This is the second essay of a three part series where I discuss issues surrounding our understanding of mental health. These reflections have been adapted from my previous writings on the matter, particularly those I’ve already posted on social media.
Our standards of mental health are defined by sociocultural expectations. “Dysfunction” necessarily implies an assumption with regard to what a “functional” member of society is supposed to be doing. So, the limitations of a society’s structures also define how we develop and define our identities. The current system we have encourages a Kaniya-Kaniya (to each their own) mentality, which tells us that we can achieve whatever we want if we set our minds to it... but failure is also totally our fault. If we are able to succeed, we gain and maintain status, which gives us access to comfort and resources. But if we can’t keep up with the cycle of production and consumption, we are set aside. We become “nobodies,” and we sever the connections necessary to our survival. The fear we have about losing our status is what Alain de Botton called “status anxiety.”1
One of the main causes of status anxiety is the assumption that we are all somehow “equal,” or that we all start in the same place. This of course doesn’t take into consideration a host of other factors that influence one’s “starting point,” such as genetic predispositions, socioeconomic status, childhood upbringing, colonial history, etc. Nevertheless, a person’s lack of productivity in a production-focused society has become an individual problem: if it’s not about one’s supposed lack of discipline, then it’s called a “mental illness,” supposedly emerging from a mistake in one’s biology, that the individual has a responsibility to seek help for.
Psychiatric medication is, of course, an additional thing we would have to pay for, and, in most cases, all it does is treat the symptoms of our actual problem, simply allowing us to be functional members of society. Many Filipinos can’t even afford medication, much less an initial diagnostic consultation. A lack of accessibility is one of the main barriers to seeking help—not only are mental health services expensive to the everyday Filipino, there are also so very few service providers, and too many of them are based in Metro Manila. There are only around 2,000 licensed psychologists—and among them, less than 1,000 are actively practicing.2
Again, what we consider to be mental illness depends on current systemic norms, so medicalizing these experiences is also heavily based on societal expectations. Joanna Moncrieff said that:
The ideological consequences of reframing social problems as individual pathology have also been highlighted, in the way this process diverts attention from the structural inequality and injustice that make life difficult for people in the first place.3
Unfortunately, in our genuine concern for mental well-being, self-isolation has been so expertly packaged as “self-care” in the Kaniya-Kaniya society. We are told that we don’t owe anyone our time, effort, or understanding; that we have to prioritize our own sanity and peace of mind. This mindset is influenced by a society that values competition over community. In that world, we can’t allow ourselves to be bothered by others; we must focus on improving ourselves and becoming the best (whatever this means). This only alienates us from other people and prevents the possibility of pakikiisa (oneness), which could threaten the status quo. And of course, self-isolation will work as a form of self-care if the expectations of our Kaniya-Kaniya society don’t change. Personal changes and psychiatric medication will remain the most ideal solutions if no adjustments are made on the systemic level—this doesn’t just mean offering more support in the form of manpower and funding; it also means an actual transformation of oppressive, exploitative, and alienating systems. We are now called to move from a “Kaniya-Kaniya” mentality to a “Tayo” (together) worldview.
In the final part of this series, I will be discussing what tends to happen when we identify with our own dysfunction.
For those who want to learn more, I’ve released a special mental health primer focused mainly on concepts and frameworks in Filipino psychology, exclusively for members of the Sikodiwa Circle—you’re welcome to join us!
A. de Botton, Status Anxiety, 2004.
A.C. Tuazon, Board of Psychology Goes Overboard (Inquirer.net), 2023
J. Moncrieff, The Political Economy of the Mental Health System: A Marxist Analysis, 2022. Frontiers in Sociology, CC-BY.
This is such a reflective piece. Enjoying the series so far!