The Lie of Mental Illness

The decades-old medical model of mental health says that “you” and “I” are unrelated, and that if a health expert diagnoses “you” with a mental illness—as being “mentally ill”—that has nothing to do with “me.” One of us is well, the other unwell.

Biology is the culprit, this model says; a person’s DNA has “caused” their mental illness. Unfortunately, this also often means that these “illnesses” will “run in the family”—a person has likely “inherited” the “mental illness” of their ancestor. We are the victims of our biology.

All hope is not lost, however, because treatment is available for this “ill” person. Diagnosis is crucial, of course, by way of The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), since only by naming the illness can experts then enact the remedy through psychopharmacology. The best anyone can ever do is to understand their mental health concern—the name of what they “have”—then take their medication.

I do not believe in the medical model of mental health. It frightens me; it reminds me too much of my own experience as a gay man who was medicalized by a system of so-called “experts” all hell bent on diagnostic criteria, then drugging my sexuality away with extreme psychiatric medication. To me, there is little difference in what is happening today with the diagnosis of, oh, let’s say, “ADHD,” and psychiatry’s diagnosis of my own “illness” as a gay man. What has changed, in the years since homosexuality was removed from the DSM in 1973—from a moment in time when the guardians of the gate of mental health “decided” by popular vote that gays were no longer mentally ill—is psychiatry’s influx of “diseases,” as all neatly categorized in the DSM, and their remedies in the form of an over-saturation of psychopharmacology—but the methods of diagnosis (i.e. labelling), treatment, policing and evaluation, has remained consistent.

“Mad in America” is a non-profit organization devoted to “rethinking psychiatric care in the United States and abroad,” which includes publishing an online webzine with “news of psychiatric research, original journalism,” and a forum a international writers—“people with lived experience,” among them, psychologists and psychiatrists. Lawrence Kelmenson, MD, a psychiatrist, begins one such recent article by writing that, “As modern psychiatry grows larger and larger, it becomes hungrier and hungrier for more clients. Its formula is to invent fake ‘illnesses’ that everyone meets criteria for, and to lure people to seek fake ‘cures’ that really make them permanently ‘ill.’ But there is a more pervasive, ominous, and subtle way that U.S. adoption of the medical model has spread ‘mental illness’ and drug addiction.”

“Mental illness,” I really do believe, has fast become the cancer of the new Millennium, and we are all at risk of being labelled “sick” because, not unlike physical diseases, mental illness also springs from our genes, attacking us in its infancy.

No longer do people feel “sad” or “depressed”—now they are all “mentally ill”; they are “bipolar.” To even admit to feeling “blue” shows signs of heredity. “Are you taking anything for it?” has become a question that I have heard all too often. Just recently, I ran into a writing friend in a local grocery store, and after telling her that I’d been feeling “a bit depressed”—following years of receiving literally hundreds of rejections on my memoir manuscript (some quite scathing in their comments), to finally getting it published (to my rejoice), but now experiencing the “down” effect on this seemingly endless roller coaster ride called Book Publication—she asked me if I was “taking anything for it.” For a moment I just stared at her, gobsmacked. She has to be kidding, I thought. “I’m on a great new antidepressant,” she said. “You should take it.”

Why should I take it? was the question that plagued me, as I left my friend in the frozen food section. What is wrong with feeling sad, or depressed? It is normal to feel the way I feel, after going through what I’ve gone through.

Why didn’t my friend ask me, instead, more about how I was experiencing this depression? As depth psychology has shown us, aside from a kind of depression that is driven by biological sources, which no doubt does affect a certain amount of people, there are all sorts of other reactive depressions that are the natural result of complex life situations—acute traumas, the passing of loved ones, prolonged illnesses, or any number of other events. Probing questions about such occurrences, how they affect us emotionally and the ways in which we face deep personal troubles and crises, seem to have been largely replaced with advice about “which medication to take.” Mental illness, like an omniscient third person, is now the culprit.

