When we think of mental illness we’re likely to recall experiences, behaviours, and psychological states that are bad for the individual: a person with severe depression loses all interest in life; another with anxiety might not be able to leave the house; auditory hallucinations can be terrifying; paranoia can make social interaction impossible; and delusions take the person away from a shared reality. When we describe these experiences and states as illnesses we are acknowledging that it is not wholly within the person’s control to act otherwise. When a person is ill, they really cannot help it. That is why being ill often protects someone from condemnation and, in some cases, garners sympathy.
The view of mental illness just outlined might seem uncontroversial, but in fact mental health activists are challenging it. While it is true that mental illness is often associated with suffering, this is not always bad for the individual; it depends on how the person interprets the experiences. For example, depression, in some traditions, is understood as a pathway to spiritual fulfilment; auditory hallucinations (or voices) are regarded by some activists as avenues to a more complete understanding of one’s self; and manic states (with bipolar disorder) can result in bouts of artistic creativity.
Mad Pride activism goes beyond these challenges and rejects the very notion of mental illness, a notion that implies a disorder or a dysfunction of the mind. In place of it, activists reclaim the term “mad,” deprive it of its negative connotations, and present the diverse phenomena of madness as sources of identity and culture. The concept of mental illness, activists argue, is discriminatory and prevents society from a fuller understanding of madness.
This is not the first time that people have challenged the concept of mental illness. In the 1960s and 1970s, dissident psychiatrists attacked the concept, with Thomas Szasz deriding it as a myth that legitimises the oppression of social deviance, and R. D. Laing describing it as a harmful notion that prevents a proper understanding of the meaning and potential of madness. And over the past two decades, the concept has been carefully dissected and analysed by the re-emerging field of philosophy and psychiatry, only to be found lacking: there is no objective way of determining who or what should fall under this class of phenomena. The challenge from Mad Pride differs from these attempts in two main ways: it comes primarily from people who use mental health services (as opposed to clinicians and academics), and it is not a technical worry about the boundaries of the concept, but a cultural and political challenge to societal views of madness.
It is a peculiar feature of many societies in North Europe and North America that the cultural understanding of experiential, psychological, and behavioural deviance has come to be dominated by medical and psychological models of dysfunction. This was not the case in earlier historical periods in these societies, nor is it the case in other cultures around the world today, for example in the Dakhla Oasis of Egypt where I had conducted field-work in 2009 and 2010. In both cases, the cultural repertoire had/has alternatives to dysfunction, for example in seeing madness as a transformative process that can lead to a distinctive form of wisdom, or as a “dangerous gift” that can allow access to unique knowledge not available through everyday experience. Part of what Mad Pride wants to achieve is to bring these notions back into the culture, and in doing so to resist the near-monopoly of the concept of mental illness over the cultural imagination.
Achieving this is not to going to be easy. To the modern sensibilities of many people, stories about spiritual transformation and esoteric wisdom are hard to grasp. Additionally, no matter how we understand madness, there is no hiding from the fact that phenomena such as delusions, hallucinations, extremes of mood, and loss of control over one’s actions jeopardise someone’s ability to live a fulfilling life. All of this weakens the claim that madness is a source of culture and identity, and not an illness.
Now these are reasonable objections and it is important to attend to them. Note, however, that the way in which they have been framed indicates that engaging with Mad Pride has already led to progress. For once we begin to talk about what makes life fulfilling, we inevitably appeal to evaluative notions such as what we consider good or bad, right or wrong. With this insight in place we can begin to ask the right questions. Do hallucinations always impair a person’s ability to live a fulfilling life, or can they sometimes be useful? Are delusions always bad, or can they be sources of innovation? At what point do changes in mood become extreme, and who should make this judgement? Mad Pride challenges people to think about these questions, and to examine their values and core beliefs in the process.
Are we witnessing the end of mental illness? If by this we are referring to the powerful experiences and the suffering that appear to be part of being human, then the end is not, perhaps even can never be, near. But if by this question we are referring to the end of the dominance of the concept of mental illness on social and professional understandings of madness, then Mad Pride has made a strong case for expanding the cultural repertoire beyond medical and psychological models of illness.
Featured image credit: “Hand holding a sparkler” by Free Photos. Public domain via Pixabay.