Scratched layers of posters and placards on wall in the streets of Florence, Italy
Artillery Row

Mental illness does not fit your easy narrative

Sanitisation is not acceptance

 There’s an episode of the sitcom Only Fools and Horses in which Del Boy wins a holiday to Majorca by entering his adult brother Rodney in an art competition. The category is under-15s, meaning Rodney has to spend a week pretending to be fourteen, participating in events run by the hotel’s Groovy Gang children’s club. 

Once, briefly, my brother imagined himself to be Rodney, except only in that one, specific episode. If I wanted to give you an account of how harmless and potentially hilarious psychosis can be, I’d give you that one example and leave it at that. 

The trouble, as you might expect, is that this is not the full story. Most things my brother has seen at his most unwell, I don’t know about. There are darker things I could tell you, only I never will. It has been this way for most of our lives. 

The story of my brother’s illness is not separate from my own. There is a belief that everyone owns their own suffering — that no one can talk over another’s pain  — but this is not how a life lived alongside others truly works. I am constantly making editorial decisions regarding the recounting of my own experiences — which parts of my life are so deeply imbued with the realities of my brother’s               illness that he gets to own them more than I do? The only way, morally, I could make a case for claiming ownership of everything would be if I could make myself into the victim, him, the villain, in a tale of oppressor versus most marginalised. Since to do so would be crass and unfair, I have to settle for occasional half-truths and silences, protecting a space which is vast but which, to others, might as well not exist. 

Unlike Kanye West, my brother has never expressed the slightest approval for Adolf Hitler. I want to make that clear. Nonetheless, the popular, liberal response to West’s open antisemitism — the insistence that his behaviour can bear no relation whatsoever to his mental illness — has bothered me a great deal. It’s not that I think a diagnosis of severe mental illness is an excuse for antisemitism, a get-out-of-bigotry free card. It’s that so many people are so clearly wedded to a sanitised, politically gratifying image of what mania and psychosis look like, based not on what is, but on what they would like to be true. 

Witness the man who tweets about having a friend with bipolar disorder as follows: “when he gets manic he stays up really late memorizing song lyrics and every so often he’ll call demanding I play him at FIFA immediately but he somehow manages to never hand it to Hitler”. Good for him! There follows a series of twitter responses in which others describe their own experiences with severe mental illness and the way in which it’s never made either them or their friends into massive fascists, either. Obviously I could have contributed my Groovy Gang anecdote to the list. I just don’t want to play that game. 

To me, those adding these tales might say “but we are making the issue less stigmatised! So no one thinks your brother’s like Kanye!” What I think, though, is that these allies end up imposing more silence on those of us whose recollections do not play to their moral framework. 

I don’t want to tell people everything; what I would like is for people not to assume everyone in close proximity to severe mental illness is waiting to offer up their particular story for social justice absolution. When someone is fragile, part of caring for them is protecting them from judgement. 

All too often, “not stigmatising” involves setting standards which I am not always sure my brother would meet. It can feel as though, rather than moving towards a time in which people with schizophrenia or bipolar diagnoses are treated with more sympathy, sympathy has become conditional on showing the world that you are good, perhaps even better than “normal” people. 

This is not just harmful to those with diagnoses, but to those around them. A Gizmodo piece claiming to demonstrate that West’s behaviour has nothing to do with mental illness quotes the psychologist Jonathan Stea:

It can be tempting for people to write off someone’s poor behavior as the result of mental health concerns, but that temptation is stigmatizing because it creates an illusory correlation between poor behavior and mental health concerns.

I’ll just say this now: right at this very moment, there are a plenty of carers and relations — partners, parents, offspring, siblings, friends — who are putting up with some very “poor” behaviour. They may not say this because they do not want to expose someone who is already vulnerable to moral censure; or they may say so and be told they must make allowances, because the person hurting them isn’t “really” their loved one. Either way, there is enormous pressure on them to suffer in silence order not to “stigmatise”, as though the truth itself is bigoted. 

This is harmful in multiple ways: it suggests to the carers that their loved one would no longer be accepted by the nice, liberal world if said world knew the truth, because their loved one would then be messing with the “destigmatisation” narrative. And it relieves the nice, liberal world from having to do anything more than promote said narrative. After all, it’s not as though things are more complex than that, and anyone who complains about the toll another person’s psychosis is taking on them is probably only doing it to make all mentally ill people look bad. 

Saying “well, they’re bad people and that’s separate” gets us nowhere

Freddie de Boer has written about the cruelty of “mental illness as meme”. I have increasingly felt that mental illness, having become a liberal target for “destigmatisation”, has been aligned not just with sanitised images of how a disorder plays out, but with specific positions on identity politics. It is impermissible for mental illness to find expression in a way that does not align with being on the right side of history, because the mentally ill are victims and victims are good. If I say this is not real acceptance, I already know what the twitter response will be (“you think fascists deserve acceptance?”). I don’t — as in, not on the basis of their beliefs — but I do not see how this helps the mother whose son’s psychosis does indeed manifest itself in far-right fantasies, or the woman whose abusive, misogynistic partner is clearly suffering from paranoia. Saying “well, they’re bad people and that’s separate” gets us nowhere. 

After decades of witnessing my brother’s treatment, I have many concerns about the function of labels, the politics of diagnosis, and the way in which anti-psychotic medications have changed very little over the years, despite the devastating side-effects. It dismays me to see so little curiosity about this in people who claim to care, but seem more interested in making a moral case for the social acceptance of mentally ill people as long as they don’t embarrass anyone in public, or deviate from the social justice script. 

People are more complex than that. If you want to include the mentally ill in your pantheon of the virtuous oppressed, there are huge numbers who just won’t make the cut. Or, you might accept them, but neither they nor those around them will ever be able to tell you what their lives are really like. It’s not that they should have to, but the day we no longer need the twee, Groovy Gang-style anecdote — when it is just assumed that the worst is not inevitable, but possible — is the day that real, difficult, self-compromising acceptance starts to become a reality.  

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