of living, as people shift between mental sets and roles (taken as accumulations of related mental sets).
8. At the level of thought feeling and conduct, at the level of the person, variability of mood and conduct depends on the mental sets tied to some circumstance, and the ease of transition between mental sets. Someone exhibiting balanced; poised and consistent conduct with easy transition between different states of mood and conduct would both feel and seem ‘balanced and well’.
   • These arguments lead to a prescriptive definition of mental health as consisting of an integrated worldview, a balanced Emotions structure, and smoothness and regularity in the transitions between states of mood and conduct.
   • It is proposed that mental health policy adopt a proactive stance, seeking as priority aim to enhance the fulfillment and life satisfaction of the population.
   • There has been no full and thorough analysis of the factors underlying social causality, however it is clear that the accepted system of norms and beliefs profoundly shapes existence for those subject to the same.
   • Much policy implementation involves specific effort against particular issues, for example drugs, domestic violence, youth suicide, road rage, road deaths and general social cohesion, integration and racial and social acceptance.
     • It is here argued that the general social platform, the general level of mental health will profoundly affect the incidence of the above specific issues and further that until due attention and effort is expended on developing greater mental health (as herein defined) in the community then limited progress will be made on these specific issues which are seen as symptoms of general mental health degeneration.
   • That resource be focused on general increase in mental health (as herein defined) to provide a more effective platform for the application of specific policies in relation to the detailed issues facing the society, and that this general platform will in fact enable a reduction of the range and intensity of the specific issues.
     • That realistic timetable is adopted in relation to development of the base platform of attitudes and beliefs and understanding of society. Progress against such specific issues as youth suicide, drug abuse community cohesiveness and crime are measured in decades, not in years.
9. Mood and cognitive sequences are a key aspect of the model only able to be managed via conceptualization of the sequence and adoption of the new or desired sequence and deliberate effort with it until it is habituated: this process is a core aspect of developing better mental health.
   • The conceptualized sequences offering more effective mental health and more effective living I call nouskills (from Tielhard de Chardin, nousphere); literally mind skills (compare to Daniel Goleman, Emotional Intelligence, this popular work gave empirical evidence to the theoretical position derived and developed within the process model).
   • That proactive mental health is pursued through the acceptance of and social development of better nouskills in the population.
10. The process model draws a tight distinction between neural events and human psychology, with neural events the mechanism of our psychology but telling us very little or anything of the nature of that psychology or the experience of it.
    • The consequence is that malfunction in the mechanism, that is neural disorder is exhibited through our psychology, but our psychology in and of itself may be dysfunctional independent of neural disorder.
    • Mental illness within the process model is defined as neural disorder solely, having symptoms through our psychology, but otherwise not relating to our psychology.
    • Neural disorder will not respond to therapy.
    • It is proposed that the term ‘mental illness’ be officially dropped from policy in favor for ‘neural disorder’.
    • That psychological dysfunction be adopted as the term describing failings psychological malfunction, this distinguished from neural dysfunction in that it is controllable by the person, and is amenable to counseling, although not always without the initial support of drugs.
    • That neural disorder is managed separate from psychological dysfunction, with a graded range of responses for each depending on the severity of the disorder.
That if given suitable therapies it is possible for a person to develop sound mental health within the boundaries set by their neural disorder (this means that someone ‘mentally ill’ can be ‘mentally healthy’, with their mental health bounded by their neural disorder).
11. Psychological dysfunction describes the manner in which our psychology can be impaired or otherwise undermine the manner and enjoyment of our being in the world.
    • The process model states that psychological change will not occur without the active involvement of the person, and the person is able to make such changes should they choose.
    • People may choose to seek ‘greater fulfillment’, at his level ‘psychological dysfunction’ is the same as ‘self development’.
    • Mental health policy recognizes ‘self development’ and promotes better mental health through self development in the same manner good physical health is promoted.
12. Clinical psychological dysfunction is severe dysfunction, and would typically be expected to have affected neural functioning.
    • Our psychology affects neural functioning via brain structures and sequencing: any such affect while stabilized by medicine, will respond to therapy.
    • The types of psychological dysfunction match the descriptions in existing approaches to therapy and psychology.
    • It is proposed that existing theories of psychology be dropped and the existing techniques associated with those theories be integrated under the process model.
    • Many of the techniques and types of therapy overlap; also no one therapy matches the range of psychological dysfunction potentially possible under the process model.
    • Mental health policy recognizes the need for multiple therapies matched to the types and nature of the psychological dysfunction. And that longitudinal research is required to assess the best assessment tools and the best type of therapy to match a particular dysfunction.
13. The process model has central to it non-linear causality, along with the multiplicity of causality. The consequence of this non-linear, multiple causal structures are that it is not possible in principle to be able to accurately predict future behavior.
    • All estimates of future behavior are judgments. Education and training does not necessarily enable the best judgment, and all such training must be placed alongside experience, and intimate knowledge of the person being judged.
    • Mental health policy recognizes the need for guidelines to judgment and that intimacy with the person is a significant factor in forging such judgment.
14. The process model gives rise to the following definitions.

• Psychiatrist: a person with a degree in clinical psychology and a degree in medicine specializing in neural disorder and its treatment. May issue full range of drugs.
• Clinical psychologist: a person with a degree in general psychology, then an extended program of study with application of therapeutic techniques as integrated by the process model; where they have specialized in some particular therapeutic techniques, then this is specified in the clinical qualification. May issue a limited range of drugs related to treatment of the psychological dysfunctions in which they are trained.
• Psychologist: a person with a degree in general psychology, not recognized as equipped for dealing with psychological dysfunction. May apply therapy, but only under guidance of a clinical psychologist or psychiatrist.
• That mental health policy adopts these process model definitions and training requirements.

Summary of mental health policy proposals

• It is proposed that mental health policy adopt a proactive stance, seeking as priority aim to enhance the fulfillment and life satisfaction of the population.
• That resource be focused on general increase in mental health (as herein defined) to provide a more effective platform for the application of specific policies in relation to the detailed issues facing the society, and that this general platform will in fact enable a reduction of the range and intensity of the specific issues.

• That realistic timetable is adopted in relation to development of the base platform of attitudes and beliefs and understanding of society. Progress against such specific issues as youth suicide, drug abuse community cohesiveness and crime are measured in decades, not in years.

