Category Archives: mental health

Avoidance

Building on what Chally talked about in her post about doing fine, I wanted to discuss some of the disability aspects of my recent semi-absence. Sometimes I feel like thinking about, reading about, writing about, arguing about, disability issues can become overwhelming for me. I feel that there are so many problems – ableist policies and laws and governments and businesses and people and attitudes and media portrayals and interactions and opinions and splainers. And a horrifyingly large number of instances of people with disabilities being abused and battered and humiliated and ignored and erased and dismissed. Each of those things seems like an immovable stone that fit together to form a wall that is beyond insurmountable.

Even thinking about everything that’s overwhelming feels overwhelming. (And this, of course, is part of the effect of the kyriarchy – to be so overwhelming and monolithic that it forces conformity, punishes people for differences like being a PWD, and places immense pressure on them to conform as much as possible to the norm.)

So when this happens, I notice myself avoiding disability related topics. I keep posts on disability issues unread until they start building up in Google Reader. I somehow don’t get around to reading that article or book on disability activism I had bookmarked. Someone I’m around in a casual setting says the R word and I let it go by. I pass as much as possible for TAB and neurotypical – even to myself. I just ignore disability – in general and mine specifically – as much as possible.

I noticed that my avoidance started right around the time I started working on a work project related to domestic violence. Working in that area always makes me aware of how many people, predominately women, are subjected to horrifying abuse on a daily basis. In the past, I’ve had the same kind of overwhelmed/avoidance response to feminist issues, when it feels that the patriarchal structure is too entrenched and too powerful to fight.

In other words, feeling vulnerable about domestic violence and sexual assault makes me feel like I cannot risk being vulnerable about disability, so I try as hard as possible to ignore it. I know that I am doing this to protect myself. But I do not like that protecting myself means ignoring disability issues or feminism. That protecting myself means, to an extent, ignoring part of who I am. Not just in the way I present myself to the world, but even in how I think about myself in the privacy of my own head.

That makes me angry. It makes me angry that retreating into my shell is coping mechanism brought on by the infinitely-headed hydra of ableism and sexism. It makes me angry that a necessary reaction to the frustration of engaging in disability activism is to take a break from that activism and to momentarily stop identifying as a PWD. (Or as a DV survivor. Or as whatever else is making me a target for kyriarchical oppression.) Basically, I get angry that the kyriarchy works, that even my efforts to stop being hurt by it are intrinsically shaped by it. That my life is inherently a response to it. That I cannot seem to exist outside of it.

Fucking kyriarchy.

I Bet It’s Exactly Like That!

[Trigger Warning for descriptions of violent thoughts of self harm]

Oh, by now, faithful readers, you know where we are about to go. We are about to go on a little journey into my mind, the scary place that it is, where I open the floor to discussion about the ways that, once again! Stars and Stripes has managed to get so much so wrong. Because tonight, gentle readers, as I clutch the place that might be close to where my duodendum is and sip my Korean Red Ginsing tea, which the lady at the market told me might help my indigestion, I am reminded once again that I am my mental health are nothing but a metaphor to be co-opted at someone’s convenience!

Let me give you a little background here, because the only online version I can scrape up is this e-version of the print edition, and while WAVE found no accessibility issues with it, I am not going to guarantee that it will be accessible to everyone or accommodating of everyone’s needs. It is, however, a way around their habit of not putting all of their content in their online version (and also allows deployed troops to access the daily paper as well). The front page has the story’s picture, of a white male soldier in Army Green uniform: a light green collared shirt, black tie, green jacket with various awards and pins, a black belt, a black beret, holding a rifle with a bayonet affixed to it. The text on the photo says “Model soldiers [break] Every detail counts when you’re trying to join the storied Old Guard”. The actual article starts on page 4 if you are so inclined to read.

The Old Guard is a ceremonial guard that headquartered out of Fort Meyer, VA, and performs most of its duties in Arlington National Cemetary, similar to the Navy’s Ceremonial Guard, in that they perform many military funerals daily with the cleanest of precision. Their military bearing is expected to be above and beyond that of any other in their branch of service. Their uniforms are expected to be ridiculously perfect, with exquisite attention to the finest aspects of the details, not missing a single loose thread or even a speck of lint. A scuff on your shoe could set you back a week in training. They stand grueling hours at “attention” (The Navy’s Ceremonial Guard does this while holding the business end of the rifle and keeping the butt parallel to the ground for hours, I do not know about the Army’s Old Guard. Full disclosure: I once and briefly dated a guy from the Ceremonial Guard). Everything you know about military bearing is wrong when you arrive for duty, and it is re-taught to “look better”, including the way you turn, march, stand, dress, and press your uniforms (you are even issued special dress white uniforms that are made to withstand the repeated ironing in the Navy Ceremonial Guard).

Do you see what I did there?

I was able to give you some brief background on the very strict regulations of the Old Guard and the Ceremonial Guard without using ableist language. I didn’t once have to compare soldiers or sailors who are required to iron their uniforms exactly right, or who are trained to notice when their medals are one sixteenth of an inch off from the proper dress line to someone who actually obsesses over things like drinking bleach or shoving cork screws in her eyes. Or what it would feel like to jump from a fifth floor balcony.

