To say that someone suffers from emotional or mental abnormality raises difficult questions about the correctness of the observer's frame of reference. To ask what is mental illness or health is quite a different question to that of bodily health. One's interpretation of normality is always conditioned by one's own social experience and culture. What may be commonly seen as abnormal and deviant behaviour in one part of the world, may be quite acceptable and even the norm in other parts. This applies particularly to the gender debate and as to which cultural or sub-cultural attitudes and practices are best or worst, right or wrong. In recent decades, persons in the forefront of research into mental 'illness' have warned about the many dangers in misapplying and over-extending the concepts of abnormal, deviant and mentally ill¹.

The idea of madness is closely related to judgements of where the line is to be drawn between 'reality' and 'fantasy'. Referring to excessive fantasy, the diagnosis 'paranoid delusion' is still in widespread use in the psychiatric profession, sometimes under cover of altered terminology. According to this, a person is judged to misperceive commonly-accepted facts and ideas so radically - and often with a consistently mad method - that they cannot function normally. The problem with this is that what can be seen as paranoid delusion in one environment may often be part of a common belief system and so be normal, or at least acceptable, in another. It may well be a matter of the proverbial 'one-eyed person in the country of the blind', or again, it may be a case of distorted vision due to severe mental and emotional disturbance.

Further, abnormal behaviour that is often classified as one or another type of affective disorder may well be the person's survival strategy. Many types of mental disorder may likewise be regarded as reactions to intolerable circumstances or pressures, as survival strategies developed in response to very early growth-restricting influences of a physical and/or emotional nature.² Chronic psychotic and schizophrenic behaviour can even be the result of a long-term and confused history of events in which weak, defenceless persons become defined as mad due to family conflicts and other social pressures. Where affective disorders may have a strong genetic component, the symptoms one classifies as 'mental illness' may equally be seen as adaptations to genetic inheritances experiences which are encountered by the sufferer as problems in living.³ All ideas about neurosis, psychosis and schizophrenia clearly must therefore be used with great circumspection and reservation of final judgement. They may sometimes be useful in trying to reach understanding and alleviation of a person's problems and difficulties, but very often they are largely but diagnostic tools as indicators of which pharmaceutics might be administered and for classification and allocation of people in health institutions.

Because highly irrational feelings and ideas about other persons are frequently evident in those who suffer from various forms of mental disorder, one can ask how and at what stage perceptions, feelings or thoughts can be said to have gone wrong and become 'deranged' as mental-emotional projections or otherwise abnormal experiences.

Mental disorders often involve disturbance of both the emotions and reason at once, but usually the aberration predominates in one or the other. The causes of psychic disorder are only psychological where they are not purely genetic or physiological in origin (eg. delusions due to a brain tumour). A majority of psychic disorders evidently tend to come of emotional problems and trauma, while the remainder are due toto various mental derangements. Mostly, however, emotional upsets come sooner or later to affect mental functioning and vice-versa. This effect is mostly indirect, through the cumulation of upsets in interaction with the social environment, but can also be direct in that feelings gradually distort perceptions and so the understanding or wrong thinking about one's problems leads one further into emotional tangles and self-destructive behaviour. Much modern psychological research clearly shows that many serious psychic problems or personality disorders are connected with unfortunate early experiences, identifications and shocks to the feelings which hinder the fruitful integration of the growing personality. The more serious a mental disorder, the more likely it has originated early in life. A very wide range of causes or complexes of factors can apply, from sensory disabilities, early emotional deprivations or (mis)identifications, traumatic experiences, inadequate care or positive stimuli and ideas and almost always the lack of proper understanding and love.

It is not possible here to do justice to the enormous literature on mental-emotional disorders or their treatment. In the following, however, certain neglected aspects of the problem are discussed from a viewpoint formed by Vedantic insights.

MENTAL DERANGEMENT

It has been seen how the Vedantic view holds that mind, not matter, constitutes the real basis of perceptual reality. In accordance with this, the term 'mental derangement' depicts the prominent role of the mind in mental illness, rather than accenting the emotions as some independent causative agency. It is in the mind that thoughts are conceived, and thoughts are precursors to words and actions. Feelings may often occur prior to thoughts, but the two are never divorced from one another. Emotions can often be directed, altered and controlled by thoughts. Moreover, it is common human knowledge that thoughts directed or controlled by emotions tend to be unruly and counter-productive. Most likely, errors of the mind just as often affect emotions and their cumulative effect can be inadequate and conflicting emotions. Vedanta tends to view thought as a primary factor in dealing with the problems of living.

