causes or roots. The tendency to such a confusion underlies the arguments of those cultural relativists who observe
that beliefs, emotional responses, and behavior considered healthy in one culture may be regarded as neurotic in
another.
Such observations have no bearing on the nature of mental health. For example: if a primitive man spoke to trees,
believing they were inhabited by conscious spirits, this would not necessarily indicate mental illness; whereas a
modern man who acted in this manner would almost certainly be psychotic. In appraising the psychological
significance of a man's behavior, it is necessary to take cognizance of his context, of the knowledge available to
him. We cannot necessarily know, from an observation of behavior taken out of context, whether or not it reflects
an aberration in a mind's thinking processes. This is an important point for the diagnostician to remember—but it
has nothing to do with the question of what constitutes mental health.
It should be noted that mental illness is not indicated by a man's momentary loss of cognitive contact with reality,
such as might occur under the impact of a violent emotion. Mental illness implies the presence of enduring
obstructions to a mind's cognitive efficacy. Mental illness implies the presence of automatized (or partially
automatized) obstructions to conceptual integration.
Even in cases where the causes of mental illness are physical (genetic, biochemical, etc.), the patient's condition is
designated as a mental illness only because there is a breakdown in his cognitive function. In the absence of this
breakdown, the condition is not mental illness.
A man whose cognitive contact with reality is unbreached, whose perceptions, judgments, and evaluations are free
of blocks and distortions—a man who is willing and able to look at any fact relevant to his life, whose integrative
powers are unimpaired—does not exhibit symptoms such as pathological anxiety, depersonalization, obsessive-
compulsive reactions, conversion hysteria, or delusions of persecution.
It is difficult to escape the conclusion that in most (and perhaps all) instances of mental illness whose cause is
psychological, there is some degree of complicity on the part of the victim. He did not will his illness directly; but
he volitionally initiated reality-avoiding policies which brought him to that end. The small evasions, the