Cognitive Dissonance and hating Tories

If you voted Conservative you are an immoral selfish person. If you are a shy Tory, then what you’re feeling is guilt. If you voted Conservative kill yourself.

People who hold this view invariably call themselves progressives, liberals, or even Marxists. Chuck in intersectional feminist for good measure. If the anguish of them being defeated wasn’t bad enough, I can’t begin to imagine the pain they must feel withstanding the cognitive dissonance tearing apart the inside their brains. It’s painful to then, but also counter-productive and counter to everything they’re supposed to stand for.

A common call to arms in far left circles is ‘We are the 99%’ when a far more apt turn of phrase would be “We are the already committed 1%”.  Any sort of analysis which relies on the idea of class relations also relies on the idea of false consciousness. The great financial crash, and its economic aftermath didn’t just impact the people at the bottom of society, but it also impacted those who managed to pick up the scraps as well. Applied consistently, the sort of people who lives a reasonably well off life as a conservative voter aren’t genuinely part of some oppressive class but instead someone who has been carved up by divide and rule to turn against those underneath them.  How they vote and behave isn’t something just decided by individual responsibility, but the material, ideological, and institutional processes. Translated into real life; they’ve done reasonably well and their economic conditions have improved since the crash, but their working conditions have become worse. They might believe in the idea their hard work is the reason for their success rather than seeing the forces at play around them. Something Something Capitalism. To paraphrase an excellent article on privilege politics by Connor Kilpatrick, focusing on party political allegiance diverts attention from the real villains.  If this is the sort of thing you believe, then you sure have a heck of a lot more in common with them than actual capitalists.

Yeah though, but they’re like bigoted. Some of them even read the Sun. Murdoch. Daily Mail. The neoliberal media etc. Didn’t you hear their tentacles managed to swing the election? All these thick people were brainwashed by the press. They were brainwashed, but we’re still going to hold them responsible for it. We think pretty much everyone is just an empty shell for the press to pour right wing propaganda into, but we’re still going to call them all (trigger warning: gendered misogyny) cunts for it. The truth is, if there’s anyone more likely to be brainwashed it’s you. Not because you’re wrong about everything (you are, but it isn’t the point) but by closing off the views of your political foes then you’re more likely to be wrong about how well you’re doing. The only people to call the election correctly were those sitting in top roles within the Conservative party. What happens when you don’t at least spy on the enemy? You contract whatever mental disorder afflicts Eoin Clarke.

On the basis unfriending people who voted Conservative is a mechanism to change their mind it suggests these people already suffer from it. They say ‘I know what we need to do. The day after we find out the vast majority of people disagree with us, we as the minority can shame them by not being their friend!” In the aftermath of the Protein World fiasco, where shaming them made sales skyrocket, you’d think they’d have a bit more self-awareness. Actually no, they went one step further and delved into the narcissistic delusion their individual friendship is so important to people it would shake at the foundations of views of everyone else. Who knew all Ed Miliband had to do to make the coalition crumble was to shake his fists and say “I’m not your fwend anymore davey wavey” like a baby?

There’s a theory about how we vote which says it’s simply an expression of our identity. It’s a form of signalling, to ourselves, and to others about the sort of person we are. Identity is important; it explains the rise of UKIP and the SNP, the failure of social democratic parties around Europe, it impacts almost every decision we make.  When you castigate people for voting Conservative, you express the identity of a selfish cunt far more interested in their own feelings than in social change. There are plenty of reasons to want to avoid the views you don’t like, but the reasons for doing so rest far more on personal comfort than on any principled political platform.

Selfish. Incapable of empathy. Engages in self-justifying narratives no matter what. Is it me, or do these people and Conservatives hold a lot more in common than they think?

Why is Transadvovacy research so bad?

The first rule of transgender identity club is we don’t talk about transgender identity.

Actually, that’s a lie. The first rule of transgender identity club is to talk about transgender identity as much as we possibly can, as long as it’s in an affirmative fashion. The second rule of transgender identity club is to hound and attempt to destroy the careers and lives of those who don’t abide by the first rule.

Now, it’s easy to understand why advocates want to do this. Putting aside the long history of troubled lives, we’ve had the recent spate of child suicides, in whose tragic final words we find explicit calls for a different world where their wishes would be acted upon. Yes, sometimes people have hidden behind suicide prevention as a way of silencing their voices. Yes, there is horrendous discrimination and exclusion throughout their lives. Behind this political traction, however, advocates all too frequently throw evidence to the wind. Why is trans advocacy research so bad – and does this state of affairs even act in the interests of those it claims to help?