Because these, my gentle readers, are actual obsessions. They actually intrude on your thoughts and disturb your life, and are really very upsetting, I can assure you. They make you do things, like pull out your hair, burn yourself with a curling iron, wash your hands again and again, and pick at the little imperfections on your skin. Yes sometimes you even iron your uniform again and again and again because you just can’t get it right and double creases are the End of The Universe as We Know It, but it might be because you are certain that if you stop then you are going to iron your hand, not because your Leading Petty Officer is going to chew you out (or your whole division, I mean, does the article expect me to believe that the entire Old Guard has Obsessive Compulsive Disorder? Because that is not on the application!) but maybe because you recently thought that you might do something very harmful to someone you loved if you stopped holding that iron very tightly. Even if your LPO has put the fear of Cthulhu in you.

Being part of an elite military unit who is honored to be charged with memorializing the fallen and handing flags to their loved ones* or escorting the President or guarding the Tomb of the Unknown Soldier is a pretty powerful thing, I am sure. The end result of the intense training, of the weeks and weeks of repeated inspections and physical demands, might very well leave some people with OC tendencies or maybe even OCD outright I suppose — I am not a doctor I don’t know and I don’t pretend to know every experience — but it isn’t the same as living with a condition that sometimes (OK, often) inhibits your day to day ability to live, interact, and (here’s the important one) do your job because you are busy carrying out compulsions to get the damned obsessions out of your head.

Yeah, getting worked up over a uniform inspection? I bet it’s exactly like that!

Only, I’ve been there and done that and bought the cheap t-shirt (hell, I’ve been the OC girl who has had to prepare for uniform inspections!).

It isn’t anything like that at all.

*I want to also point out that the article, for those of you who aren’t able/don’t want to read it via the e-reader the requirements for Old Guard: Must be 5’10 or taller, must have combat experience, blah blabbitty blah. Nothing like another exclusionary Old Boys Club for the military, so they can sit around and pat each other on the backs about how Awesome! they all are. I might note, out of some Branch Pride that the Navy Ceremonial Guard frequently wins the Joint Service competitions and they have *gasp* women in their guard.

Oh, and those people receiving flags? Always widows. Always. Way to erase anyone else who might be a surviving loved one of a fallen troop, there S&S, Army, and anyone else involve. UGH!

Coming Out In a Dangerous World

Irish novelist Marian Keyes recently came out about her depression and just published an update for her fans. The decision to openly discuss her depression is being widely covered in a lot of circles, as any disclosure of mental illness by a prominent figure tends to attract attention. Stephen Fry is also a public figure who has written about depression and discussed it publicly. Carrie Fisher is another example.

Something that often gets said about disability and mental illness in particular is that if people just came out, the stigma would go away. That people have an obligation to come out, to talk about their conditions with others, to educate, to dispel myths. This insistence that people, especially public figures, somehow owe it to the world to talk about their personal lives is really frustrating and it illustrates a profound lack of understanding.

It’s true that coming out may, over time, erode stigma, but at a great cost to the people who come out. It places the burden squarely on people who are experiencing oppression, not on the society that creates that oppression. It is not up to individuals to fight stigma and ableism, using their own bodies as a battleground. It is up to society to hold the mirror to itself and to examine its own complicity in the development and perpetuation of stigma.

The case of Marian Keyes is of particular interest to me because, as Meg at fiction_theory points out, there is a great deal of ableism in the publishing industry. There’s a pervasive myth that writers in particular are often mentally ill, that mental illness and creativity are linked, yet, at the same time, being openly mentally ill and working in publishing is a highly stigmatised position to be in. Editors and publishing professionals routinely belittle mental illness, making it no small wonder that writers would be reluctant to openly discuss mental illness. Aside from the obvious desire to not openly attract abuse, disclosures can kill a publishing career.

There’s also a lot of internalised ableism that expresses itself in how people deal with public disclosure of mental illness. Keyes wrote:

I know I’ll be criticised for saying all this, I know it sounds horribly selfish, when life is such a precious gift and many people desperately want to be alive and are denied it, but honestly, I’ve had no control over it.

I have no doubt that her fears of being criticised for being open about mental illness were well grounded, but there’s also a certain amount of self defeat between the lines. It almost seems like she feels like she needs to be guilty about her depression. This thread is consistent throughout her update; she constantly reminds us that she feels bad about not appreciating her life more, as though she bears some personal responsibility for her depression and should just try harder. Even as she’s telling us that these attitudes are not productive, she’s reinforcing them.

I’m well aware that I have an enviable life and there are bound to be people who think, “What the hell has she got to be depressed about?” But whatever has been wrong with me isn’t fixable by an attitude shift. Believe me I’ve tried (Mindfulness, Cognitive Behavioural Therapy, gratitude lists…)

This speaks to a lot of social attitudes. Ideas about who is ‘allowed’ to experience depression, about how people should just snap out of it. At the end of her piece, she says:

I hope you’re all well and if you’re not – and some of you may not be, one of the things I’ve learnt is that this sort of headspace is far more widespread than is openly acknowledged, so many of us are hanging on, almost overwhelmed with desperation and feeling like it’s our fault, that what’s wrong with us is just self-pity or negative thinking or innate defectiveness…

Yet, she concludes with a note of feeling guilty. Surely, someone with such a privileged life can’t be allowed to be depressed!

