What Is Mental Health? Toward a Philosophy of What We Are Actually Doing

Written by Lance Allan Kair, Licensed Professional Counselor

Lance Kair is a licensed professional counselor, founder of Agency Matters Mental Health, and published philosopher integrating trauma-informed care with existential and postmodern insights. He brings depth, compassion, and decades of lived experience to the evolving landscape of mental health.

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We talk a lot about mental health. We talk about a “mental health crisis,” a “mental health epidemic,” mental health days, mental health apps, and mental health awareness. We have diagnoses, medications, evidence-based treatments, brain scans, and endless opinions online about what people should do to feel better. But underneath all of that, there’s a surprisingly simple question that rarely gets asked directly. What is mental health? Not what are mental disorders, not what treatments work, not what the brain is doing, but mental health itself. The thing all these efforts are supposedly about. That question is where what I call Mental Health Philosophy begins.

Mental health as the capacity to live one’s life

I’m a practicing mental health counselor. On the regular, I sit with people who are struggling with anxiety, depression, relationship conflict, substance use, anger, meaninglessness of life, burnout, trauma, grief, and sometimes experiences like hallucinations or paranoia that many of us can’t relate to. 

The contexts are endlessly diverse. One person attributes their distress to being raised in Hong Kong. Another is convinced it’s because they’re a man. Another point is a specific political environment, or a family legacy, or the town they grew up in. And all of that matters, of course. Our histories and environments are not irrelevant. 

But notice something simple, for every person whose distress seems linked to a particular circumstance, there are others in similar circumstances who are not suffering in the same way, as well as those who are not suffering at all from them. 

So while context can shape how distress shows up, it doesn’t fully explain mental difficulty. When you take a moment to think about it in this way, there is no “anxiety disorder” that a bunch of people suffer from any more than there is a “dinner time” that people undertake, or a “driving a car” problem. Yes, there are those things that we talk about, but those notions tell us little about what is actually happening in those instances of a person being involved with those events. 

Then, at least from my perspective in the therapy room, if there is one working description of mental health that fits everything I see, all of the various situations and circumstances of problems, it is this:

Mental health is the felt capacity to do one’s life, to live one’s life. 

Not to live perfectly, not to feel good all the time, not to match someone else’s ideals. A mentally healthy person, in this basic sense, is someone who generally experiences themselves as capable of meeting their life, relationships, responsibilities, conflicts, limitations, and losses.

When people seek therapy, something about that capacity has been compromised. They don’t just say, “I’m sad” or “I’m stressed.” They say, “I can’t get out of bed,” “I can’t stop drinking,” “I can’t leave this relationship,” “I can’t turn my mind off,” “I can’t stand myself.” There is a sense of not being able to live as they otherwise might.

My job, then, as a therapist, is not to live their life for my clients, nor to tell them what kind of life they should live. It is to help them develop that sense of being able to live their life to their own measure of success (and maybe a little better).

This introduces a subtle but important distinction:

• Personal philosophies of mental health, opinions about how life should be, what is “healthy” or “unhealthy,” what matters, and what doesn’t.

• Mental Health Philosophy, which is not an opinion, but a description of what is actually happening whenever we are involved with mental health, no matter what we personally believe.
  

Mental Health Philosophy is not entirely a competing theory about how to treat depression or trauma. It is not a new modality that claims to be better than CBT, mindfulness, or medication, those are fine, and there is nothing wrong with them necessarily. It’s a way of stepping back and asking, when we say here is a mental health problem, yours, mine, or what have you. What is really going on in that situation? What assumptions are we already making, often without realizing it?

The loop: “I’m depressed because I’m depressed”

Consider a common example. Someone comes into therapy and says, “I’m depressed.” They tell me they can’t get out of bed, they haven’t showered all week, they cry for no apparent reason, they’ve been calling in sick to work, and they feel like a burden to everyone around them. They might say they hate themselves, or that life has no meaning.

I have many ways of understanding this. There’s the DSM-5 and ICD-11, the official manuals for psychiatric and psychological diagnosis, which give specific symptom lists for “Major Depressive Disorder.” There’s my professional training and experience with hundreds of other clients. There’s my own life, my friends, my culture. All of this indeed helps me to be able to say, “Okay, this person is describing what our society calls depression.”

