Society is the enemy that makes life with mental health difficulty unbearable, not us
The enemy in mental health is assuming we’re the problem. We must learn to stop apologising to the enemy for suffering at the hand of its indifference.
All who know mental health know people who didn’t make it. Stories that will never have a happy ending. Contacts in your phone that will never be used, faces in photographs that no one will remember as the years march on. Voices you heard six months ago and then will never hear again. They’re the people we feel we failed. I propose it wasn’t us who failed them.
I demand an apology for my dead friends and colleagues. I demand an apology for all that I know who are suffering for want of support, encouragement and care. I demand an apology for the all of the years stolen, all of the comforts missed, all of the relationships that never happened and all of the lives that were never what they could be. More than that, I want it to stop happening to generation after generation. Like so much in mental health, this is just a voice wailing in emptiness. If we are even going to make change, we will have to find the forces that defeat us and learn how to defeat them. In mental health we are taught to believe our worst enemy is ourselves. But I think that’s wrong. I think our worst enemy is everyone else.
The revolution obscured
In mental health we have yet to go through the political revolution that Disabled people went through in defining exactly how those without physical impairments made life impossible for those that do. We know that many things are wrong. That so much in the world does not work well for us yet we still find it difficult to name our enemy and turn our discomforts into demands. The question is not why we are broken, but why no one cares enough to change the things that break us still. To come to a similar moment we must analyse where we are and then we must identify the enemy that keeps us there. Because there are enemies. If the hopes and dreams of people with mental health difficulties are a force, there is an equal and stronger force that pushes against them.
People experiencing mental health difficulty find it difficult to identify the things that oppress us. It doesn’t seem obvious or even relevant to many. We are taught to be realistic because we embody a threat to others, a dangerous deviation that might upend the world. We are trained to see our mental health difficulty as what we take from other people, but never trained to see it in terms of what the indifference of others takes from us, our families, our lives and our communities. We feel embarrassed, guilt flushing our faces at our anger, as if hoping that things could have been different is somehow a childish tantrum, like shaking a fist at a thunderstorm or shouting at the sea as it rolls onto the beach. We accept that mental distress is a problem situated within us. We feel that it is adult and mature to make ourselves responsible for our own inability to find our equilibrium. We feel like we must accept the endings, must accept the loss, must accept the never weres and might have beens. But we do not. We should not. If we accept this version of realism we will never conceive of changes big enough to turn into demands; will never conceive of our situation as anything more than personal misfortune. We will actively fight against the possibility of collective change.
As people experiencing mental health difficulty and distress we are socialised to be ashamed of our failures and our malfunctions. We internalise our fuck ups, paint the walls inside of our heads with never-drying persecutory graffiti. We do not need police to to tell us what we should do because those cops are stationed eternally within ourselves. Though some of us won’t escape the police outside ourselves either. With mental health we are trained to formulate the enemy as ourselves. Our beautiful, magnificent, terrifying broken selves. We turn into incarnate apologies; walking talking IOUs to society. Damaged goods, we every day feel our distance from the shining path of productivity and growth. Each of us marooned on an island of one; isolated by an ocean of self judgement.
Understanding causes
We are confused about causes of the mess that mental health difficulty and mental distress make of people’s lives. Our illness and deviation of experience is only an agent within the problem, it is not the cause. As RC Lewontin says in his book ‘The Doctrine of DNA: Biology as Ideology’:
“To say that pesticides cause the death of farm workers or that cotton fibers cause brown lung in textile workers is to make a fetish of inanimate objects. We must distinguish between agents and causes… So long as efficiency, the maximisation of profit from production, or the filling of centrally planned norms of production without reference to the means remain the motivating forces of productive enterprises the world over, so long as people are trapped by economic need or state regulation into production and consumption of certain things, then one pollutant will replace another… Asbestos and cotton lint fibers are not the causes of‘ cancer. They are the agents of social causes, of social formations that determine the nature of our productive and consumptive lives, and in the end it is only through changes in those social forces that we can get to the root of problems of health; The transfer of causal power from social relations into inanimate agents that then seem to have a power and life of their own is one of the major mystifications of science and its ideologies.”
In mental health we are confused between agents and causes. We see ourselves as the cause of our own miseries. When the case for investment in mental health is made it is always stated in terms outlining how much effective and timely treatment will save society. The cost of mental health is always represented in lost person hours of work; expressed as how much we cost normal people and how that cost can be reduced. It is seldom stated in terms of what inflexible attitudes to mental distress cost us. The way in which our society is structured actively prevents us from accessing things that would help, would soothe or would alleviate our discomforts and our suffering that is the actual cause of our problems. And we swallow it.
The reality of mental health difficulty is this: if you have a mental health difficulty you are more likely to end up poor. If you have a mental health difficulty you are more likely to end up dead sooner. If you have a mental health difficulty you are more likely to have poor physical health. If you have a mental health difficulty you are more likely to end up estranged from family, to never taste love, to never find a comfortable home. The years spent unwell takes money from your pocket and years from your future. These are the result of social organisation, not of individual illness. These facts result from decisions about the limits to put upon help offered and the amount of resources to be allotted to that help. The amount of help and support offered those experiencing mental distress is not a result of how much people want to help but how much help our social organisation will tolerate being given to those in need.