• That proactive mental health is pursued through the acceptance of and social development of better nouskills in the population.
• It is proposed that the term ‘mental illness’ be officially dropped from policy in favor for ‘neural disorder’.
• That psychological dysfunction be adopted as the term describing psychological malfunction, this distinguished from neural dysfunction in that it is controllable by the person, and is amenable to counseling, although not always without the initial support of medication.
• That neural disorder is managed separate from psychological dysfunction, with a graded range of responses depending on the severity of the disorder or dysfunction.
• That if given suitable therapies it is possible for a person to develop sound mental health within the boundaries set by their neural disorder (this means that someone ‘mentally ill’ can be ‘mentally healthy’, with their mental health bounded by their neural disorder).
• Mental health policy recognizes ‘self development’ and promotes better mental health through self development in the same manner good physical health is promoted.
• It is proposed that existing theories of psychology be dropped and the existing techniques associated with those theories be integrated under the process model.
• Mental health policy recognizes the need for multiple therapies matched to the types and nature of the psychological dysfunction. And that longitudinal research is required to assess the best assessment tools and the best type of therapy to match a particular dysfunction.
• Mental health policy recognizes the need for guidelines to judgment and that intimacy with the person is a significant factor in forging such judgment.
• That mental health policy adopts these process model definitions and training requirements, for psychologists, clinical psychologists and psychiatrists.

  Introduction

Current theories and approaches in psychology¹ do not offer prescriptive definitions of mental health and wellness, depending on reverse definitions arising by identifying mental dysfunction and identifying mental health as the absence of mental dysfunction. There are various other difficulties with all other theoretical approaches, the most significant being that while each current approach embraces a valid insight into human causality, none alone manages to embrace the full range of causal elements, in that none manages to embrace the insights from all other approaches². The second major deficit is that none deals with and defines clearly the nature of the knowledge of which the theory is based, and finally none defines and deals clearly with issues such as cause, and the body mind problem, so that discussions can occur within a clear and defined framework of base concepts³.

The Process Theory of Psychology is currently the only available theory that resolves all of these issues. The final validity of the theory is yet to be determined, and while the details of the final accepted theory may change, there can be little doubt that the direction of the theory, the framework within which it is created, and the structure of the theory, in the sense of what it does an does not say of specific people in specific circumstances, are all correct.

Having developed the theoretical structure, I have for the last months (latter half of 2002, and into 2003) been developing the consequences of the theory in the form of detailing what it does and does not say, and working on the interpretation of the theory and the relation it makes to the values that must describe particular people in particular circumstances. This paper continues this process, and focuses on the following questions.

• What can we mean when we discuss mental health, and what general propositions can be derived from the theory that do not invoke cultural or moral or ethical values?
• How does mental health relate to mental illness and general psychological dysfunction, and what might be the nature of that dysfunction? Noting again, that any propositions must be general and derived from the structure of the theory not specific values of any variables⁴.
• What social processes lead to better mental health management in the society (regardless of culture or moral choices)?
• From the foregoing, what then follows for social policy as regards mental health, and to what extent is this policy shaped and bounded by culture and/or gender issues?

A prescriptive definition of mental health

I have developed much of the argument elsewhere, and will not repeat it here⁵. The arguments lead to a view of mental health that encompasses the dynamic aspects of the theory in operation.

• Integration, a consistency within the person’s worldview: There is an integrated quality to their thoughts and attitudes giving rise to a consistency of attitude and approach across various situations.
• The person has no extreme Thought, with the overall pattern of their worldview exhibiting an integrated quality with a balanced relationship between attitudes and reactions in one mental set as compared to another.
• Nouskills will enable the identification of extremes and the developing of self-statements, self-arguments and attitudes that moderate the extremes and provide the balance.
• Poise, a consistency of emotion within the psychic structure: Within the emotional structures of a person there are no great swings of mood, emotion or attitude not related to events of significance to them.
• Supported by nouskills that enable self-management of emotional states and when under stress and pressure of circumstance (so resulting in diminished likelihood of regret or guilt over one’s conduct).
• Transitions, shifting between roles and mental sets within role systems: There is an ease of transition from structure to the next.
• They have the skills to shift from one role to another, to allow transitions between mental sets that do not exhibit marked breaks of conduct.

1. The theory itself does not differentiate between ‘no poise’ and the ‘best possible poise’, the reason being that ‘poise’ or ‘no poise’ describes a specific individual in some specific circumstance, and the theory can only describe the variables into which values are fitted. For a person exhibiting ‘no poise’, then the values for emotional variables, and for their reactions would then show behavior quite different from a ‘poised person’ in same circumstance, or different for same person who was poised in different circumstances.
2. To emphasize these factors as key aspects of ‘mental health’ is not selecting values of variables, but nonetheless is making choices of some sets of values as being of more value than others. It is doing this in that if we were to choose ‘poise’, we are saying that those values of Thought and Emotion that would be described as ‘poised’ are given greater human regard than values of Thought and Emotion that would be described as ‘not poised’.
   • Our laws in fact tend to reflect this issue, for instance a person is only afforded the right to react so far before the law will punish them, and a mitigating factor is circumstances beyond that where a reasonable person would be expected to cope.
   • The law places bounds on the type and extent of reactions acceptable, and does so in all societies. From the point of view of the society, mental health can then be described as integration poise and smooth transitions within the bounds as determined by the legal strictures, this represents the most extreme definition, since it leaves much scope for, for example, un-poised conduct.
   • The arguments can be extended to build an ‘ideal’, that is the image of a person to which the society might aspire. An ideal might be an image of a person who allows their anger, but not to the point of leaving them ashamed or regretful, that allows their pleasure and losing themselves in some such moments, who may pursue their own beliefs and politics, protesting as needed, breaking laws to drive home their points, but doing so in full understanding and expectation of consequences. The imagery of the ‘ideal’ is not one of compliance, but one of reasoned understanding of themselves, their life and place in time, and making and living choices for themselves within their time.
   • The ideal as described does not define specific values but as stressed, does afford higher regard to some sets of variables over others, and the variables given greater regard do represent moral and ethical choices, with the greatest extremes of those choices being the legal system and its definitions of allowed and not allowed, followed closely by the social strictures guiding and pressuring people on what is right and what is wrong.
   • These issues have important and poorly understood policy issues on the point and purpose of government, especially in a democracy. A key social policy issue for governments within the model is the balancing of laws such that behavior is constrained appropriately, while at the same time the government widening the legal strictures and encouraging the development of the necessary understanding and discipline within the population. I know of no government now or in the past that has conceptualized this issue, the conflict between law and human development, and developed effective policy and actions in regard to it.
3. The approach does not prescribe morals or norms, so a hired killer or a drug czar may be ‘mentally healthy’, despite enacting behaviors repugnant to most people.
4. Since mental health seeks to embrace key dynamic components, this is most immediately represented by the brain structures the psychic flows in relation to events with these flows determining the values adopted by the variables. Nouskills are then the conceptualization of these brain structures, and once adopted and enacted and built into habit, then become themselves the functioning brain structures.
• It is this argument that mental health focuses on the dynamics of the model and the potential impact of nouskills as the chief tool for altering that dynamic that leads to promotion and development of nouskills in the population as a primary aspect of mental health policy.
5. It can be argued that this view is descriptive and normative in that if a person holds to the idea that ‘what I do is what I do and I will never look back or regret, for it is me’, then they live and are what ever is, and however they react and respond, and that this is legitimate and refutes the views above on mental health in that this person see themselves as mentally healthy and ignores the process dynamic issues that underlie the definition of mental health.
   • For a person on their own, this is perhaps legitimate; at issue is the question whether their experience of life and of consciousness and of themselves would be enhanced by adopting a manner of being in the world less centered on their own psyche and more tuned to what is about them.
   • There are also related questions on disciplines needed to gather food and security from the weather etc, and whether these mapped neatly onto ‘I choose to do exactly what I want when I feel like it’.
   • There are further social issues and issue of composition, it may be okay for one person, but if the whole society or community acted in such a manner…?
   • Overall I find this position extreme, with many, many issues and all bringing me to question the living reality of such an extreme philosophy. A very large majority of people, even highly creative and/or highly iconoclastic people simply are not like that to the necessary degree to refute the views on mental health as proposed.