So far, so good. Naming can be useful.

But if I ask the obvious question, “Why do you feel this way?” I often hear some version of, “Because I’m depressed.” Or, “Because there’s something wrong with my brain chemistry. I have depression.” It sounds circular because it is.

The person is suffering, and they also know enough psychology language to interpret the suffering through a diagnostic category. The category then becomes both the name and the reason. They are depressed because they have depression. Their experience speaks for itself.

I call this the subjective loop:

• “I feel this way because I have this condition.”

• “I know I have this condition because I feel this way.”
  

Psychology and psychiatry, as they are commonly practiced, often reinforce this loop. The diagnosis is taken as the central truth, the person’s own report confirms it, treatment is then aimed at “fixing” the condition as defined by the diagnosis.

Sometimes that works well enough. Symptoms decrease, function improves, life opens up. When that happens, there is no problem. If a medication or a structured therapy genuinely helps someone suffer less and live more, wonderful.

But often the loop becomes a problem when things don’t change, or when the identity “I am depressed” becomes solidified as a kind of permanent truth about the self.

Then the question “What is mental health?” quietly gets replaced with another question, “How do we get rid of these symptoms?”

That shift from what mental health is to how we can get rid of what bothers us is where Mental Health Philosophy wants to slow down and look more carefully.

Phenomenology, humanism, and the expert of experience

To see how we arrived here, it helps to briefly visit the history of a philosophical word, phenomenology. Phenomenology is the tradition, rooted in thinkers like Edmund Husserl and grounded in Descartes’ “I think therefore I am,” that takes seriously the difference between:

• the subjective world “inside” a person, and

• the objective world “outside” them.
  

It is based on appearances and says basically that we only deal in appearances, never the actual thing. Psychology is built on this notion of things. If someone has an inner world of thoughts, feelings, and perceptions, then an educated professional can, in theory, observe, describe, and intervene in that inner world because the appearance is understood to be the same as the thing or the person in the psychological case. Brain chemistry, neurons, cognitions, expressions, and so on, are phenomenological appearances. So when someone says they are depressed, psychology assumes that the appearance (as reported by a person) means that the psychologist can do certain things to that person, and they will get better. 

This seems like a great idea, and for sure, many times it helps, but somehow, overall, this approach apparently was not working. 

Something important changed in the 1950s with Humanistic psychology, especially with Carl Rogers. Before Rogers, the psychiatrist or psychologist was often assumed to be the expert about the patient’s mind.

After Rogers, a different idea took hold:

“The client is the expert of their own experience.”

In practice, this meant that the therapist is tasked with listening deeply, empathically, and non-judgmentally, rather than imposing interpretations. The role is to facilitate the client’s own process, not to dictate it. This shift was both philosophical and ethical, it recognized the person as the central authority on their inner life. But here is the paradox, once you turn that approach into a technique, it can flip back on itself.

A therapist trained in “client-centered therapy” may genuinely try not to impose their views. Yet their very technique, how they listen, how they reflect, how they respond, is itself built on a psychological theory. They now know “how to be non-directive,” and that knowledge can quietly become a new form of expertise about the client. In other words, the therapist becomes the expert in letting the client be the expert.

The subjective loop now operates on two levels:

• The client’s loop: “I know I have depression because I feel like this, I feel like this because I have depression.”

• The system’s loop: “We know what depression is because people report these symptoms, we know these symptoms are depression because our manuals say so.”
  

Neither layer is inherently malicious. They are attempts to help. But they also reveal how deeply our understanding of mental health is woven into certain ways of seeing the person, ways that may leave the basic question “What is mental health?” untouched.

By mental health, we have a way to get out of the subjective loop, to circumvent its power. 

Behavioral health: Moving house vs living there

Another aspect of mental health a person might ponder is why psychology is often associated with what we call behavioral health.

Behavioral approaches focus on what a person does, but specifically the appearance of what someone is doing. For our example of depression, it might be if a person ever leaves their house, how they sleep, what they avoid, how they talk about their life, and how they perform at work or school. These are observable, measurable, and (at least in principle) modifiable.

Behavioral interventions can be helpful. If someone is paralyzed by anxiety, learning breathing techniques, scheduling, exposure practices, or cognitive reframing can open up possibilities they couldn’t reach before. But behavioral health is not identical to mental health.