Self-appointed (trans)spokeswoman Paris Lees writes for Vice in a piece which could be presented to a first-year undergraduate in what mistakes not to make in research methods. She confidently quotes “research” stating most trans people “got the memo at the age of five” about their identity. Take a cursory look at the ‘research’ she links, incidentally by another trans person, and the credibility falls to pieces: the data was gathered from a forum poll by the website Crossdressers.com. A forum poll! That’s what academic research has descended to!

Let’s run through the obvious flaws. The first rule of Research Club is to at least make an attempt to control the group you are selecting for: in a forum poll like this, the respondents are self-selecting and self-define as a of different identities. The ability to opt in excludes a range of bystanders, and this puts aside the fact members of such a site will be more committed than most to any such identity. The poll asks adults to reflect back on their lives and decide, post hoc, when they realised they were trans. Anyone who knows the first thing about research on memory knows you can’t accurately remember what happened last week, never mind up to thirty years ago.

“If we also know that 94% of people who walk into gender identity clinics are adults, that means, although the figure is accelerating, only 6% of trans children are currently being identified,” Lees continues. Spot the logical fallacy.  Even if we accept the ‘research’ mentioned above as fact, it doesn’t necessarily suggest everyone who believes they may be trans when they were a childwill go on to identify as transgender later in life. Paris obviously has a problem with data, so are there any more reliable – or highbrow – sources which do a better job?

Vox presents itself as a website for the well-informed which looks to explain the world. Its problem is that it suffers from a bad case of publication bias: it quotes studies it agrees with and never looks too closely at its own priors.  It confidently quotes psychological research revealing children who strongly identify as trans perform almost identically to their chosen gender in Implicit Association Tests, and references interesting research on whether transgenderism has a biological basis. My response to this is simple: so what? People who hold strong beliefs also identify strongly with those beliefs implicitly; that is, after all, exactly what we’d expect from a “strongly-held belief”! If you’re going to be advocating starting to transition at an early age, then the real test is whether those beliefs hold over time, and whether it’s beneficial for their psychological state.

Can we find this out? Kennedy argues we ought not even to try, claiming there are ethical issues in interviewing children, problems with collecting data (ha!) because people realise their identity at different times, and because the sample would be biased towards those who were ‘apparent’. Translated, that means owt. The last objection is unusual, because if anything those who are apparent appear to me to be the ones most convinced about their identity. The study regarding implicit association mentioned above specifically interviews this type of ‘trans’ child, and is no doubt better than the obfuscation from Kennedy.

It isn’t a completely bleak picture. Some academics have tried to do better. It may have a small sample size, and an unfortunate dropout rate, but this sort of study [which?] at least tries to answer the relevant question when we treat people. Some people may criticise it on the grounds it focuses specifically on those diagnosed as gender dysmorphic; but again, if anything these folk are likely to be more committed than the average.  Almost half of those who completed the study reported they no longer believed they were trans.

Does this matter though? Paris quotes another study which looks at young people who started transitioning with puberty blockers who went on to take reassignment surgery and claims all the psychological distress and the suicide rates to go with it desisted. Again, this study has some unusual characteristics* in that it only surveys people who transition one year after the surgery was complete. Believing you’re in a much better psychological state after going through major surgery and medical treatment isn’t exactly unusual; I don’t think I need to explain the placebo effect to anyone.

What would give us a more accurate picture is to measure their state over a longer period of time. Lo and behold, we have another study which tries to do this, finding suicide rates, psychiatric disorders, and general impatient care are still more prevalent for these people. Of course, a lot of this is to do with the exclusion a lot of people face after treatment, but to pretend transitioning is going to solve all the psychological distress and other issues in life is simply a lie.  You could say all this doesn’t matter, because treatment to halt puberty is reversible. I abide by a weird, somewhat old-fashioned principle the first rule of Medicine Club is to refrain from dispensing treatment which isn’t necessary. The study explicitly doesn’t pass any comment on the medical effects of puberty suppression, and I’m not scientifically trained enough to pass any real comment on it.

I do have a passing interest in psychology, and what is interesting about the press release for the study is  it completely neglects to mention  those involved in the study went through a number of psychological treatments. With the extremely high co-morbidity of psychological disorders amongst young people who identify as trans, it isn’t surprising this sort of treatment goes a long way to improving their reported quality of life. We know, at least with some confidence, that these therapies work. What we don’t know is whether facilitating transition as soon as possible is either a true expression of people’s identities, or whether it even helps the majority of people once they do. We ought to pause for thought before we commit ourselves to massively expanding the creation of transition treatments. Evidence I‘ve seen suggests there is no long term harm, but then we said the same thing about SSRI treatments, and the scepticism around them years down the line is starting to fester.

