Like Minds Perspectives


Find out what we think about madness in all its glory.

Stigma and discrimination are two of the biggest barriers to recovery from mental health problems. The Like Minds project promotes more inclusive ways of thinking about, and doing, things.

Article by Graham Panther.

Edited and adapted By Taimi Allan. 

Copyright Mind and Body Consultants Ltd.

 

Index:

What’s in a name?
What is madness?
Valuing madness
Madness makes sense

What’s in a name?

reTHiNK Perspectives features a number of different views on what society currently tends to label ‘mental illness’. We have already seen a variety of words and phrases used to describe them: ‘mental distress’, ‘madness’, and, even, ‘mental illness’. So, even among those who think these experiences can be of great value, there’s not necessarily any agreement over what to call them.

How we think about things tends to affect what we call them, and what we call them tends to affect how we think of them. Mental distress is such a uniquely personal experience, it’s actually impossible to choose a word or phrase that everyone who has experienced it can fully relate to.

Since we have to call it something, on this site we tend to use the phrase mental distress, mental unwellness or sometimes the word madness. Mental distress is a useful phrase precisely because it is quite vague, and therefore more neutral than some other terms. Madness is a more confronting term, but we use it nevertheless for a couple of reasons. For some, terms like ‘mental health’ (and even ‘mental distress’) are euphemisms that imply that what we’re talking about is somehow taboo, or not to be discussed too directly. The word madness is definitely more direct. It’s a reminder that what we’re talking about is indeed something that can at times seem radically unusual – in other words, mad. At the same time, our use of ‘madness’ is also an attempt to reclaim the word, part of an underlying message that madness can actually make sense.

You could argue that ‘mental distress’ and ‘madness’ refer to slightly different things (since not all mad experiences are distressing) but the terms are used interchangeably on this website.

‘Illness’ v ‘Experience’

Our society invests a lot in the notion of ‘mental illness’, not just a phrase but a whole mode of thinking. We propose that it is equally valid, and at times far more useful, to think of mad or distressing experiences as just that: experiences, rather than symptoms.

Some people think that what society calls ‘mental illnesses’ have a physical cause, like physical illnesses do, that there is something different or disordered about the brain of someone diagnosed with schizophrenia, or depression, for example.

Others think that mad or distressing experiences are a natural, human response to certain life events. People experience mental distress not because they are somehow physically different to other people, but simply because such experiences are very much part of the broad spectrum of human experience.

Either way, it is well worth remembering that, from the perspective of anyone experiencing mental distress, it is an experience first and foremost. Whatever your beliefs about its causes, it makes sense for us all to think of mental distress as an experience at least as much as we think of it as a form of illness.

This subtle shift in how we think about these experiences can make a big difference to how we think about mental distress and people who experience it.

When we think of an ‘illness’, we tend to think of something:

  • Requiring hospital treatment
  • That doctors know the most about
  • Potentially contagious, requiring quarantine
  • That makes you dependent or weak
  • That makes you broken, needing to be fixed
  • With a prognosis, i.e. expectations of a return to wellness, ongoing disability, or death

When we think of an ‘experience’, it can be something:

  • Good or bad, or both
  • That can be learned from
  • Of value, e.g. when job-hunting, or helping others with something you have experience of
  • That can be shared, that others can relate to
  • Unique, or universal, or somewhere in between
  • That no one else is the expert on, if they haven’t had that experience

Notice that when we think about mental distress as an experience, it’s a lot easier to recognize the positive as well as the negative aspects of it.

Valuing the Experience

Our society recognizes the value of what people learn from distressing periods: the insight into oneself following a relationship breakup, the insight about the value of life gained after the death of a loved one, and so on. Yet for whatever reason this same value isn’t often recognized in relation to periods of mental distress, other than by people who’ve experienced them.

It makes sense that you potentially learn a lot about yourself and about the world through experiences that challenge you. This includes experiences of severe anxiety, extreme highs or lows, hearing voices that no one else hears, and whatever else of the many and varied experiences usually labelled ‘mental illness’.

Of course, everyone responds differently to the challenges of mental distress, because, quite simply, everyone is different. We challenge everyone who reads this to at least consider these two ideas whenever you think about what gets called ‘mental illness’:

  • Distressing or mad experiences are human experiences
  • People are people, whether they experience mental distress or not, and everyone’s different.

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What is madness?

The short answer is: there is no short answer. When we’re talking about something as complex as the mental lives of humans, we need to look at it from a number of different angles. Our aim here is to find a way of making madness or mental distress seem a little less mysterious and a little more easy to relate to for those who haven’t directly experienced it.

