Ways to Understand Mental Illness

Mental illness, and the attempt to understand it, is not new. One popular theory in the Middle Ages was the notion of humour (from the Latin word for fluid). We have four fluids running through our body - blood, phlegm, choler (yellow bile), and melancholy (black bile).

Your personality, or temperament, results from the various ratios of fluids present in your body. Someone with excess blood, known as sanguine (again Latin), is optimistic and sociable. Someone with excessive phlegm is relaxed and peaceful. Too much choler makes one short-tempered and irritable. Too much black bile makes one melancholic, analytic, and gloomy.

Your mental state, then, results from something within you. The black bile may have been placed there by a demon, but depression was a real thing inside you, not an illusion of the mind or a figment of the imagination.

It is you that is sick, your physical/spiritual being. You need to fight against this inner thing that is inside and a part of you. I take it you can see the appeal of having a priest come and hear you repent, announce absolution and offer you the body of Christ in communion when you see the world this way.

We no longer understand mental illness like this, and we are quick to say – thank goodness. Not so fast! We now tend to see mental illness as a chemical imbalance. It is a sickness that has happened to you – it has beset you – but it is not essentially you.

Much of this is right and helpful. Mental illness often is a result of brain chemistry and hormone changes, some of which can be triggered by circumstances that happen to us. But I propose we may have lost something.

When we separate the physical body from the soul/spirit, and we separate disease from sin, we risk losing the role and identity of self. Sin is a part of our inner self – it is a thing that is part of who we are. Unchecked, it can negatively affect our spiritual and emotional well-being, and we need to fight against it. The battle against our demons is a daily expression of the good fight.

At times, a both-and rather than an either-or view is more insightful.

By Rev. David Rietveld