Thursday, 9 October 2014

Marketable Madness

'Mad' is not a flattering or nuanced adjective on the whole.  It tends to be used humourously or as a term of abuse, and on the whole, although it might be the kind of term which people diagnosed as mentally ill might wish to reclaim as with the N-word, or "queer", it's very difficult to decide whether one is oneself in such a category, or even to what extent the category makes sense.  However, the fact that it may not make sense renders it in itself useful, and so perhaps lazy, shorthand for the mental conditions reflected by "abnormal" behaviour understood as part of a medical model of behaviour and mentality.

Having got that out of the way, it's often been suggested throughout most of my life that I might be mentally ill.  It would probably be quite straightforward for a mental health professional to observe or elicit behaviour which could easily tick a lot of boxes for a diagnosis, for instance of depression, avoidant personality disorder, Asperger's (seeing that as a diagnosis is of course controversial) or ADHD.  However, it would also miss the point somewhat, not just for me but for other people who could also be so diagnosed, although it is a useful process whereby one can gain a purchase on a society wherewith one might otherwise find it harder to engage, a problem very familiar to me.

Two reasons come to mind as to why this might not be a helpful way of looking at it.

There's a scene in the film 'Amadeus', which I may have remembered wrongly, where his amanuensis is transcribing his music and exclaims overawedly and enthusiastically that "This is genius!", and the composer just says "yeah, yeah, yeah" in a bored and dismissive tone and carries on in an uninvolved and prosaic manner.  That reflects how I feel when people say I'm mentally ill.  I feel it's the kind of thing which is easy to see and not very interesting or relevant.  It's more important to unpack the concept and see if it leads to useful conclusions and a course of action.

Bearing in mind that Oliver Sachs was the man who mistook his patients' confidential medical notes for a writing career, I have to be wary about plonking people's private information in front of you, so I'm not going to do that.  Instead, I'm going to give examples which are intentionally different from the real world ones I have in mind and just hope I'm not distorting them too much.  A single one will suffice here.  If you happen to recognise yourself in this, it's not you literally.  I have made this person up and have nobody I've ever met in mind when I'm describing them.

Envisage a bipolar person.  Half the time, she lies in bed, can't summon up the energy to get herself out of it, eat more than a few scraps of food or go out of the house.  In fact she hasn't even got a home of her own and spends most nights on a friends' sofa.  However, every now and again she has a boost of incredible energy and spends her time 24/7 frenetically scribbling down poetry, performing it passionately and successfully publishing said poetry to the adulation of hosts of fans.  This is a familiar picture, found also among comedians and many other creative people.  Crucially, she is unable to derive an income from anything while in her depressive phase but that's more than compensated for by her manic one, and that tides her over, so whereas she's not exactly fine, she survives and there is an element of flourishing in her life.  You might also replace the bipolar label with OCD or schizophrenia and get the same kind of picture, although perhaps without the cyclical nature of what I'm describing here.  These are of course labels, but I do have in mind people who would be classic, textbook cases of these labels.

Crucially, the point here is not that these people are "mad", but that they successfully engage with others to a degree that they are, for example, able to support themselves.  Nor is economics the point here:  there are all sorts of ways in which one might exhibit "marketable madness" which needn't involve money.  For instance, one might use one's experiences of isolation and exclusion to reach out to others who are stigmatised or as a resource on a suicide helpline.

I should also point out that even if you can't do any of this you are still of infinite value.  Comparisons are odious.

The second aspect of this is less to do with the market and more to do with wisdom, and I can tediously relate this back to my gender dysphoria, although it's more widely applicable so don't worry, I can still be universal.  Again, these are fictionalised examples and "any resemblance to persons living or dead is purely coincidental".  One of them is in fact from fiction, namely 'Tetrasomy Two' by Oscar Rossiter, but they reflect the kind of things which happen in real life.

A woman believes she has turned into a statue on a tombstone.  As time goes by, she becomes weaker and paralysis sets in.  She turns out to have a motor neuron problem which leads to inability to move.  Note that this is a motor neuron problem, not a brain pathology.

A man diagnosed as psychotic believes that his body is dissolving and passing out through his urine, and that eventually he will be an empty sack.  It later emerges that he has a tumour which is producing a hormone which causes the mineral portion of his bones to enter his bloodstream and be excreted via his kidneys.

Less dramatically, someone is very adept at picking up on friends' relationship problems where other people wouldn't notice them, but also unfortunately "notices" completely non-existent problems such as being stalked when it's clear to others that this is not so.

These three examples are more picturesque than the findings of a less involved observer would demonstrate, but they all express truths and insights which are real, and which the people involved notices long before others would.  They are often metaphorically expressed.

Many people, on hearing these for the first time, would fit them into a narrative of mental illness and call them delusional, i.e. beliefs strongly held despite overwhelming evidence to the contrary.  They may also be beliefs on which the person concerned is highly focussed, i.e. they are liable to be seen as overvalued ideas.  The mere facts that something is both not supported by the evidence available at the time, is not literally true and preoccupies the person involved to a degree which is perceived as excessive does not mean it should simply be medicalised or floccipaucinihilipilificated.

Let me be tedious and link this back to my personal overvalued delusion.  Someone with motor neuron disease thinks she's a statue.  In a sense she is.  Someone with a parathyroid tumour thinks his body is disappearing through his penis.  In a sense it is.  These senses are to some extent more important than the apparent truth and had they been taken more seriously earlier, would probably have at least slowed the courses of these people's conditions if not healed them completely.  Similarly, someone believes themselves to be a different gender than others perceive them to be.  Is it not plausible that this is a similar phenomenon?

It's not the point whether I'm "mad" or not.  The points are twofold:

  1. Marketable madness:  Can I engage better with the world and flourish more effectively by being "mad"?
  2. The wisdom of madness:  What real truth is expressed by my conviction that I'm female?