There are layers within layers here. If there wasn’t such a stigma, coming out wouldn’t be such a loaded act. If society wasn’t so ableist, Keyes might not have internalised so many attitudes. If the publishing industry wasn’t so judgmental, perhaps Keyes might be able to neutrally state that she has depression, to thank her readers for their support, and not have to feel like she needs to justify it, or apologise for it.

And if society wasn’t so determined to place the burden of fighting oppression on the oppressed, Keyes’ admission wouldn’t have been a political act.

Why My Disability Makes Me a Better Employee

As people may have noticed, I’ve been a bit quiet lately, mainly due to being totally snowed in and overwhelmed at work. I’ve had a major project with a hard deadline and have been devoting nearly every waking moment to either working about it or just worrying about it. That worry and constant fretting is directly related to some of my anxiety issues – it’s a worry I feel both mentally and physically, with tensed muscles and clenched stomach and jitters. And I’m convinced that anxiety helps make me a better employee and better at my job.

I am a lawyer and my major project was a hearing with an administrative law judge to determine whether one of my clients will be considered disabled by the Social Security Administration and thus eligible for cash benefits and medical coverage. Our office had been working on this case since his initial application for benefits in 2006 and in the interim, I’d seen him struggle to avoid homelessness while his income disappeared and his medical condition deteriorated without access to effective medical treatment. So this case was an extremely big deal and the outcome would make an enormous difference in the course of his life from this point.

No pressure, right? And it didn’t help that it was an extremely complicated case involving about 15 years of medical records from 10 different medical providers and facilities about three or four distinguishable medical conditions. And that, although his disabilities have extremely serious effects, they were the kind of disabilities that Social Security usually has a hard time understanding and so tend to lead to findings that the individual is not disabled. So – a major case with a lot of difficult work for an extremely important outcome. And the short time between when we were notified of the hearing date and the actual date meant that to succeed, I would need to spend nearly every waking minute in between working on the case.

Which is when my anxiety kicked into high gear – and actually made that possible. I spent all my time in the office reviewing records, teaching myself relevant medical terms and context, and coming up with an overarching narrative to frame the disabilities. But when I would close the file and go home at the end of the day, my anxiety would not let me stop thinking about it. While I was driving, making dinner, in the shower, at the gym, my mind was constantly spinning, either worrying over some aspect of the case or making a list of my next steps when I got back to work. I was not only waking up in the middle of the night to spend some time thinking about the case while staring at the ceiling, I was dreaming about it.

When I’m that anxious about a specific topic or issue, I think of my brain kind of like a rock polisher – it takes a dull idea or problem, with jagged edges, and rolls it over and over and over (and over) again until the edges are worn down and the surface is polished to a brilliant finish that can be appreciated by even the most casual observer. But the end product wouldn’t be the same without the constant, unceasing motion and effort. If the motion, the tumbling, stopped for stretches of time, the end result would not be as smooth, as shiny, as easily appreciated.

My anxiety makes it impossible for me to slack off while working on such a major project. Even when I try – by watching tv, reading a book, talking to my cat – there’s a portion of my brain that keeps spinning and spinning away, and my whole body is ordering me to pay attention to that part of my brain. Yoga wouldn’t help, hot baths didn’t work, even a hard session on the treadmill just made me more tense. The only thing that would reduce the anxiety was making some progress on the case.

I think that drive makes me a better employee and results in better and more persuasive case work. I certainly know that I would love to take breaks and put work out of my mind and to not dream about it every night. But I don’t think the end product would be as good if I were able to do that. So my employer never needs to worry about me blowing off a case or putting less that my full effort into it, because of the anxiety that will not permit me to do anything less.

(By the way, we won the case and my client will get his benefits. Yay!)

There are definitely other aspects of my disability that either aren’t relevant to or actually make it more difficult to do my work, and I don’t want to imply that everyone who is a lawyer should have anxiety to make them more effective. But this particular aspect of my disability definitely enhances my ability to focus and concentrate and motivates me to put in lots of time and thought, which is an advantage for my job.

Are there aspects of your disability that enhance ro amplify your abilities in certain areas?

Recommended Reading for June 3, 2010

Two totally adorable golden lab puppies with floppy ears, wearing blue cotton bandanas with the tag "Service Dogs."
Two totally adorable golden lab puppies with floppy ears, wearing blue cotton bandanas with the tag "Service Dogs."

Service puppies in training!!