Mental health and spiritual well-being

It is important to understand what I mean by ‘spiritual’. First, I do not mean any form of religion or any form of religious spiritualism; this, I reject⁶ For me, to be spiritual means a certain way of being in the world, and that way being represented by the image of the ideal as outlined above. A person can be spiritual, full of life and complete without choosing any form of religion or God.

The definition of mental health offered is then a part of a ‘spiritual person’ within the definitions offered, this makes it quite different from the normal religious views, since they all involved an idea, that of the religion or God, and so specify a certain value for one of the central variables, Thought. The views developed here do not include such a specific idea, specific value for Thought, what is offered in this definition of mental health is advancing and developing the processes whereby we ‘be in the world’; poise, integration and transitions are how we ‘are’, these are core to how we conduct ourselves, regardless of our life choices.

Life choices are the other side of ‘spiritual humanism’, and draw the line between spiritual humanism and mental health. For example, the drug czar killer may be mentally healthy, so that extent they exhibit spiritual humanism, and one would judge them with no knowledge of what they did. However, knowing them to be hired killers for a drug czar would have them dismissed due those life choices, regardless of how mentally healthy they may be.

Mental health is thus seen as an important aspect of spiritual well being, and the definition and imagery for a mentally healthy person being in the world is the same as the manner in which a spiritually healthy person would be in the world. Spiritual humanism is a broader idea, embracing as it does moral and ethical choices, but mental health as herein defined is a crucial aspect of spiritual humanism, such to say that social policy developing mental health is equally facilitating the spiritual development of the population.

A question I will consider in a later paper is the extent that enhancing the mental health/spiritual development of the population will lead to greater life enjoyment and fulfillment. Furthermore, whether or not development of mental/spiritual health and well being would influence such factors as crime, domestic violence, and racism. These questions are only relevant within the definitions and framework of the Process Theory.

The nature of psychological dysfunction Mental illness is not psychological dysfunction.

This is a very important point, often not well understood. Mental illness is precisely parallel to breaking a leg or being sick, it is a physical disorder of the neural systems, it just happens to have symptoms that undermine and alter our psychology. Psychology is a unique and stand-alone discipline within science, the mechanisms of psychology are neural, but the psychology is not reducible to those neural functions. ⁷

Human psychology involves the following variables: Thought, Emotion, attention, brain structures and the dynamic elements of the model as defined by mental health. It follows that dysfunctional psychology involves dysfunction of one or more of these variables. Note well that because the mechanisms of all these variables are neural functions, then any failure or malfunction of this mechanism will also impact the functioning of these psychological variables.

Determining between psychological and neural functioning is yet in its infancy, and must progress before full and effective treatment of mental illness and clinical psychological dysfunction can occur. A further important and poorly understood issue is the extent that psychological dysfunction will translate into neural dysfunction. In the first instance, the model suggests that neural dysfunction resulting from psychological dysfunction is via the brain structures.

The encoding of Thought

There is a vast range of Thought represented across world cultures and their history. Given this range, it suggests that no particular set of neurons or neural operation encodes some particular Thought. It has been suggested that ‘I’ or ‘self’ or even ‘consciousness’ is located in some particular set of neurons. Within the theory this is largely rejected, ‘self’ or ‘I’ do not exist in the theory, they are not objects in the theory, or variables. Upon interpretation, this is appropriate, since self or ‘I’ is an emergent object, we learn about our self in precisely the same way as we learn about everything else. We develop particular emotions and thoughts attached and associated with self and ‘I’, since we learn and know that these conceptual objects are ‘us’, they emerge as uniquely significantly to us, and uniquely powerful within our emergent psychology.

The encoding of types of Thought may occur in different sections of the brain (the now limited two hemispheres type of hypothesis). Overall, the hypothesis is that no two people encode the same idea in precisely the same place or the same way: and that any encoding is as much a function of the management of knowledge (particularly in adults) as neural functioning.

From these arguments it then follows that a thought itself does not shape the nature of the encoding of that thought. However, the sequencing of thoughts and emotions will become encoded as brain structures. This means that thinking a given thought will not alter brain chemistry, but if then thinking a given thought results regularly in me breaking down and crying, then this sequence if repeated enough can become the norm.