There’s an irony when Kennedy takes a swipe with the slur ‘TERF’  where she claims they believe trans people “exist as the result of pressure from patriarchal male psychiatrists to become stereotypical females”, and thereby the supposed TERFs erase their identity. She casts disdain on a lot of the past research into trans identity from the psychiatry profession because they seek the “prevention” or “elimination” of what is judged socially unacceptable gender-transgressive behaviour.”*

Far be it from me to quote Brendan O’Neill. Brendan O’Neill is a dickhead. He lives for the thrill of the #hottake rather than to inform. It’s hard though, to escape the truth behind his fuckwittery on the issue of trans politics . With advocates like Kennedy and Lees it’s difficult to escape the idea they are trying to impose their own political identities on children, with scant regard for the truth.  Trans children, trans adults, parents, and those wrestling with the clusterfuck which is gender need the facts rather than what is considered in advocacy circles to be socially acceptable or transgressive behaviour. Culture war posturing helps no-one and hurts everyone. First, Paris, do no harm.

 

*Are such high levels of support weird? This goes completely against most reports of peoples experiences of discrimination when they transition. This could be another reason for the very positive results of the study. Sweden is also a highly pro-trans nation.

“Families were supportive of the transitioning process: 95% of mothers, 80% of fathers, and 87% of siblings. Most (79%) young adults reported having 3 ormorefriends,were satisfiedwiththeir male (82%) and female peers (88%), and almost all (95%) had received support from friends regarding their gender reassignment. After their GRS, many participants (89%) reported having been never or seldom called names or harassed. The majority (71%) had experienced social transitioning as easy”

 

*Also from Kennedys study, testimonies to illustrate trans identity. It may just be me, but if anyone is trying to shoehorn them into an identity it’s her.

It was also evident that their perceptions of gender identities soon appear to maketransgender children feel different from those around them.“The earliest indication that something was unusual was that I had an interestin stereotypically male things. I wanted to drive a train when I grew up (agefour) and I was obsessed with trains and how they worked.”

 

“Somehow I knew that what I felt was simply not acceptable – and I wasfrequently told ‘boys don’t do that’”.“feeling ecstatic about going to a party as a fairy, but then feeling so low atbeing told it was sissy and had to go as cowboy.”

The signalling approach to depression – Review of Reasons To Stay Alive

“Jesus Christ, they’re publishing my book.” is one of the last sentences you read after reading Matt Haig’s memoir on depression. “Jesus Christ, they published your book.” is more than likely to be one of your first thoughts after finishing it. Haig is the poster child for right on types who want to be able to say they understand depression and mental illness without wanting to do anything about it.  Stigma, stigma, stigma. All his media appearances are banging the drum about how the worst thing to be when you’re depressed is to be stigmatised. By the way, do you want to understand depression? Please buy my book while I think of more gimmicks to keep it in the charts. All we discover from his book however, is how painful it is to be him.

Haig tells us he craves knowledge, he craves facts, like buoys in the sea. There is a chapter, entitled “Facts”, which runs to two pages long, giving us some basic facts about suicide.  The rest of the book is dedicated to either denying knowledge exists, or refusing to pursue it. He tells us depression is “mysterious even to those who suffer from it” to “try what works for you”. He quotes Foucault approvingly, that champion of knowledge. When recovering from his medication he confesses to not trying antidepressants and cognitive behavioural therapy, medically recognised treatments. On the other hand, he is happy to jump on board with the mindfulness fad (be mindful is a phrase very much repeated throughout the book) and to have indulged in homeopathy. Of course we all know what a fantastic relationship the homeopathy industry has with factual based analysis.  He is still content with making blasé statements about these things he is too afraid; he is scared of psychiatric medicines, probably why he runs away from trying to understand them rather than flee. But he pours water in one short page on the serotonin theory of depression. There aren’t any comprehensive studies quoted, and there isn’t any reference to the long running debate within the profession. He mistakenly promotes the idea psychiatrists believe in a simple ‘chemical imbalance’ theory of depression. He doesn’t reference the new research pointing to the efficacy of the psychological based treatments he rejected. He doesn’t promote the new theories we have as to what causes the ailment. He doesn’t even quote the research in favour of his own go to treatment, mindfulness. There is sometimes a fleeting moment where you think we may be actually starting to grapple with an idea in this book, but you turn the page to stumble into another one of his peter pan syndrome nightmares.