Miami Herald – Embedded therapists protect National Guard members’ mental health

Roger Duke is a Vietnam veteran, a retired Marine lieutenant colonel and a licensed marriage and family therapist. Since 2006, he’s spent at least one weekend a month embedded with a California National Guard unit. Duke, 57, wasn’t deployed with the unit’s soldiers in Iraq and Kosovo, but he’s a trusted face whom the soldiers confide in before and after their deployments. “Some of the best conversations I have with them are at one in the morning in a Humvee during a training exercise,” said Duke, who’s part of a California program designed to help returning Guard and Reserve members by attaching mental health counselors to their units.

Threadbared – Hanky Pancreas: insulin pump accessories and cyborg embodiment [this post was so nuanced and complex and beautifully written that I hesitate to even do a pull quote because I strongly (strongly) encourage you to click through and read the whole thing]

Floeh’s designs permit wearers to make a strategic double-move around camouflage and visibility, simultaneously hiding the pump and drawing attention to its location (i.e., waist, hip, bustline). When I’m in disability-pride mode, I’m troubled by this kind of hiding, following the logic that visibility is good (i.e., wearing the pump on the outside makes us legible, shows the limits of clothes designed for bodies without peripherals, disrupts conventional, hetero feminine gender presentation) and hiding is, well, hiding, with its affective companions: shame, fear, desire for normalcy, willingness to pass.

But visibility is only one tactic among others, and hiding the pump can also be a radical act – especially if it facilitates feeling-good-while-diabetic (for example: the best act in my burlesque repertoire hinges on repurposing a strap-on harness as an under-dress pump-holder; most of the time, my solution to the dress-problem is a jury-rigged system involving a black garter with small cosmetics pouch from Benefit, bra straps, and safety pins to keep things from sliding down my leg – unless I’m already wearing a garter belt). Of course, in the case of hiding or disguising one’s pump, feeling good can also mean feeling closer to a conventional femininity and mythic norm. I don’t want to elide that possibility, but I also return to the reality of living with chronic illness: that we live in a space of contradiction, that we work with what we have & do what we need to do to claim our (sick, cyborg, incurable) bodies as desirable. In my ideal world – one I suspect Floeh wants, too – we’ll recognize that transformation can (and should) mean more than transforming the pump, or the wearer’s relation to it, to align more closely with a dominant, normate feminine ideal. Creating, enabling, accommodating, and celebrating a multitude of diabetic, cyborg embodiments — and advocating for wider access to the pump (with all of its troubling potential) for those who are uninsured and can’t afford the $6000 price tag — these are the kinds of social transformations that need to happen in conjunction with personal ones.

BBC News – Mental health research is ‘incredibly underfunded’

Only 5% of medical research in the UK is into mental health, despite 15% of disability resulting from disease being due to mental illness.  Last week, one of the major research funders, the Medical Research Council, published one of the most up to date reviews of the strengths and challenges of mental health research in the UK. It not only showed that the research that does get funded is world-class but that the UK is well-placed to lead the way in this area. The review concludes that there are several opportunities to fund more research in the UK that would help accelerate progress in developing new treatments, or lead to better ways of preventing mental illness in the first place.

7 News Denver – Is Xcel’s Tiered Rate Program A Surcharge On Disability?

Xcel Energy’s new tiered-rate program [for electricity] began Tuesday. Customers whose lives depend on electricity aren’t given an exception. Xcel users who need electricity 24 hours a day to power oxygen tanks or ventilators have to pay the same usage costs as someone who wastefully keeps on their air conditioning.”That’s what the problem is, it’s basically a surcharge for disability,” said Julie Reiskin, executive director of Colorado Cross Disability Coalition.Reiskin told 7NEWS her organization was never notified by the Public Utilities Commission prior to the tiered-rate system decision. The PUC oversees Xcel.”I was shocked we did not know about it,” said Reiskin. “It’s disturbing that the PUC saw fit to get input from Xcel, but not from the people who are directly affected by this.”

A Happiness That Forgets Nothing – You know what? I take back that shit about not hating people.

SO. My brother—my clinically depressed brother—was met by police today. You know why? Because he mentioned to his friends that he had suicidal feelings. So what did they do?
CALLING THE POLICE, TELLING THEM WHERE HE WORKS, AND HAVING HIM HOUNDED BY THEM ABOUT HIS PERSONAL FEELINGS IN FRONT OF HIS COLLEAGUES.
I am in tears right now. Enraged tears.
My brother has a mental illness. But he is still an autonomous, competent fucking person. He can make his own goddamned decisions without alleged friends having  him hunted down like a fucking criminal.

[and finally, a mystery in which I ask for your assistance! I have seen several blog mentions of this thing – product? service? – called ‘Buddy’ that has a contract with the NHS and is supposed to help people with disabilities and I cannot understand it! Perhaps you can help?]

Buddy is a post-digital social care service that seeks to improve the well-being of people living with long term conditions, and at the same time, reduce the cost of service provision. At the heart of Buddy is a social media radio which lets users broadcast from a physical device, to a range of social media platforms. By using social networks, Buddy extends the community of carers around an individual beyond healthcare professionals, to friends, families and peers. Our idea is to decentralise and socialise care, creating a more people-powered service, where friends and families are working alongside professionals to support individuals, in real time. Co-production is the jargon.