According to higher psychology, then, development of the personality is achieved primarily - though not entirely, through right thinking. Behind mental acts and reactions there often lie very intricate and long and uneven processes of perception and misperception, of fortunate and unfortunate thought or interpretation of reality and of understanding and misunderstanding.

Vedanta teaches how the mind conditions reality itself - rather than vice-versa, and articulates whichever desires we allow to bind us. Reality is not simply registered by our minds like passive receptors. Nor is it 'given' as raw data through the gross 'five senses' (jnanendriyas) so much as by a corresponding inner principle of mind which activates the senses and makes their data intelligible. This same subtle principle can be observed apparently reproducing the 'data' of the actual sense in memory, in imagination and in dreams etc., yet this principle can and does operate creatively and independently of external stimuli, and even when stimuli are being noticed.

Further, the chief expression of the human mind, the will - constituted through the five organs of action (karmendriyas) - was for far too long underrated or even neglected in psychology . This resulted in a bias towards regarding the psyche more as a passive receptor than an active actor. Thus, the view of mental 'illness' and associated emotional disturbance was, and still largely is, suffering from it. However, when the will, determination and resolution are strong and also misguided due to confused or fallacious ideas, excessive mental disorder can occur. This is one common result of an ego that wishes to dominate others, the social environment etc., the manipulative and often a ruthless psychopathic mentality.

The present view, that mental illness is almost always partly, and even sometimes wholly, the result of a process of mental derangement, is not incompatible with what is presently known in psychiatry as to the mind's functioning or in neurology as to the activity of the brain. The term 'derangement' here covers most kinds of chronic confusion and irrational delusion that can affect a person's mental balance so that some of a person's ideas are seriously misguided or misplaced and prove a hindrance in fulfilling one's role in life. Such wrong thinking includes vagaries of the mind due to misinterpretation of experiences of oneself and others and in reasoning unrealistically about them. Such disorder of thought and behaviour occur where basic confusions persist in the interrelated processes of perception, conception and/or in subsequent emotional and intellectual evaluations and decisions.

The role of the mind - as opposed to that of instinctual drives, acquired habits and basic emotional reactions - is seen as much more fundamental in the overall growth of the sane and fully balanced human personality that is recognised by the main body of Western psychology. The environment, though always involved, cannot be regarded as itself causing mental illness. The notion that mental illness is caused very largely by severe lack of love and emotional traumas of various kinds has become widespread in popular thought too, without realising sufficiently that it is the subjective reaction that is the determining factor. Likewise, failure to recognise how the intelligent child and the sensitive child can experience, both for better and for worse, what means nothing to other children can be very disruptive of healthy mental-emotional development. What would be a catastrophe for one person can, for others, sometimes be without appreciable influence or even be experienced as a form of liberation.

The distortion or disorganisation of mental functions does not necessarily affect the processes of actual reasoning, unless we are talking of 'reason' as common sense plus sanity. As G.K. Chesterton once wrote, "Everyone, who has had the misfortune to talk with people in the heart of or on the edge of mental disorder, knows that their most sinister quality is a horrible clarity of detail, a connecting of one thing with another in a map more elaborate than a maze. If you argue with a madman, it is extremely probable that you will get the worst of it; for in many ways his mind moves all the quicker for not being delayed by the things that go with good judgement... He is more logical for losing certain sane affections. Indeed... the madman is not the man who has lost his reason. The madman is the man who has lost everything except his reason." Chesterton was, however, doubtless thinking of what are particular kinds of mental derangement, such as have been classified in traditional psychiatry as 'paranoid delusion' or 'obsessional neurosis' etc.

