The concept of emotional disorder

The concept of emotional disorder

In August 2024, a special report on ‘ecological medicine’ was published in Psychiatry Online. The authors of the report describe ecological medicine as “the structured and deliberate use of connectedness and interaction with plants, animals, and other species to generate a therapeutic effect for individuals.” While few would doubt the value of spending time in the natural world, the suggestion that we need medicine to mediate our connection to nature is a striking one. Surely nothing could be more direct and immediate than the sense of awe we feel when we gaze upon the vast night sky, or the sense of renewal we feel when wandering in a spring meadow? And surely, too, it is more than just our health that is affected by this engagement; we are affected.

That the concept of ecological medicine seems to be pointing at something so familiar, and yet seems to be expressing it in such a striking and novel manner, gives us pause to reflect. How have we arrived at a point in our civilisation where it seems sensible to describe as a medical discovery the idea that “other species are worthy of respect”, and that the recognition of inter-species reciprocity that is enabled by participating in ecological medicine “serves to counteract some of the societal elements contributing to society’s epidemic of mental health problems”?

This manner of approaching our sense of connection with nature is, arguably, emblematic of a sweeping cultural trend:

Today, we speak of ‘mental health’, often treating this as synonymous with the notion of flourishing itself. To accept the notions of ‘mental health’ and ‘flourishing’ as synonymous with each other involves a commitment to the conjunction of the following two claims:

C1 takes mental health to be sufficient for flourishing, whilst C2 takes it to be a necessary condition. C1 is the stronger of the two claims insofar as it asserts that nothing else—apart from being mentally healthy—is required for human flourishing. C2, unlike C1, allows for the possibility that there may be other conditions besides that of mental health that are also necessary for human flourishing—conditions pertaining to other domains of value such as ethics or aesthetics (domains that are of course salient in our connection with nature). But even the weaker claim, C2, imports a medical connotation into our conception of human flourishing that would have once seemed novel, perhaps even puzzling. Aristotle in the Eudaimian Ethics, for instance, takes health (like wealth or honour) to be a means by which we might come to flourish, rather than as tantamount to flourishing itself. How did this connotation appear, signalling the shift towards the medicalisation of our understanding of what it means to flourish?

Here is one story of the origin of this connotation (told by Martin Seligman, a founding father of the positive psychology movement): if (severely) distressing emotional experiences are cast as states of pathology, as contemporary psychiatry does, then it isn’t a huge leap (although it is a substantive one) from this claim to the idea that being in a state opposite to this—that is, enjoying a preponderance of pleasant emotional experiences—amounts to a state of wellness, a state of wellbeing, indeed a state of flourishing. This chain of inference is one of the major paths we have taken that has led us towards the medicalisation of our conception of flourishing. If this is right, then recovering alternate, non-medicalised conceptions of human flourishing, conceptions that might well return to us the expressive power to capture (amongst other things) our immediate connection with nature that we intuit, will involve a dissection of the concept of emotional disorder.

What, then, is the basis of the claim that (severely) distressing emotional states constitute states of pathology? From what general concept of disorder is this identification derived, and in light of what conception of our emotional lives might this identification be motivated? Surprising lines of inquiry emerge in the course of this exploration, all of which point to the pivotal role that our emotions play in the myriad ways we appraise our lives and make sense of ourselves. One particular line is worth mentioning here: it is often assumed that the medicalisation of our understanding of human flourishing signifies progress, at least in the sense that it yields an understanding that is informed by scientific knowledge. But this line of inquiry invites us to consider whether human flourishing is something we should seek to understand exclusively in scientific terms (as the invocation of the idea of progress implies). Indeed, is it something we should seek to understand in scientific terms at all? A systematic investigation of the value of emotions in human life suggests that there are visions of human flourishing that invite, indeed compel, not the detachment of the scientific gaze, but our immersion in life through the exercise of our rational agency. It is in appreciating the trade-offs between these alternative conceptions of human flourishing, and the appraisals they lead us to make of our emotional experiences, that we arrive at a clearer reflective understanding of our current predicament. It is in so doing that we may recover our power to express the immediate connection we feel with nature when we plant an acorn and tend its growth.

My aim is not to argue in favour of any particular conception of flourishing—and so I do not, for instance, claim that it is a mistake to medicalise our sense of connection with nature. It is rather to display as perspicuously as possible some of the conceptual structures that guide our ongoing quest to live happier and more enlightened lives. This quest has, for the most part, taken a very distinctive shape over the past half century: we pour billions of dollars each year into the enterprise of improving our ‘mental health’. It is ultimately for us to decide, individually and collectively, whether thinking of our flourishing in terms of the notion of ‘mental health’ is a good thing to do—rather than being, merely, something we’ve simply ended up doing.

_{Featured Image by Sébastien Bourguet on Unsplash.}

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