Too Human
In a recent essay in the New York Times, psychoanalyst Christopher Bollas writes affectingly of his long therapeutic relationship with one particular Norwegian woman, “Lucy,” who was wrestling with schizophrenia. He tells of her frequent imagined encounters with Celtic and Nordic gods, of the dragon that came to her house to kill her, of the gradual diminution of her symptoms, and, most movingly, of the role he believes talk therapy played in enabling Lucy to take control of the narrative of her life.
What really caught my eye, though, was a moment when he steps back to say something about his broader understanding of schizophrenia. He writes:
I have been working with schizophrenics since the 1960s. I am sometimes asked about the possible causes of schizophrenia. I do not know the answer to this. To me it is rather like asking what causes the being of human being. Nonetheless a certain theme has emerged in my work: To be a child is to endure a prolonged situation in which the human mind is more complex than the self can ordinarily bear. Our minds — in themselves — produce contents that will be overwhelming. To be successfully normal, then, we rather have to dumb ourselves down.
Work with schizophrenics has taught me that when defenses against the complexities of the mind break down there can be a breakthrough of too much. Selves cave in.
That idea of “too much” is interesting to me on a few fronts. Back when I was a science writer, I had the chance to write about a team of computer scientists who were deploying natural language learning software to model what schizophrenia might be doing in the brain. They experimented with tuning the dials on their software to see if any of the adjustments they made ended up producing schizophrenic-like patterns in the software’s language.
These adjustments weren’t random. The researchers began from the various neuroscientific hypotheses about how schizophrenia works in the brain, and then tried to model those dynamics using their software. What they found, after running a lot of different scenarios, was that they got the most “schizophrenic” language patterns when they turned up the dial on the software’s learning rate.
In a sense they made it smarter. The network was compelled to forget less, and because it had to construct its narrative from too much data — because it contained too many pieces of information that had to be assigned meaning within the overall narrative — the stories it told fell apart or became baroque or paranoid. As I wrote back then:
It put itself at the center of fantastical, delusional stories that incorporated elements from other stories it had been told to recall. In one answer, for instance, [it even] claimed responsibility for a terrorist bombing.
It was suffering, as Bollas might say, from “too much.”
There’s no consensus in the scientific community on the exact neurological processes at play in schizophrenia, but what’s striking to me, in the context of the broader discourse around mental health, is how often this idea of “too much” comes into play. Anxiety is too much worry, and can be the result of assigning too much catastrophic salience to problems. The manic end of the bipolar spectrum can bring too much confidence, too much energy. Schizophrenia, perhaps, is the result of the brain forced to make sense of too much input. Even depression, from an existentialist perspective, can look like the result of too much vulnerability to, and honesty about, misery and suffering in the world.
There’s nothing blindingly novel about this observation. We’ve always known that what we call mental illness can be a condition of deficit or excess, often both at the same time. We’ve known that what we admire most about ourselves, and our species, can cause disturbances when there’s too much of it.
As someone charged with telling the story of mental health and illness, however, what’s intriguing to me is both how tantalizing and how tricky this notion of too much-ness can be.
Tantalizing because it holds out the possibility of reframing what we typically think of as a deficit in “normal” functioning as a positive state, as a refusal or inability to dumb ourselves down, to numb our sensitivities or selectively filter out threatening data.
On behalf of this perspective we can call to the witness stand the relationship (and there does seem to be some kind of relationship, though it’s complicated) between creativity and mental illness. We can run down the names of extraordinary people whose talents and accomplishment seem inextricably linked to their too much-ness, to their unwillingness or incapacity to desensitize themselves fully to the onslaught of reality.
I’ve been reading graphic novels on mental illness lately, and it’s notable how often the artists use the psychological struggles of famously accomplished people — particularly artists of one sort or another — as touchpoints for thinking through what their own diagnoses and experiences mean.
