The Abolition of Mental Health Stigma: Unbridled Individual Mental Illness Destigmatization as Cultural Normalization
Utopian anti-psychiatry ideology, civic degradation, & social anomie
“Present-day philosophers developing metaethics try to go further; as they slip and slide along the elastic space leading to an analysis of the language of ethics, they contribute toward eliminating the imperfections and habits of natural conceptual language. However, penetrating this ever-mysterious nucleus is highly tempting to a scientist.”
— Andrew M. Lobaczewski, Political Ponerology
The current academic and cultural climate of inclusivity, equity, and social justice cannot be fully understood without considering the impact of efforts within the mental health professions of psychology, psychiatry, and their allied academic disciplines to eliminate stigma associated with mental illness. As I previously noted:
Behind the ‘moral imperative’ for such legislation as Proposition C is an ideology of anti-psychiatry and “community care” for homelessness and mental illness (including addiction) that dates back to the sixties when capitalism, the mental health system, and mental institutions in particular, were targeted by social labeling theorists and others as defining or giving rise to mental illness. In short, the ideology was grounded in the notion that mental illness was arbitrarily defined by those in power and/or that capitalism and the mental health institutions themselves, were the source of mental illness (rather than mental illness being viewed as an organic brain disease process).
Pulitzer Prize winner George F. Will recognized both this anti-psychiatry ideology and its deleterious effects on civic functioning in a prescient Washington Post op-ed in 1987, entitled “A Right to Live on the Sidewalk.” So did another Pulitzer Prize winner, the brilliant Charles Krauthammer.
Nonetheless, radical progressivist anti-psychiatry ideology continues to be propagandized as both morally righteous and a noble social project.1
Indeed, coinciding with World Mental Health Day in 2022, the Lancet published a Commission on ending stigma and discrimination in mental health. Destigmatization efforts often take the form of changing specific diagnostic nomenclature to less categorical and illness-specific language; (e.g., a “person with problems in living” cf. “a person with substance abuse problems”), and the elimination of the term ‘abnormal’ altogether in undergraduate and graduate course titles. It also encompasses softer forms, including sanitizing any notion of ‘negative value’ (negative deviance) or ‘problematic or pathological denotation’ with reference to what various psychological, psychiatric, or other mental health constructs and categorical diagnosis imply about the afflicted individual. This same softening of language away from any potential negative implication about a given ‘diagnosis’ or ‘condition’ has also spread more broadly into social science research, including my own area of research investigating the ‘disorganized/disoriented’ infant attachment classification. Pushing back against this, I have argued that calls to remove any notion of ‘negative deviance’ from the construct of infant attachment disorganization are innaccurate, misguided, and unhelpful.
This professional and public destigmatization advocacy has evolved within the broader context of a social-media ecosystem that has emerged around the notion of ‘neurodivergence’ – a general concept that is used to refer to a brain that functions differently than normal, or ‘atypically.’ Importantly this neurodivergence is framed as a uniquely personal strength that makes an individual special, rather than as a ‘deviation’ from normative functioning. Thus, functioning previously that would likely have been seen as ‘negative deviance’ is now cast as ‘positive uniqueness.’ A vast network of online communities for various mental health conditions has arisen in which users share experiences, diagnoses, and lived experiences ostensibly reflecting the unique experiences individuals with these mental health conditions face. Despite the potential for positive individual benefits, such communities, often appear better characterized as affinity spaces in which the social currency is the (often self-diagnosed) mental health condition, rather than an accurate understanding of the pathological mental health condition and a valuing of a desire to effectively mitigate or overcome its negative personal and social effects. Instead, the mental illness or its symptom display appears to be reified as central to the individual’s identity or self-concept. That is, it makes them unique rather than deviant or afflicted with a non-normative pathological condition.
Along with my colleagues, I have recently written about this from the vantage point of several mental illness conditions. We have suggested that there is an urgent need for researchers, clinicians, and those suffering from mental illness to arrive at a contemporary common understanding of what is and is not considered within classical notions of psychiatric definitions of mental illness. To delay this conversation risks an increasingly dangerous blurring of the lines between progressive-minded, humanitarian destigmatization of individuals suffering from mental illness and a pathological cultural normalization of destructive interpersonal behaviors and civic conditions.
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