The notion that we’re all a little bit crazy is repeated often enough that it borders on cliché, but if we’re serious about rethinking madness, it’s really just the beginning. Rather than ‘everyone’s a little crazy’, we might say: everyone can relate to the things we label crazy, if they’re explained well enough.

Not every way of looking at mental distress achieves this – indeed some seem to make mad experiences seem radically different from ‘normal’ experiences. But even those ways of looking at mental distress can still be useful if we’re willing to take them as only one part of the story, so we’ll cover them too. First let’s look at the ‘mental illness’ approach.

Ill vs Healthy

There are two versions of this division between mental health and mental illness. The first is the black and white approach, and the second involves the notion of a spectrum of mental health.

The black and white approach

The black and white approach to mental distress is that you’re either mentally ill or you’re mentally healthy. You can potentially move from one group to the other, but you and your experiences are always defined by what side of the line you’re on:

 

From this point of view, there is a point at which certain experiences or behaviour go from being normal to being abnormal. E.g. feeling happy a lot of the time might be considered normal, but if that happiness lasts for a certain period or reaches a certain intensity, a psychiatrist might label it no longer just an experience but a symptom, e.g. mania. Similarly, a period of feeling particularly down might be considered normal until it lasts for a certain period or reaches a certain intensity, at which point it is interpreted as a marker of illness.

This model appeals to people because it is so simple. Its simplicity is also its biggest flaw however, and on reflection most people – psychiatrists included – would agree that the mental lives of humans are far too complex to fit into just two boxes: ill and healthy.

This black and white model also makes it hard for people supposedly on the healthy side of the line to relate to the experiences of those on the supposedly ill side. This is because labeling certain experiences symptoms of ‘illness’ makes those experiences seem fundamentally different from ‘healthy’ experiences. So the black and white model of mental life produces an ‘us and them’ division, which we see reflected in, for example, the fear of people with experience of ‘mental illness’ apparent in our mainstream media.

The spectrum of mental health

One response to these issues has been to remove the dividing line between mental health and mental illness, and think of mental health as one continuous spectrum we are all on:

 

In this model, there is no fixed point at which certain experiences become signs of illness. Yet there is still an understanding that experiences at the right-hand end are signs of illness, signs that something is wrong with you.

This label of ‘illness’ can be useful, because it offers a kind of explanation for experiences that can often be quite baffling at first. It can also be very limiting. Sometimes it’s both at once.

It must be remembered that the ‘explanation’ of mad experiences offered by the phrase ‘mental illness’ is quite superficial. This is not to say that the phrase has no value. We’re simply pointing out that it doesn’t actually explain much when you look closely at it. We’re taught to think of doctors as having all the answers, but they’d be the first to admit they do not, particularly in this area. Diagnoses of mental illness tend to be simply descriptions of what the supposedly ill person is experiencing, without much consensus – even within the medical community – on what causes the experiences or how to treat them.

Medical science has never discovered any wholly convincing evidence that there is any difference between mentally ‘ill’ and mentally ‘healthy’ people’s brains. Indeed, most medical scientists would agree that what gets referred to as ‘mental illness’ is a complex collection of phenomena that cannot be accounted for in solely medical terms.

So the idea of ‘mental illness’ must be thought of as just that – an idea – one that can at times be useful but at other times needs to be challenged. That is, it’s only one side of a many-sided story.

Madness as Human

Here’s another approach. You can think of it as a replacement for the mental illness model, or as just another side of the story to consider.

Put aside for a moment the notion of mental health. Consider that when we’re talking about people’s mental lives, we’re talking about something that sometimes relates to health but can’t be defined in terms of health. Because we’re basically just talking about people’s lives in general.

Imagine we’re all on one unbroken spectrum that runs from extreme distress, at one end, to extreme happiness at the other (or whatever you think of as the opposite to distress) :

 

We’re all at different points on this spectrum at different times. You might start the day somewhere in the middle, move toward the happy end after your morning coffee, then toward the distressed end when your car doesn’t start and you’re late for an important work meeting etc.

The key thing is that, unlike the mental illness/mental health model, nothing on this spectrum is considered abnormal, or necessarily unhealthy in any way.

For example, we all experience extreme distress at certain times in our lives. In this view, what others call ‘mental illness’ is understood as the tendency some of us have to spend more time near one or both ends of the spectrum.

This makes it easier to try to relate to mental distress if you haven’t experienced it yourself. On these terms, people can discuss those experiences they do have in common, and how more intense forms of those experiences might be similar, as well as how they’re different.