In Marbles, Ellen Forney’s 2014 graphic novel on wrestling with bipolar disorder, she writes that the despair she felt, when she first got the diagnosis, was “alleviated by a back-handed sense of cred.” The accompanying illustration shows her fantasizing about her new membership card in “Club Van Gogh,” where “The true artist is a crazy artist.”
In Psychiatric Tales, Darryl Cunningham’s 2010 graphic novel about working in a psychiatric hospital while wrestling with his own demons, there’s a whole chapter on the great accomplishments of men and women who had to contend, in often excruciating ways, with the too much-ness of their own brains.
We see the depressive Winston Churchill, the actress and singer Judy Garland, the musicians Brian Wilson and Nick Drake. Of Drake, who died of an overdose, Cunningham makes explicit the connection between Drake’s suffering and his art, writing that his “introspection, shyness, and loneliness all come through powerfully in his songs.”
Even in our own, non-famous lives, which don’t have such weighty accomplishments to set in the compensatory balance against our suffering, we know it’s possible to come back from a journey into one kind of excess or another with nuggets of insight, and new sensitivities, that simply weren’t available to us when we were oscillating on a more regular frequency. If nothing else, we can draw on these experiences to have more empathy for others who are having a hard time.
This is the idea, I think, that animates the effort among many contemporary mental health activists to popularize the term “lived experience” to describe the experience of mental distress without using negatively or medically connotated language. You’re not schizophrenic; it’s not a defining characteristic of your being. Instead you have lived experience of schizophrenia, or just “lived experience.”
It’s a powerful inversion of both the broad concept of mental illness and whatever specific, DSM-defined diagnosis a person may have received. The person with lived experience has lived, as you and I have, and had experiences, as we have, and had the opportunity to learn and grow and understand as a result of his experiences, as we have. It’s made him who he is, as our experiences have made us who we are. If anything, it’s made him more human for having lived these unusually intense and challenging experiences. And it’s armed him with a quiver of insights and strategies that enable him to be more resilient in moments of challenge and difficulty. He has, as Nietzsche wrote in his famous aphorism 35 in Human, All Too Human, “the means whereby the burden of life can be made lighter.”
Yet “lived experience” also highlights what’s so tricky about the effort to rebrand what we’ve traditionally called mental illness. Just like “mental illness,” the phrase subsumes under one broad rubric a radically diverse set of experiences. My lived experience is probably not like your lived experience, except insofar as we’ve been through one kind of hell or another. And in its laudable desire to destigmatize that shared experience, it runs the risk of deodorizing it to the point where it’s no longer evocative of precisely the hellish experiences those of us with lived experience have lived.
My own struggles and diagnoses, which are modest, are painful enough. They have a negative cast even when I can recognize that I’ve gleaned insight and wisdom from them. How awful it must be for people whose minds betray them even more profoundly, who end up in jail, on the streets, in bed every day unable to get up, haunted by fears and impulses they feel powerless to control or exorcise, driven to end their own lives. There is too much, and then there is just far too much. There are the hard experiences that we’re grateful to have had, after the fact, for the wisdom extracted from them, and then there are the hard experiences that just leave us wrecked and torn down, less than we were before.
Sometimes we don’t need de-stigmatizing, or empowerment, or ennoblement. We just need help, and care, and unasked for generosity, and a recognition that we are in pain.
And it’s here — at this point of vulnerability and dependency, suffering and helplessness — where I think we see most clearly the limitations of the rhetorical strategies that focus on positively re-framing the experience of mental distress.
Not so much in their utility, for certain people and communities, in redescribing the individual experience of mental illness. New language can strike real blows at the flaws and pathologizing tendencies of diagnostic language. It can offer an ennobling and empowering lens through which to understand one’s own life. And it can make a statement, like the civil rights languages of so many other groups, that society needs to stop pathologizing people who are different and instead recognize and respect their strength and integrity.