You may think I am being unfair. This is, of course, meant to be a personal tract, and not a textbook on the state of debate. You can’t hold this to the same standard. We can, and should. It’s possible to write something moving, even vain, while managing to not patronise and write off the reader’s intelligence. Scott Stossel, an American (who are known for their humble nature) journalist for The Atlantic managed to do this in his memoir “My Age of Anxiety”. It was charming, self-deprecating, and a comprehensive as well as accessible account into the history of the disorder. Haig lists a number of books he purchased and read while he was in the stages of recovery, one of which is “The Concise Collins Dictionary of Quotations” with the tagline “Because quotes are easy to read”. Presumably the majority of his book of plagiarised from the dictionary, as every next page is branded with an easy to digest quotes from the trite school of philosophy. It is tragic Haig takes the easy option of marketable self-help cum half-finished tumblr post because we so urgently need a UK writer who has the decency to take mental health seriously.

Depression has an image problem. Not because of imagined stigma, because people don’t take it seriously scientifically. It may look as if the way forward is to churn out articles for Guardian readers about how horrible stigma is, how we just need to be understood, we just need someone to talk to. All this does is let these people off the hook. People who suffer from depression don’t need you to understand ‘them’. They need people who are willing to commit their time and energy to understanding the condition; then making it their goal to abolish it.

Haig tells us when he was a teenager he was a teenager he was Bukowski obsessed, which explains a lot. Rather than growing up to write hipster misogyny, he instead brings us a hipster account of psychiatric illness. If you need a reason to stay alive, it’s to make sure this kind of unscientific thinking doesn’t strike the mental health community terminally.

The ShitLords Guide To Devils Advocacy and Gender Politics

Devils advocacy is great, but quite a few people hate it for very good reasons. Being a shitlord and engaging in thought experiments for the sake of it is one of the best devices we possess for advancing moral debate. It upsets some people, sure, but maybe they’re ignorant of how DA techniques advance their own arguments. One of the most famous thought experiments was advanced by Judith Thomson with her arguments in favour of abortion. It’s the go to argument in favour of slaughtering tens of millions of children every year. Let’s be blunt, people aren’t against using the techniques of devil’s advocate; they’re actually pissed off when people use it against them.

Okay, I’ve finished being a ShitLord. Instead, let’s do a thought experiment in which I’m a nice, sincere human being acting in good faith. The problem with people (men) playing the devil’s advocate is they a) fail to abide by the rules of DBAD (Don’t Be A Dick) and b) the vast majority of them are morons.

Don’t fear, you can carry on being a ShitLord while still having a seat at the table. Just keep these facts in mind.

You are not the first person to make this argument

You’ve arrived at university as an undergraduate, finally happy you’re in an arena where you can set the world to rights. Back home, other kids thought you were weird for being interested in ideas. You are more interesting and #deep than the rest of them put together. They’re focused on the mundane, you are interested in the Big Issues of Our Time. You’re finally going to have your voice heard. You couldn’t find a course in mansplaining, so you decided to enrol in philosophy instead. In all your excitement you forget you’re an idiot.

There’s a famous quote saying all philosophy is a footnote to Plato, and you’re best off having it stapled to your forehead. When you’re trying to enlighten feminist groups you should replace that with ‘my contribution is a footnote to a turd’. You’ve studied utilitarianism? You’re a rational altruist? Good for you, have a cookie. I’m sure these groups have never heard these arguments before. Do you think you are being daring and original when you engage in thought experiments about rape, abortion, and misogyny in general? No, people have done this before, and better than you probably ever will. Read a book. You don’t have any contact hours so you may as well do something with your time.

Please remember everyone can quote a well-known thought experiment to show you’re a psychopath. What do you mean you’ve heard the trolley experiment millions of times and it’s starting to wear thin? Oh.

 Do ask questions; but respect the fact you’re annoying

Imagine someone coming along to your atheist society (and you are always an atheist) and throwing accusations saying don’t know the first thing about theology, you’re all going to burn in hell, and have no conception of morality. Imagine someone coming to your libertarian society (and you are always a libertarian) saying you want the poor to die, and ask the oh-so-silly question of who will build the roads? You’ve developed memes in response to this, and mock people for asking what you consider stupid questions. Hey, they are simple questions, and ones you’re tired of people asking. Why is it when feminists develop their own memes in response to the inane questioning you hurl abuse?