As said before, the line between sanity and insanity is extremely tricky to draw, as are the lines between different forms of (so-called) insanity, quite apart from the questions as to their causes. One may rather think of a very extended continuum of degrees of sanity between two ultimate experiences, say from chaotic and raving madness to virtual human perfection (as exhibited by very saintly and fully self-realised individuals). There are all manner of origin and type of misconception that can affect mental balance to any degree of seriousness, whether having to do with oneself, with family relationships, with society and how it works and even with the world or cosmos generally.

The human mind obviously possesses very many potentials - whether conscious or beyond awareness, which are amazing in their variety and capabilities, often bewildering. The mind can itself transform reality in many ways, both sanely and insanely, especially over time. The uniqueness of combination of events and details in mental development - including derangements, are legion. Understanding anyone involves learning the relevant details of that person's specific history and there simply are no foolproof or even reliable short cuts to understanding a person's condition through generalised diagnoses (such as in psychiatry), categories or statistical features (as in clinical and social psychology). On the contrary, the direct and indirect effects of a diagnosis as a 'patient' can certainly very often cause more suffering than if one refrains.

A clinical system of treatment that relies upon diagnoses, especially when leading to life in a mental health institution, very often leads to human casualties and even to the repression of the basic right to be respected as a person, whatever one's sufferings, problems or failings. The approach to investigation of persons must be more scientifically and analytically open-minded than through categorisations, which systems have already here been shown to have many weaknesses.

INNER MENTAL PROCESS IN DERANGEMENT

Over time, the internal structure of the mind - including emotions and thoughts - whether as conscious or subconscious processes - can go awry from early on... or else later warp away from a sane and healthy mainstream development. Such a deranged process cannot be described and defined with any neatness according to any reliable scientific diagnosis, due to the special circumstances in each person's total physical and social environment from birth onwards.

Mental derangement is always at some point identifiable as such through the sufferer's ideas. The nature of our experience and our subsequent behaviour are strongly formed by our ideas... wrong ideas lead to confusion, right ideas to clarity. Confusion deepens or one's view of the world becomes 'disarranged' the further the mind pursues the wrong ideas. Likewise, the further the mind pursues the right ideas, the greater the order and clarity that will ensue in perception, experience and understanding. What is 'the right idea' in any connection depends both upon what is a relevant and adequate response to a given situation and also simply what is a good - or conversely a bad - idea.

The emotions are known to be disturbed in practically all types of so-called 'mental illness'. This disturbance can, of course, be both the cause of wrong ideas and their result. Through time, the emotions affect thinking and thoughts work back upon feelings in a mutual process. Not only do uncontrolled negative emotions affect a person's relationships and activities, but can also badly affect the long-term interests of the individual towards autonomy, self esteem, confidence and fulfilment. Emotions that prove chronically inadequate for dealing with one's challenges or unbalance a person in other serious ways often result from powerfully disturbing experiences of various kinds (traumas). They can, however, also be the product of the gradual development of fruitless or wrong ideas... especially morally bad ideas.

The ego is indeed a product of the sense of self acting upon its impulses and reacting to its environment. From the Vedantic viewpoint, all supposedly 'objective events' are something to which the mind reacts and in relation to which it forms itself, guided consciously by the ever-present 'I'. This stands in contrast to a common assumption that the psyche is the end product entirely of sense experience and other objective causal forces (scientific physicalism).

The importance of the self-experiencing mind and thus of the subjective processes of perception, thought and emotion in mental illness, was first firmly recognised by Freud through his method of studying the free associations of the mind. The same basic insight into one or another aspect of the subjective has been recognised and reasserted in various ways by many new approaches in therapy.⁴

Most derangement can be analysed at the most basic level, it being a pathological counterpart to the correct and balanced use of the faculties of perception and understanding. Disturbed emotions from raging maniacal outbursts to frozen depression of the feelings are thus seen as arising on the background of intimately connected thoughts in their the mutual or interwoven relations (inclinations, tastes, attitudes, values, opinions, desires etc.).

FALLACIES OF PERCEPTION AND COGNITION

One model for defining the confusion of thought at a very basic and clearly demonstrable level combines elements of fallacious reasoning well known from Francis Bacon, J.S. Mill and others. This model is so basic that it is able to incorporate practically all common forms of erroneous perception. It is not limited to reasoning or intellectual activity, for it is also an excellent pointer in self-analysis and in the understanding of how the mind either punctures its delusions or goes through stages of increasing derangement. Vedanta and related Indian philosophy also provides analysis of the same errors of thought. Its terminology is so foreign and involved, however, that the Western model is chosen here.

