Thursday, December 30, 2010

Crash Course in Care - Step 1: Checking Your Privilege at the Door

Salutations, New Mad Nation.

I've decided to begin my Rants Proper by dealing with one of the more practical issues: HOW to not be a jack, especially when your friends are at their must vulnerable - when they are coming to you for help.

Ladies and Gentlemen, welcome to my Crash Course in Care. Today we will be taking a close look at the most important first step in giving care to someone who is "mad" or otherwise in extreme (and in particular, though not exclusively, chronic) distress. That step is recognizing in yourself the things that prevent you from being an effective care-giver, and one of the biggest umbrella terms that can cover these obstacles is "privilege." For a handy-dandy reference as to what privilege is in general, and how it applies in a variety of situations, please continue to reference www.derailingfordummies.com, that hilarious site that gets it oh-so right.

Privilege, when it comes to the concept of mental health and distress, can best be defined as a person's "chill factor." Essentially, your ability to "chill out" about whatever is bothering you and "play it cool" with the people around you determines your privilege in these matters. Your capacity to "let it go," "not let it get to you," "not dwell on it," "focus on other things," etc. etc, this is all mental health privilege, and it will all get in the way of you being able to understand and care for a person who is in distress.
In fact, as I continue to develop The Weekly Madness, you will probably hear me use the terms "mad" and "chill" as direct opposites, in much the same way that one would use "rich" and "poor." Madness is generally a social burden, while chillness is a social privilege. This conflict can be resolved, I think, but it will only happen once there is widespread recognition of the privileges that come with being "chill," and more importantly, a recognition of the fact that it is not usually a choice.

This second part is very difficult. For many seeking to give care, there is an immediate obstacle in the cultural underpinnings of the United States, known in some psychological circles as the "Protestant Work Ethic," a.k.a. "Pull Yourself Up By Your Own Bootsraps!" People feel like others have to be responsible for their own happiness; "After all, if I can manage to be happy, why can't they?" This is erroneous and dangerous. In much the same way that the rich enjoy wealth because they work hard (or not) within a system that supports them, while the poor toil and face great difficulty, rarely to advance their own wealth significantly, because the system does not support them, the mad cannot simply "become happy." It is usually all they can do to stay at the wellness poverty line as is.
[Okay, I understand that my description of socioeconomics here is incomplete at best, but I hope you will bare with me here and accept it as merely an attempt at illustrating another point.]

So, first and foremost: it is not all in the Mad person's head; if they could be "happy" or "well" all on their own, they probably would have already. Never assume that they just need a "kick in the right direction;" even if this has worked for you, recognize that you are privileged to have this work for you, and that not everyone is so lucky. As to the "why" of this, well, that we could debate on quite endlessly, but I will put forth simply for now that most people who are "mad" have probably not received the kind of support in life that allows them to flourish within the current system. But as I said, this is a very complicated topic that we will probably discuss another time.

Privilege in the form of Chillness manifests first in the assumption that your Mad friend can "chill," but simply hasn't yet. Once you get over this privilege, you have to face many of the other privileges you may enjoy that your friend may not. Never assume they have parents that love them; never assume they have friends (even you) who have shown them genuine care before; never assume ANYthing about their life that could give them happiness or comfort, just because you have had it. To do so would be a classic mistake of "chill" privilege, as these assumptions come from a place of enjoyment of emotional and mental comforts that your friend may not have access to.

Beyond that, Privilege can get a bit more tricky. Once you pass material circumstances, you get into hypothetical situations - perhaps you suggest your friend see a psychiatrist, because you assume that a psychiatrist is an easy solution. Again, this would be privilege talking: if you have never had a difficult time with a psychiatrist of a therapist, you are privileged. Most "mad" people have had very difficult times with the mental health system and many will be hesitant to accept suggestions to visit that system. Those who don't outright refuse will be justified in their hesitance and you MUST respect that.