Where About Us But Without Us Leads

On 1 June 2010, E. Fuller Torrey MD wrote an op-ed column for the New York Times, “Make Kendra’s Law Permanent.” Dr Torrey is the founder of the Treatment Advocacy Center (TAC), a nonprofit group whose sole purpose is to lobby states for the passage of so-called assisted outpatient treatment (AOT) laws like Kendra’s Law in New York and Laura’s Law in California. The New York law is named after Kendra Webdale, who was killed by Andrew Goldstein in 1999.

Dr Torrey and TAC will tell you Mr Goldstein had untreated schizophrenia. They’ll tell you people like him are dangerous, they’ll tell you people like Mr Goldstein are often so sick they don’t understand they’re ill and need treatment, and they’ll tell you they know best. They won’t tell you that Mr Goldstein had been seeking treatment desperately and been turned away repeatedly.[1. Source: Time Magazine, “Will the Real Andrew Goldstein Take the Stand?”] Continue reading Where About Us But Without Us Leads

What Is Justice? Incarceration of Mentally Ill Youth in the United States

The University of California, Berkeley recently released a report discussing the incarceration of youth with mental illness. Mental Health Issues in California’s Juvenile Justice System (.pdf) examines juvenile detention in California and the ways that it is falling woefully short in terms of providing adequate mental health services to incarcerated juveniles. Unsurprisingly, it is getting very limited attention in the media because it contains a trifecta of things society doesn’t want to address: rising incarceration rates, youth, and mental illness.

We cannot examine this study without considering the larger context of juvenile incarceration in the United States as a whole. The US incarcerates more youth than any other country in the world, in a prison-industrial complex that happens to be a major moneymaker for thousands of private prisons run with minimal accountability. The ‘justice’ system in the United States is deeply flawed, with stark racial and class disparities, including for incarcerated youth. Numerous regions claim to be ‘tough on youth crime’ and as with other ‘tough on crime’ initiatives, nonwhite juveniles are far more likely to be arrested, prosecuted, and imprisoned. White juveniles, when they do enter the legal system, are offered far more alternatives.

‘Tough on youth crime’ results in life in prison for teens. Like other residents of the prison system, incarcerated youth are at risk for sexual assault, rape, and physical violence. They lack access to adequate health care. Despite the fact that we have a legal and ethical responsibility to provide health services to the people we incarcerate ‘for the public good,’ prisoners are routinely denied access to their medications (content warning, this prisoner died of complications from an eating disorder), life saving medical treatments, and even the most basic of health care.

Juveniles are held in overcrowded prison environments that expose them to the risk of violence, infectious disease, and stress-related mental illness. Thanks to prison crowding and ‘tough on crime’ laws, some juveniles end up being held in adult facilities. Youths housed with adults are at increased risk of assault. They are also more likely to attempt suicide. Our prisons, for the most part, are no place for human beings, no matter what those human beings may have done, and the disparities in our justice system mean that there is no guarantee that we are incarcerating the right person for the crime.

We have too many juveniles in prison. The justice system in the United States imprisons too many people in general, with few explorations of alternatives to incarceration. ‘Justice’ plays out along racial and class boundaries and this is impossible to ignore. We cannot talk about the problems with prisoner care without talking about why and how people are incarcerated in the first place, and exploring the social attitudes that play a huge role in the construction of our justice system.

There are several problems going on with the incarceration of mentally ill youth. The first is that because community support services are limited, many youth who do not belong in prison at all are being incarcerated for ‘behaviour problems.’ Mentally ill children are not provided with support and end up being institutionalised on involuntary psychiatric holds, while their parents are told that if they want help, they should call the police (content warning, problematic framing). As a society, the United States is using the juvenile justice system as a mental health treatment program.

Who is least likely to have access to services, support, and the funds to provide adequate mental health treatment? People in poverty and nonwhite folks. Parents with disabilities caring for their mentally ill children. A vicious cycle is created where people with nowhere to turn go to the option of last resort and it ends with youth in prison because they are mentally ill. Not because they have committed crimes. Because they have mental illnesses (h/t MsFeasance for this link!). The Berkeley report shows, though, that once those youth arrive in prison, they are not provided with the mental health services that they need.

Incarcerated mentally ill youth often do not receive mental health treatment in prison. Screening of incarcerated youth is inadequate and spotty. Diagnoses are missed or disputed. Youth who have diagnoses aren’t provided with medications, therapy, and other treatments. Other youth are psychiatrised and subjected to abusive ‘treatment.’ Meanwhile, California is slashing its budget and although prison spending is one of the few areas of the budget that is increasing, that spending isn’t improving health care in prisons. It’s going to the construction of new facilities and into the pockets of prison administrators and private companies that make prison contracting a big business.

The report puts forward a number of suggestions for improving mental health services within the prison system, including establishing diversion programs to provide juvenile offenders with community-based treatment options. It also recommends taking some steps to keep mentally ill youth out of prison in the first place, by improving support and outreach so that the prison system stops being used as a dumping ground. In order to get mentally ill youth out of prisons, we need to change our attitudes as a society about mental illness and about incarceration; jails and prisons need to stop being regarded as holding facilities for people who are socially undesirable.

