Mental health viewed as an ideal

The concepts of health and disease have always challenged the human mind. They continue to be frequently discussed with reference to both the body and the mind, but conclusions seem elusive or at best heuristic. With respect to the mind, especially, the challenge seems awesome: When the investigator and what is being investigated are one and the same, impartiality, objectivity, and the other virtues of scientific inquiry appear difficult to assess, much less attain. And yet, not surprisingly, the subject continues to attract investigators (e.g., Kaplan, 1967; Sabshin, 1967; Shakow, 1967; Offer, 1973; Sedgwick, 1973; Bruhn, 1974; Margolis, 1976). Philosophers and physicians alike respond to the subject's appeal--its theoretical interest, the conceptual problem it presents, and its implications for our understanding of ourselves. And those of us who are clincians cannot deny the practical importance of our concepts of mental health and illness: We each daily base decisions on our understanding of these concepts, and even if we cannot provide solid basis for such an understanding, we perhaps owe it to our patients to make explicit what this understanding, our philosophy, is.