Perhaps the biggest privilege of all, however, is the privilege of being "right" because you are "chill." Many "chill" people will assume they know what is best for their friend, simply because they are "chill" and their friend is obviously in distress, or "mad." They can enjoy the privilege of this assumption because there are more chill people than mad people, and most chill people share this assumption together. "Well, it's not that we think we know what's best for them better than they do, it's just...they're obviously too upset to be thinking clearly about this issue. We're just trying to provide some perspective." This patronizing platitude is very similar to those who attempt to "reason" with an "hysterical" woman on her period. (Even more so when missed medication is involved, but that's another rant). The Chill enjoy the privilege of not having to explain or justify their position on most of these issues simply because they are in the social majority, almost always; this is incredibly oppressive and can immediately make any situation with the person you are trying to care for become vastly worse. Avoid this privilege at all costs.

Instead, approach the person you are trying to care for with deference. Recognize that they are the only ones that have any real insight into their world (usually, and we'll talk about exceptions to this eventually), and try not to make any assumptions about what is best for them, or even good for them at all. Ask questions that are actual questions, coming from a place of not knowing. In particular, ask questions of yourself: "What assumptions am I making that are unfair or dangerous? How is my ability to pass as 'chill' interfering with my ability to understand this person who cannot do so (at the moment/ever)?" Etc.

In further installments in this crash course, we will discuss specific methods of approach for various types of care required, as well as follow through, intervention, and finally, techniques to prevent the need for care in the first place. But next time we will probably discuss something a bit more socio-philosophic. Or, perhaps, Katy Perry. Who knows!

For discussion I would love to hear ideas about what "Privilege" means in this context and how it can be deconstructed, or questions about anything I have written above. Thanks for reading, and once again I bid the New Mad Nation my fondest Salutations.

Peace,
R

Thursday, December 23, 2010

Let the Madness Begin

Madness? THIS. IS. SPARTA!!!!!! ::kick::

Okay, that out of the way, let's get on to some serious business.

Welcome to the Madness Weekly. (No affiliation with Krinkels' Madness on Newgrounds) My goal here is to post one rant about what I call "Madness," and related issues, every week. So this week I'd like to begin with the basic answer to the basic question: "R, how do you define 'madness?'"

In a world gone wrong, only the mad can see the truth. On websites like theicarusproject.net, you can find the concept of a "mad" identity beginning to circulate amidst those frequently referred to as "mentally ill." Rather than viewing our condition as a medical illness that we must quietly accept and try to treat until we are "normal" again, some of us view our different perspectives and experiences as "dangerous gifts" that require careful cultivation. Others have other views, but the central point of my argument here is that "madness" can be a rallying cry for anyone who rejects the labels of psychiatry; anyone who rejects the language of "mental illness."

Perhaps the word "mad" is not right for you, and of course, I respect that. I am hugely supportive of comments that encourage respectful discussion of alternatives. But for my part, let me further explain the decision to rally under the term "mad."

There is a certain energy invoked with this word, and a certain counter-culture sense to it. It is a way to invoke pride where there was once shame; a way to face plainly the truth of a situation. Because when faced with a world that does not understand us or respect our perspectives or our distress, we DO get mad. I, for one, get EXTREMELY mad when people like Katy Perry use the term "bipolar" to flippantly describe the mood swings of her "Hot and Cold" boyfriend (because this has little to nothing to do with the actual diagnosis). I get mad when doctors ask me if my behavior and emotions are conforming to the standard norms that they, the doctors, have established, and when they note any deviations as "symptoms." I get mad when my friends and loved ones must hide the depths of their distress, because the medical system might hospitalize them if that system found out the truth - and as many who have been hospitalized will tell you, that process usually makes things worse.

I am MAD that mental health and emotional wellness are so difficult to discuss and that emotional responses to things are often viewed as signs of immaturity or downright "illness." Yet these are the realities I am regularly forced to confront, especially in academic and professional settings; my feelings and beliefs and experiences must be kept hidden for fear of persecution, and yet this makes me one of the lucky ones because I am actually ABLE to keep things hidden.