Lack of access to treatment and services for incarcerated youth is a symptom of a larger problem. It’s a symptom of the way mental illness in general is addressed by our society, of how we think about funding and budgeting priorities, of how we think about youth themselves.

Ableist Word Profile: Crazy (to describe political viewpoints or positions)

  • Ableist Word Profile is an ongoing FWD/Forward series in which we explore ableism and the way it manifests in language usage.
  • Here’s what this series is about: Examining word origins, the way in which ableism is unconsciously reinforced, the power that language has.
  • Here’s what this series is not about: Telling people which words they can use to define their own experiences, rejecting reclamatory word usage, telling people which words they can and cannot use.
  • You don’t necessarily have to agree that a particular profiled word or phrase is ableist; we ask you to think about the way in which the language that we use is influenced, both historically and currently, by ableist thought.
  • Please note that this post contains ableist language used for the purpose of discussion and criticism; you can get an idea from the title of the kind of ableist language which is going to be included in the discussion, and if that type of language is upsetting or triggering for you, you may want to skip this post.

We just ran an ableist word profile on the word “crazy,” written by the lovely guest poster RMJ, who discussed how the term is used in a variety of contexts and situations. This follow up is sparked by what I’ve seen as a recent resurgence here in the United States in use of the term in a political context, to describe or characterize an individual with a particular set of political views. Every time I see it, it grates on me, and I thought it was worth a focused discussion here at FWD.

Before I begin, I should make clear that I personally identify as “crazy” sometimes. Not always, but when the depression gets overwhelming and I can tell my thoughts are getting tangled, or especially when I’m in the grips of a manic episode. (More accurately, I identify as a “crazy bitch,” but that’s neither here nor there.) I’ve also been consistently described by others as “crazy,” in contexts ranging from affectionate to outright hostile and dismissive. So when I see this term tossed around in the media, it feels personal to me.

And it’s been tossed around a whole lot lately, largely by traditionally liberal or progressive media outlets. I first started seeing it show up at Talking Points Memo, Josh Marshall’s blog that combines “breaking news, investigative reporting and smart analysis.” Marshall doesn’t mention it on the site, but it also contains a big heaping spoonful of ableism with that political analysis. Here are some recent examples:

This is just a sampling of the posts with headlines including the term “crazy” and is not at all comprehensive. Even within this sample, we can see that the term is used to describe viewpoints with which TPM does not agree (like revising history textbooks or arguing, like Gaffney, that the Pentagon logo indicates a secret plan to subject the United States to Shariah law) and thinks are biased, bigoted, racist, or otherwise offensive (such as the protests about Obama speaking to schoolchildren or the racial laws in Arizona).  None of the posts, though, engage or critique those viewpoints or speakers in a substantive way – simply describing them as “crazy” is seen as self-evident and no further discussion is needed to demonstrate these views or people should be excluded from reasonable political discussion.

There’s been an even more recent explosion of use of the term to describe Rand Paul and Paul’s views, after he won a Republican congressional primary in Kentucky.[1. An earlier version of this post had stated, in error, that Dr Paul won the Republican congressional primary in Virginia. Thanks, Katie, for the catch.] Paul favors the free market and freedom of private business, to the extent that he seems to believe that anti-discrimination laws are an unreasonable restriction on businesses. Now I am no fan of Mr. Paul – and wrote about my problems with him previously on FWD – but that doesn’t mean I approve of political cartoons like this:

A political cartoon portrays Rand Paul as the Mad Hatter from Alice in Wonderland. Added to the original Tenniel illustration are a 'Don't Tread on Me' flag, a Rand Paul button, and an I Heart BP button.
A political cartoon portrays Rand Paul as the Mad Hatter from Alice in Wonderland. Added to the original Tenniel illustration are a 'Don't Tread on Me' flag, a Rand Paul button, and an I Heart BP button.

To my mind, characterizing Rand as “mad” or “crazy” and not saying anything further is a lazy way to dismiss him and his ideology without actually having to engage with it. There is a lot to say about Rand’s ideas: how prioritizing private business over human rights preserves existing institutional structures that will continue to perpetuate racism, sexism, ableism, and other oppression if not checked by a larger force like the government; how the line between private and public realms is a lot fuzzier and less distinct than Paul implies it to be; that the Gulf of Mexico oil spill and BP’s seemingly inadequate safety protections and near complete inability to effectively respond are strong indications that business will prioritize profits over public goods like environmental safety; how an attitude of business before anything else will influence Rand’s views on everything from the minimum wage to immigration policy to climate control to internet neutrality. Those are all important discussions to have, discussions where we can’t assume that everyone in the audience will come down on the same side, but calling him “crazy” or “mad” and leaving it at that elides all of those complicated issues. Even more strongly, it implies that those discussions are not even worth having because it is so evident that the views or person being dismissed are wrong and absurd and laughable.