An analogy I often use is moving into a new house. Packing boxes, loading the truck, driving, unloading, assembling furniture, that’s a lot of work. It’s necessary work if you’re going to live somewhere new. But moving in is not the same as living there.

Behavioral change is like the moving process. It’s helpful and is a part of moving, but the deeper texture of a life, the meaning of being in that new place, how relationships unfold, how one experiences oneself there, is something completely different from just behaving. The move lasts a short time, life is the whole time. 

When we collapse mental health into behavioral health, we risk telling people that if they just adjust their behaviors, and maybe their brain chemistry, their inner world will automatically follow. Sometimes it does. Often it doesn’t. And when it doesn’t, the person can conclude not only “I am depressed,” but also, “I am failing treatment, therefore, there is really something wrong with me.” Again, the loop tightens.

The clinical gaze and the loss of the person

The French philosopher Michel Foucault described something he called the clinical gaze, a way of seeing people that emerged in modern medicine, where the person themselves gradually recedes and what comes into focus are descriptions, symptoms, syndromes, charts, lab values, and

diagnostic codes. In that gaze, the human being becomes a subjective case, as we have said, a phenomenology. 

We can understand this without demonizing medicine. For sure, we all need a shared language. We need categories to communicate, to research, to allocate resources. The manuals of diagnosis, like the DSM and ICD, explicitly admit that their categories are negotiated social constructions, created by committees of experts who did their best to describe patterns in human suffering.

The problem is not that these categories exist. The problem is what happens when we forget they are tools, and treat them as though someone has this disorder or that they have this disorder. 

• A person comes in with complex pain.

• They leave with “Major Depressive Disorder,” “Generalized Anxiety Disorder,” or “Borderline Personality Disorder.”

• Over time, they may internalize this as identity, “I am a depressed person,” “I am an anxious person,” “I am borderline.”

  
  

The category, created as a shorthand to help, becomes a lens through which they see themselves. And that lens is then reinforced by systems of care, insurance structures, and even social media communities.

From the standpoint of Mental Health Philosophy, we can say, in most cases, a mental disorder is not just a thing a person “has”, it is more like a thing that we are using to try to begin to help someone with their struggle. In this way, a disorder is more like describing a relationship between a person, a language, a system, and a way of seeing. That relationship can be helpful, neutral, or harmful depending on how it is lived. Sometimes it can become what one is or something a person has because of what the person has been told about what is going on for them. 

But if it helps for a person to think they have a disorder, then it is all to the good. Regardless, whatever way works, it is their mental health that is happening. 

Mental health as the “parent category”

This brings us to a key claim of Mental Health Philosophy, mental health is the parent category.

Psychology, psychiatry, neurology, coaching, self-help, social work, spiritual care, all of these practices are sub-activities within the broader field of mental health.

They are not competitors for who “owns” the mind. There are different ways humans have invented to address something more basic, the difficulty of being a person who is living a life.

Seen this way, Cognitive Behavioral Therapy is one way of organizing human experience to make it more livable, for example. Medication is another way of supporting the nervous system. Diagnostic categories are another way, in this case perhaps, one way of classifying recurring patterns (there are indeed many recognised and valid ways of recognizing patterns). Also, even as this is a mental health philosophy, there is at least one modality called Philosophical Counseling, which is another way of examining meaning and value, there are other ways of examination. 

Mental Health Philosophy doesn’t try to prove any of them wrong. Instead, it asks:

• What is happening when these approaches work?

• What is happening when they don’t?

• What assumptions about “self,” “problem,” “solution,” and “reality” are built into them?

• How do those assumptions shape what people experience?
  

When you look closely, a striking pattern appears. Despite enormous scientific advances, the overall burden of mental distress in the world has not vanished, but indeed, it appears to be increasing.

The looping is not something that goes away, or that can be overcome, it is not a problem that can be done away with without creating another subjective loop, more sophisticated descriptions, interventions, and measurements that are the cycling through experiences, only now with more language to describe them.

Mental health is not a ‘curing’ or ‘fixing’ of the phenomenological loop. Mental health is the recognition, literally a different kind of understanding what is happening, of what it is to be a human being living life. 

