The_Illusion_of_Mental_Health - The Illusion of Mental...

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The Illusion of Mental Health Jonathan Shedler, Martin Mayman, and Melvin Manis // is argued that researchers' reliance on "objective" men- tal health scales and disregard for clinical judgment has led to many mistaken conclusions. Specifically, standard mental health scales appear unable to distinguish between genuine mental health and the facade or illusion of mental health created by psychological defenses. Evidence is pre- sented indicating that (a) many people who look healthy on standard mental health scales are not psychologically healthy, and (b) illusory mental health (based on defensive denial of distress) has physiological costs and may be a risk factor for medical illness. Clinical judges could dis- tinguish genuine from illusory mental health, whereas "objective" mental health scales could not. The findings call into question the conclusions of many previous studies that rest on standard mental health scales. They suggest new ways of understanding how psychological factors may influence health. Finally they suggest that clinical meth- ods (which researchers often malign) may have an im- portant role to play in meaningful mental health research. T his article addresses two issues that are usually dis- cussed in separate literatures. The first has to do with the assessment of mental health. We will argue that the most widely used and cited measures of mental health suffer from a serious limitation. The limitation is that they cannot distinguish between genuine mental health and the facade of mental health created by psy- chological defenses. The second issue has to do with the relation between psychological factors and physical health. We will argue that psychological defenses have concrete physical costs and may be risk factors for medical illness. Genuine and Illusory Mental Health Countless scales exist to assess one or another facet of mental health. In general these scales are straightforward. Items tend to be transparent in intent, and investigators tend to accept scale scores at face value—assuming, for example, that high scores on depression scales signify depression, and low scores signify relative psychological health.' In contrast, psychoanalytic thinkers (and depth psychologists more generally) are often unwilling to accept self-report data at face value. They take seriously the no- tion of unconscious processes and unconscious defenses and assume that psychological distress is often covert, experienced and expressed only indirectly. From this per- spective, many people who report psychological health may not be healthy at all. To explore this possibility, we will investigate the following hypothesis: Among people who "look good" on mental health scales, there are two subgroups. One subgroup is psychologically healthy. A second subgroup is made up of people who are psychologically distressed, who maintain an illusion of mental health through defen- sive denial of psychological distress?
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This note was uploaded on 06/01/2011 for the course PSYCH 3250 taught by Professor Segal, h during the Spring '08 term at Cornell University (Engineering School).

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The_Illusion_of_Mental_Health - The Illusion of Mental...

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