The limitation, rather, lies in the degree to which these positively oriented languages are deploying the same deep grammar of values and assumptions that inhibit us, as a society, from achieving a truly compassionate nation in the first place.
Strength, resilience, empowerment, recovery, rights. These are powerful words and concepts, and highly strategic ones. They call on a vocabulary that has a lot of instant purchase in our culture and politics, and as a result they can get results, or at least a hearing, without too much resistance.
But they’re also deeply individualistic. They’re the words of marketing and self-help, the words that seeks to persuade us that the solution to our anxiety or unhappiness is the next thing, the next drug, the next diet, the next technique. It’s in our power to change our lives, now.
They can’t make the argument that we deserve help because we’re helpless, or healing because we’re suffering, or empathy because we’re each other’s keepers. They can’t make the argument that often we’re not a match, on our own, for the forces that threaten to swamp us.
There is a fundamental opposition, or at least a deep tension, between language that draws on individualistic values to make the case for the integrity and strength of people with lived experience, and language that would make a broader political and moral claim on the society that it has a responsibility to help each of its citizens, period. When too much means better than, or able to stand on one’s own, it can’t also mean “help me.”
One simple alternative to this, of course, is the prevailing language of mental illness and health, with its medicalization and biologization of mental illness. What you’re experiencing is a brain disease. It’s a health condition. You have a diagnosis. You’re sick. Here’s a treatment.
And let’s give this language its due. Specific diagnoses can be liberating for people. They can provide a coherent conceptual scaffolding for experiences that once felt chaotic and terrifying. They can point the way toward treatments that help and networks of people who share the diagnosis and can provide support and fellowship.
The broader construct of “mental illness” can be a very strategic language in its own right. It has been a potent tool, for instance, in the ongoing political campaign to require the government and health insurance companies to provide parity of treatment for mental and physical ailments. If being mentally sick is like being physically sick, then of course we should provide the same level of treatment for both conditions.
The problem with this equation, though, is that it’s already given the game away from another angle. It’s saying that we deserve care not because we’re human, but because we’re sick. Sick people deserve help. People with diagnoses, whether it’s cancer or generalized anxiety disorder, deserve help.
But what if — and this is the radical idea I want to put out there — we all deserve help and compassion? And what if — dare I say it? — we can all be too much?
If what we want to do, as mental health advocates, is truly transform our culture around ideas of mental health and illness, then my suspicion is that we have to start here. We also have to cultivate as much skepticism of language that depends heavily on notions of strength and autonomy as we do of the language of illness and pathology.
One of the privileges, and drawbacks, of my job is that I get paid to watch, read, and analyze a lot of mental health education campaigns, public service announcements, infographics, and YouTube videos. It’s a privilege because I get paid to think and write for living about how to best communicate the ideas of mental health. Even when it’s tiresome it’s a good gig.
It can be tiresome, though. After a while these campaigns start to look and sound the same. There are a lot of sad lonely people shot in black and white, with somber music in the background. Later we see the after, after they’ve sought and received help. Now they’re in color, surrounded by friends and family. We see a lot of celebrities talking about their own experience of depression of anxiety. Or testimonials from regular folk who suffered and recovered. There are a lot of statistics about how many people suffer from a diagnosable mental illness in a given year (1 in 4, sometimes 1 in 5), and how many suffer in a lifetime (1 in 2, usually).
Underlying almost all these communications are one or two basic messages.
One is that mental illness is real. It’s concrete. It’s something that can be known, and understood, and treated.
The other message is that mental illness is common. A lot of people have it. It’s nothing to be ashamed of.
These campaigns are admirable. We want people to better understand their own experience of struggle, or the experience of a loved one. We want people in need to be able to access help. We want to de-stigmatize mental illness.
Just once, though, I’d love to see a public awareness campaign from a major mental health group that aims its language in the other direction. Instead of humanizing and normalizing the experience of mental illness, imagine a campaign intended to destabilize the idea of “normal” by interrogating whether normalcy, or for that matter “mental health,” is as uninteresting or as uncomplicated as we persuade ourselves it is.