Madness, for me, is about far more than an archaic terminology that has since been replaced by a medical terminology; it is about an emotional reaction to the current state of the world. Emotional distress is hyper-medicalized, with only a few exceptions, if not outright dismissed. Here's a good example of some of what I'm talking about: http://www.akimbocomics.com/?p=573

The thing is, the language of "mental illness" completely locks emotional distress into the purview of the Medical Academy, and prevents anyone from having legitimacy in their distress for longer than a few days (in some rare cases, weeks or months) without being labeled as "mentally ill." I see this as a problem. Here on the Weekly Madness, we will not be dealing with "mental illness" exclusively, but rather with emotional and mental distress. This includes virtually anything that could upset someone: racism, sexism, bigotry of any kind, really; rape, assault, death, loss of any kind; even issues of physical impairment or, (and I use this word VERY cautiously) "disability;" anything that could affect someone's mental health, which is essentially anything at all. Our weekly dose of Madness will aim to change the way we think about distress in general, not "mental illness" specifically.

Another question you may be asking yourself right now is what qualifies me to speak on these issues. The full answer to that is too long for a single blog post, so let me offer a simplification:
I have been diagnosed with one form of "mental illness" or another since I was about 12 years old, receiving "bipolar type II" at 15 or 16, and I am currently 22. I have seen many therapists and psychiatrists and visited the inpatient hospital a few times as well, and have come out relatively balanced, if not what they would traditionally call "stable." I owe this largely to the support network I have amassed, which has nothing to do with psychiatry and only one therapist to do with psychology. Many of my issues I have worked through entirely with myself and my friends, and far more effectively than "medicine" could ever do. This has only weakened my confidence in the medical establishment. Now, I have come to question it so severely that I have started this blog, a crystalization of many varied attempts to invoke my feelings on the subject. Let's hope it works.

That said, here's, a few guidelines for what you can expect here:
1. I am not religious, nor do I encourage religious discussion of these issues. However, I understand that some experiences of distress can be chalked up to spiritual causes, and I would like to explore these in due time; but this is an incredibly sensitive subject and must be addressed cautiously, and at the discretion of the person experiencing them. ANY AND ALL EVANGELICAL SUGGESTIONS ABOUT DISTRESS/"MENTAL ILLNESS" WILL BE DELETED. Careful, cautious possibilities will be considered.
2. I lean heavily towards the political left, but very careful and respectful discussion of politics relevant to these subjects is acceptable. You can expect me to step in and shut you down if you are a jack about it, however.
3. Please read and regularly consult www.derailingfordummies.com. It is an extremely thorough and funny site about how people with privilege will try to shut down people speaking from a position of hardship. If I see anyone doing the things that are listed on this site, your comment will be replaced with a citation of what you did wrong.
4. Probably more to come in the future, but generally, just don't be a jack. The whole point of my movement is to create an emotionally sensitive society; if we are jerks to each other in the process, we have already failed. 

I am hoping this blog will eventually grow to be one of the sign posts of what I am tentatively calling "The New Mad Nation." Ambitious? Hell yes. Most of us "bipolar" people are. Aim for the moon, land amongst the stars, as they say. So, I am hoping that all of my readers will share their thoughts on this idea, as well as links to other comics/news articles/research studies/anything else you can think of that elaborate on these themes. Also, if you have any suggestions for rants that I can go on about these topics, I am elated to receive them. A few things you can expect to see in the next few weeks:
1. Why Katy Perry completely sucks
2. Why "It Gets Better" has some serious issues
3. Lots and LOTS of stuff about psychiatry/medicine (open to suggestions on specifics)
4. Crash courses in how to help a friend in distress
5. Just what the heck is "Bipolar" anyway?
6. The trick with "personality disorders."

Thanks for reading, everyone! Let's turn the world inside out until it comes out right.

Sincerely,
R