How we understand what a Mental Health Issue is depends on our philosophical perspective or worldview. We might look at two opposing perspectives on this matter: realism and relativism. In our daily common sense view of the world, most of us believe that the world is as we sense it to be, i.e. what we see, hear and feel. However, in philosophy, this position is referred to as ‘naive realism’ because it fails to consider other sensory experiences, such as those of bats who use echolocation to ‘see’ the world. Essentially, humans might see the world in one way, but we know other animals see the world in different ways. Therefore, the knowledge we have of the world is only relative to the way we sense it, i.e. relative to us.

And so, relativists are sceptical of what knowledge we can have of the world. They believe that what we perceive as reality is a human construction and not necessarily an accurate representation of reality itself. Post-modernism is an extreme variant of relativism that goes a step further by claiming that logic is imposed on the world by humans rather than existing independently of us. I know many postmodern thinkers and often their actions contradict these extreme relativist beliefs. For example, they might use contraception to prevent pregnancy, suggesting that they implicitly acknowledge some logic does apply to the world.

Taking a psychological perspective, many clinical psychologists, psychotherapists, and coaching psychology practitioners adopt a pragmatic approach, acknowledging that we cannot be 100% certain about our theories of the world. They recognise that while our understanding of the world may be useful, it is subject to revision over time. Therefore, they treat Mental Health Issues as categories that are empirically verifiable. They do not say where or how they exist. Moreover, they understand that certain interventions, such as Cognitive Behavioural Therapy for Anxiety, have been proven to alleviate the distress and symptoms associated with a particular disorder.

The DSM-5, the clinical manual that categorises clinically significant Mental Health Issues, explicitly states (p. xli) that practitioners should understand Mental Health Issues in this pragmatic perspective of diagnosis and treatment. Unfortunately, not all practitioners interpret Mental Health Issues in this way.

Danny Mc Enery


Danny is a Coaching-Psychology Practitioner, former detective and trained philosopher. He works with a team of experienced professionals at Coaching-Psychology Ireland (master and doctorate trained Coaching-Psychology Practitioners)