In “Head Case,” an episode of the TV show “The Commish,” Michael Chiklis’ character uncovers a plot at a mental hospital to frame an innocent man for the death of a patient. He is kidnapped, locked in the hospital, and drugged – I can’t remember how he ended up getting out of this particular dilemma, but I do remember the numerous scenes where he tried to convince the staff of the hospital that he was sane and being held against his will. At that point, I had narrowed down my career choices to Neurosurgeon, Actor, or Therapist, and it was disturbing to me to watch Our Hero so easily thwarted by being designated as mentally ill.
It isn’t hard to browse a catalog of mental disorders and see things you identify with. Undergraduate Psychology classes are filled with people who are drunk on the power of self-diagnosis and who are more than happy to tell you what is wrong with you. Flipping through one of my Psychiatric Desk References, I see that I have symptoms of Narcissistic Personality Disorder (“Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).”), Avoidant Personality Disorder (“Self-critical about their problems relating to others”), and Histrionic Personality Disorder (“Excessive sensitivity to criticism or disapproval.”)
When you have just enough theory to be dangerous, you tend to err on the side of an affirmative (amateur) diagnosis. You assume that even if you don’t meet the threshold (5 or more of a cluster of symptoms for most disorders) you are probably in danger of developing these disorders in the future.
Mental Health is like other types of health: a single symptom, in itself, means nothing. Shortness of breath is one of the symptoms of a respiratory disorder, but if you show up at my door wearing running shoes and sweat bands and you’re out of breath, I won’t assume you’re teetering on the brink of emphysema. Positive mental responses are not always the “healthy” response to stimuli – being emotionally buoyant and sunny in the face of desperate circumstances is a bigger red flag than crying or becoming emotional. Speculating about “defense mechanisms” isn’t helpful, and it puts the other person in a situation where everything they say is assumed to be an attempt to evade scrutiny.
Mental Health treatments are ultimately about a person’s ability to function. Do I have the symptoms of various personality disorders? Yes. Do they effect my ability to work, to earn a living, to form friendships and relationships? No. If you notice, every single one of those symptoms has an opposite extreme that would be equally problematic. Have you ever met a person who isn’t self-critical about their problems with others? ASSHOLES, every single one.
Trying to pick apart these symptoms outside of a larger context creates a situation where sanity is viewed as the temporary state that most people reside in, and turns everyone else into “the other.” Neurotypical functioning is just that: typical. It is what most people are, most of the time. If you fall outside the normative range of any one trait, that simply indicates that you aren’t typical. The problem arises when other people make value judgements, assuming that the goal is to be completely neurotypical, to calibrate your emotions to the mean, and have the rest of your life play out in placid serenity.
Marginalized people are particularly susceptible to having their emotions pathologized, partly because their experiences aren’t typical. When young queers are experiencing depression related to the stigma of their sexuality, people like Tony Perkins swoop in to point the blame at their sexuality, and not the stigma that they themselves are perpetrating. Women, queers, the disabled, people of color, political dissidents, atheists; all of these groups have a history of being labeled “insane” to control them. In the movie Changeling, Angelina Jolie plays a woman who has a boy returned to her who isn’t her missing son. It was based on a real case where a woman was committed to a mental institution for questioning the police. After being released, Christine Collins was awarded 10,800$ by the court, which the Police Chief that had her committed refused to pay. This is not history, this is topical. We continue to live in a society where, once you have been pushed over some arbitrary standard of insanity, you lose all control over your own destiny.
For marginalized people, it is in our best interest to defend ourselves from the blunt, unstudied ‘splaining of people for whom Psychology is a weapon. You say we’re irrational, we’re unhealthy, we’re sick, we’re hysterical. I, for one, would like a second opinion.