This week, I present at no less than two workshops/conferences: MANCEPT (Manchester Centre for Political Theory) workshops 2021, in the panel The Ethics of Mental Health and Illness, and the Conference of Responsibility, Psychopathology & Stigma, held at the universities of Antwerpen and Leuven. Fortunately, everything is still online due to the pandemics, otherwise it would have been hard to manage both… (My schedule will be tight enough as it is.)
At MANCEPT, I present a text called “Against the lightning bolt view of mental illness”. Back in the day, madness was blamed on bad parents, mothers in particular. This was obviously not a nice experience for the poor mums. Today, this view has largely given way to the “lightning bolt view”: There is talk of how some people have a genetic vulnerability, and it’s mentioned that unspecified environmental factors can play a part, but overall, it’s stressed again and again that mental illness can happen to anyone. It’s bad luck – like being struck by lightning.
I argue that there are two big problems with the lightning bolt view. First, it makes mental illness wholly apolitical. There’s much research showing that poverty, homelessness, racism, stressful jobs, and so on, play important parts both for the onset and worsening of mental illnesses; the lightning bolt view tricks people into believing that the only thing that can be done politically to ease the suffering is to fund psychiatry and research on neurology and psychotropic drugs, and campaigns urging people to “talk about it”. Politicians get away with claiming to take mental health very seriously, while making decisions which we know will increase mental health problems.
Second, there are clear correlations between dysfunctional family environments and mental illness. This was the basis for the old blame-the-mother-tradition. In the new lightning bolt paradigm, the correlation is instead explained by the opposite causal hypothesis: All family problems are caused by the mentally ill person. If we see a family where the parents alternate between hostility to and infantilization of their child, and the child in turn has a mental illness, this is explained by the child being so hard to be around with their problem that the initially normal parents react the way they do. We have no scientific basis for this strict, one-way causal hypothesis, but it has nevertheless been argued that we ought to promote this view since it is considered non-judgmental. The mentally ill child causes all problems, but lacks guilt, since they cannot help being mentally ill and therefore terribly hard to deal with.
I argue, in short, that this causal explanation still loads all responsibility on the child’s shoulders; it is not made okay by adding the “of course you can’t help being such a pain”-caveat. We should accept that cause and effect can be complicated and run in circles and spirals when it comes to dysfunctional families and mental illness, and that all people (not just those with a particular diagnosis) can hurt each other even though they care and didn’t mean to.
At the psychopathology-responsibility-stigma conference, I present “Exemption, self-exemption, and compassionate self-excuse”. In moral philosophy, exemptions are traditionally distinguished from excuses. A person who is, by and large, considered a moral agent, can sometimes be excused for something bad they did, if they temporarily lost control (for instance, stepped hard on someone’s foot, not out of maliciousness, but because they slipped and lost their balance) or if they lacked relevant information (for instance, played loud music all night even though their neighbour needed to sleep, but they thought for comprehensible reasons that their neighbour was on vacation). When someone is exempted, on the other hand, it is because we consider them so generally out of control, unintellligent, and/or irrational, that we simply cannot demand anything from them.
In moral philosophical texts, it is usually taken for granted that madpeople should be exempted, and we’re discussed in a very objectifying manner. That this is ethically problematic have been acknowledged by philosophers before me (even though way too few people react against it, and way too many stubbornly defend this philosophical tradition). However, I want to argue for something more: That the standard objectifying exemption is not merely problematic, but often impossible to apply to one’s own case, if I am the madperson who wrestle with feelings of guilt over mad things that I have done. (Virtually all literature in the field talk of madpeople in the third person, assuming that everyone who writes and reads philosophical texts must be sane.)
Next, I present compassionate excuses as a better option for actions that truly were prima facie wrong. Instead of trying to see myself objectively and from the outside, I should take my own memories and experiences – including how difficult everything was and how much I struggled – seriously, and on this basis stop being so hard on myself.
I further discuss how we should be more critical regarding how much mad behaviour actually is wrong (here, I enter into neurodiversity territory). A lot of mad stuff might actually just be weird, not wrong, and should be more accepted.