This relates back to point one. Your question is not original, and this applies to anyone who joins a group for the first time. There is a certain strain of feminist thought which believes they don’t have to answer any questions, and this can be frustrating. It misunderstands the nature of activism. An activist, by definition, is someone who leads advocacy and education of others. They’re wrong, but this doesn’t mean you have to throw away the rules of DBAD. If someone doesn’t want to answer your question, ask yourself why they don’t want to. People are not your personal Google. Sometimes they should be and they could probably persuade many more people if they did.

Christianity wasn’t built on the back of “educate yourself”. However, having to do this is really annoying and tiring. Removing the responsibility from them of having to answer stupid questions means when you actually do have an original point, they’re going to be a lot more responsive to it.

Lurk lurk lurk.

Imagine being in a bar with a group of your friends, you’re discussing something important to you, and a stranger comes barging in with an opinion you’ve obviously never heard before. You kindly allow them into the discussion, but every time you try to speak they just raise their voice and direct the conversation back toward them. They’re getting drunk, and the opinions become all the more obnoxious as time goes on. You’re wishing they would piss off so you and your friends can go back to your pleasant chat. The night ends with the stranger throwing over the table, and everyone’s night is ruined. They make a mental note to themselves never to talk to strangers in bars again.

This is what it’s like when you have your invite to join a feminist group for the first time and you jump in with your Important Opinions. Sit down, sip your drink, and listen. Get to know the different personalities of the group, what makes them tick, and find out what they’ve already considered before you dive in. When you meet strangers for the first time you get to know them. This is the 101 of making friends. You probably don’t have any, so consider this advice for being a shitlord and a functioning human being.

DBAD. DBAD. DID I MENTION DBAD.

DON’T BE A DICK. DON’T BE A DICK. DON’T BE A DICK. breathe. Before you mention one of your ShitLord opinions, take into account a lot of people will probably think you’re a dick. Sometimes this can’t be avoided. You can’t please everyone, and there’s enough infighting amongst feminist activists to be a testament to that. Be aware though, when you express a contrary opinion for a lot of people you are attacking something critical to their identity and their lived experience. The only sort of violence you believe happens is when someone physically assaults a human being, and you get sad at that. These people believe the vast majority of their life is a form of violence against them. Yes, they’re probably wrong, but why rub their face in it? A little bit of empathy goes a long way, even if you don’t instinctively see the problem. I personally find a lot of studies trans advocacy groups use to try and justify early transition disturbing unscientific (stay tuned) but what do you gain by going down the route of intentionally trying to piss people off? Always ask yourself whether you’re expressing an opinion to make yourself look clever, or whether you want to advance understanding of something. If it’s the first opinion, go straight to your parents basement, do not pass go, do not collect your human contact.  If it’s the latter, before you voice it, consult with people on whether you’ve made the point in the best possible way. Only ask the question if it’s something you can see yourself genuinely believing. If you genuinely think rape is like leaving a car unlocked, you’re probably a sociopath and you’ve got much bigger problems. Ask it because you’ve a naïve ShitLord and there’s hope you can play by the rules before you’re run out of town. Live by the rule of DBAD and people won’t be BAD to you.

 


 

I realise by writing all this I have automatically broken the first rule. I’ve also been obnoxious to a subset of people and failed the rules of DBAD. On the other hand I’m a ShitLord, and this was just a thought experiment. As you were.

 

Mental health policy: Be careful what you wish for.

It’s difficult not to stand behind a rallying call to alleviate distress; especially if you suffer from it yourself. Politicians like Nick Clegg are making it their banner at the next election. It’s said their politically strategy for 2015 is to appeal to the green middle classes. The focus on mental health fulfils one of their goals, appealing to middle class parents concerned their children are on the verge of mental breakdown and need more support, especially of a financial nature. Politicians however, are being too eager to pour money into a structure where success hasn’t been proven. Politicians, however, are unable to step back and tolerate uncertainty while we search for a solution. As laudable as a focus on mental health is, without pause we risk making a fragile situation even worse.

