They f*** you up

After my hospitalisation for eating disorders, my brother's schizophrenia diagnosis came as a relief, of sorts. Whether family history or chemical imbalance, we desperately seek a reason for the unreasonable.

Getting a mental illness diagnosis can feel like a reprieve. You’re not going mad, or rather, you are, but in a structured, officially acknowledged capacity. If not method, then there is at least legitimacy in your madness. You’re no longer alone in your isolation. You and those around you are no longer uniquely incapable people, failing at life.

I was first hospitalised for anorexia in the late 1980s. Back then it wasn’t seen as an illness, at least not by those who were treating me. I was admitted to a general children’s ward to address the physical symptoms. The not-eating itself was understood to be a moral issue, hence responses to this were strictly punitive, a pattern that continued with later admissions to supposedly more enlightened institutions.

When I found myself in an adolescent mental health unit, I was forced to sign a contract detailing which “privileges” – receiving letters, getting out of bed, being permitted to speak to other residents – I would be granted in line with weight gain. Mentioning food itself was strictly forbidden. Instead, the pressure was on to find some magic key to the past, one that would unlock the mystery of one’s own disruptive actions. Said key was most commonly located in the family home. We all knew this. We all knew that finding monsters under the bed would let each of us off the hook. Until then, as problem children we were obliged to carry the weight of all the pain we’d caused.

Like most people, I didn’t have a perfect childhood. I can sort through the jumble of memories and piece together different patterns, depending on whom I wish to blame for what went wrong, or praise for what went right. Each and every one of us possesses the raw materials for countless neatly structured morality tales. The truth changes from day to day, as joy is rediscovered or trauma relived. Of course, there are some fundamentals, some steps that should never have been taken, some actions beyond the pale. Nevertheless, far more of what goes on requires a particular form of editing, a certain lighting, in order to bestow upon it the necessary meaning.

When my brother was diagnosed with schizophrenia, it felt like a relief, of sorts. Once more family history was tossed in the air, only this time landing in a pattern that said “not anyone’s fault”. This time, it’s the chemicals. The imbalances. Take these words and hold onto them for all you’re worth, for therein lies your salvation. Schizophrenia is the trigger, the root cause. Not human frailty, but science. You can measure it in a test tube, you can even fight it with drugs. No more need for stories. You are officially exonerated by the very life sentence you’ve just been given. Good for you. Then the years drag by and you realise this means nothing.

The question “is mental illness real?” has a self-indulgent, gamey feel. It’s the kind of thing that should be reserved for first-year philosophy students, late at night in someone’s room after too many shots of vodka. Instead it is apparently “medicine’s big new battleground,” psychiatrists versus psychologists in a battle over – what? Professional status or the purity of the human soul? It’s not entirely clear.

As the American Psychiatric Association publishes the fifth edition of the Diagnostic and Statistical Manual (DSM-5), the Division of Clinical Psychology has released the following statement:

Psychiatric diagnosis is often presented as an objective statement of fact, but is, in essence, a clinical judgment based on observation and interpretation of behaviour and self-report, and thus subject to variation and bias.

Which to me seems fine, as far as statements of the obvious go. It’s not enough to shatter a whole world view. Psychiatry is flawed. Psychiatrists – who are also people – might enumerate symptoms and classify responses but don’t possess some unique insight into the meaninglessness of the human condition. If anything, it’s reassuring to hear this said out loud. After all, if psychiatry was as precise and objective as it’s apparently claimed to be, you’d want to know why human despair still existed at all.

For those suffering from mental illness and their carers, there’s very little to take from this. According to Oliver James – a man who’s ended up basing a whole career on the first line of a Philip Larkin poem – blaming mum and dad for their fuck-ups provides a way forward:

There is a huge body of evidence that our early childhood experiences combined with subsequent exposure to adversity explain a very great deal […] We need fundamental changes in how our society is organised to give parents the best chance of meeting the needs of children and to prevent the amount of adult adversity.