We believe it’s our fault that we cannot get on. We are failures at being human. In our mental distress we are misshapes, bad programs, aberrations. Unlike other people with disabilities we yearn to be let back into the normal world. Most of us yearn to pass, to be invisible, to be normal folks. We, those in need, are expected to, and expect ourselves to, find within a reserve of energy, a magical pool hidden within the source of our being that will rejuvenate and fix us. Somehow we believe that one day we will be reborn, springing from the garbage of our disordered lives and glistening like stained glass dragonflies free of the hideous, misshapen larval stage of our mental health difficulty. Each day we chase the deeds of our place in society as the wind blows them further and further from our hands, each step drawing our chests tighter, making our muscles burn. We are sorry, we shout, for our inability to catch up with ourselves. We will try harder, we will somehow make a miracle happen, alone. We will magic a solution from nowhere because all we have to do is somehow get our mental health back on the right track, somehow rise from the ground and walk on air.
It’s easy to slip into glib assertions that mental health difficulty is caused by capitalism, or neoconservatism, or totalitarianism, or liberal moral values. All of these are material conditions. All of these have ways in which a majority avoids addressing the needs of a minority. All of these have particular expectations of the true and right abilities of people based upon ideas of individual competency and the value of the individual to communities and to the goal of a society as a whole.
There are few modern forms of social organisation that find it easy to situate mental health difficulty as anything other than a malfunction, all have different tolerances of certain forms of malfunction and different expectations of what the individual as a discrete unit should be able to achieve. It is this expectation that people with mental health difficulties, people experiencing mental distress should either just knuckle down or should somehow cost less and become ghosts in their own lives that is the enemy.
The face of the enemy
The enemy of people experiencing mental health difficulty and mental distress is everyone who makes us the problem but keeps us from the the tools by which we might solve it. What keeps us from those tools? The idea that it is not the problem of our society to provide those tools. This realism crushes dreams and creates a logic where you are either in or you’re out, where you are either a normal person not doing well or an abnormal person who has no right to expect any better than what is afforded to you by the charity of others. What are those tools? Second chances. Effective treatments. Adjustments. Choices. The money to live. The opportunity to thrive. A home. Safety. Support. Access to what we need when we need it.
The experience of marginalisation will be familiar to many excluded from privilege. Mental distress and difficulty can be another axis of oppression on top of others. Those whom society chooses to exclude from opportunity will be more at risk of mental health difficulties and distress and will also have fewer insulations against its excluding effects. In common with other marginalised identities, the effect of mental health distress and mental health difficulty is not evenly spread. Some people with privilege in other areas might seem to get away relatively unscathed. They will usually be those who already have substantial security, power or influence. They will take a hit, but the hit will not knock them as low as someone who took the hit early on, or who is taking a hit every day for their race, their gender, their sexuality, their way of life or their beliefs .
We must fight the view that Mental health difficulty is an individual tragedy; resolved through individual action or inescapable. This is blaming a worn out cog for not sharpening its own teeth, railing against a seed for not sprouting in a soil that is barren; admonishing each individual brick in turn for its failure to prevent the collapse of a house on a cliff as it slides into the sea.
This is not a call for a lack of personal responsibility. It is a demand for the tools and the support that make personal responsibility possible. For us to be everything we can be we must learn to demand what we need to be that best version of ourselves. If we experience mental health difficulty we have been dealt a shit hand, sometimes one that runs the risk of erasing our sense of self and agency completely. To overcome yourself you will need additional help, support and understanding from others. It is impossible to untie a knot when you are at its centre. Social organisation is the means by which we extend our lifespans, pool our resources, create collectively what would not be possible in one lifetime with one brain and one body. Instead of extending that social organisation to afford the help and support needed by those experiencing distress, disorientation and mental crisis, collectively we draw arbitrary lines of convention and practice saying ‘society will go this far in assisting, but no further’. We must begin to ask those who do not experience mental distress: what are you prepared to give up so that you fellow humans might in enjoy the same pleasures you do?
In many countries we are at a turning point where decisions are being made about exactly what the social fabric and the limits of our obligations are to each other. We must learn to see the face of our enemy, to detail the ways in which it distances us from what we need. We must learn the arguments the enemy makes for why it is better for everyone that we do not get what we need.
It is not our fault that we need different things. Our self respect must be based upon being the best we can be and making it clear that we matter.
I am unlucky with my mental health, but far luckier than many. I have some of what I need and am an able advocate for myself. I will do what I can to make this change happen. No person should fall into poverty or live in poverty because of their mental distress. No person should settle for a horrible half life when a life fully lived could be theirs. No one should suffer alone when there could be support and community. It’s up to us to envision a future for mental health that is not limited by the logic of those who would rather we did not inconvenience them. No one should die when they should have thrived. People being nicer will solve nothing if underlying assumptions about the way the world should work remain unchallenged.
We must learn to stop apologising to the enemy for suffering at the hand of its indifference.
@markoneinfour
