Reply #25: "Mentally ill" is a populist and not a diagnostic term. Don't conflate them.

[nolabear]

People ask me all the time when they come to me for psychotherapy, "Am I mentally ill?" or "Am I normal?" I tell them that I don't think in those terms. As with physical illness, no one has anything that doesn't have some potential for activation in every one of us, and, ironically, it won't be the same in any two of us. We are all deluded in many ways; denial is a necessary defense against huddling in terror over the fact that we are so vulerable to pain and death. And every last thing we do is ruled by the chemical goings-on in our brains. You can control those chemicals, within limits, by pharmacology or by interaction with other human beings, the environment, nature, and a host of other things that cause the brain to produce those chemicals. If the brain produces a more-or-less average number of said chemicals, our interactions with others over our lifespan determine what percentages of endorphins, seratonin, melatonin, hormones (many), cortisol, etc. bathe our brain and how we act accordingly. Our higher order functions, i.e. thoughts and actions, connect those chemicals to events in the exterior world and reinforce things that are laid down very early, associating them with emotions and the unconscious responses that are created before we have those higher order capacities.

ALL our brains operate somewhere on the continuum. I don't hear voices or hallucinate, but I guarantee you if you give me the right psychotropic or deprive me of sleep or isolate me for long enough, I will. I happen to be a relatively calm person, a little too damped-down for my taste, but if I drank enough caffeine, did enough cocaine or speed and not too much, I would feel just wonderful as I would during a certain part of a bipolar swing, before it would go too far and my brain would tell me things that are not true about my own invinceability and how fantastic the world is, causing some incautious behavior (mildly put). I'm not paranoid, but enough trauma within the context of having no supportive counteraction would likely give me a whoppiing case of PTSD. The chemicals that casue these responses are exactly the same.

There are reasons people are the way they are, even freepers. Even Dick Cheney. Even Charles Manson. Sometimes the person is on a place on the continuum where their brain can't be changed by interaction with ours and they are too dangerous as a result of it, (the aforementioned Manson)and they have to be contained. Sometimes we, because our sense of what is tolerable or not (the aforementioned freepers and Cheney) don't want to get past our own anxiety and fear of what might happen were we to be vulnerable enough to work toward understanding and interacting with them. Sometimes they create such anxiety in us that we hate them and want to kill them (Iraq, death penalty, your average killer).

I have a cetain nervousness around here because I fear I may be perceived as a lecturer and there is truth in that, but when this comes up I do think it might be helpful to post this fact again and again. There IS no "us and them." There's just us. And I am an advocate for actually saying what we mean when we're tempted to use a catch-all term like "mentally ill." I'm more inclined, up until I can't tolerate the anxiety someone creates in me, to say "I don't understand your reality but I know it's as real to you as mine is to me. Can we find mutual territory?" When pushed too far my feet become total clay and I resort to "what an asshole!" But it's not that they've got a mental illness. It's that I can't stand the s.o.b.