Which is all very well, to a degree. Don’t we all want this? As a parent, I want to best meet the needs of my children, regardless of whether mental illness is considered a specific risk to them. After all, is there anyone who believes that the intentional or accidental neglect of children is harmless? We try our best and we could do better. But what of those of us who are already damned? Does the route back lie in unpicking the past? Is there always a route back, or do we just have to plough onwards, making the best of what’s there – whether or not it involves chemical imbalances, and whether or not it’s helped by drugs? When it comes to this, it’s perhaps not so easy to take sides.

I see what the drugs used to treat schizophrenia do to people and it terrifies me. The side-effects are extreme and potentially life-shortening. I imagine books a hundred years from now, documenting our obscene treatment of the mentally ill in the same way that we currently look back on the Victorians, shaking our heads at their unenlightened attitudes towards so-called lunatics. Why did we do that to people?, we will say. Why did we drug them up like that? What were we thinking? The answer is because no one has given us an alternative. No one has yet offered “the truth”. The two options we have – the damning, relationship-destroying blame game versus the slow, drugged-up death sentence – aren’t even options. They overlap. We end up dealing with both at the same time. Take the pills, hate your parents, cling to whatever truths you can get, whatever gets you through the day.

It is easy to create a narrative in which family members deemed to be mentally ill become scapegoats. The victim in the corner takes his Clozaril so no one else has to face up to his or her sins. A neat, quasi-religious reading of what’s really a mess in which everyone’s drowning, measuring out doses and damned if they do, damned if they don’t. The horrific thing about the DCP statement is the degree to which it then fills you with guilt and false hope. You start to wonder whether actually, you’re living in some sci-fi nightmare in which all that’s required to step out into bright sunshine is to stop doling out tablets and inhale the fresh, clean air. And yet you know it doesn’t work like that. You know because you’ve already tried, so you’ve retreated back inside. You know that you’re poisoning yourself and your loved ones. You know that you’re probably living a lie. You watch the decline day by day and yes, the excuses are pathetic and prosaic – but they are real.

We don’t do it because we’re duped, we don’t do it because we’re evil. We haven’t sided with one medical faction over another. We do it because we wake up each morning and there are seconds, minutes and hours to be endured. We make the best of our lives and our guilt-ridden relationships, using the pitiful amounts of knowledge we have. There is still love, and self-awareness, and questioning, but there are also lives to be lived. Until this battle is magically resolved in one blinding flash of truth, what more can any of us do?

Photograph: Getty Images

Glosswitch is a feminist mother of three who works in publishing.

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Jeremy Corbyn's fans must learn the art of compromise

On both sides of the Atlantic, democracy is threatened by a post-truth world. 

Twenty years ago, as a new and enthusiastic Labour MP, I wrote an article for The Observer in praise of spin. I argued that if citizens are to be properly informed and engaged in their democracy, politicians - and in particular governments - have a duty to craft their messages carefully and communicate them cogently. It was a controversial notion then but less so now that we have entered the era of post-truth politics. In the old days, we used to "manage" the truth. Now we have abandoned it. 

We’ve probably come further than we think, for when truth is discarded, reason generally follows. Without a general acceptance of the broad "facts" of any matter, there can be little basis for rational debate nor, therefore, for either the consensus or the respectful disagreement which should emerge from it. Without a commitment to truth, we are free to choose and believe in our own facts and to despise the facts of others. We are free too to place our faith in leaders who make the impossible seem possible. 

We condemn the dictatorships which deny their citizens the right to informed and open debate. But in our own societies, unreasoned and often irrational politics are entering the mainstream. 

The politics of unreason

In the UK, the Leave campaign blithely wedded brazen falsehood to the fantasy that Brexit would cure all ills – and millions of voters enthusiastically suspended their disbelief.  “We want our country back” was a potent slogan - but no less vacuous than the pledge to “make America great again” on which Donald Trump has founded his election campaign. On both sides of the Atlantic, people want to take back control they know they never had nor ever will.

