Madness
PMDD and Me. A more personal essay, but also a mediation on mad liberation. My suffering is soup.
CW: Discussions of suicidal ideation and self harm,
Insanity and Me
It is the 16th of the month and I am insane again.
Describing myself as insane always feels gauche. It’s a word used for Gothic brides in attics, scraping their nails down the yellow wallpaper until the woman trapped inside bursts out. It’s also an archaism. No one is insane anymore — they’re mentally ill, or (if you’re being euphemistic) unwell. Sick. There’s a dryness to those terms, a clinical passing-over of what’s actually happening. You’re ill when you have particularly bad hay-fever, and you’re ill when you have a psychotic break. It’s a flattening of experience. Being described as mentally ill makes me feel as if I’m being described as having man-flu.
To establish perimeters: I am not ill. I have a life-limiting mental condition that occasionally flares into bouts of insanity. Insanity, to me, is a state. It is a way of experiencing the world so dissonant with reality that it ceases to be helpful. While I do not believe in an objective standard for reality outside of the boundaries of human thought, I do believe that there is a consensus on reality for a reason — that reality consensus allows for the social contract to be upheld. My understanding of reality is contingent on that notion of consensus, which is formed around some agreed upon facts about aspects of the embodied phenomenological experience. Hence, insanity is when my assurance with that consensus breaks. Those agreed-upon facts destabilise, and I lose the ability to perceive the world as it is most helpfully perceived.
It is during these periods of time that I cease being able to trust myself to keep myself safe: I become liable to flashbacks, where I am un-anchored and I float along my own memories like the time traveller’s wife. The past and the present congeal into one another, and I’m stuck in their gummy residue. My feet catch in molasses. Everything slows. I am swallowed whole, the soles of my shoes slurp-squelching in mud. When I come out the other side, I have no idea what I’ve done, what I’ve said, and often, no idea that time has even passed at all. This is a dissociative state, but I do not often find psychiatric linguistics helpful in discussing my own experiences. It is not an epistemology that I enjoy, and I find the proliferation of therapy-language (establishing boundaries, lovebombing, gaslighting) sickeningly saccharine. My moments of insanity are moments of teleportation. They are not moments of presence, but of absence. I get eaten by my unconscious, and left behind is raw nerves. It is as if my sentience is the skin encasing my mind, and when that sentience is flayed away, Something Else is left behind.
The Ephemeral Nature of Madness
Not trusting one’s own mind — it is unpleasant. My only consolation is that I know when it is going to happen. Although I possess no small amount of disdain for the institution of psychiatric practice, I do find some of its diagnostic practices useful. What I have is described as PMDD, or pre-menstrual dysphoric disorder. My body is hypersensitive to its own hormones, and when those hormones fluctuate, I experience my bouts of insanity. Sometimes this lasts for the full two weeks before I start bleeding, and sometimes (like this month) it lasted two days.
I also have a host of other clustered properties that, when viewed in the light of psychiatric literature, constitute distinct disorders. Autism, ADHD, PTSD, NPD, anorexia, ARFID, previous experience of gender dysphoria— the list is endless. Reams could be written about the usefulness of these categories as distinct, when I experience them simultaneously. My NPD is filtered through my autism which is filtered through my PTSD. They all chew each other’s tails, a human centipede of shit. They are more of a soup than the croutons individually floating on the surface. My phenomenological experience, the sociology of my knowledge (as Robert Emerick puts it) [1] , all tastes like the same soup.
Parsing the distinctions between all of these things, instead of seeing them as composite parts of the processes by which I occasionally break from reality, is not useful. Instead, they are all different instruments mixed into the same song. On occasion, the sound mixer ratchets up one of them beyond the rest, and I experience symptoms associated with the PTSD cluster than I experience the symptoms of gender dysphoria, but generally speaking, they’re all playing alongside each other. Seeing my madness as a holistic set of flares rather than several distinct systems separate from another has been helpful in establishing the boundaries of myself and of my mind. When I acknowledge that I am insane because I’m drowning in soup instead of choking on a single and seemingly insignificant crouton, my connection to consensus reality clarifies itself.
My dasein, my being-toward-death, is one occurring in the mire of madness. It has been a relief, recently, to understand that some of that madness has its roots in biology. I question why this comes as a relief. The soup is the soup regardless of whether it is organically generated or imposed. There is something about the PMDD that feels distinct — something about it that feels more real. Whereas the PTSD and autism and ADHD are all ephemeral and the borders between them are blurrednonextant, the PMDD is something hormonal. At least, if we take the most likely explanation as true. It could be that this is another useless distinction invented for convenience and ease, but sometimes I prefer convenience and ease. PMDD provides me with a framework for myself. I know that on the 15th/16th of every month, I will experience insanity.
