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- Daniel Goleman (1976). Meditation and Consciousness: An Asian Approach to Mental Health. American Journal of Psychotherapy 30:41-54.
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WHO suggests mental ill health in terms of depression to be the highest ranking disease problem in the developed world in 2020–2030 and claims a public health approach to be the most appropriate response. But some argue that the alarming reports on mental ill health have their ground in the methods of inquiry themselves and refer to medicalization as an important issue. The aim of this article is to explore and illuminate the issue of what is meant by mental health and mental ill health and what it means that mental ill health is a major public health problem. Basically, two understandings and aspects of public health exist: a ‘reductionist’ and a ‘holistic’ with connections to different theories of health. These diverging understandings may lead to quite different public health responses, and they may have different consequences with regard to medicalization. It is concluded that we need more clearly elaborated ways to think about public health so that the increased attention to mental ill health as a public health problem does not in itself lead to medicalization in terms of just medical treatment. Otherwise, we risk losing the importance of public health as an overarching social and political instrument.
The authors describe the ethical considerations underlying the inclusion of mental health services into a prioritizedhealth care system. The Oregon Health Plan is a process for defining and delivering basic health services to an entire state. As the plan was developed, the mental health community needed to decide whether or not to participate in the process and, if so, how. Lengthy discussions among mental health consumers, family members, and providers led to a strategy that emphasized the integration of mental health and chemical dependency services into a comprehensive and universal health care program. This approach appears to have achieved relative parity for mental health.
Many spiritual traditions employ certain mental techniques (meditation) which consist in inhibiting mental activity whilst nonetheless remaining fully conscious, which is supposed to lead to a realisation of one’s own true nature prior to habitual self-substantialisation. In this paper I propose that this practice can be understood as a special means of becoming aware of consciousness itself as such. To explain this claim I conduct some phenomenologically oriented considerations about the nature of consciousness qua presence and the problem of self-presence of this presence.
I first attempt a taxonomy of meditation in traditional Indian Buddhism. Based on the main psychological or somatic function at which the meditative effort is directed, the following classes can be distinguished: (1) emotion-centered meditation (coinciding with the traditional samatha approach); (2) consciousness-centered meditation (with two subclasses: consciousness reduction/elimination and ideation obliteration); (3) reflection-centered meditation (with two subtypes: morality-directed reflection and reality-directed observation, the latter corresponding to the vipassanā method); (4) visualization-centered meditation; and (5) physiology-centered meditation. In the second part of the essay I tackle the problem of the epistemic validity and happiness-engendering value of Buddhist meditation. In my highly conjectural view, the claim that meditation represents an infallible tool for realizing the (Supreme) Truth as well as a universally valid method for attaining the highest forms of happiness is largely based on the crēdō effect, that is, a placebolike process. I do not deny that meditation may have some positive effects on mental and physical health or that its practice may bring changes to the mind. Meditation may be a valuable alternative approach in life and clinical treatment, but it is far from being a must or a panacea.
Mental health, in one awake, guarantees that person knowledge of the central phenomenon-contents of his own mind, under an adequate classificatory heading. This is the primary thesis of the paper. That knowledge is not itself a phenomenon-content, and usually is achieved in no way. Rather, it stems from the natural accessibility of mental phenomenon-contents to wakeful consciousness. More precisely, when mental normality obtains, such knowledge necessarily obtains in wakeful consciousness. This thesis conjoins a version of Cartesianism with the concepts of mental health and human nature. Demonstration of the thesis requires that we show that a particular human mental potential fails fully to be realized when such self-awareness is impaired. That potential is for consciousness of the world (w-Cs), wakefulness. W-Cs divides into consciousness of the outer world (ow-Cs), and consciousness of the inner world (iw-Cs), and we need to demonstrate an essential dependence of ow-Cs upon iw-Cs. Now w-Cs is the adoption of the correct occurrent epistemological posture to the world, and this involves free rational determination of occurrent cognitive attitudes via the internal systematized knowledge of the world, which requires adequate awareness of mental phenomenon-contents. Therefore ow-Cs needs iw-Cs. This is displayed in mental structural accounts of hypnotic, drunken, and psychotic disturbances of consciousness. (For we endorse a structural account of mental health.) We show how failures of self-consciousness entail disturbed modes of determination of cognitive attitudes by the knowledge-system, which is loss of contact with the personal yet true internal representation of the world, which is loss of contact with reality, which is a disturbance both of w-Cs and of consciousness itself.
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