The converse also applies, that is because a person has a mental illness, this does not mean they cannot judge their own thoughts. The content of the thought is not determined by the neural functioning; failure of neural functioning can have a number of effects on a thought, first, it can cause strong emotions to be associated with the thought so giving that thought a preeminence in the mind of the person it should not otherwise have; second, neural failure can cause some part of the thought to not be there, say remembering the face but not the name; finally, thoughts and feelings inappropriate to the circumstance may be activated, that is the ‘normal’ brain sequences break down becoming dysfunctional and problematic. These malfunctions can and will cause grave dislocation of the person and their psychology, but in and of themselves these malfunctions do not determine that which is encoded, they determine the functioning of Thought and psychic flows (brain structures), but do not of themselves determine the content of that Thought.

These arguments support the proposition of the model that is process theory that neural dysfunction a result of psychological dysfunction is restricted to the effect on the brain structures, the psychic flows and that dysfunctional psychology does not otherwise greatly impact the underlying mechanisms of the neural system.⁸

In short, psychological dysfunction is psychological, and is only indirectly neurophysiological. ⁹

The categories of psychological improvement

Human psychology is dominated by words such as purpose, intent, self, feelings relationships, attention, knowing and desire. Consciousness itself is not a ‘thing’ but an emergent property, nowhere structured into the model, but the result of the model in practice. Consciousness can be nothing else, the easy problem of consciousness being the model and its construction, the hard problem being nothing less than a summary of what it is like to be …a summary of the experience of consciousness, already well understood and discussed in novel and poetry and song; all cultures celebrate what it is like to be in love, or young or old or dying or related…. Not only between peoples, but also for ourselves, we can grow in our depth of understanding and the depth of our own awareness, the very essence of our internal consciousness becoming in touch with yet our deeper yearnings and desires so easily buried under daily immediacy and pushing by this or that circumstance. Amid such diversity conscious can only be a value, a collection of values of all variables at any one instance an emergent property.

From within the model there does emerge two types of dysfunction as shown in the diagram below. Assuming some formal of perceived or actual ‘normality’, without seeking to be too precise as to what that might be, there emerges two types of dysfunction, first, that emerging from some form of shortfall in relation to how it should be, this is the traditional model of ‘therapy’ as in form of fixing something; second, is seeking some preferred state, striving to become better than what I am without needing to change.

All interventions into the psyche of any person fall into one or other of these two categories. It is important to understand which, for the style, manner of application and expectations and demands will be quite different in each case. It is also quite possible for the exact same goals and outcomes to be desired in each case. For example, someone requiring anger management as directed by the courts, and someone seeking greater emotional control, including and in particular managing anger and staying poised under pressure.

In assessing the types of psychological dysfunction I have only taken to account the Process Theory and sought the ways and manner in which the theory can be psychological dysfunctional in that these ways represent definite undermining of ‘normal’ functioning. I have defined ‘normal functioning’ as that functioning that would be expected in the absence of the dysfunctional element. In this case, the concept ‘normal’ will be varied and wide, and to some considerable degree relative to the individual. In the case of a ‘therapeutic need’, that is a shortfall in functioning; the concept ‘normal’ has diagnostic characteristics. In the case of someone seeking self-improvement, this can be from any pre-existing state.

I have identified the following types of dysfunction, in that if these did occur in the person, they have the potential to disrupt, distort and interfere with the functioning of the person. Each of these can occur as a ‘dysfunction’, that is the person ‘needs’ to do something about it because it is undermining ‘normal’ functioning, or the person can seek to improve upon the issue to enhance their own life and experience of it.

1. The unconscious. Responses and emotions arising from historical experiences. Our experience builds within us the mental sets and psychic flows, particularly our early experience. These become truncated mental sets consisting only of emotional responses, buried within the developments of conscious experience; these truncated mental sets can produce strong emotional responses without us being aware of their source.
2. Cognitive management. Having attitudes and beliefs resulting in maladaptive actions and reactions and/or ability to manage own thoughts.
3. Emotional intelligence. Inappropriate emotional responses and/or inability to reasonably manage emotions.
4. Cognitive nets. Interlinked system of cognitions, bridging many mental sets and role structures, such that once the psychic flow becomes enmeshed, it flows to some specific set of thoughts and feelings. Grieving loss of loved one; it can be that no matter the occasion, thoughts seem to link and track back to point of grief.
5. Lack of congruence and balance among mental sets.
1. Extreme mental sets that result in inappropriate feelings and thoughts.
2. Unrelated mental sets that produce different responses to the same or similar circumstances.
6. Existential malaise. Pervasive feeling of emptiness and lack of purpose (see cognitive nets, and pervasive maladaptive tone).
7. Pervasive maladaptive tone. Similar to cognitive nets, except that this is a tone to the thoughts, the ‘style’ of the person’s world view or novel. Examples include lack of purpose, lack of hope, pessimism or excessive optimism. The issue is the quality of the thought not the thought itself.
8. Lack of assertiveness: Can extend far beyond relationships, for example knowing the life desired, and it is realistic, but not pressing for it, which can be for many, many reasons.
9. Ineffective processing and interactive skills: Can include problem solving and planning, creative option development, evaluating and judgment skills, self-management, and relationship skills.
10. Inappropriate self-images: Specifically how the person ‘sees’ themselves in their life and the relevance of those images to them.
11. Mal-adaptive self-esteem: Typically low self-esteem, but can be aggressive, unjustified over confidence. The nature of the mental sets surrounding the concept of self, the realism or otherwise and the impact of these mental sets of the actions and experience of life of the person.

In any particular circumstance any number of these can occur in any combination; multiple dysfunctions are likely the norm.

Any one of these dysfunctions can also be combined with lack of mental health, noting that the dysfunctions themselves will undermine mental health.

Mental health itself is a crucial aspect of spiritual health, and since psychological dysfunction will undermine mental health, I call psychological dysfunction an affliction of the spirit, an affliction and disruption of the fullness of our being in the world.

Mapping of psychological dysfunction onto existing approaches to therapy

In his book, Richard Nelson-Jones (see note 1) lists and describes some ten or eleven approaches to therapy, each with its own theoretical background and rationale. I have mapped the list of psychological dysfunctions as listed above onto this list of approaches, and find that the existing approaches all match most neatly one or other of the above theoretical dysfunctions. I interpret that as each of the existing approaches and systems of therapy is based on a valid insight, as evidenced by the mapping of a dysfunction; also, it is useful that the Process Theory of Psychology successful embraces the existing range of approaches and therapeutic techniques without needing to reach too far and without needing extensive discussion and review. There is a match, which is positive for the theory and for the existing approaches.