In his The New York Times’Op-Ed, published May 11, 2012, Allen Frances, former chairman of the psychiatry department at Duke University School of Medicine, and leader of the task force that produced the most recent DSM in 2013, wrote that The American Psychiatric Association has come dangerously close to turning “the existential worries and sadness of everyday life into an alleged mental disorder . . . The DSM has become the arbiter of who is ill and who is not . . . The DSM-5 promises to be a disaster . . . it will introduce many new and unproven diagnoses that will medicalize normality and result in a glut of unnecessary and harmful drug prescription . . .”

Our conversations, I fear, are already being reshaped by the “new normalcy” of mental illness. People seem less and less inclined to ask the “old” questions about feelings. As future generations come of age, they obviously won’t even have the frame of reference to remember that there was a time, in the not-too-distant-past, before the world of “mental illness” and its psychopharmacological cures, when the remedy to feeling “down” was human relationships. People actually talked about their feelings—and not on-line but face-to-face; they sharedstories, and hugged, and the simple but palpable recognition that what is in me is also in you, actually helped. When you don’t even remember anymore that there are other questions that can be asked, what happens then?

It frightens me to think that it’s all just a matter of being easier to talk about “mental illness” and psychopharmacology, than real human feeling. And not just to talk about feelings, but in between all our texting and emailing, to actually feel them. Perhaps we’ve become a lazy culture, generation upon generation, with talk of this diagnosis or that diagnosis, this drug or that drug—even this side effect or that side effect (and which drug will help with the side effects resulting from the other medications) becoming so much easier and black-and-white, than the murky waters of our complicated emotions.

But being alive is not a black-and-white affair, and neither should it be. Feelings are not Conservative or Liberal, GOP or Democrat. Struggling through emotions is, at least in part, what it means to be alive. Psychopharmacology, I’m convinced, is robbing us of our humanity. Agency has been replaced with the prescription pad.

Meanwhile, I sometimes wonder about all these mass shootings, their alarming increased rate of frequency, the role that this mental health + psychopharmacology paradigm has perhaps played in these killers’ actions. I also do not think there is any accident to our culture’s increased fixation on “torture porn”—graphically violent films that are also often laced with sexual brutality. An industry plagued with controversy over sexual impropriety (to put it mildly) produces fodder to their masses, then stands back bewildered, along with everyone else, when violence erupts. How can a movie like Jigsaw actually earn close to 20 million dollars in just one weekend? I thought recently. How is it possible that this kind of inhumanity is considered “entertainment”? Even the mere idea depresses me. In considering these “torture porns,” I remember the more benign horror movies of my adolescence, like John Carpenter’s Halloween or even Steven Spielberg’s Poltergeist, with mild nostalgia. At the same time, I can also see how the ante has been seriously “upped”—it needs to be upped. There is no end to the well of human misery, and what we no longer feel must always be increased to penetrate our deadening senses. What we will not face, we will project, I keep thinking, as I witness depictions of extreme violence in our media; and I suppose that also means that what we medicate away will sooner or later show up by some other means through our projections on the screens of our lives. We need to see it outside, because we will not look at it within. 

Medicating it away—whatever “it” is—does not mean that it has gone away. I fear that this will all get a whole lot worse before it gets better.

Gays Cross Borders

With President-Elect Donald Trump and his running mate, Vice President-Elect Mike Pence, about to take office, much has been said about, among other issues, each man’s policies and opinions affecting LGBTQ citizens. During his first successful run for congress in 2000, for example, one of many statements Pence added to his website under the heading “Strengthening the American Family” included, “Resources should be directed toward those institutions which provide assistance to those seeking to change their sexual behavior.” Taken from within the context of Pence’s other anti-gay rhetoric, as well as his subsequent 2015 “religious freedom” bill, which would have allowed businesses to deny service to gays and lesbians based on religious beliefs, it is not difficult to interpret Pence’s comments as endorsing the practice of “conversion therapy”—that is, therapies aimed at trying to “change” a person’s sexual orientation from homosexual to heterosexual.