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Valuing Madness

This way of thinking about mental distress also makes it easier to see the potential value in having experienced it. If you’ve spent a fair bit of time at the distressed end of the spectrum, that experience can teach you things that open up the other end of the spectrum in new ways.

Consider obsessive thought patterns. Obsessions are repetitive thoughts or worries that can seem impossible to stop thinking about. Most people are familiar with the idea of people obsessing about cleanliness, and washing their hands excessively, or obsessing about the oven being on, and checking it several times. People can obsess about anything though, just as we can all find any number of things to worry about in less intense ways. Learning to deal with obsessions can have great spin offs for the rest of your life. If you figure out an effective response to those obsessive thoughts – as many people do over time – you potentially learn skills that can help you let go of other more everyday thoughts that many people spend a lot of time and energy worrying about.

Consider another example. Experiencing extremely low mood or other elements of what we call depression can be profoundly difficult, whatever the cause. For precisely this reason, for some people it can also have a significantly positive effect, as it forces you to re-evaluate many things, to take stock of your life and where it’s going. Our society tends to recognize this potential value in the experience of grief following a major loss or change. For some reason, when the cause of the experience of depression is less immediately apparent, this potential value is not so readily recognized.

Healthy Mental Distress

From this angle, madness or distress is thought of as an experience, not a concrete state of being. Everyone responds to different experiences differently. Many people learn to respond to the challenge of mental distress in a way that benefits their overall wellbeing. Looking at it this way, you can see how it’s possible for someone to be experiencing episodes of extreme distress and to be very mentally ‘healthy’ at the same time.

People may then continue to experience episodes of distress, but this doesn’t necessarily make them unhealthy. Indeed, as we’ve suggested here, it may continue to contribute to their wellbeing, for example, with people:

  • using their episodes of depression as reminders of what matters most to them; or
  • using their nervous energy to fuel their endeavours; or
  • treating the voices they hear as a source of potential insight into how they really feel about a situation.

These are all just examples. Everyone experiences and interprets these things differently.

This approach may seem to simplify things. But so does the ‘mental illness’ approach we looked at earlier. No single model can fully capture something as complex as people’s mental lives. Often the most helpful thing that people can do to support others experiencing mental distress is to recognize that there are many different ways of viewing these experiences, and to support people to find their own way of making sense of them, i.e. to find what works for them.

It can be difficult to discuss the potential value of mad or distressing experiences without seeming to minimize how tough they can be. Yet mainstream society’s consistent focus on the tougher elements of these experiences can leave people who experience mental distress looking fragile and hopeless. We contend that, on the contrary, experiencing such things is something that requires great strength and resourcefulness.

This website presents the views of some people with experience of mental distress, talking about how they have made their madness work for them, and what they have learned from their experiences. At no point do we claim that our views, or the views of anyone profiled on the site, are representative of all people experiencing mental distress, madness, mental illness, or any other experiences that might be included in this discussion. We aim simply to fill a perceived gap in readily available information about different ways to consider (and reconsider) the complex issues we’re discussing here.

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Madness makes sense

Most of us, whether we’ve our own experience of mental distress or not, have had at least some experience of trying to make sense of others’ mental distress. It’s easy to hear stories of people acting strangely, or witness such things yourself, and think: this behaviour makes no sense.

But anything looks crazy out of context. One argument is that madness actually isn’t mad at all. Mad experiences can make sense when you look at them in context.

Looking at them in context involves looking at how, for instance, seemingly mad experiences and behaviour can actually be very reasonable, human responses to problems in life. One way to make sense of mental distress is to consider how it can often have a function.

The function of mental distress

This is easiest to explain through examples. Consider dissociation. This psychiatric term can refer to quite a lot of different things, but generally speaking it’s a label for the various different ways you can sometimes feel not quite present, or ‘out of it’, or otherwise detached from yourself and the situation you’re in. Sometimes people just feel a little fuzzy, others feel quite strongly detached from their body or from the world for certain periods. These sensations can be very distressing, and confusing.

Out of context, dissociation can seem completely mad. Yet, it starts to make a little more sense if you look at it in context. Dissociation is very often an after effect of having a particularly scary, life-threatening or otherwise traumatic experience. When you’re going through something terrifying, or reliving it in your head, it is a completely natural, reasonable, and human response to detach from that experience, to escape it as best you can by drifting away in your mind.

For those who have not experienced dissociation, it might help here to consider something everyone can relate more readily to: daydreaming. You’re in a situation you’d rather not be in – at work, in class, stuck in traffic – and so your mind wanders. Sometimes you’re in control of this, and other times you just can’t help yourself.