There are several immediate consequences.

• The theoretical rationales for each approach is dropped and replaced by the Process theory. This has the positive impact of providing a unifying framework of known validity and underpinned by comprehensive epistemological analysis.
• Each existing becomes a particular technique for the intervention into the system ‘person in their environment’.
• There is no ‘one approach fits all problems’. The techniques are a tool kit; the tool selected depending on the identification of the dysfunction, the process and tools integrated into a single theoretical system of thought.
• Necessary research and development is as follows:
• Development of diagnostic tools to clearly identify the nature of the dysfunction(s) within the person and to guide the application of the best therapeutic tools to the situation of the person.
• Longitudinal studies to assess and review the efficacy of all therapy, and refining of therapy as a technology in relation to the dysfunction for which it is the cure.
• Training and coaching of psychiatrists and psychologists is given better focus and clearer direction. There are not ‘schools’, but one ‘theory’ integrating the numerous therapy techniques, these techniques given validity by each addressing unique dysfunctions derived from the theory. With this ‘tool to match dysfunction’ approach, it is likely that not all therapists will become fully proficient with all tools, leading to groups offering a spread of tools and that used based on diagnostic analysis.
• Psychologists and psychiatrists trained in same theory and tools, with psychiatrists also being trained in neuro-physiology and mental illness.

There will be a forthcoming paper elaborating on this research and offering detailed discussion and argument.

Mental illness, insanity, psychological dysfunction and mental health

The elements insanity, mental illness, psychological dysfunction and mental health have quite independent definitions and arise in quite different but clear ways from within the theory, this leads to the interesting proposition that while they are related, they are in fact separate, and should be viewed separately and in particular treated quite separately.

Mental illness (neural disorder) and mental health

Initially it seems unusual to propose that a person mentally ill can have at least in some part sound mental health. The use of terms now becomes important, the person with a neural disorder will have their life, consciousness and psychology bounded and shaped by that disorder. The experience of life for a person with a neural disorder will always be markedly different than the experience of a person who has no neural disorder. Within the process model, the experience of neural disorder and the bounds and restrictions imposed by it are analogous to the experience of life as a tetraplegic, and as many inspirational people have shown, life can be lived and vigorously experienced by a tetraplegic, the essence of the inspiration being the glow of their spirit, bounded as we all know it is by their physical disorder and the major psychological impact of that affliction.

The definitions and underlying concepts and the appropriate use of terms now makes it clear that people with neural disorder are not ‘mentally’ ill, rather they are forced to experience life from within the bounds of an affliction imposed upon them, over which they exercise little if any influence. Within the bounds of neural disorder a person can seek and achieve sound mental health, and it is most important the two not be confused, this caution being crucial, since neural disorder is evidenced psychologically, with the strong temptation to see any form of psychological impairment stemming from the neural disorder, which is not necessarily the case.                        

Our human spirit is the essence of how we are in the world; it is the living embodiment and expression of the core of our being. Psychological dysfunction and weak mental health will undermine our spirit; undermine how we are in the world. The core of our living is spiritual, this being most clearly evident in adversity when we must fight, and we show our true spirit.¹⁰

Insanity and mental health

I have previously discussed this issue¹¹, insanity is defined as values to all variables falling beyond those regarded as ‘normal’ in the society within which the person is located. This definition could also cover the term ‘criminal’, with ‘normal’ behavior being replaced by ‘behavior outside the law’.

An insane person can be of sound and full mental health. Simply holding to views and actions that are not normal within some society does not make the person mentally unhealthy. An extreme example considered in the earlier paper is of a person with normal neural functioning who may believe it appropriate to kill children if money gets tight, and shows no remorse or guilt when they do kill several children and gets caught, in fact does not try to hide the crime. All the aspects of insane behavior are evident, they are not remorseful merely puzzled at the fuss, they do not understand why they are in jail and being tried for a crime, etc. The views and behavior have a consistency, a permanency, and the person is at peace with their own conduct, all of which suggests they are indeed mentally healthy, but completely at odds with our society, in all likelihood the person would be found insane, likely an appropriate decision, since they are a danger to others in the society and as measured by the values of the society.

Psychological dysfunction and mental health

I argue it is possible to achieve some satisfying level of spiritual fullness within the bounds of neural disorder (mental illness), and under circumstances where the person is regarded as insane. Taken together our psychological and our mental health are the total of our spiritual potential, therefore any impairment, any psychological dysfunction or any shortfall in our mental health will undermine our spirit, undermine our way of being in the world, and restrict our experience of life, in whatever way we choose to live it.  

Summary of issues in mental health policy development and implementation

I have reviewed the issues of policy development and implementation under five headings as follows: Aim, Understanding, Social attitudes, Management system and Confidence. These comments ¹² intended to build upon and extend earlier comments of mental health policy and strategy.

Mental health has been given quite a tighter and improved definition that specifies what it is, rather than alluding to the absence of ‘mental illness’. The effect is to raise questions as to the best description for this aspect of public policy, for now I have retained the term ‘mental health policy’, but when used here it is intended to convey a broader concept than the definition I have developed, and should be taken to include all aspects of managing and developing the mental well being of the population to which policy applies. So there is ‘mental health policy’ as embracing all that associated with this area of overall social policy; and ‘mental health’ which meaning the quite specific definition as developed, generally I expect the context to make it clear which is which, and where I mean policy issues, I will use the term ‘policy’.

As to alternative names, perhaps the term well-being, since that is what the policy is intended to achieve, greater mental well-being. But this does feel cumbersome, so for now I will leave renaming the policy and deal with the summary of issues.

Aim of social policy on mental health

An overall summary of the aim of mental health policy could be to raise the mental well-being of the population. Such an overall goal is certainly appropriate in democracies where Governments supposedly are put in power to serve the needs and well-being of the population. Somewhat more specifically the goals of mental health policy could be summarized as follows.

1. To enhance the social spiritual wholeness¹³ of people.
1. The enhancing of psychological development and mental health but is not intended to cover clinical provisions for psychological dysfunction. This is a proactive goal, with the Government committing itself to more than merely economic and social provisions, but doing some fundamental things in relation to positive sense of existential well-being in the community for all people.
2. To enable diagnostic and therapeutic functions to identify neural disorder and clinical psychological dysfunction.
1. Covers all the ‘typical’ therapeutic and diagnostic systems and resources currently the primary focus of policy.
3. To enable educational and information resources that inform and encourage each person to seek and actively embark on suitable activities to increase their mental well-being, life experience and social spiritual wholeness.
1. Focused on schools, curricula, and provision of information and resources that inform and develop the necessary understanding leading to mature confidence in the systems and policies.

