Thursday, June 21, 2012

Problems in Living

I watched the film “Night of the Iguana” recently (we’re having a Tennessee Williams fest), and I was struck by the incredible compassion of this line: “Nothing human disgusts me,” spoken by the itinerant painter during the fallen minister’s dark night of the soul.

Dissident psychiatrist Thomas Szasz has challenged the very concept of mental illness; he theorizes that every human struggles with what he calls “problems of living,” the effort to cope with the reality they find themselves in. Some people have more difficulty coping than the average person, and these are the ones our society labels “mentally ill.”

The journal American Psychologist published an essay by Szasz in 1960 entitled, “The Myth of Mental Illness,” in which he argues that the concept of “mental illness” will one day be seen to be as primitive as the belief that the devil causes us to misbehave. In addition, he makes clear that much of what is labeled mental illness is determined by adherence to cultural norms: “what people now call mental illnesses are for the most part communications expressing unacceptable ideas, often framed, moreover, in an unusual idiom.” In Szasz’s view the psychiatrist acts as a form of policeman enforcing society’s consensual reality: “The psychiatrist does not stand apart from what he observes, but is, in Harry Stack Sullivan’s apt words, a ‘participant observer.’ This means that he is committed to some picture of what he considers reality—and to what he thinks society considers reality—and he observes and judges the patient's behavior in the light of these considerations.”


Szasz concludes the essay by saying: “I do not intend to offer a new conception of ‘psychiatric illness’ nor a new form of ‘therapy.’ My aim is more modest and yet also more ambitious. It is to suggest that the phenomena now called mental illnesses be looked at afresh and more simple, that they be removed from the category of illness, and that they be regarded as the expressions of man’s struggle with the problem of how he should live.” The mental task of a modern human is incredibly complex. We have created vast interconnected systems of thought based on abstract concepts, and every child is required to master them. We are all doing the best we can to accomplish an extremely difficult task: to maintain an abstract mental model of reality through time, including an elaborate personality structure.

Recently I watched a juggler tossing seven balls in the air simultaneously, and it occurred to me that all of us are doing a similar mental juggling act. We keep innumerable balls in the air all the time: our professional/job persona, our lover persona, our son/daughter/sister/brother persona, our parent persona, our friend persona. Animals don’t have this complex subjective mental perception to maintain. Their mental models contain things like: memory of food source, how to find water, possible predator movement patterns, etc. But humans have to maintain models of such behavior as: how to act at a cocktail party as opposed to a family gathering, what mode of discourse is acceptable towards our boss as opposed to our friends, what is an appropriate hug from a lover or a co-worker or a friend’s child, and what’s the proper etiquette as we pilot our car through traffic on a rush-hour clogged freeway.

All of us struggle with problems of living, from the most “normal” to the most “psychotic” person. I had this thought in mind when I read the review of three new books that all assert that our thinking is dominated by our subconscious to a startling degree. (“The Amygdala Made Me Do It,” by James Atlas.) Atlas writes that one of the author’s “thesis is that we can’t change our habits, we can only acquire new ones. Alcoholics can’t stop drinking through willpower alone: they need to alter behavior — going to A.A. meetings instead of bars, for instance — that triggers the impulse to drink. You have to keep the same cues and rewards as before, and feed the craving by inserting a new routine.” 

What hit me was this idea: what if that’s because some of these people don’t really have a “disease”? They are people who like to be around other people—they are highly social animals—and one of the easier ways to have an active social life in our culture is to hang out at a neighborhood bar. You can be with your friends every night of the week. Because they are in a setting that exists for the consumption of alcohol, these people are going to drink a lot and eventually become physically addicted to the alcohol. But this dependence arose not because there is something wrong with the individual person. Instead it is a symptom of a different problem: as a society we are dysfunctional when it comes to social contact. We are increasingly an isolated, loner society where we only interact with those we know. 

The film “Lost Boys of the Sudan” is a documentary about young boys who hiked hundreds of miles out of the killing fields of Sudan and were living in refugee camps in Ethiopia and Kenya. Life at the camps was filled with communal interaction; they sang, danced, and told stories. A few “lucky” boys were brought to the United States. At first when they went out on the streets they would immediately begin talking to whoever they encountered, even turning to walk with a person down the sidewalk. Of course the Americans would act startled and rush away from this “crazy” person, and the Sudanese were confused that these strange people did not want human interaction. 

The film “Forrest Gump” is almost entirely told by Forrest to various people waiting on a bench for their bus. He is a primitive; he can’t imagine not interacting with whatever person he is with. He doesn’t see the barriers that we of normal intelligence see, which is a clue that those barriers are imaginary. Just another one of those juggling balls we’re keeping up in the air. 

A.A. helps the “social” alcoholics because they’re still getting the social life they need, they have just switched a meeting for the bar. And, there’s a bonus: the level of social interaction they’re experiencing has just shifted up a notch. 

Szasz’s insight is that people are not mentally sick; everyone copes with life the best way they know how. Many of the things we perceive to be “mental disorders” are, as the alcoholic example above shows, really a problem with our society. The society is mentally-disordered, and when people try to cope with an insane society they are going to experience some mental distress in the process. 

More than one in ten Americans is taking an anti-depressant drug today. Maybe the reason we’re so anxious and depressed and having trouble sleeping is because we live in a dog-eat-dog competitive capitalist society which values only money and fame. But instead of looking at our culture we call the people sick and drug them, reinforcing the lie that the society is sane while hiding the symptoms of its actual sickness.

This post might seem strange in a blog entitled “We Are ALL Insane,” but the basis for our claim that insanity is universal is the concept that the entire human race is confused in their thinking. Since we are all confused, our cultures are confused and insane. All of us do the best we can to cope with the problems of living in an insane human society. The first step out of insanity is recognizing its existence.

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