In 2020: defining and treating mental 'illness' in an age of capitalism and total surveillance
|Whitney Fishburn||Jan 27|| 1|
vol. 2, issue 1
I was sitting in the home office of a clinical psychologist. Behind where she sat facing me, the sun shone through sheer paneled curtains. She was pantomiming rain with her fingers.
“You’re very sensitive. You’d have to have a cocktail of drugs to make it work right for you, and that will take time. We’ll have to test a lot of different things,” she said, by way of explaining her phantom rain. She had connections, she told me. People in the medical community who could help.
I acknowledged I was depressed. I disagreed with other aspects of her diagnoses, and I certainly wasn’t up for months of trial and error medication.
“Why wouldn’t you want to take medication that helps you stop feeling so badly?” she asked, incredulous, and I think, genuinely trying to help.
“Because my pain is my pain. If I don’t own it and examine it, then how am I supposed to learn anything from it?” I responded. The therapist was also an ordained minister with a degree from a well-respected seminary. I suspected she would understand this emphasis on the existential, and affirm my search for meaning what was the matter.
I was mistaken.
“That is a very unusual view and I don’t think it’s a healthy one,” she said.
So ended my first and only experience with psychotherapy.
And then the darkness came. Months of it. It wasn’t until one day sitting on the staircase of my home, staring blankly at the wall, as was the usual routine anymore, that at last an inspiration occurred to me: I could not do this to my son. I got up, I got out of the house, I got tough, I did things I hadn’t thought I was capable of doing. And I asked others – friends and family – for help. Gradually, the pain receded, and I determined I would somehow become an expert in what had happened. I now count among my dearest friends and mentors a number of psychiatrists, having been a reporter, editor, and investigative writer in the field for over a decade.
Was I wrong to reject the help I was offered?
I don’t know.
That I emerged from the depths of despair without the aid of psychiatry in any form, seems as though it should make me unique. Yet, that is not so. Plenty of others overcome what the field would argue is difficult to do without “intervention”. Resilience, that ever elusive factor in mental health, is only part of it. How and why is that possible? Is it advisable? Would the quality of my life and those of loved ones who watched me suffer have been better if I’d not “gone it alone”?
I have a few friends who aver completely that their lives are far better than had they not gotten psychiatric and, in most cases, pharmaceutical help. How could I discredit that? I don’t. But what is the ratio between their medications and other factors when it comes to the calculus of their relief from pain and suffering?
Throughout this year, 2020, volume two of docu-mental will explore these kinds of questions.
For me, what seemed to work were plentiful walks in nature, listening to live and recorded music, singing, reading poetry, viewing art, journaling. Lonely as I was, talking with trusted friends helped, too, although of those I had few. Religion did not play a part of healing for me, but for some it does. The key was to find ways to gain perspective and to see how my pain fit into the larger whole.
Although there were personality and childhood traumas in the constellation of my depression, many of the dark stars were the so-called economic and social norms I was supposed to accept, but that to me seemed insane. For example, I could not understand why I had to accept the level of debt required to attain what I’d been led to believe were the correct aspirations to have as an American, including a good education for my son.
Now, all these years later, where all of my reporting, editing, and research has brought me is the nexus of where the personal and the political meet as “mental illness”.
As we saw in volume one of docu-mental, there are connections between economic policies and the states of mind they can generate. After all of 2019’s researching, writing, and interviewing podcast guests, I am now convinced our nation’s rising rates of anxiety, depression, and suicide are correlative with the runaway train that is capitalism in an age of Big Data surveillance and monopolies. Together, these have created a form of social injustice. Big Data has taken away our privacy, a resource once unique to each of us and within our purview to control. It happened without our permission. Big Data has turned us into commodities. This is theft, this is destructive, this is unjust.
Meanwhile, monopolies, in part made possible by Big Data, do not run the system, they are the system.
Monopolies are threatened when we have freedom of choice, when we have what I was looking for that day in the therapist’s office: the right to assign meaning and mattering to my life, including my pain. That is why they want to define what my meaning and mattering is for me. Big Data makes that possible through buying and selling our privacy without our explicit permission, and colonizing our minds. Even worse, in our enslavement, we not only are the product that is bought and sold, by liking and re-posting and re-tweeting, we are help create the market where we are the commodity.
Now, narrowing it down to systems within systems, I am thinking about the pharmaceutical industry. It is life-saving, no question. But are there times when it creates a demand for itself and then relies upon us to be the product and the marketplace? Consider that the industry has embedded itself into academic medicine, helping to frame the way the system says things “are” to be. Together, these forces have set the parameters for how to conduct studies, what questions to ask, and who will be rewarded and how much for answering them.