Stepping outside the circle

So what does Mental Health Philosophy offer? It doesn’t offer a new cure. It offers a different orientation upon things. Instead of starting with, “What is the diagnosis, and how do we fix it?” it starts with, "What is actually happening in this situation that we are calling a mental health problem?"

For example:

• A person says, “I can’t get out of bed because I’m depressed.” We can ask, "What is 'depressed' here, its meaning, how it shows up in the reality of this person’s life?" How does that concept shape what they feel able to do, or not do?

• A treatment “fails.” We can ask, "What does 'failure' mean in this context?" Are we measuring the person against a theory, or listening to what their actual life is showing us?

• A diagnosis provides relief and validation to one person, and crushing identity to another.

• We can ask, "What is different in those two relationships (validation or rejection) in the same category (the diagnosis)?
  

Seen this way, mental health is everything and anything that grants us any understanding of mental health. It might seem ridiculous, like we are not really finding anything, but then what does that say about what we are talking about when we say mental health? The psychology, the physiology, the disorders, the interventions, the symptoms, the opinions and attitudes, it is the ongoing field of knowledge and known experiences by which people, professions, systems, and so on, interact. It is the context within which psychological theories, brain sciences, therapies, and social conditions show up to be meaningful at all, but more so the greater situation by which any of this exists to have meaning!

Why this matters for the individual

All of this might sound philosophical and abstract, but it has very concrete consequences for real people. If you are someone who struggles with depression, anxiety, trauma, addiction, or any other mental difficulty, your experience is real. Your attempts to name it are real. Your efforts to seek help are real.

But what Mental Health Philosophy invites is a small but powerful shift. Instead of taking every label, narrative, or explanation as a final truth about you, you begin to see them as tools you are using in a larger process of living your life.

The philosopher Graham Harman calls this “Tool Being”, and he has a really complicated philosophy book of the same name!

Instead of “I am depressed,” it could be, “I am a person who is currently relating to my experience through this diagnosis,” or, “I am someone moving through patterns of experience”, “I am also more than those patterns.”

Instead of “therapy must fix me,” it could be, “Therapy is one place where my life is being examined. It is part of mental health, but it is not the whole of it,” or, “If one approach doesn’t help, that doesn’t prove I am broken. It might tell us something about the fit between this method, this moment, and my life.”

This shift does not magically solve pain, but it could. Or, it could loosen the loop just enough to let something new appear, curiosity, self-respect, a sense of dignity that is not entirely defined by problems. The pain could become tolerable, or even transformational. 

Mental health philosophy in a sentence

If I had to compress Mental Health Philosophy into a single idea, it would be this:

Mental health is itself that which organizes all things within its purview and domain. The shared field within which all our efforts to understand, measure, name, and help human suffering take place, but also that which is not named due to the limits of the names. Psychology, psychiatry, neurology, therapy techniques, diagnoses, and identities are elements within that field, parts of mental health, constituent and not definitive.

Recognizing this doesn’t make psychology or psychiatry obsolete. It situates them. It allows us to validate what they do well, question what they assume without noticing, and make room for the aspects of human life that don’t fit neatly into any existing framework. It opens mental health to be itself, a subject that exceeds every context. 

Most importantly, it re-centers something that risks being lost in the clinical gaze, the person who is, in their own way, living.

Mental Health Philosophy does not ask that person to become a philosopher in the academic sense. It simply invites them, and us, to pause the rush toward solutions long enough to ask:

• What are we really doing when we talk about mental health?

• What loops are we caught in, personally, professionally, culturally, existentially?

• What becomes possible if we see the loop clearly, as a limit instead of an ongoing sentence, an opening to more life, instead of living inside them as if they were the whole story?
  

In fact, at the end of the day, it creates the possibility where solutions become moot, because the problem is seen for what it is. 

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Lance Allan Kair, Licensed Professional Counselor

Lance Kair is licensed professional counselor and founder of Agency Matters Mental Health, he blends trauma-informed therapy with deep philosophical insight drawn from thinkers like Zizek Badiou, and Kierkegaard. Formerly immersed in 1990s psychedelic and rave culture, his lived experience with addiction, grief, and harm reduction drives his radically compassionate care. He's the author of multiple philosophical works, including The Moment of Decisive Significance, and is a leading voice in the emerging field of Mental Health Philosophy.