There is an increasing body of research showing that, for practically every psychic function or stage of experience/awareness, there is a possible corresponding malfunction, a pathology. Pathology is thus seen as a negative reflection of the model of the 'healthy' psyche, secondary to it. Most forms of psychic pathology will involve the distortion of perception at some stage in their genesis or development.

Mental derangement is a malfunctioning of normal thought operations. It occurs in all degrees of seriousness and triviality and probably very few persons indeed are entirely free of it in some form. Yet a large or crucial part of a person's mental life can develop in such a way that one's ideas - and even perceptions - become very far removed from common sense and reason.

The basic types of fallacy of observation occur very widely indeed, whatever the subject. Ignorance of facts, misinterpretation and poor thinking is far from uncommon among people in general. This subject is a vast one, requiring constant renewal of analysis due to the ever-changing fads and fashions in how we tend to misperceive and misinterpret the world around us, society and ourselves. There are many ways in which our conceptions distort our observation and lead to wrong understanding, whether by expectation, preconception, habit of mind, misunderstanding due to linguistic problems ('the bewitchment of intelligence by language' Wittgenstein), acquired fixed ideas and prevalent misinformation, or by absorbing social prejudices, being misled by ideology or false theory and so on. Some perennial insights into this are being applied in contemporary psychotherapeutic work on problems where mental derangement is evident, such work as 'de-programming' troublesome and unwanted mental, emotional and behavioural patterns. Relearning processes aim to correct such problems, often through opening up to alternative perceptions, more constructive interpretations, making better identifications and role models, improved self-image and the realistic, gradual affirmation of future possibilities.

Derangement through misobservation: The level at which such 'derangement' occurs may be primary or secondary, depending on whether it is due mainly to basic perceptual impairment (such as due to poor eyesight, hearing or in the use of alcohol, drugs, poisons etc. and other causes of abnormal brain functions) or mainly impairment of apperception, such as in faulty interpretations and understanding or in the confusions of one's ideas and attendant emotions.

People with mental disorders can, in all seriousness, sometimes put very unrealistic and fantastic interpretations on fairly commonplace events. However, the judgement that a very unusual interpretation is paranoid derangement or chronic obsession can itself be due to narrowness of vision, lack of knowledge of other cultures and belief-systems etc. Therefore, what appear as deranged interpretations, ought always be taken in, considered seriously and investigated. However, when the derangement is systematic and obtuse, or is so endemic as to bear no relation to observable behaviour or rational consistency the problem of investigating its origin and embroidery becomes very demanding. This is where the practical demands often lead a therapist to give up and declare that there must be a deep-lying traumatic or basic deprivational cause, and possibly a physical impairment.

Among the various possible approaches to the analysis of serious mis-observation are:-

Malperception: This is perceptual derangement where there are physiological causes, such as the malfunctioning of sensory organs or the brain. It ranges from simple defects, say of colour vision or the judgement of distances by hearing or sight to the full hallucination in which the entire environment can alter one's vision etc.

Misinterpretation: Wrong interpretation of sense impressions arises at various levels of the observational process. The 'instinctive inference' exemplifies the more basic level, such as where one 'sees a ship on the horizon' even though it is only a vague shape... automatically inferring that it is a ship on the basis of past experiences. The shape may prove to be a distant headland etc. etc. A less basic level of misinterpretation may be exemplified by someone who has read about and is interested in UFO.'s interpreting the shape as such instead. This misinterpretation is made at a more conscious level. The more reflective the level at which the misinterpretation is made, the closer one comes to either unwitting delusion or conscious lying.

Misinterpretations due to such unreflected and habitual apperceptions are closely related to preconceived ideas and other prejudices of thought and emotion, which they also themselves tend to reinforce. The so-called 'fallacies of reason', as traditionally analysed and exemplified in logic, provide a useful summary of certain general types of misinterpretation at the level of observation.

