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, 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.



  1. And this is why it takes a fellow "crazy" person to understand and help someone who is going nuts at any point in time. Kind of like if you haven't been there, don't try to give directions as if you live there and know everything there is to know about said place. For one, it's pretty easy to tell when one is BSing that hard and for two, it's *not* going to be any help anyway.

    Looking forward to reading about and discussing the rest of the process ^^

  2. I like your road map analogy. And, I might characterize some (not all) of it another way...

    In some cases, you might have someone who is down a well of despair. I like to think that one does not need to have been at the bottom of that well in order to help someone else out - what they need is to correctly assess the circumstances of the well and then create a plan. In order to assess those circumstances correctly, it is absolutely crucial to give full stock to the perspective of the person at the bottom.

    It is also important to remember that having once climbed out of a well yourself doesn't mean that they are in the same well, even if it looks that way from the surface, so your experience may not even be relevant at all. For example, your well may have had a rope hanging down in it, or maybe the walls were nice and carved so it was possible to climb them; perhaps you had a really hard time after all, and the walls were coated with slime to boot, but the other person's well might be lined with spines and other crawly things that are a different kind of challenge. Or maybe the person just isn't very athletic and so telling them to climb out would be like telling someone in a wheelchair to walk.

    None of this is discernible from previous experience or even looking at the well. Thus the importance of communication. Thus the importance of knowing how to effectively communicate. Thus, my ongoing crash course.

    We'll see you next time. :)