While dissociation and daydreaming are quite different experiences, at fairly opposite ends of the spectrum of distress and happiness, they serve a similar function: detaching from an unpleasant situation. Of course dissociation is more extreme than daydreaming – and usually a lot less pleasant – but that makes sense in relation to the more extreme nature of the situation you’re responding to.

Again, anything looks crazy out of context. It’s often a lot easier to make sense of mental distress when we know the context of someone’s less ordinary experiences. Often the expert on this is the one who has experienced the mental distress or madness in question.

If someone is experiencing intense dissociation, or psychosis, or anxiety, or whatever, they may not be particularly up for (or interested in) explaining their experience in a way you can understand. But once people have had time to process their experiences – particularly if they are well supported to find whatever information they think is relevant and to pursue whatever ways of thinking about the experiences they think might help – they will generally understand their experiences better than anyone else.

Social Acceptability

Public opinion is often swayed by sensationalist media representations of mental distress, and, in decades to come, discrimination against people experiencing mental distress may well be one of those things our descendents look back on and can’t understand. It’s well worth taking a closer look at what we consider acceptable and unacceptable in relation to our mental lives. It’s also another good way to rethink mental distress.

It’s fairly safe to say that some things are socially acceptable or desired, others are socially unacceptable, and everything else falls somewhere in between these two poles:

 

This all seems pretty straightforward. Yet sometimes it gets more complicated than that – particularly when we’re talking about something as contentious as mental distress.

Diagnoses of ‘mental illness’ all tend to be at the unacceptable end of the spectrum:

 

Recent public awareness campaigns have helped shift depression, in particular, a little further toward the acceptable, but in general ‘mental illnesses’ are not considered acceptable or desirable things.

Yet, at the socially acceptable end of the spectrum, we can find all kinds of experiences that correspond to each of the things these medical labels attempt to name. These are just a few examples – everyone has a different experience of what these psychiatric terms describe, and we could say the same of the non-psychiatric terms here, so other people might come up with other comparisons.

 

Mania is a medical term describing a period of elated or euphoric mood, in which you might have a whole lot of energy and really big ideas that others think are crazy but which make perfect sense to you. We could often use the exact same words to describe someone in the first throes of new love.

The point here isn’t that there’s no difference between love and mania. The point is, we need to ask the question: if they often share a number of key traits, why is one so completely acceptable and the other so unacceptable or feared?

You could argue that, even if we can compare supposedly mad experiences to supposedly more normal ones, there is no way for people to fully understand madness without experiencing it themselves. Nevertheless, if we challenge the questionable logic that stigmatizes that experience, it becomes completely obvious that people with and without experience of mental distress can relate to one another simply as people, with all sorts of common ground.

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The Continuum of “madness”- a social construct?

Click on the following timeline to see a fuller picture.

The perception of Madness therefore depends a lot on the context of what we see as “socially acceptable” or “not acceptable” in our society, and depends a lot on our culture, our personal experiences and the attitudes of those around us. For example, behaviour which may be socially acceptable in one culture or environment and therefore seen as “normal”may be completely unacceptable in another and therefore be more likely to be seen as a symptom of a “mental illness”.

One way in which we can make something seem more “normal” in our society is to increase education and understanding about how it feels to be in this place by relating normal every day experiences to those words and behaviours linked specifically to a mental disorder experience. Many of these words are misunderstood due to the fear associated with them. If we can demystify these experiences by finding experiences that, whilst not disordered, are common to all of us we can go a long way to reducing some of this fear and increase empathy.

This diagram developed by Taimi Allan and Miriam Larsen-Barr  compares mad experiences or behaviours that often hold a lot of stigma to experiences most of us will relate to. While this diagram does not attempt to downplay the distress that some may feel in acute phases of these experiences, it does go a long way towards normalising these experiences for those who have not experienced them. Furthermore it seeks to highlight the fact that people who experience these things are not always at an acute phase and with the right tools can live well in the presence or absence of these experiences.

Remember that for most of us, regardless of our experiences or diagnosis, we move through periods of being able to “turn down” the volume on our experiences with skills and tools for coping, and at other times we may feel overwhelmed by these experiences. For no one are these experiences a fixed state, and for a majority of people it is possible to recover from the distressing parts of these experiences.

Please note – none of these experiences lead on to one another, and do not constitute a disorder or diagnosis, they simply seek to highlight thoughts, behaviours or processes that are easier to relate to for those who have not experienced those terms on the far right.

For the full context of this resource, book a reTHiNK Madness Workshop with us.

Please feel free to leave a comment.

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