Mis-selection: All perception and observation is selective, whether consciously or subliminally so. Two general sorts of error include: One fails to notice or attend to what is relevant to the circumstances. Secondly that one lays too much emphasis on what is trivial and incidental in trying to avoid the first sort of error.

Non-observation: There are a great number of ways in which the failure to observe what is relevant, important or crucial to forming a correct opinion occurs. Some general errors of non-observation are:-

1) Bias due to preference for noticing only what is acceptable to our own beliefs or theories.

2) Neglect of cases where one would otherwise expect a phenomenon not to occur ('negative instances'), but where actual observation would have shown that it does occur.

3) Traditionalism and orthodoxy, where one tends to infer that, because something has never been noticed or judged to have been observed in the past, it is non-existent.

4) Accepting the truth of an assertion on an insufficient amount of 'negative evidence' (i.e. in the lack of checks on otherwise-expected observables). For example, because something, say teleportation, is reported to occur but fails to occur in many cases where it seems it should also therefore occur, one may incorrectly infer that it never occurs.

REALITY SENSE AND DERANGEMENT

The forms of misobservation building on malperception and diverse misinterpretations outlined above can, under unfortunate prevailing conditions, lead towards increasingly serious and pathological forms of mental derangement. The piling of meanings upon meanings whereby one gradually modifies and thus distorts the original facts characterises many psychotic delusions. Once underway, such processes tend to 'spread' to other matters than those wherein they originated, not least where the facts are contended within a context of conflict-filled emotional personal or group relations where social power is at stake.

The identification in practice of any degree of mental derangement depends upon how it is understood or defined. This is itself a highly variable factor, depending much upon cultural traditions and on judgements and beliefs of both religious and semi-scientific nature. Mental derangement may itself sometimes even be argued to apply to some real extent in cases where beliefs are clung to so that over-confident subjective judgements result. Such beliefs may, of course, be founded on apparently rational systems. This does not exclude certain psychological and psychiatric theories, nor ideological and religiously-held superstitions, all of which can and do easily become instruments of suppression of their victims. Usually, for a belief system to be regarded as derangement it must be enforced and reinforced by strong emotions, unusual actions and inconsistent behaviour.

Less serious for pathology are those milder forms of mental derangement which arise at the higher levels of abstraction, such as is often seen in the rigid absolutisation of faulty or non-universal political and religious ideologies of the narrow kind. They can, however, be all the more fateful for many people. There are various combinations of primary and secondary derangement before extreme pathological states of mind in which one constantly perceives as fact what is mere imagination. To avoid confrontation with self-contradiction or the 'healthy confusion' that can open for fresh insights, some people 'cut out' certain experiences from awareness or compartmentalise their minds. When excessive, this can even lead to the division of one's own identity or 'splitting' of personality. This can create many enigmas, especially when these are encountered by an outsider at a late stage in the process. The confusion can obviously be so thorough or long-standing as to make reconstruction of the case history of derangement as unfeasible. Much so-called schizophrenia is regarded thus and is still seen as untreatable except by physical methods (drugs, electro-shock and worse).

The faculty of will can play a major role in mental disturbances. The well-regulated and steady will, when directed towards right and good ends, is itself not only a mark of sanity but also of vital and dynamic psychic health. The lack of will power - an unusually weak will - is a mark of some degree and type of mental derangement. In both cases, the conditions can be traced back to certain ideas which, though they may not be the sufficient cause of the condition, nevertheless accompany it and serve to maintain it. On the other hand:

"Sometimes when the will or determination behind the resolution becomes too strong, the mind overleaps its limits and man is rendered insane." Sathya Sai Baba.Sathya Sai Speaks Vol 10. p. 279

The above would probably be classified as some form of megalomania or obsessive psychosis. Sudden outbreaks of dramatic madness do occur in some people, usually 'triggered' by some disturbing event, the person having long been a so-called 'borderline case'.

The work of the American clinical psychologist Wilson Van Dusen, shows that what has long been held to be fact in the Vedic-oriented cultures of India, has demonstrable basis in the experiences of mental patients: namely, that there is indeed and literally such a thing as 'spirit possession'.⁵ Whatever status one may ascribe to the various 'spirits' or 'elementals' that are capable of driving vulnerable persons to exhibit the signs of madness, phenomenological description of their various types and levels of development accords with the analysed contents of verbatim reports of these spirits' own words and with much that is available in the world's huge literature bearing on these subjects. The causes of these so-called 'auditory and visual hallucinations' are otherwise quite unknown and inexplicable.