The tagline wouldn’t be, “This is what mental illness looks like.” It would be, “This is what mental health looks like.” The television spot would include various scenes of people being too much: grieving survivors keening uncontrollably at a funeral; a married couple arguing bitterly in the kitchen of their home; two lovers passionately kissing; a young brother and sister yelling at each other and then, seconds later, hugging and laughing; rabid sports fans with flecks of spittle on their lips, screaming with fury as their team gives up a run.
The point of such a campaign wouldn’t be to erase the distinction between mental health and illness, between flourishing and suffering, between being in rough control of ourselves and not being in control at all. The point would be to highlight the degree to which rough control is about as good as gets. The point would be that in some deep sense we can all be aliens, both to each other and to ourselves. We can all be too much.
In his New York Times piece, Bollas almost gets it right. He writes: “Our minds — in themselves — produce contents that will be overwhelming. To be successfully normal, then, we rather have to dumb ourselves down.”
What I’d suggest is that we’re not even as good at being normal as Bollas’s formulation would suggest. We can’t dumb ourselves down that much. Or if we can, it’s at the cost of living a fully human life.
What we can do, and I suppose one might call this “normalcy,” though it seems like too gray a word for the experience, is struggle every day to manage our brains, and their excess, well enough to sustain good relationships, experience a wide range of emotions, cultivate an authentic self, care for each other, and move toward goals that are an extension of who we are, what we believe, and what we care about. Even this we can’t do without a lot of help and support from others, and a baseline of material, familial, and political security.
In that struggle, the too much-ness — the vulnerability, dependence, pain, and powerlessness —
Isn’t at odds with the fluorishing life. It’s intrinsic to it. What we call mental health isn’t the absence of these things. It’s a fruitful and healthy relationship to them. What we call mental illness is a state in which our capacity to live productively with too much is impaired in some fashion.
If we could deploy language that would reframe the conversation in this light, perhaps it would begin to chip away at the illusions of individualism and independence that inhibit us, as a culture, from really caring for each other, whatever the label we slap on each other, whatever the degree to which we’re “sick” or just having a hard time or just being human.
Maybe it would carve out some space in which those of us who’ve had experiences of mental illness could make a claim on society even if we’re not strong, even if we have no special wisdom or insight we bring to the table, but simply because we are in fact your brothers and sisters, and our vulnerability and need of care deserves your attention as yours does ours.
Maybe. Maybe not. I want to be careful to distinguish between what language can and can’t do. There is no silver bullet language of mental health that can do everything we’re asking it to do, which is destigmatize, mobilize political sympathy and support, restructure the traditional power dynamic between service providers and recipients, ennoble suffering, and also serve as a focal point for a collective identity that binds together all people who’ve experienced whatever it is we’re trying to talk about.
The thing we’re talking about is too big, too diverse, just way too much to be captured by a unitary phrase or concept that can also feel distinct and meaningful enough to serve everyone’s identity needs.
Language also can’t substitute for good politics. It’s appropriate to advocate for the language we like best, and critique what we don’t like, and these efforts can have political effects. But it’s fantasy to imagine that if we succeeded in bringing everyone into line, using the language we preferred, it would transform our culture and politics in the ways we hope. And the effort it would take to approach this, even if it were possible, would be subtly or explicitly toxic.
What language can do, when it’s an organic extension of a coherent and deep political and moral worldview, is serve to bind together and sustain a social and political movement. And it’s such movements, amplifed and enriched but not created by new language, that have the potential to change the world.
The question we need to ask ourselves is whether the languages that we’ve been promoting, as a community, are these kinds of language, organically connected to these kinds of movements. Or whether they’re the best we’ve felt we can do within an impoverished moral and political ecosystem. And if the latter, then we need to go one step further and ask whether they’re serving not just to optimize within a bad system but to reinforce the system as well.