It’s strange to have a ticking clock set for one’s own madness. I feel the stirrings of it on the fourteenth, always. I consider pinging the metal catches of hairbands off my wrists, to see the red marks they leave behind. I have especially pale skin. Scratches and bruises appear readily. I experience bouts of eczema, and just before I go mad, my ankles dry out. I scratch them until they ooze, until I am left with scabs and a burning sensation that lances through my calves and legs. Therefore, my madness is always accompanied my pain. The metaphor imposed on me by my own skin is hilarious: my skin literally becomes too tight, dries out too much. I scratch what is inside of me outside in order to find some relief. Instead of self-harming because I need to see what my blood looks like to feel alive, my body compels me to do so blamelessly through its own innovations.
And then on the 16th, I go mad. I will not describe the madness, primarily because I can’t remember what it feels like until it happens. I become a madwoman, locked in the attic of my own interior, my sentience haunting my raw and flayed body. This is what feels real. This is what feels realer than the soup-cluster-blur-flares, to excuse the extensive mixture of metaphors. My body fights itself until I’m allowed to return. It puts itself under siege.
I am then allowed safe passage from the attic into my body. I become calm. I can laugh again, and trust myself again. I breathe a sigh of relief, my shoulders slumping. Thank God, I say, I’ve got another month until I go insane again.
Mad Liberationist Theory
Like all uncertified academics, I like to ground my life in theory. There’s a reason I prefer the words ‘mad’ and ‘insane’ to the more sterile ‘mentally ill’, and it’s the efforts of the mad liberationists.
As defined in the Oxford Journal of Medicine and Philosophy, mad liberationism ‘reverses the customary understanding of madness as illness in favor of the view that madness can be grounds for identity and culture.’ [2] Philosopher of psychopathology for King’s College, London Mohammed Abouelliel Rashed discusses some counterarguments made to Mad Pride — that madness always causes suffering, that having mad pride is as ridiculous as having cancer pride, that what are described as mental illnesses are disordered ways of interacting with the world rather than different ones — and goes on to make a brilliant argument in the defence of madness. I would love to talk to Rashed; he is, to use the parlance of the extremely online, based. He notes that it cannot be empirically argued that the cluster properties considered ‘mental illness’ would always cause suffering even with the removal of exacerbating social factors, because those exacerbating social factors have never been removed. If one considers madness innately disordered because it deviates from the natural function of a given mind, then one must take a teleological view of the human experience. For there to be a deviation from purpose, there is a presupposition of purpose. Arguing that mental illness will always constitute a disordered way of interacting with the world implies that there is a normative, prescribed way that people should be interacting, at which point I have to ask, who gets to define that prescribed way? Medical professionals? Self-help gurus? Philosophers? God forbid, spiritualists?
Of course, when making a purely philosophical argument for mad liberation, it is easy to bat away the claim that insanity is always generative of suffering — the reason it is generative of suffering, I respond, is not because that suffering comes from the inside, but instead, because it is external. Mental illness is not intrinsically unpleasant; it is instrumentally so, because of a social contract written without the mad in mind. And then, I slap myself directly in the face, because I suffer when I am insane. That may be because of social norms surrounding madness, but that still is. It is truly hilarious to be both a mad liberationist and someone who suffers when mad, because I am simultaneously positing that my madness is not intrinsically awful while it is pummelling me with metaphorical hammers.
Paranoia is unbearable. It is physical and it is cruel and it inclines me to act in ways that I would not otherwise. It makes me deviate from the ways in which I would ordinarily perceive myself in reference to consensus reality. As Rashed points out, as a ‘nonconsensual belief’, ‘“delusional” beliefs are outside the scope of the social model.’ This is something that I agree with him on, as is the rest of the article: I am a devoted, philosophical mad liberationist, but I also experience delusion that sometimes disables me. Rashed snakes around the limitations of the social model through bringing nonconsensual belief back into its scope — yes, delusion is disabling, but reactions to delusion are similarly disabling. If the person believing they are being gangstalked is ridiculed for this belief, it will reaffirm their belief that they are being gangstalked. He posits that the issue with delusion is that most delusion is experienced alone; when persecution of the delusional begins, ‘discrimination in question would be no different to that which some religious minorities or sects face, except in relation to the question of numbers; the delusional person goes it alone, whereas sects tend to have a larger following.’
I question whether my delusional beliefs and the beliefs of the committed spiritualists are the same. I suppose that my occasional flaring belief that people can read my thoughts, or that no one will love me if I do not present myself as a sexual object, or that I am unloved because I express cluster properties of madness more frequently than other people are all non-consensual — I do not want to believe them, and I take no comfort in their presence when they emerge. People who believe that rose quartz is lucky, or that keeping malachite will lead to bad luck want to believe those things so that they can come into possession of pretty gems. Then, I question if I’m being misogynistic, because the belief in gems is primarily held by women. Then, I ban myself from using Twitter and resist the temptation to tweet about how radiators are transmisogynistic just to feel something.