The fact remains today: every leading psychological and psychiatric organization has denounced conversion therapy, and laws banning its practice on minors have been passed in recent years both in the United States and in Canada. In 2015, President Obama condemned the practice of these therapies, and up until the recent election at least, efforts were well underway to classify conversion therapy as a fraudulent practice and illegal under the Federal Trade Commission Act. As someone who has actually lived through the experience of “conversion therapy,” I find it deeply troubling that the next Vice President of the United States would have ever endorsed therapies that the World Health Organization has said, “lack medical justification and threaten health.” The Offices of the President and Vice President of the United States of America set the tone on the world political stage. Even affirming the notion that “gays can change” potentially strengthens a kind of homophobic ideology that gives rise to violence against gays everywhere—between doctor and patient, teacher and student, parent and child, classmates and friends—and not only in the United States of America. Gays cross borders.

The Inheritance of Shame: A Memoir, forthcoming on May 16, 2017, by Brown Paper Press, is about my own six-years in this therapy and, later, medical malpractice suit against my former psychiatrist for treating my sexuality in an effort to “change” me from homosexual to heterosexual. In our relatively pro-LGBTQ, culturally sophisticated Western world, many people may not believe that these kinds of therapies actually still exist. The truth is, I had not initially sought help to try and change my sexual orientation; rather, I began psychotherapy with a licensed psychiatrist after coming out as gay and being rejected by my family. I was young, depressed, and isolated—as so many young gay people often are—and in need of help. I trusted Dr. Alfonzo. 

Homosexuality itself was declassified as a mental illness and removed from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973. Despite such progress, many forms of conversion therapy, usually bible-based (“pray away the gay”), have persisted through the years. My own treatment was neither religious-based, nor endorsed by any specific psychiatric community: instead, Dr. Alfonzo simply took it upon himself to try and “cure” me of what he considered to be the “error” of my homosexuality—he prescribed massive amounts of multiple psychiatric medications, used aversive techniques, and generally contextualized my entire life history (my “problems”) in an effort to convince me that I really was heterosexual. 

“Conversion therapy,” as an umbrella term signifying a vast array of therapies aimed at “curing homosexuality,” was actually created decades ago by, and from within, an anti-gay-rights movement aimed at affirming and endorsing psychiatry’s long-held belief of homosexuality as a mental illness in need of “change.” In other words, though the American Psychiatric Association’s official policies may have changed, its homophobic legacies have lived on in the hearts of some who still treat gays as “disordered.” Changing laws or official policies is not the same as changing hearts. The term “conversion therapy” is, in truth, a misnomer—since nothing, in reality, is ever “converted” during the course of these treatments. Even the alternately used term “reparative therapy” inaccurately describes what I now consider to be more like a psychic lobotomy, where the “surgeon” probes into the psycho-sexuality of the individual, cutting and scarring their way toward the establishment of a different sexuality, while the “patient,” severely undermined by lifelong messages of heteronormativity, becomes co-conspirator in their own loss of agency. Patients of these therapies who do claim to have “changed” their sexual orientation typically later admit to mean that they have merely learned to control their sexual behavior—they “become” heterosexual in as much as they learn to partner with a member of the opposite sex. For “ex-gays,” words like “homosexual” and “heterosexual” are less descriptors of erotic desire as they are mutable social identities. “Change,” for ex-gays, is taxonomical.

The Inheritance of Shame: A Memoir is a personal story about my own, honest experience in one of these kinds of “therapy,” but its themes are universal: generational trauma, childhood sexual abuse, powerlessness in the face of adversity, self-acceptance, identity, the resilience of the human spirit, and the recognition that we have within each of us a core essence that cannot be killed, or “changed.”