Figures announced in August of last year revealed that, in many (Northern) towns in England in any given month, one adult in every six is prescribed antidepressants. If it does nothing else, this statistic once again raises questions about the significance of the word 'mental' in the designation 'mental illness.' The word 'illness,' we can understand; it places conditions like depression on a par with conditions like heart disease and cancer. But 'mental'? What can that mean? Of the mind, presumably, but what is the significance of that? Isn't the mind physical too? This is a big question, of course, but, since the default reaction these days is to treat the mind as if it is purely physical - antidepressants alter the chemical balance of the brain - we can at least conclude that medical orthodoxy, ordinary behaviour and government policy all agree that 'mind' illnesses are no different from 'heart' illnesses or 'stomach' illnesses. The question remains, then, as to what is implied by the catch-all qualifier 'mental' that isolates a certain range of conditions as somehow distinguishable from physical/purely physical conditions?
What is implied is this: that conditions like depression, while being a matter of physical imbalance, are also - in ways that are poorly defined and rarely explicit - a matter of personal responsibility in some way. We are made to own these conditions in a manner that we are never made to own conditions like heart disease (despite the fact that heart disease is often the result of lifestyle choices, a fact of which almost nobody can now be unaware). The various psycho-therapies, relatively rarely sponsored by the NHS, are premised upon this, with their reliance on a long-drawn out testimony on the part of the patient and a tendency to locate the origins of the 'mental' illness in an event/events construed as utterly determining. Your 'mental' illness is yours, and was always destined to be yours, in a manner that 'physical' illnesses rarely are. A vaguely articulated atmosphere of personal responsibility, and therefore of guilt, pervades the very concept of 'mental' illness, an atmosphere that belies the rhetoric of 'understanding' that surrounds our society's ever-increasing doling out of pills to help alter certain psychological experiences.
The fact that Cognitive Behaviour Therapy has become the NHS therapy of choice is, in this context, telling - a therapy whose commitment to altering ways of thinking and therefore of behaving emphasizes the importance of norms and function. CBT is premised upon there being standards of behaviour which it is undesirable to fall short of, and upon the absolute value of fitting in and putting the next foot forward. A therapy, then, that combines the controlling effects of guilt-dissemination and normalization - a realization of Foucault's claim that 'mental' illness occurs half-way between medicine and morality as a significantly ambiguous and sinister mix of innocent determinism and culpable freedom. You can't do anything about your depression - hence the horrifying numbers that agree to the pills - yet you are also guilty, of its causes and its effects. That this guilt is now as pervasive as it is poorly defined no doubt explains the relative increase in pill-prescription and decrease in therapy provision - the term 'mental' nowadays more or less does the trick on its own. No more costly apparatus is needed to continue to make us feel as if we are the ones who are 'down.'
Thursday, 20 March 2014
Tuesday, 18 March 2014
For the Victorians, taste was a moral achievement; conformity to standards – of dress, of décor, of demeanour – part and parcel of an upstanding life and character. To us, this seems highly conservative and judgmental – we are committed to a degree of individualized aesthetic experience that makes the conformity of previous times feel oppressive, and, insofar as we form explicit moral impressions of anyone or anything, we do not form them on the basis of, say, choice of colour for the sitting-room walls.
Yet it is perfectly rational to argue that taste is a moral, and not just an aesthetic achievement: as Kant explained, a person’s willingness to submit to a consensus view when there is, as in matters aesthetic, no rule of reason to follow but only a shared sense, a common experience, is a very good sign of that person’s being more than likely to submit to a consensus view when there is, as in matters moral, a rule of reason to follow. If you subjugate your will in the matter of colour for the sitting room walls, on the basis of a common sense for what is beautiful, then you are unlikely not to subjugate your will in the matter of right and wrong, on the strength of a universal reason for what is good.
And to what, after all, does our contemporary so-called freedom of choice amount? A great eclecticism? A dynamic experimentalism? If anything defines the aesthetic in our time, it is rather a stultifying genericism: in dress, in décor, in demeanour too. Conformity, then, still obtains – a mass and mind-blowing conformity of which the Victorians could not have dreamed. So the difference between us and the Victorians lies not, after all, in the advent of freedom of thought and expression, but in the explicit attribution of moral import to conformity in matters aesthetic.
This makes all the difference in the world. What is striking about contemporary genericism is its terrible thinness, its awful convenience, its flattened-out ease. ‘Boys and their toys,’ said with a smile between women of their men; ‘He’s at that stage,’ pronounced with no real idea of what stage that might be and whether he’s really at it, among mothers over cappuccinos; ‘The well-being of our students is our first priority,’ stated with no commitment to well-being, on every university brochure in the land. The generic mode is both impossible to object to – it is almost always positive – and utterly alienating, at least of any concern with content, any real engagement. It is the steel-magnolia mode of our times – saccharine sweet and absolutely forbidding of any dissent, the aesthetic equivalent of the ‘there is no alternative’ of contemporary capitalism.
There is, then, also an attribution of moral import to our time’s mode of conformity, but it is not an explicit attribution, and it is assigned on the thinnest of grounds, with no sense at all for the moral relevance of the content to be conformed to; there is nowadays only an implied insistence on the moral relevance of conformity itself. We have no notion of why it is that IKEA-style furnishings should have about them anything of a moral nature, and yet we have an absolute and very defensive sense that they do. The Victorians, on the other hand, had strong notions of why, say, a bustle to the rear of a woman’s skirts was of moral import, and this gave a depth to their insistence on conformity that our age is utterly without.
In the end, it is hard to really value what comes too easily. For the Victorians, standards of dress, of décor, and of demeanour were difficult to achieve: try producing crisp white linens in a dark and smoky home without electricity; try achieving a calm and spacious parlour in a two-up-two-down, housing a family of six. Hard won, to say the least. And therefore just the kind of indicator of a moral person that Kant understood the sense of taste to be. And think now of the shameful convenience of our choosing from H&M’s exhaustive range of cheaply sold ‘jeggings,’ while sitting on the couch watching X-Factor, or the terrible thoughtlessness of our conversations, as we sign up to a ‘global’ conformism, a ‘global’ common sense, that is as binding as it is lite, as steely as it is magnolia.
Contemporary moral life is degraded and degrading. It is born of no resistance, except that offered by the great wall of genericism. It is not formative, because it has nothing to do with substance. It is premised on outlines of people, not on people. And it makes outlines of people, not people.