In Newsweek, Conor Friesdorf made an interesting observation about the policies and people who are dismissed as “crazy”:

Forced to name the “craziest” policy favored by American politicians, I’d say the multibillion-dollar war on drugs, which no one thinks is winnable. Asked about the most “extreme,” I’d cite the invasion of Iraq, a war of choice that has cost many billions of dollars and countless innocent lives. The “kookiest” policy is arguably farm subsidies for corn, sugar, and tobacco—products that people ought to consume less, not more.

These are contentious judgments. I hardly expect the news media to denigrate the policies I’ve named, nor do I expect their Republican and Democratic supporters to be labeled crazy, kooky, or extreme. These disparaging descriptors are never applied to America’s policy establishment, even when it is proved ruinously wrong, whereas politicians who don’t fit the mainstream Democratic or Republican mode, such as libertarians, are mocked almost reflexively in these terms, if they are covered at all.

What I conclude from that is that the media doesn’t consistently use “crazy” and other ableist terms to refer to absurd policies or those that lack rational support, but instead reserves those terms for people outside of mainstream politics. Which in turn implies that the term is used primarily to further marginalize and dismiss people who don’t fit expectations of what a politician is or what are common or popular political arguments. To me, this is even more evidence that the implicit subtext of terming a person or policy “crazy” is “shut up and go away, or start blending in better.” Which, again, is exactly the message leveled at people with mental illness when they’re called “crazy” or “loony” or “unhinged” or any number of synonyms.

This selective usage is even more reason the term “crazy” shouldn’t be used in the political context – partly because it’s a lazy out for commentators who refuse to engage with the actual policy issues or political ideas being proposed on a substantive level, and partly because it fiercely underlines and reinforces marginalization and dismissal of people with mental illness. It reminds me that when people call me “crazy,” what they really mean is “stop existing in my consciousness – either disappear or become normal.” To see progressive writers and organizations rely on the marginalization of people with mental illness to score easy points against unpopular politicians is upsetting not only because of their perpetuation of ableism, but also because it puts me in the extremely uncomfortable position of defending people like Palin and Paul against this kind of criticism.

What is “healthcare”? A tale of a murderer, a victim, and a tattoo.

[*** WARNING for detailed domestic violence description from the fourth paragraph on. ***]

My local paper has been abuzz with righteous taxpayer outrage over the State paying for a tattoo removal for a woman, who I’ll call JMN.

The story of JMN disrupts a number of neat stereotypical societal narratives about domestic violence, about victimhood, about killers, about the meaning of ‘healthcare’.

To go back to the beginning, at least to the beginning of the public part of the tale, JMN is a convicted murderer. She was found guilty nine years ago of murdering her “Internet lover”, MW.

According to published accounts of the trial, JMN’s husband MH, an abusive, violent gang member, found out about her relationship with MW, and “punished” her repeatedly. He violently cut off her hair, leaving her needing skin grafts to her scalp and hand. He beat her repeatedly, with fists, with pool cues, with a belt. He poured boiling water over her. He forced her to have a tattoo reading “Property of [MH’s full name]”. He punched her and choked her, leaving her needing hospital treatment.

And after all of this abuse and intimidation which left her in fear for her life, he visited and threatened the lover, then ordered JMN to kill him.

JMN shot MW under her abusive husband’s orders, backed by this violent intimidation, and she was convicted of wilful murder. She has been in custody ever since, with a minimum sentence of fifteen years.

Unsurprisingly, perhaps, JMN now has mental health issues. (These are not described in detail in the press, nor should they be.) She was a victim of unspeakable violence (as well as being a perpetrator under duress), and is currently seeking criminal injuries compensation – which is what has triggered off the righteous-taxpayer-indignation. Her criminal injuries compensation was initially refused, and the case is now under appeal.

But the Righteous Indignant Taxpayers haven’t stopped there. The papers are now pawing over the rather insigificant detail that the State may partly fund tattoo removal for JMN. The Department of Corrective Services has committed to paying for half the cost of the procedure, which is expected to cost only $2000.

$2000.

The shadow attorney-general is outraged, he says, outraged! How dare the Precious Indignant Taxpayer be asked to fund “cosmetic surgery”! The Corrective Services Commissioner has responded in sensible and general terms, saying that he “was acutely aware he had to take into account many factors when making difficult and sensitive decisions in cases that involved complex social, psychological, cultural and physical health considerations”, and that he made a judgement call, as he does on a daily basis.

JMN is statistically at very high risk for mental health problems, self-harm, and suicide. She is incarcerated, and suicide is the leading cause of death in Australian prisoners. She has been the victim of horrific domestic violence, and victims of domestic violence are five times more likely to commit suicide than average. The Commissioner took into account psychological reports and his personal interview with JMN when making the determination that the State would fork out a grand or two to take off the tattoo she was violently forced to get, the tattoo that is reminding her constantly of her abuse and contributing to her mental health difficulties.

Let’s get a little perspective. One acute psychiatric bed-day in Western Australia costs just over $1000. The cost of this tattoo removal equates to around one weekend stay in hospital for a relatively minor psychiatric crisis. We’re not talking huge pots of cash here. We’re talking about a sum that is absolutely tiny in the scale of costs involved with healthcare and with the justice and corrections system.