What disposes people to such possession varies greatly and is not systematically researched. Sudden emotional or even major physical shocks sometimes precede the onset of such symptoms, as can occasionally the use, especially under insecure circumstances, of large doses of mind-influencing drugs. Extreme asceticism, from fasting to bodily mutilation, can also lead to such experiences. It is well known in India and other societies where esoteric mysticism is widespread, however, that there are those who, through obsessive practice at certain kinds of breathing exercises (pranayama) and other esoteric techniques too involved to describe here, open the psyche for the invasion of uncontrollable voices, visions and hallucinatory experiences.

MENTAL DISORDER, SELF-IMAGE AND IDENTITY

A prominent characteristic of much mental derangement is identity confusion. Classic cases of 'delusions of grandeur' represent an extreme here. Much more common is having too unrealistic a self-image or being in severe conflict as to one's identity - what is one's authentic personality or what should be one's social role.

The types of fallacious observation and thinking already considered also usually apply in the gradual generation of a false self-image. At the same time, an active imagination can well be at work - whether relatively unawarely (unreflectedly) or wilfully. This is probably most widespread during unstable periods in one's life, whether caused by external factors (from the birth of a child to loss of employment) or inner changes (from experiencing anxiety to transcendental experiences). Periods of vulnerability to insecurity of identity may occur at any time and are also frequent for example when starting at school, puberty, 'nest-leaving', marriage, divorce, bereavement, accident, illness and similar potential 'watershed' experiences.

Inner conflicts or confusions that arise due to major specific turning points in a person's life are doubtless often the starting point from which one may begin to foster unrealistic ideas about oneself, often first met through how others appear to view one. Daydreams, doubtful surmises about how one appears to others, inflated self-evaluations, and self-denigrating guilt feelings can all accumulate and interweave with misunderstandings about the workings of the world around one and which of its various possibilities or dangers might apply to oneself. Many an alternative role or persona may be 'tried out' mentally until elements that seem to provide a suitable ploy for one's perceived circumstances become ingrained. Conscious plans can be developed and tested bit by bit against one's perceived situation until one's persona accords sufficiently with one's environment and the challenges with which one must cope.

This summarises some of the ways in which a discordant self-image or perceived identity can come about. Not only does the social environment certainly not always - if ever - provide an objective, balanced 'feed back' to people on their best or worst qualities, but it as often fails to respond adequately or even return signals to many confused, seeking persons.

The results of such processes vary greatly, depending both on the external culture and the inner person, and the type of identity formed with its many uniquely individual elements. Ideally, we become firmly integrated persons of strongly affirmative selfhood with distinctive character and individual extensions of special qualities and abilities. The alternatives to this are legion, from the diffuse and underdeveloped character, through many kinds of partially-integrated personalities to the dual, multiple and so-called 'schizophrenic' and disintegrated identities.

It is well-known to social anthropologists how important rites of passage are for the adolescent to mark puberty and establish adulthood. This applies even, or especially, in societies where the rites of passage are often no longer instituted as distinct events controlled by the adult society. It is also applicable to the pluralistic, liberal type of Western industrialised social model where many 'alternative' ill-planned types of (usually delinquent) behaviour arise in the phase between childhood and adulthood, or in the confusion about how to attain and enforce one's own identity as an accepted member of society.

It is also established that 'mid-life crisis' in men and menopause in women are transitions that can have strong psychological effects on self-image and sense of identity. A redefinition of self, at least of the outward persona, takes place in most persons over forty. The approach of illnesses with age and decline often cause inner turmoil or instigate important inner reassessments.

Since right and good ideas play a much more crucial role in causing mental illness than it is fashionable to recognise in most Western thought today, especially within psychology, they can play a crucial role in regenerating mental balance and the cure of disorders. Which ideas are 'right and good' or the converse cannot, of course, be stated meaningfully except at a very general level because every idea also has its correct time and place in the individual drama. The most universal statement of right and good ideas here, however, is found under 'human values'.