Politics is a branch of neurology: folk conceptions of mental illness


A friend linked me to an article on the BBC news website that claims a scientific study has proven the link between mental illnesses and creativity. This is an old and somewhat tired discussion, although it does hold some importance when we’re living in a situation where many mental illnesses seem to be on the rise and where, faced with this situation, a kind of embrace of this epidemic might prove more fruitful in some sense than a pure rejection of it. Of course, there is a risk of accelerationism and romanticism in this and we should be wary. That news story, which can be found here, is not what I want to write about just now but it did remind me of another topic: how mental illness appears in something like a popular consciousness.

There is a dispute regarding the popular, or folk, conceptions of mental illness. I am aware of one position on mental illness being primarily caused by genetics and neurological factors, a kind of chemico-biological individualism that ignores the social causation of mental illness and prompts its biological instantiation as if it were the cause. This position is articulated by Mark Fisher in his Capitalist Realism. I was recently reminded of Anodyne Lite‘s contesting of Mark Fisher’s writing on mental illness as having a primarily social causation with specific emphasis on the idea that this image of mental illess as a socially construed phenomena is precisely the popular image (in comments of a Larval Subjects post on the topic). That is, the go-to explanation of mental illness being boiled down to life-events, I suppose with a vulgarised Freudianism in mind. Admittedly these are quick and caricaturisations of what are far more nuanced positions but I think it gets at the general thrust of what each claims to be the dominant conceptualisation of madness in the public domain.

I do not think either mode is correct for some personal and observed reasons. Now, I should explain that I have no directly personal experience of having any mental illness but I do work in the field (as a nurse) and my ex-girlfriend has bi-polar depression and some associated anxiety problems. In my experience with her, whenever her bipolar disorder caused difficulties in our relationship, the reaction of those around me, including some other people with mental illness, was that it was all a put on. Indeed where I work there is a patient that, without wishing to breach any kind of confidentiality, having been bombarded with every clinical and neuropsychicatric test at their disposal, the multidisciplinary team of nurses, psychiatrists, psychologists of varied specialisms, and indeed the gentleman’s own wife consider that he is in some sense ‘putting it on’. Sometimes this is said in terms of him having ‘behavioural’ rather than any other kind of problem. So this attitude seems to take in both the popular and the clinical conception of those with mental health problems, to greater and lesser degree.

It also seems to me that the cycle of things occur thusly: the emphasis on psychiatric work is placed in the community, institutional services are withdrawn and community teams predominate. At this point something will happen, some person who is unable to function at the level demanded “does something” (you know the sensational headlines; murder, rape, and so n). One need only look at the recent story in the British media about the man who used his  research student knowledge of criminology to commit the ‘perfect’ murder. This gets picked up on and a swing towards institutionalisation, or at least a deep suspicion of ‘care in the community’ occurs. The cycle repeats. I admit this may be a hyperbolic narrative.
Essentially it seems to me that the hegemonic picture of mental illness is neither composed in terms of genetic or social organisation and/or life-events. Rather there is a kind of assumption that the illness itself is in some way illusory, a cover, and that the ill person is faking illness in order to excuse their intentional acts of cruelty, at the lesser extreme, or their corrupt or evil nature, at the more extreme. It thus appears to me that the folk conception of illness, when it is presented to persons in a face-to-face encounter, is accusatory. It is almost as if the popular image of the mentally ill person is still, as Foucault commented, that of the ‘dangerous individual’. It also seems to me that the popular image of mental illness is a strange inverse of anti-psychiatrist Thomas Szasz’s infamous declarations that ‘mental illness does not exist’ in his landmark The Myth of Mental Illness. The subterranean folk conception seems to be, in a disavowed form for the sake of the big Other (accept where the worst happens, when polite and empathetic discourse can be dispensed with), that mental illness does not exist. Whether this notion came before or after Szasz and anti-psychiatry seems more or less unimportant to me as, in either case, it will have been modified by the filtering of such a belief into the public. Once again an intended liberation becomes a loss; reversal is a bastard.

As regards the truth of the matter, the debate of whether mental illness be socially or genetic/neurologically caused, the approach seems to be stunted by the retention of a division between nature and nurture; the impossible dualism that any realist philosophy rejects. On each side of the debate there is acceptance of the role being played by the each, simply with more weight applied to one pole of the relation. This politico-philosophical and empirical conflict is mirrored in the world of psychiatry itself where there remains a kind of split between a medical model and a biopsychosocial model. Philosophically this corresponds with the ongoing opposed vectors of eliminativist strains of speculative realism and the more emergentist object-oriented positions (in both their relational and non-relational capacities). These are important debates and it is my hope that object-oriented thinking will be able to provide a way out of the drive to physicalist reductionism without neglecting the importance of all physical, as well as social, political and so on, actants; this is, of course, the strength of a position like OOP. I am not expert on the nuances of its operation, being a pretty slow (in a dual sense) and necessarily thinly spread reader. It is my hope that those who hold such a position will find their way into discussing these urgent problems in depth, especially in regards to illnesses where no specific disease agents can be identified.

Well, that said I suppose I should bugger off back to the tasks I am supposed to be doing right now: packing for my move to new digs in Dundee… unfortunately further away from the centre of town.

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