We expect, as a society, to provide healthcare for prisoners. Western Australia is committed, on paper at least, to providing prisoners with the healthcare they need, including mental healthcare. The general level of care we as taxpayers have committed to equates to the level of care that people should be provided in the public healthcare system. Tattoo removal is on the proscribed “cosmetic surgery” list for State hospitals, but that list comes with one very important caveat – that the procedure should be denied State funding if there is no “clinically significant” indication.

I can’t think of any more “clinically significant” indication than a tattoo someone was forced to get at the hands of her abuser, a tattoo that is making her sick. A tattoo that reminds her around the clock of his attempts at intimidation and dehumanisation. A tattoo that states outright that she is the “property” of this violent man. A tattoo that contributes to her greatly increased risk of self-harm and suicide.

Cannot we, as fellow humans, can find enough shreds of compassion to be comfortable with spending this trivial sum on what is likely to be a cost-effective contributor to the health of someone we are, as a group, responsible for?

This case is a touchstone for a whole pile of prejudices. It makes people particular uncomfortable, I believe, because it disrupts the nice little myths that nice little Indignant Taxpayers like to indulge in. The neat little “innocent-victim” narrative of domestic violence is disrupted by the fact that this women is also a perpetrator. The neat little “evil-murderer” narrative is disrupted by the fact that she was the victim of horrendous abuse, and that she committed the killing under fear for her own life. The neat little “nasty slut” tattooed-woman narrative is disrupted by the fact that she was forced to get this tattoo in the course of her husband’s abuse. The neat little “adequate healthcare” narrative is disrupted by the fact that tattoo removal usually lies outside of what some of us might usually consider to be “healthcare”.

All of this is adding up to a situation where the Righteous Indignant Taxpayers want to wash their hands of it altogether, though it’s clear they’d rather have a set of public stocks and rotten tomatoes to throw. They shout in comments “Give her nothing but bread and water”, “Why am I responsible?”, and “This woman knew what she was marrying into – hard cheese, I’d say”. Revolting.

Australia’s National Mental Health Policy states that as a nation, our key aims in mental healthcare include the prevention of the development of mental health problems and mental illness, the reduction of impact of mental health problems, and the promotion of recovery from mental health problems. These aims apply no less to people in custody, who are at extremely high risk and have particular mental healthcare needs that are all too frequently dismissed or actively resisted by people in a society that wants nothing more than to inflict as much suffering as possible on prisoners.

There’s an interesting wider question here, which is about our definitions of healthcare, and about the fact that the determinants of health often lie outside the very narrow systems and procedures that we label “necessary healthcare”. For example, we know damn well, on a macro scale, that poverty and inequality is a more important determinant of health than doctors and nurses and public education programmes aimed toward “behavioural modification”. Could not a piece of marked skin be a more important determinant of health in a single person than all the psychologists and pills in the world?

For Cereal, Internet?: I Has A Hotdog edition

I love looking at pictures of cute animals on the internet. Cats, dogs, monkeys, dolphins, turtles, otters – whatever. And I find that skimming through a few LOLcat macros during the workday can do wonders to perk up my mood or give me a smile before diving back into work. Which is part of why I get so annoyed when the LOLcat sites do something offensive or wrong – this is supposed to be my fun time, not my get-my-rage-on time! I have a whole other folder of RSS feeds for rage time!

So I got mighty cranky when I saw this at I Has a Hotdog, the spinoff site from I Can Haz Cheeseburger that has LOLdog macros:

A group of identical white pomeranians, with the caption "Multiple Personality Disorder: you're doin it right."
A group of identical white pomeranians, with the caption "Multiple Personality Disorder: you're doin it right."

Ok, FOR CEREAL??? This is not only offensive, it doesn’t even make sense. A person with Multiple Personality Disorder (MPD), which is more commonly and more accurately termed Dissociative Identity Disorder (DID), does not manifest in multiple identical bodies. The whole point is that there is one body/mind that manifests multiple, distinct identities or personalities, called alter egos. A person who could split themselves into multiple identical bodies, all with distinct identities, is not a person with MPD or DID, but instead is some kind of magical self-cloning person who should probably be off fighting crime in Gotham City.

This underlined for me how DID is a go-to joke, a punchline often used in contexts or situations that make absolutely no sense to anyone who actually understands what DID is. It’s a lazy way to make a joke about a “bizarre” or “outlandish” mental illness without even taking time to understand the diagnosis being thrown around so cavalierly. For me, it reads as a shorthand “hahaha saying the name of a mental illness is funny isn’t that funny??”

I can’t imagine how this use of DID as shorthand for “exotic and hilarious mental illness” must affect people who actually experience DID. Given that the second google link when I searched for “multiple personality disorder” is to a site discussing whether MPD or DID actually exist or whether they are made-up movie illnesses, I imagine there’s an extraordinary stigma experienced by people with DID and an overwhelming tendency to doubt and discount their experiences at best, and to mock and ridicule them at worst. These kind of “jokes” only add to those issues. And they should not be tolerated.