Two of the goals (1 and 3) are quite proactive, rather than the reactive type of therapeutic policies currently typical of this area. Until the development of the process model it was not possible for any Government to be very pro-active, there was not the rationale, with psychological understanding distributed among competing ‘schools’, none of which was complete, but all of which had their political proponents, which official policy left in the wilderness¹⁴. The aim in this split of effort and resource is that by delivering upon goals 1 and 3, the pressure and need for delivery on goal 2 will be reduced, in short, by enhancing existential well-being, people more proactive and with a clearer and better base of social attitudes, there will be a diminishing of psychological dysfunction, although not necessarily neural disorder.

These goals form the focus, and appropriate policy actions then developed in relation to each of these goals.

Understanding of the issues

Psychology is a confused mix of opinions, half-truths and sometime useful theories and views. Intellectually, it is fractured into competing schools of thought, each typically based on an appropriate and sharp insight in human affairs, but none offering the scope of explanation enabling it to embrace the all core insights. Other problems were noted in the introduction.

Amid this confusion, the general person is left with no guidelines as to what is or is not an accurate assessment of human causality, common sense and popular psychology dominate the thinking, and while much self-help and popular works is based on sound views, it does not provide the overview, the orientating scheme of thinking enabling us to understand ourselves and what we can or should do to best help ourselves and/or to be helped.

The policy decision maker is left in no better state, any advice will depend significantly on what school the advisor attended. Eclectic positions are adopted, but even then there is no orientating framework, no guidelines on what is or is not effective strategic and policy directions.

It has been put to me that it is not the place of policy and/or Governments to adopt one or other of the psychology schools, and that is correct: but progress will and can only come from an integrated approach and understanding, and that is not provided by the competing schools of thought. There can only eventually be one theory of psychology, the right one, scientifically validated and encompassing all the criteria of effective scientific judgment¹⁵. The correct theory of psychology will and must impinge upon policy creation and upon the populations understanding of itself.

Science is not a political endeavor, so with no social policy on photons the Government and policy makers would give little regard to developments in quantum theory. There is policy for people, their physical health and their mental health. It follows that any accurate theory of psychology must impinge and guide policy as well as orientating people to what they can and cannot expect and how to best understand themselves and others.

As some time adoption of the accurate theory of psychology will be mandatory for development of policy, and further should become mandatory as part of the policy thrust that people did understand the rationales behind policy.

The development and availability of information to facilitate the understanding of psychology provides an essential base for building confidence in the systems and resources of the mental health policy sector.

The theory will provide accurate and clear understanding of the core issues, and enable terms and definitions that chart a path through otherwise difficult territories.

Social attitudes

There have been attempts to influence social attitudes to the mentally impaired using advertising, and I have discussed examples, particularly the New Zealand efforts in earlier papers. Suffice that it seems to be having limited affect, although that could be expected, but more significantly it does not seem to be well conceived, and this more than anything is the chief weakness.

The question is: in this area of mental health policy, what social attitudes should the government and other interested bodies be trying to facilitate?

As an initial attempt from within the process model the following emerged as useful and effective attitudinal targets for government and supporting organizations.

• Better mental health results in greater satisfaction and greater sense of well-being.
• Neural disorder is the same as a ruptured knee ligament, it just happens to have symptoms in feeling, thinking and behavior.
• People with neural disorder can live fulfilling and successful lives, but it is not easy for them exactly as it is not easy for a tetraplegic to lead a fulfilling and successful life.
• There are skilled and professional people who can make a difference to my mental well-being, I will feel better, be more effective and generally have a better life if I accept some of the support and advice.
• Sometimes I can undermine my experience of life by developing and allowing serious psychological dysfunction – like holding onto grief or anger, or allowing myself to slip into sense of hopelessness or powerlessness. I can deal with these issues, and I can build a better life, but it will often require help from the skills providers of support and guidance.
• Psychological disorder can sneak up just like we can become unfit, or lose skills at tennis or golf. I need to work at keeping my balance and positive worldview, it is just maintenance of a crucial part of my life, my attitudes and sense of purpose and sense of self. Regular mental health days are just like preventive maintenance on the car or house or garden, if you ignore the garden it grows weeds…
• It is important to begin with effective tools to get clear what the issue is for me; diagnosis before taking action is good sense, making sure that I am not wasting my precious time or money.
• I do not need to be ‘sick’ or to have a psychological dysfunction to seek support and to work on my mental health, I just want to enjoy my life and the opportunity I have in my time and in my place.

These attitudes are merely the first pass at a list. Others could no doubt be developed and these refined, but even so they do represent a major advance on the efforts I have noted to date in New Zealand. I hope it is obvious the means of promoting such attitudes, via brochure, television and/or radio.

The process model does emphasize that humans are prone to self-fulfilling prophecies, what we think most of the time does have the tendency of coming back to us and influencing our life and existence. These attitudes take that to account, and any others must be conscious of this potential of the species.

Finally, the attitudes I suggest are less powerful in the absence of the process model; it is the model and understanding of it that links the attitudes into a coherent scheme that is positive and useful for those who choose to adopt the attitudes.

Management systems and providing resources

Elsewhere I have discussed providing resources, and developing a structured system of diagnosis and resource delivery¹⁶. In terms of management the most telling issue emerging from the theory is in relation to the necessary limits of prediction and the appropriate expectations of recent graduates in psychology and psychiatry.

The process model is a feedback system, not only that it is a self-correcting and self-creating feedback system, that is the ‘person internal’ aspects of the system, involving Attention can select, decide and choose actions. Responses beyond only the most basic and simple are subject to factors of intent and purpose and understanding.

The consequence of this can be summarized in the social equivalent of the uncertainty principle as follows.

It is not possible to simultaneously know the Thought and Emotion of the person, and their behavior.

Thought and Emotion are causal in behavior, and in relation to the enacting of some behavior; Thought and Emotion precede the behavior. Once enacted, the experience of doing it can feedback via the system and alter the Thought and Emotion giving rise to the behavior, and/or provide opportunity for new creative insight, and/or the person may simple change their mind as to their intent or purpose or plan. Hence once done, there is potential for the experience to alter what the person thinks and feels and to never act that way again, despite the feeling and thinking occurring again.