Rashed, as always, is right (and takes himself far more seriously than I can when I am discussing the fact that I periodically exhibit symptoms that would have been described as hysterical). An adjustment of social environment would help even those of us plagued with non-consensual beliefs, even though that help would be received on a relative scale to the help that could be accessed by someone with depression caused by a late capitalist work environment. There seems to be a line emerging between typologies of insanity, a delineation based on how thoroughly the social model of disability is able to apply. This makes sense. Property clusters like schizophrenia or Capgras delusion do tend to be treated with more fear than anxiety and depression. Perhaps some of this is due to media representation, but I would posit that it’s the distinction between intrinsic and instrumental harm making itself known again. Depression and anxiety can hypothetically be ameliorated with a change in societal construction, whereas it is difficult to envision a utopia in which I am not at least slightly convinced that everyone is lying to me at all points constantly despite all evidence to the contrary.
Similarly, would my anorexia and body dysmorphia vanish in a post-capitalist society? I do not believe so. They were generated by forces that are intertwined with matrices of capital and gender relations — specifically, the urge to subjugate and take power experienced by the rapist — but an approach to my anorexic behaviours solely focused on amending society to elide the power of rapists without treating the non-consensual phobia of calories gained alongside it feels incomplete. Making arguments about this is a fraught process, namely because I do not live in a post-capitalist society, and arguing as if I do is pointless. As it stands, I am drowning in soup made of property clusters of mental illness, exacerbated by my body seemingly being allergic to its own hormones — mad liberation does on occasion seem too utopianist to me, and not pragmatic enough.
Rashed goes on to discuss (wonderfully, I must say) the seemingly paradoxical nature of the mad liberation movement as a social one.
phenomenological psychopathology literature describes the “schizophrenic” person as having a crisis of intersubjectivity; a disruption to the two fundamental poles of social reality: sensus communis and attunement.
Some forms of madness disrupt one’s presence in society — how can Mad Pride campaign for madness as a deviation on sociality when madness is often innately asocial? Rashed makes a beautiful argument against this; the people whose experiences of madness present asocially have simply not been ‘brought to a conception of themselves as social subjects.’ That is to say, while it is true that schizophrenics are often experiencing crises of intersubjectivity, that does not mean that a schizophrenic version of the social subject cannot be generated for the purposes of mad liberation. Individuals ‘should be supported’ so that they can fight for justice within a social system; for that to occur, they need to be given the resources to access an activist standpoint. While I think that Rashed falls into the trap of creating an authority figure that can determine who does and does not need to be elevated to a comparably intellectual standpoint, a belief rooted in epistemic privilege, I do think that the broader belief is sound.
I am a mad liberationist, therefore, because I hold the beliefs that my madness is not intrinsically but instrumentally awful, that there are aspects of society that should be altered within a framework of social justice to amelliorate the thickness of the proverbial soup, and to avoid a medicalising standpoint that reduces my experiences into pathologies of suffering, rather than as deviations from normative understandings of reality. My embodiment in the world is not solely one generated by the obscure mechanisms of the nebulous mental illness. It is one generated by complex interplays of overlapping matrices — those of power, of capital, of hormonal rejection, and of oppression.
Madqueer Solidarity
I take on the label mad as some take on the label queer.
Queerness is fundamentally a rejection of an assimilationist politic. It is looking the extant hierarchic structures of society in the eye and demanding that those structures blink first. Similarly, I take my madness and I reject a politic of assimilationism. Mental illness. I’m not just ill. I don’t have a head-cold that spread through my cortexes instead of my sinuses; I am mad. Sometimes, I enter a state of insanity. Not gay as in happy, queer as in fuck you? Not sick as in ill, but mad as in fuck you. My madness is my life is my embodiment is my sociological knowledge is my relationship to the reality consensus.
I stand as a mad dyke, and I stand in solidarity with the rest of the world’s mad. That is what my madness enables me to do. My madness reaches out to the rest of the world’s afflicted and it holds them to me. As Dr. Rashed argues, ‘madness…continues to be excluded from normative moral and political theories…questions of how we act and what we owe each other’ [3]. Madness as a framework allows new ways of knowing what we owe to each other, both the mad and the sane.
It is the 16th of the month and I am insane again. I walk the halls of my mind as a sheet-white ghost, not knowing what my body is doing, what it is saying; I am only cognisant of the fact that my jaw aches and my eyes sting. However, I am at peace. I know it will be over soon. I know that I am mad. I know that I will be myself for a month before I am flayed again. My suffering is not intrinsic to who I am or what is within me; my suffering is instrumental.
My suffering is soup.
[1] Emerick, Robert (1996), ‘Mad Liberation: The Sociology of Knowledge and the Ultimate Civil Rights Movement’ in The Journal of Mind and Behaviour Volume 17, San Diego State University, p.135.
[2] — Rashed, Mohammed Aboulleil (2018), In Defense of Madness: The Problem of Disability, Oxford University Press. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420721/. (accessed 19 April 2024).
[3] — Rashed, Mohammed Aboulleil (2023), Madness, The Philosopher. Available at: https://www.thephilosopher1923.org/post/the-new-basics-madness. (accessed 19 April 2024).