The first problem is swallowing the statistics from the disorder industry without question. Clegg himself in January parroted the one in ten young people suffer from a mental disorder statistic. Do one in ten really have a critical disorder? No. Delve into the statistics a little bit more and you find half of the children in this category suffer from something called a ‘behavioural disorder’. Take one of these disorder “Oppositional defiant disorder” (Or what I prefer to brand “Obnoxious dickhead disease”) classified as the “Frequent refusal to obey parents or other authority figures” otherwise known as being an eleven year old. Disorders such as these came under criticism from prominent psychologists such as Peter Kinderman of the University of Liverpool. This isn’t to deny a child’s behaviour can be problematic, but with a blanket expansion of CAMHS we run the risk of psychiatrists being able to run amok and expand the burden of mental ‘disease’ further. Academics are starting to rebel at the over diagnosis of dyslexia.  Putting aside debate over the existence of the disorder, the evidence shows the label is doing nothing to help those afflicted with it. There aren’t any implications for treatment, and the best it does is allow middle class elbow to secure more funding and  assistance for their child. I was banded by CAMHS when I was younger, giving my school more financial assistance for my uh, behaviours, but when seen by a psychiatrist he shunned from giving me a label and decided I would grow into myself. Here I am now. Replace this with the current climate where there will be desperation for parents and children alike to cling to a diagnosis and we will pathologies the entirety of childhood.

Desperate middle class parents run in tandem with the interests of the psychiatry profession. As revealed in James Davies book Cracked the current head of the Royal College of Psychiatrists doesn’t appear to be interested in debating the evidence and track record of its own house and is entirely obsessed with getting the ‘disease’ status. Something being a disease is attached to money, money allows you to expand the profession, expanding the profession gives you the resources to lobby more saps like Clegg.  Norman Lamb falls prey to this too, quoting research from Time To Change indicating mental health stigma is going down. What is actually happening is the perception from a personal failing is turning into the perception people are falling prey to a disease to be medicalised. Progress? Perhaps not when we see people are treated with even less empathy when being seen this way

Worldwide the focus is more vague. The current head of the World Psychiatric Association thinks the focus should be on turning psychiatrists into social workers. Rather than seeking out ‘ social inequalities’ and trying to manufacture better public relations with gay people and women you would think his focus should be on the dire record of psychiatry full stop. Medications which don’t work, not to mention their side effects. The relationship between his profession and corporate institutions. Even things as simple as improving the DSM are seen as irrelevant. I’m not hostile to the concept of psychiatry; I know from personal experience mental anguish is real and rehabilitating, but we have an establishment abandoning what should be the aims of their practice in favour of their institutional interest.

Psychologists aren’t innocent either. They primarily have the ear of the government at the moment, hence the massive expansion of assess to clinical therapies such as Cognitive Behavioural Therapy (CBT) under the last government and the current. Academic advisors such as Richard Layard spearheaded it into the NHS and continue to bang the drum as it being a catchall saviour to our woes in books such as Thrive, devoured by right thinking people. CBT isn’t and cannot be this solution, despite it being useful in many circumstances. When the British Psychological Society are criticised over their weakly evidenced report in favour of CBT it too lashes out and calls for unity. One of the authors said criticism must be reserved for journals rather than the internet. Kinderman, referenced earlier, goes down into the comments to condemn the authors for not putting on a united front.

Any taskforce instituted by a government must down the route of insisting we discover what works before we devote resources to expanding the institutional power of the professions where we can’t even have confidence their remedies relieve our ailments. Mental health research is too neglected and too underfunded. The new charity Mental MQ is developing a project to discover what courses of action people respond to; congratulations to them for reminding us what clinical practice should be about. By the time any of this research comes to light, we may live in a world of the insane led by those who are insane enough to think they can cure insanity.

On suicide and selfishness. The mentally ill are people too.

An outpour of sympathy and new awareness spilled in the wake of the death of Robin Williams. Equally there has been an outcry of condemnation against anyone who questioned the reasons as to why he would want to take his own life. Calling someone selfish is an act of stigmatisation and cruelty.  Some motivated by spite as in the case of Fox News, some misgivings out of ignorance like our own health secretary Jeremy Hunt, and finally out of a sense of Christian morality.

The backlash against these people is understandable because people want to see themselves as being on the side of the downtrodden victim. However, to brand mentally ill people as victims  entirely misunderstands the nature of most people with these conditions. It’s perfectly possible to brand the act of suicide as selfish without branding it the absolute indicator of someone’s moral character.

I don’t want to comment on the path Robin Williams took before his decision.  People much more qualified than me can cover the background to personal debt and Parkinson’s. I didn’t know him, so I can’t comment on whether he was a good person. Suicide, whatever the background, is still selfish. It leaves victims around you; the oft quoted statistic is each suicide leaves behind on average six to ten survivors. Suicide imposes a torture on them equal to battles with depression.

Anxiety, hopelessness, guilt,  everything someone who tries to escape through killing themselves transfers onto other people.  It never reduces a burden, it is never a selfless act. You may respond to this by saying depressed people suffer from a disease and therefore have no control over their actions. This is nonsense.