Both campaigns have deliberately bypassed rational argument. They play instead to the emotional response of angry people for whom reason no longer makes sense. Since the time of Plato and Aristotle, democracy’s critics have warned of the ease with which reason can be subverted and citizens seduced by the false oratory of charismatic leaders. Trump is just the latest in a long line of the demagogues they feared. He may not make it to the White House, but he has come a long way on unreasoning rhetoric - and where he leads, millions faithfully follow. He has boasted that he could commit murder on Fifth Avenue without losing votes and he may well be right.

But if Trump is extreme, he is not exceptional. He is a phenomenon of a populism of both right and left which has once more begun to challenge the principles of parliamentary democracy.

Democracy in decline

All over Europe and the United States, consumer-citizens are exasperated by democracy’s failure to meet their demands as fully and as fast as they expect. If the market can guarantee next day delivery, why can’t government? The low esteem in which elected politicians are held is only partly the consequence of their failings and failures. It is also evidence of a growing disenchantment with representative democracy itself. We do not trust our politicians to reflect our priorities. Perhaps we never did. But now we’re no longer prepared to acknowledge their unenviable duty to arbitrate between competing political, social and economic imperatives, nor ours to accept the compromises they reach - at least until the next election.

We have become protesters against rather than participants in our politics and, emboldened by hearing our chosen facts and beliefs reverberating around cyber space, have become increasingly polarised and uncompromising in our protest. 

The Trumpy Corbynites

Which brings us to Labour. Despite the obvious political differences between Jeremy Corbyn and Donald Trump, there are striking similarities in the movements which have coalesced around them. For many of their supporters, they can simply do no wrong; each criticism provides further evidence of a corrupt establishment’s conspiracy against them; rivals, including those who share many of their beliefs, are anathematised; unbelievers are pursued across the internet; inconvenient facts are reinterpreted or ignored; rational, civil debate is shut down or drowned out. 

There are other similarities in these insurgencies: both mistake slogans for policies and mass rallies for popular support; both are overwhelming and quite possibly destroying their own parties – and both, ultimately, are movements without practical purpose.

Trump may give vivid expression to his followers’ grievances but, other than building a wall along the Mexican border, his plans for government are obscure. Similarly, while Corbyn and his supporters know what they’re against, they have not yet articulated a clear vision of what they’re for, much less how it can be achieved. For many of them, it is enough to be "anti-Blairite". 

But in disassociating themselves from a Labour prime minister’s mistakes, they are also dismissing their party’s achievements under his leadership. Their refusal to acknowledge the need for compromise may well enable them to avoid the pitfalls of government. But government’s potential to bring about at least some of the change they want does not come without pitfalls. In wanting it all, they are likely to end up with nothing.

The art of compromise

Democracy cannot be sustained simply by what passionate people oppose. And though movements such as Momentum have important roles to play in influencing political parties, they cannot replace them. Their supporters want to be right - and they often are. But they are rarely prepared to test their principles against the practical business of government. The members of political parties want, or should want, to govern and are prepared, albeit reluctantly, to compromise – with each other, with those they seek to represent, with events -  in order to do so. Parties should listen to movements. But movements, if they are to have any practical purpose, must acknowledge that, for all its limitations, the point of politics is power.

We have to trust that the majority of American voters will reject Donald Trump. But closer to home, if Labour is to have a future as a political force, Corbyn’s supporters must learn to respect the historic purpose of the Labour party at least as much as they admire the high  principles of its current leader. There isn’t long for that realisation to take hold.

In the UK as in the US and elsewhere, we need to rediscover the importance of common cause and the art of compromise in forging it. The alternative is a form of politics which is not only post-truth, post-reason and post-purpose, but also post-democratic. 

Peter Bradley is a former MP and director of Speakers' Corner Trust, a UK charity which promotes free speech, public debate and active citizenship.