By these terms, we now have a situation where virtually anyone in the mental health field will tell you there are limited resources in a time of high demand. We will not be able to counsel our nation’s distressed population out of our rising – indeed, epidemic – levels of mental health crises, we are told. There aren’t enough trained personnel and there isn’t enough access to the ones we do have.
But key to this paradigm of supply and demand is a prevailing point of view that mental illness can only be addressed within a certain system. And while it’s not front and center in policy debates, there are competing views on what constitutes mental illness. This debate frustrates the question of how best to pay for mental health treatment, how to assess how much mental health personnel are actually needed, and how they should be trained.
Addressing this conundrum around limited clinical resources, informed by my personal experience demonstrating that it is possible to heal without clinical helped lead, in part, to my creating docu-mental.
My goal is not to disprove current approaches to diagnosis and treatment, but to expand the ways we view, and thus alleviate, human suffering in the form of mental and emotional distress. My goal is to awaken people to their options and perhaps inspire them to take action to protect and preserve the resources that make those options viable.
I am doing this by connecting two seemingly disparate concepts. This first is that there is the potential for systematic profit off of enslaving people, in this case, enslaving them to the idea that they must have clinical help to be well. The second is that people are increasingly unwell because of a larger system that has eroded and corroded access to other potentially healing resources such as our imaginations, our privacy, our access to nature including its silence and beauty often lost to development and industry, and to the arts which are often under-funded or corporatized.
My theory is that the more of us who become aware of how we have been enslaved to a system that we did not intend to create, the stronger the herd and the better our chances for resisting the pain of enslavement, which I believe is correlative with anxiety and depression.
Put simply, without freedom, we are not of sound mind. We are told we are free, but without access to these resources that is a lie. Therefore, we are at risk for anxiety, depression, and suicide.
In public health, “herd immunity” is when enough of the population has been inoculated against a virus there is sufficient protection against its virulence, no matter how persistent. The key, of course, is to have a proven vaccine in place, and to ensure access to it for everyone. That requires testing that the vaccine works, and it requires public education about the vaccine’s life-saving importance.
What if we could create herd immunity to anxiety and depression?
Although there are not a lot of data in support of clinically defined mental disorders having the same kinds of mechanistic effect on the public as, say the chicken pox, there are some addiction studies that do pursue that line of inquiry. As an interesting aside, they were conducted in the early 70s, before the rise of Big Data in the form of electronic medical records and massive amounts of private equity – two pillars of today’s health care system. Today, however, these studies are largely ignored.
Whether or not we ever prove scientifically there is such a thing as mental illness contagion, I argue that in a time when federal data already conclusively show we are experiencing dramatic rises in mental health concerns by anyone’s reasonable definition, then having a compendium that explores different ways of approaching mental and emotional resilience at least gives us a way to examine what works and what doesn’t when it comes to protecting ourselves against the pain of mental and emotional suffering. It can offer us new avenues into viewing other forms of illness like schizophrenia or psychosis, and their biological, societal, and generational mechanisms, too.
To that end, volume two of docu-mental will explore this topic on most Fridays.
The first Friday of every month will be available to all subscribers, and will introduce that month’s topic, such as depression for example. Links to how that topic is viewed across a variety of sources will be featured.
Successive Fridays will be for paying subscribers only, and will feature my personal stories, insights, and experiences with that month’s topic. A secondary focus throughout the year during these Friday entries will be on what is useful from psychiatry’s past that got lost in our present day application of the field, in other words, a look at what is regressive, and what can be rediscovered and made new with good effect.
The last Friday of each month will be a podcast interview with an expert on the month’s topic, and will be for all subscribers, premium and non-paying. Already lined up are a NYT bestselling physician-author, an award-winning Harvard psychologist film-maker/documentarian, some well-known musicians and artists, and a few well-known psychiatrists.
The first podcast will be this coming Friday, January 31st. It’s an interview I did with University of Mississippi journalism professor Joe Atkins, who is also the biographer of my uncle, the late character actor, Harry Dean Stanton. My discussion with Joe is rife with ponderings about how one family member’s devils and demons can become an entire family’s cross to bear.
In a sense, that makes January’s topic about how our respective family of origin sets the tone for our mental outlook. It’s a fitting place to begin our “docu-mentation” of the ways we suffer and heal our mental and emotional pain, how we can start there and then look outward toward the systems that profit from our pain.
That’s what’s in store for 2020 at docu-mental. If you’d like to be an intimate part of it, you can become a premium subscriber by clicking on the link below. If not, just know that I value however little or much of your time and attention you share with me and do not take it for granted.
I wish you peace.
Feb. 10, 2020: This post was updated to reflect that this topic will be covered on Fridays, but docu-mental also publishes occasionally on other days.