Thinking About Our Work: What Do We Mean by “Mental Health”? Lee Kassan1 issn 0362-4021 © 2017 Eastern Group Psychotherapy Society group, Vol. 41, No. 2, Summer 2017 147 1 Supervisor, Couple Therapy Program, Training Institute for Mental Health, and Supervisor, InterCare Ltd. Correspondence should be addressed to Lee D. Kassan, MA, LFAGPA, 240 Madison Avenue, Suite 10J, New York, NY 10016. E-mail: lee@leekassan.com. I think the trend of increasing medicalization of psychotherapy is a dangerous one, both for therapists and for patients. As early as 1926, Sigmund Freud, in The Question of Lay Analysis, warned against the possibility that psychoanalysis could become the exclusive domain of the physicians. Freud believed that the training a physician received was not only of little value in doing psychoanalysis but was actually at odds with basic psychoanalytic principles and techniques. More and more, however, psychotherapists of every background are being required to justify their treatments in medical terms. (Kassan, 1996, p. 588) I wrote the preceding paragraph more than 20 years ago, and the situation appears to have gotten even worse. I see every day on the professional list servers therapists struggling with insurance companies over diagnosis, payment, and number of sessions. All of this takes place within the medical model, but I work from a very different model (one I learned from one of my mentors, Michael Kriegsfeld) of self-discovery, self-acceptance, and self-disclosure (Kassan, 2007). I find it challenging to describe people with diagnostic labels. Here’s another quote from my book (Kassan, 1996): “Although psychotherapists are required to make a diagnosis, most people seeking therapy do so not because they are ill but because they are unhappy” (p. 589). I think we all know this to be true. In fact, the people who are actually ill (bipolar disorder, schizophrenia) are the least likely to seek help and the least able to benefit from talk therapy alone, although it can be useful when combined with medication. 148 kassan Many other people struggle with issues and problems that compromise their ability to thrive and even to function. But does labeling them as having a “mental illness” lead to more effective treatment? So I cringe a little each time I see in print (or hear spoken) mental illness and its counterpart, mental health. They imply to me the whole medical model of disease, symptoms, diagnosis, and cure. And why mental illness? Why not just illness? I understand that if we abandon the medical model, insurance companies won’t cover therapy. And our incomes will suffer. Prospective patients (another medical term) have come to expect treatment to be covered by their insurance, and many won’t even consider a therapist who isn’t on a panel and doesn’t accept insurance. We don’t want to become a “boutique” profession that only the wealthy can afford. But are we not compromising our values when we force ourselves into a medical model? Can we not find a better phrase? And some more meaningful way to organize our thinking? REFERENCES Kassan, L. D. (1996). Shrink rap: Sixty psychotherapists discuss their work, their lives, and the state of their field. Northvale, NJ: Jason Aronson. Kassan, L. D. (2007). Who could we ask? The gestalt therapy of Michael Kriegsfeld. New York: iUniverse. ...