Depression and other mental disorders cause mental suffering. They don’t turn you into a mental and a moral cripple.

Not only is the notion is depressed people have no autonomy dehumanising, but it’s also exceptionally dangerous. Suicide is rarely something done spontaneously: it’s a process. Presenting suicide attempts as the inevitable outcome of mental suffering is a sure fire way to keep it alive. Depressed people need to be selfish, but an act causing so much unnecessary harm isn’t necessary.

I don’t like to talk about my own mental health background publicly, but sadly in these debates it’s the only way to get a pass into the conversation. I’ve tried to take my own life, and was shocked and uplifted when people came and helped me to restart my life in the aftermath.  When I posted some initial thoughts about this on Twitter I received a message from someone I used to know over Facebook, hur ling abuse at me for suggesting suicide attempts could be selfish. When I disclosed my history to them their shit couldn’t crawl up their arse quickly enough.  It wasn’t irritating because they hurled abuse at me; some opinions are awful enough to have abuse directed toward them. What was irritating is the validity of my opinion changed because I revealed a part of my personal history, because I was suffering from some sort of disease I had to be pandered to. Even if my opinions were wrong, I had to be treated as a delicate flower.

To put a cringeworthy spin on a trite quote:  I am not a disease. I am a free man.  A diagnosis of mental illness should stimulate empathy and understanding, but it doesn’t put you outside the obligations to others everyone else should too abide by.  Some mentally ill people may feel better  perceiving themselves as victims- it’s your choice, but you must accept this self imposed identity is a choice. Choice, whatever people may say, isn’t the sole preserve of the healthy.

Can we please stop the tired trope of Tories hating the mentally ill?

Mental health, just like any other form of health, is a serious complicated business. Certain treatments will work, others will not, and in some cases it will deepen the symptoms a person is facing. We also know in any clinical treatment there are matters of ethical consent which need to be given. It’s more than fine to criticise someone in the Department for Work and Pensions for flying a kite for the idea those suffering from mental conditions should have their social security linked to their adherence to treatment.

The problems are well covered in this article over at the Guardian by Pete Cashmore. In short, CBT is not the panacea it’s thought to be – talking therapy is often triggering, and SSRIs often leave sufferers with side-effects that worsen – at least in the short-term – their condition. The article is reasoned quite well, until it moves on to the idea the Tories are in on a conspiracy to shame and make people suffer.

Pete’s piece isn’t the only one which does this, nor is it the worst. All of the noises from the online mental health community say the same thing in a more direct and tin-hat way. In short, it’s nonsense. The refusal to see a difference between someone being wrong is in part the reason why mental health is so shoved down the list of priorities by officials. Coincidentally the mental health blogger Sectioned ran a great conversation over Twitter after the story settled down asking people to reveal what they wish would people would say to to them in their situation. S also made a revealing comment over how many people don’t say anything at all because they might say the wrong thing, and what a shame this was. Strangely enough, this attitude goes out the window when Tories are involved.

Personally, I’d rather take the Tory source at their word when they say they want to help people with mental health conditions. Yes, it is a national disgrace there are so many people left on benefits without treatment. Yes, they could be forgiven for thinking CBT is all it takes given the national fanfare it’s been given by mental healths most prominent advocates. Yes actually, it is a disaster taxpayers are picking up the bill for our policy of sectioning off a subset of society onto permanent benefits. Yes, their idea of tying it to benefits is completely inappropriate. We all know it’s the long waiting lists which are the main barrier to treatment, but if we want to put words in the sources mouth then we could generously see this as a commitment to roll out a vast amount of treatment.

Should we? No, because choosing peoples meanings for them is a stupid idea. What we know about so far is the creation of the pilots to integrate treatment with receipt of benefits, which incidentally is a fantastic idea and should be applauded. This is the party that created parity of esteem between mental health conditions and physical conditions because it understood that the two can be linked.

Whatever you think about waiting lists in general, the addition of them to waiting list targets from next April to should be commended. But this doesn’t translate for people who suffer from a clinical condition of Toryitus.

The desire to help people from this source though is completely clear, and it’s a good thing people in senior positions are starting to, and wanting to, grapple with the tragic position a lot of us are in. There’s so much interest certain group of influential Tory MPs who want to make mental health a cornerstone of their election manifesto.

Are these people just a group of pathologically evil “Tories” who dedicate their political career to tramping on the minds of the people they represent? No. Like most people in politics when  they tell you something, they are being honest in what they say, and they mean it to their literal word. A lot of the time they’re going to be wrong, so sometimes they’ll need to be nudged along in the right direction. Purposely hounding them away because they might say the “wrong” thing is the reason so many people will be sectioned from politics forever.

