Institutions and Language (2): Loss of imagination

Recently I was thinking about how it feels to feel not quite right and yet not know how to describe it. I suppose I am not talking about a vague queasy feeling or anything of that sort. Imagine instead, if you can, a rather "psychological" malady in which you don't quite feel like yourself, or you don't feel as you think you ought, or you are committing repeated failures of character that you just can't seem to control. Or perhaps you feel just a bit of madness. Whatever it is, there is the distinct feeling that something is wrong and that it is not, at least symptomatically, physical. In what ways can we say to someone, "Excuse me, something is wrong with me" when we find this to be the case?

Ignoring the reader's potential desire to psychoanalyze me here, let's continue with what I was thinking the other day. What, for example, do you tell someone is "wrong"? At this point, perhaps you start searching the internet for a list of symptoms that match your own, even if, at this point, you are not quite clear what the symptoms are beyond a feeling that something is wrong or that you just haven't been quite right. This brings me to the particular neurosis that I wondered about. I wonder if someone desperately searching Google for a diagnosis has not at some point simply adopted symptoms of another simply to make it clear that something is wrong. Say, for example, someone has some unnamed psychological burden that does not "cause" alcoholism but for whom alcoholism becomes a way to declare that burden in a way that is no longer "in your head".

Maybe this seems far-fetched. Maybe. But maybe it is not. It would be a hard thing to test - precisely because it lies at the very margin of our ability to measure (which is the cornerstone of diagnosis). There are, I think, several "syndromes" that act as catch-alls in medicine, a way of saying "You hurt, but I don't know why". And equally, there are mental health diagnoses that are so subjective that self-diagnosis might seem to be step up in objectivity were it not for our predispositions to behaviorism (I'm reminded of the behaviorist joke: A couple of behaviorists slept together. Afterwards one looked to the other and said, "It was great for you, but how was it for me?).

It strikes me that the real tragedy here might be the atrophied ability to describe what's wrong in the first place and to communicate it. Bombarded by lists and check-lists of common symptoms, perhaps we are just losing our imagination for navigating our own psychology, in the process simplifying the mind to a set of banal faculties.

How does this tie into "institutions"? It ties in through language, and how the language that we use to describe our mental lives comes to shape the possibilities available for those lives. The types of diagnosis we offer, the standards for those diagnoses, and the legitimacy of pain that does not fit those diagnoses has the power to shape what people can feel and communicate. In this sense, mental health care based on a narrow scientism has the real potential of making us more psychologically uniform in experience and yet perhaps infinitely less "healthy". It's too much to aim at offering any sort of satisfying alternative in this post. Let it suffice that I think we should cultivate the ability for all people to communicate the richness of their experience. This means we need to train people both to speak in rich terms and to listen in great depth. These sorts of things only happen in a community.

There will be some who read this and say, "Yes but..." and list all the potentially harmful forms of mental illness, harmful both to the sufferer and their neighbors. That is a legitimate concern, but it's precisely the type of concern that tosses baby out every time we empty the bath water. At root, I think that "Yes, but..." is founded on the fear that someone else's well-being might depend on my willingness and ability to listen to and understand what's going on with my neighbor. It's Cain's dilemma all over again except that now we are killing our brother (and even ourselves) by slowly eroding the possibility for life. It's a poisoning corrosion of the mental leaving us gradually more fragile.