The consequence of the level of uncertainty is that there is no way in principle of predicting future behavior, and the best and most likely predictor of future behavior is past behavior.

Another consequence is that knowing and understanding people is not something necessarily or only learned at a university of college. The people who then know a person the best is as likely to be as good if not better judge of the future actions of that person than someone who only knows the person via clinical interviews.

Experience has a prominent place in judgment, and while guidelines and tools to aid judgment can be developed, the essential act cannot and must not be shrouded in theory and mystery; it is an act of judgment by experienced and skilled people.

Finally, training in psychology and/or neurophsyiology does not predispose a person to accurate judgments any more than training in commerce trains a person to accurate business judgments. This is not to diminish training or its importance, merely to caution about assuming too much and insisting upon certain priorities when the issue is the best possible judgment of what might happen in the future, with experience and maturity at the core of such decisions.

Building social confidence

A crucial aspect of the process theory is that the causality of human conduct is non-linear. Appropriate conceptual schematics for social systems and for causal insight into social systems are not yet available; however it is clear that socialized Thought definitely impacts individuals.

In specific terms this means that what is commonly accepted and adopted socially can and will shape individual behavior. Humanity has this great potential to create ideas then be definitely shaped by those ideas. Self-fulfilling prophecies have a place in the causality of human conduct, but also from one generation to the next as ideas created become social norms.

No Government need adopt official doctrine for photons, but no Government has the task of seeing to the economic and social well being of a photon, including its inner states and the wellness of those. In no other sphere does science so sharply intersect social policy.

Human confidence of the most relaxed and purposeful kind is rooted in understanding. The alternative is for people to accept things on faith, and in social policy this faith is invested in the politician. In many crucial areas and I suggest mental health is one such, few people would or do afford our politicians the level of faith that accepts they know what they are doing. At very least there is concern and disquiet at mental health policy, the concerns valid, especially given the confused and varied views within the ‘scientific’ community.

There is a deep-rooted perception of human conduct that is based on myth, superstition, ignorance and fear; a perception grounded in views and opinions, oral and written that can be traced back to the beginning of history. This circumstance of confusion and fractionation of modern rational thought and ancient, popular mystique combine to undermine confidence in modern mental health policy, resulting in politicization of an issue that should not be politicized.

The process theory proposes mental health can be improved, not by reactive dealing with mental ill health, but by proactive development of a more increased social spiritual fulfillment based on a model rooted in reason, and enabling accurate assessment of causal factors of human conduct.

The implications and questions arising are profound. Would development of greater social spiritual fulfillment:

• Reduce psychological dysfunction?
• Reduce suicide and youth suicide in particular?
• Reduce domestic violence?
• Moderate violent crime?
• Significant also is the question of the impact of a shared view of humanity.
• Would a common view of humanity make it harder to sustain differences between peoples, such as racism, and religious fanaticism?

While Governments avoid adopting any position in the politicized modern views of psychology they in fact compound acceptance of those views. There lies no answer in fragmentation, and there can only be one valid theory of psychology, the right one, that integrates the range of significant insights, that is soundly based on accurate and well conceived understanding of epistemology and causality, and that deal with long standing philosophical issues such as intention, goals, and mind/body in such a way that removes them from the realm of philosophy and makes them science.

Social confidence must be rooted in proper understanding, not myth or faith. The model is emerging, and with it the causally non-linear, reflective, self-fulfilling nature of much of what we create and do. A shared and agreed self-image is essential for the emergence of common acceptance of a mental health direction. The potential of such a shared view of our humanity is such as to make it unacceptable that it be left politicized and subject to popular opinion and popularity. Because Governments deal with people it seems difficult for them to avoid facing selection of a scheme on which to base their policies, and if not this scheme, then one like it for only in the manner of the process model will suitable integration be achieved.    

  Appendix 1: President’s New Freedom Commission on Mental Health

Response from President’s Commission on Mental Health and my reply, January 2003.      

-----Original Message-----

From: Staff Staff [mailto:Staff@mentalhealthcommission.gov]

Sent: Friday, 22 November 2002 11:52

To: grl@xtra.co.nz

Subject: Re: Adequate theory of psychology

Dear Dr. Little:

In response to your e-mail below, the Commission is not in a position to provide any endorsement of any particular philosophy, methodology or technique.

Thank you again for your interest in the work of the President's New Freedom Commission on Mental Health.

Sincerely,

Commission Staff

President's New Freedom Commission on Mental Health

5600 Fishers Lane, Room 13C-26

Rockville, MD 20857

Visit our website:

www.MentalHealthCommission.gov

Hi

I note and understand your policy, but must also point out its serious shortcomings. It seems to me your thinking is pervaded by the paradigm of multiple theories and 'schools' of social science, which to me merely highlights the real inadequacy of thinking in this area of science.

1. There can and will eventually be only one general theory of psychology, the right one. And scientific truth or validity is not politically negotiable, nor the subject of popularity polls.
2. Over the Christmas I have reviewed the range of positions generally accepted, researched from original, but also usefully overviewed in Theory and Practice of Counselling and Therapy, by Richard Nelson-Jones. None adequately addresses issues of causality, epistemological structure or the necessary breath of perspective. My theory currently the only one that does this.
3. I was actually a little surprised at the ease my theory mapped the existing range of techniques so that I can now say that I have replaced the 'theory' of all existing positions leaving the therapy process as a technology with the same emphasis, but in several cases, given a more refined and sharper focus.
4. Essentially the analysis establishes that the existing therapies all address potential psychological malfunctions of the system (my theory), and all are valid to that extent.
5. Two crucial research issues then emerge:
1. There are many ways the system can malfunction, and identification of the nature of the malfunction is crucial before the appropriate therapeutic technology can be applied. Development of effective tools for distinguishing and diagnosing the manner of malfunction is a priority research issue for developing the technology leading to greater mental health.
2. Efficacy of the therapies needs to be researched and refined via ongoing studies of remission rates etc. These issues are crucial in regard to therapy effectiveness, mental health policy and development of greater mental health in the community.