Let’s talk about depression.

Recently, Giles Fraser published an interesting article about the way in which we approach the issue of mental health. Interesting – but almost entirely uncontroversial. The response was pretty much unanimous. There was no debate. Fraser was condemned for his ignorance, condemned for his callous attitude, and dismissed. His dismissal, I allege, was both unfounded and unjust. It was also symptomatic of a growing problem with the way in which we approach this topic as a whole.

 

An emerging phenomenon in well-meaning, apparently ‘progressive’ circles is that discourse around mental health has shifted away from the idea that we ought to understand causes of depression. It has shifted away from inquiring about the extent to which depression exists, and away from asking what solutions to the problem we possess. It has shifted away from asking how far we should be sceptical towards those who claim to know everything on the subject, be those the sufferers themselves or doctors and pharmaceutical companies.

 

Instead, what has been adopted is the idea that depression is some kind of disease. We man the barricades against those we feel might contribute to any stigmatisation of sufferers at all. In the name of protecting the “victims” from perceived slights, we have decided to shut down discourse altogether. Whilst I am entirely open to disagreement, my own experience in various mental health communities suggests that we seem to have reached a state where sufferers are wont to wear their “disease” as some kind of badge of honour. Pride in overcoming something awful has become pride in simply experiencing something awful. Whenever journalists like Fraser contribute something to the debate, the insistence is that he has no knowledge of mental health – doesn’t he know the science? As someone who hasn’t experienced the terrifying blackness of depression, what right does he have to write on it?

 

Well, actually, fellow sufferers: you know nothing. I know nothing. The current medical profession knows very little. It may well be the case that the voice of those who suffer has been stifled for too long, but it is worse than ignorant to suggest that you alone now hold the answers. The individual experiences of what we call mental illness are so diverse, so intensely private and personal, that to form “communities of understanding” through which external responses can be quashed is both naïve and dangerous. In a situation where we know so little about mental health, any external voice – such as Fraser’s – which might contribute to our understanding is to be welcomed. However difficult and painful it may be, the reintroduction of robust standards for discussion is indispensable if we are to progress even slightly in this field.

 

Now that my small diatribe about mental-health discussion is over, I want to move on to dissecting some of the points Fraser made in his article – points which are worth discussing, rather than being dismissed as though they were some kind of attack. Again, the perspective offered here is but one, and as subjective as any other, but stated in the interests of broadening and advancing debate.

 

The claim that drug companies have decided to fit existing chemicals into “normal” conditions is not just speculative emotional backlash. In Frasers’ case, we deal with the Christian argument against the ‘unnaturalness’ of using pills to treat the human condition. This approach is not just confined to religious groups: Harvard, for instance, has conducted many symposiums on what is termed the “medicalisation” of society, and the role of capital in driving this. The condemnation of this medicalisation has also come from the accounts of those who have been mental health professionals. Also of note in the above piece is the massive shift from doctors’ prescription of talk therapy to the prescription of anti-depressant drugs. When we place our emphasis on causes rather than symptoms of depression, this shift visibly demonstrates the NHS’ complete failure to deal with mental health issues, and its increasing reliance on what is seen as a simple, trouble-free solution.

 

The fact we have these supposedly-easy solutions is one reason why the NHS, and the rest of society as a whole, is saved from ever having to confront actual causes of despair. The demand on mental health sufferers is simply to adapt to this shift; aided through the quick prescription of SSRIs or some substitute. In fact, the prescription of pills and the claim that these “help people get back on their feet” is likely to do more to enhance the perception of blame upon the individuals involved. This medication will redeem the chemical imbalance within you, we are told, and if you still can’t adapt after that? Well, then, it is no structural problem but a real personal failing. This approach stands in lieu of open and robust discourse about causation, and it is silencing. It is repressive. When we are miserable, it doesn’t matter whether or not it is a disease. All that matters is the abject malaise and unhappiness to which we are, crushingly, subject.

 

Until our reactionary mentality is dropped, and we can progress from treating the discussion as a battle – a fight to the death between Them and Us, between those who understand and those who do not, even between what is right and what is wrong – we will be stuck in inertia. Our task is to look at the means available for the reduction of human despair. This is the only way in which progress might, finally, begin to emerge: progress not just for those who suffer with poor mental health, but progress for society as a whole.

 

A shorter version of this article is here at Nouse.