Robin Skynner: The Mental Health Continuum

“Show me a normal person, and I will cure him.”¹

“The normal person is an ideal goal for failures—for all those who fall below the general level of adaptability.”¹

C. G. Jung


Pain Is Not Illness

One of the most misguided beliefs about psychotherapy is that turning to a psychotherapist for help means that you are not normal. Such an attitude leads to unjustified feelings of inferiority and failure, missing what is truly important—namely, that the time for change has come. What is experienced as failure may later turn out to be the most valuable thing in our lives.

The destruction of the old is inevitably accompanied by suffering, but pain is not always an expression of illness. Very often it is an impulse for development—a sign that the answers we are seeking cannot be obtained from our habitual way of thinking or from the way the average person thinks. At such a moment, we need a new kind of knowledge, and the provision of such knowledge is an integral part of any therapeutic work.

As you will see below from the “mental health continuum” presented by Robin Skynner, not only is there a substantial difference between mental illness and psychological suffering, but as a rule it is precisely developing individuals who are more prone to passing through psychological crises and periods of suffering. We also tend to equate “normal” with “average,” but average does not coincide with normal. Moreover, human development does not take place by maintaining the status quo, but by changing it.


A New Concept of Mental Health

Robin Skynner, a well-known English psychotherapist, presents a new concept of mental health in his book Life and How to Survive It. This concept turns the traditional psychotherapeutic approach upside down, which defines mental health as the opposite of mental illness. Instead, it seeks the definition in the characteristics of mentally healthy individuals who have achieved high levels of success, happiness, fulfillment, and meaningful relationships with others.

Through analysis of data from a long-term psychological study of such individuals (a so-called longitudinal study), a new definition of mental health was reached. The new definition ceases to divide people into mentally ill and healthy; instead, it states that mental health is a variable magnitude. In other words, all of us fit along a single continuum, manifesting different degrees of mental health—from the lowest to the highest. This applies not only to individuals but also to larger human groupings—families, organizations, and societies.

According to this continuum, the so-called average person, whom we usually use as a benchmark of normality, is simply statistically average in terms of mental health. In other words, being “normal” by average standards does not mean that one has a high level of mental health.

Moreover, the few individuals who truly have high levels of mental health may be perceived by those in the middle range of the continuum as “suspicious,” because each level of mental health has its own value system (a set of beliefs and rules) according to which the other levels are seen as inferior.


More on the Continuum

At the very bottom of this continuum are individuals for whom life is a struggle. These are people who use immature or neurotic defense mechanisms that disconnect them from contact with reality. This group varies widely and includes both representatives of schizophrenic, antisocial, or manic behavior, as well as individuals with depressive or neurotic behavior, who have a less distorted sense of themselves and others but still experience significant difficulties in relating. What they share is a strong desire to become like the others—that is, to join the people in the middle range of the continuum.

These people comprise about 20% of the population in developed countries.

Characteristic of the mental well-being of people in the middle range of the continuum is that they have achieved a certain degree of stability and clarity about who they are. Unlike the previous group, they “know their limits.” Their problem is that deep down they are not entirely confident in their ability to preserve what they have achieved. They still fear losing stability and clarity if they do not cling to them. Hence, rigidity is common to them. Everything of theirs—relationships, opinions, beliefs, and principles—is tightly fixed so as not to slip out of control. These people cannot fully relax; they suppress their emotional reactions and live a rather even, tightly controlled kind of life.

These people comprise about 60% of the population in developed countries.

In contrast, exceptionally healthy individuals and families have refined the art of living to such a degree of confidence that they can let things unfold and simply enjoy their experiences. Spontaneity, goodwill, confidence, a healthy connection with reality, and living life to the fullest are the main characteristics of people with high levels of mental health.

This type of people makes up the remaining 20% at the upper end of the mental health continuum, with those who are “exceptionally mentally healthy” constituting only 5% of them.

I hope it becomes clear why “normality,” in the broad sense in which this word is used, is far from bursting with mental health.


The Mental Health Continuum and Psychotherapy

Another interesting fact from the cited study is that the more mature an individual is, the more open they are to psychotherapeutic help. They are aware of their limitations and therefore have a greater desire to improve their situation. For example, 40% of those observed in this study who reached the highest levels of the continuum had attended psychotherapy at some period in their lives.

In my experience, those who most often turn to the services of a psychotherapist are people in the middle range of the continuum. These are individuals who suffer from the limitations and rigidity of the average model of thinking but do not yet have a family and cultural model that can provide answers to the questions that torment them. They realize that the way they were raised no longer works, yet at the same time they do not know what the alternative looks like. They may also feel confused—unsure whether they themselves are abnormal because they cannot adapt to the average, or whether the opposite is true.

I recall a client of mine who sought me out because she was unhappy in her marriage. At our first meeting she asked me, “Am I the abnormal one for believing that a happy marriage is possible, or are my friends right when they tell me to endure and not ask too much of life?” What I told her was that she was not abnormal at all—quite the opposite: it is psychologically healthy not to resign oneself to an unhappy marriage. All of us can be much happier than the average levels of happiness we see in the homes of relatives, acquaintances, and most of all in our own families of origin. To achieve this, however, we will have to work seriously on ourselves and renew the “records” in our family system.

As Robin Skynner writes, although the best way for a person to attain a high degree of mental health is to have been born into a very healthy family, individuals born into unhealthy families also have a chance to reach the very top of the continuum. According to the study, by the time people with less satisfactory childhoods reach their fifties, they function no less healthily than those who had very happy childhoods. This is due to the fact that these people first acknowledged that something was missing, and then sought out the experiences that could compensate for their initial deprivations.

My client was right to believe that a happy marriage is possible. Her friends were also right to say that the majority of families indeed do not stand out for high levels of happiness, intimacy, trust, openness, and freedom. In turn, I have sufficient grounds to claim that happiness is not a privilege reserved for a few lucky ones, but a possibility open to every person.

Thus, the prevalence of something is not a criterion that it is the best. It is merely an expression of what is statistically average. Psychotherapy can help a person free themselves from the rigidity of average levels of mental health by supporting them in the effort to discover, at a deeper level, who they truly are and what they want—and then to encourage them to take the risk of embodying this in their lives. Moreover, individuals who succeed in making the shift toward higher levels of mental health subsequently become agents of positive change in the families and groups to which they belong.

We live in a time in which there is a ripe and urgent need for average notions of normality to be transformed. Who claims that psychotherapy is not for “normal” people?!

Kameliya Hadzhiyska


Further Reading / Related Topics:

Psychologist and psychotherapist, founder of espirited.com.
English
  • Bulgarian