The theory I have developed may or may not be the final version but the path I am on is the right path, and what I have is a vast step forward from the intellectual jumble encountered in the literature. It seems to me of all people you need exercise judgment and step above the politics and popularism so plaguing psychological thinking, your current policy merely reinforces schools and divisiveness by accepting it and tacitly working with it. Nothing can or will come of such a position, the only way forward to forge the intellectual integration as I have done. If you do not want to accept mine, then build another, for it is the only way the President will achieve any advance toward greater mental health in the community at large.

Cheers

Graham Little

PhD AFNZIM

  Appendix 2: Services offered

Dr Graham Little has been developing the model and theories for twenty years. It is now largely complete, and represents the most comprehensive overview of human causality and theoretical social science available. The focus of the effort for twenty years has been the following four questions:

• If we had a full and valid general theory of knowledge what would it tell us of knowledge and how would that knowledge relate to the objects represented by that knowledge?
• If we had a full and valid theory of psychology, what would be its structure and what would and could it tell us of particular people in particular circumstances?
• If we had a full and valid general theory of sociology what would and could it tell us of particular societies in particular circumstances.
• What is the relationship between the first three questions?

Services

1. To research and teaching organizations focused on psychology and epistemology:
1. Advice on teaching and training psychology practitioners based on the process theoretical rationale.
2. Advice in development of teaching and research programs on epistemology.
2. To therapy and practical research organizations.
1. Advice on therapy types and applications in relation to proposed psychological dysfunction.
2. Advice on assessment processes to identify and distinguish types of psychological dysfunction.
3. Advice on longitudinal studies to assess best therapy types in relation to dysfunction within the target population.
3. To national and local government groups responsible for mental health of the population, and for community social spiritual fulfillment.
1. Development of mental health policy, and policy on national and community social spiritual development.
2. Implementation of policy.
3. Advice on normalization of the theory to different ethnic and cultural groups.

For further information, contact Dr Little at phone 64 9 418 4623, email grl@xtra.co.nz, or post to POBox 36656, Northcote, Auckland, New Zealand.

Notes

1. Any numbers of texts provide an overview of current approaches to psychology. Useful is the postgraduate text Theory and Practice of Counseling and Therapy, by Richard Nelson-Jones, Continuum, London and New York, 3rd Edition, 2001.
2. I have discussed this issue many years ago when embarking on the program of thinking and theory development, back then I did not realize it would be so difficult or take so long. See Little, Graham R. Creativity and conflict in Psychological Science. UNESCO: Impact of Science on Society 134/135, 203-210, 1984.
3. See the papers 1 to 5 at www.grlphilosophy.co.nz for a full discussion and defining these issues leading into the full development of the Process Theory of Psychology.
4. This criteria arises from the epistemological position in papers 1-5 at www.grlphilosophy.co.nz that a variable is distinct from its value, and that any general theory must be variables or systems of variables, and any specific instance of that theory can only be described by inserting the appropriate values into the theory. In social science, this fundamental epistemological factor also means that whenever values are so inserted into any social science theory, those values themselves represent moral and ethical choices, and no matter how right or how certain of their human value we might be, they are not science, being completely life choices made by individuals bounded by whatever human values selected by those people. It is essential that I only discuss that which can be derived from the variables and their relationships, only these will necessarily cross all cultures, all gender issues, and all life style and moral and ethical choices.
5. See Little, Graham R., A strategy for mental health policy and the Process Theory of Psychology at www.grlphilosophy.co.nz.
6. My position follows the writings of Lloyd Geering asserting God to be a man made concept. See Lloyd Geering, Christianity without God, Bridget Williams Books, Wellington and California, 2002. I go somewhat further, proposing a completely humanist spirituality, not requiring God or any form of religion, but nonetheless a profound and full faith and belief system, focused on living a full and vigorous life in one’s own time and place: for an initial introduction to the ideas, see Little, G.R., Nouskills: skills of the mind, at www.grlphilosophy.co.nz.
7. See the relevant papers at www.grlpsychology.co.nz, issues of reductionism and mechanisms are all aspects of crucial epistemological considerations that had to be resolved before any valid theory of psychology could be developed.
8. See diagram 6 in Little, G.R., Why we do what we do: the outline of a general theory of psychology, at www.grlpsychology.co.nz. The model states that Thought does not immediately impact neural functioning, but that persistent types of thinking will feedback through the system (the model of diagram 6) and result in affect neural functioning in due course. The first and most immediate way it does this is via brain structures altering the sequences in which Thought, Emotion and Attention are organized in relation to some situation experienced or conceptual.
9. It could be argued that this is countered by the effectiveness of drugs on non-melancholic depression (see Parker, Gordon, Dealing with depression, Allen and Unwin, Australia, 2002 for a full discussion on depression and its different levels and states). But this is not so, the model does propose and allow the development of comprehensive systems of thinking whereby large parts of the world view are infected with certain ways of thinking, these ways of thinking leading to certain emotions and responses, such as pervasive feeling of helplessness. Under those conditions the model holds, and drugs will have a dramatic impact, but also the person will have to undergo significant counseling if ever to let go of the drugs, for to do so would simply allow the cognitive net (the term I use to describe the trap the person is in) to again guide all psychic flows to a single type of emotional state.
10. In the early nineties I suffered a heart attack, and while in Greenlane Cardiac Unit, Auckland NZ, I was interviewed by two young interns. For several years they had interviewed people who should have died but did not. At the end I asked of their results, they said all they could uncover was that some people seemed to have a greater will to live.
11. See Little G.R., Psychological theory and its impact on mental health practice and policy, www.grlphilosophy.co.nz.
12. See earlier papers, in particular Little G.R., Definitions of insanity, mental illness and impossibility of temporary insanity; a strategy for mental health policy and the process theory of psychology; Psychological theory and its impact on mental health practice and policy at www.grlphilosophy.co.nz.
13. The term ‘social spiritual wholeness’ is intended to convey the type and precise development of a person’s psychology and mental health resulting in their raising of their way of being in the world to their greater satisfaction and existential sense of well-being.
14. This situation is typified by the response from the President’s New Freedom Commission on Mental Health. Their policy position and my reply are in the appendix to this paper.
15. See the paper at www.grlphilosophy.co.nz for a discussion on scientific truth and judgment, Little G.R., Perception and a general theory of knowledge; and a model of knowledge and tools for theory creation.
16. Little, G.R., A strategy for mental health policy and the process theory of psychology, at www.grlphilosophy.co.nz.