The politics of, oooh, feeling cool
By Tim Barry
In a world that is becoming increasingly brand driven, it strikes me that the world of diagnosis adheres to the same rules of the market as cosmetics or fashion. I remember, as an intern, coming across creatively mad people - they could fall straight to the floor without batting an eyelid. They could stay motionless for hours despite any attempt to move them. They could talk at breakneck speed and make their words rhyme. These forms of madness have strict entrance requirements and take a certain amount of dedication. They are the haute couture of diagnosis.
I suspect we may be growing a little sloppy with time and many people just don't seem prepared to put in the effort. All told, being mentally ill just isn't what it used to be. Or perhaps there are just more ready-to-wear diagnoses out there today - a kind of protest against the indulgence and expense of high fashion. And because there is no Ojibwa curse for distress, there is nothing to stop everybody getting in on the act (especially if the marketers of the new illness can convince us that a absence of Prozac is the cause of the condition).
I suppose it is a bit like when the creators of fashion manage to convince us that wearing a certain brand name will improve our self-esteem. And a brand is nothing more than a promise. A successful brand is a promise that is kept, and in our fashionable therapy set, some diagnoses seem to deliver time and time again. The promise they provide is allowing us the luxury of never having to take responsibility for our own lot.
Like any new and innovative fashion, there is a time of increased interest as the new line hits the shelves (especially if the packaging is enticingly designed), followed by a time of relative disinterest. To keep the interest going is not easy (why else would things like catatonia have fallen out of fashion). And, like any product, the underlying message is that you need it what the hell, you deserve it. But what drives the interest is the marketing division's creativity, not the actual product.
I saw a young man the other day, who triumphantly announced to me that he was suffering from ADHD. He said that he found the resourceful and boundless energy associated with the disorder to be especially intriguing. I'm not saying that there is no such thing as ADHD, but it does seem to me that many disorders have been hijacked by the high priests of cool. This gives a bad name to those of us who actually deserve the titles.
It also seems to me that the more exotic the disorder, the more entertaining the cure. If I was a bit more cynical, I might start to believe that fashionable cures were looking for victims to treat. The whisper of any good cure is that it will make our lives easier - that there actually is a short cut. That there actually is a cure for existential loneliness.
So, it's not surprising that there are many potential buyers. This is where the marketing division really earns its keep. The trick is finding the constellation of amorphous symptoms that best describes the natural protest of our psyches against an increasingly lonely world and making these elements the core of our new disorder. To enhance sales, the disorder should balance two tricky aspects in the right proportion. Firstly, it should be as far from the ordinary, tired trends of last season as possible. Secondly, the more people that can emotionally afford the diagnosis, the better it will sell. In a world where the promise is that we can actually have it all, ordinary is unbearable. And discipline as a path to maturity really is like wearing grey.
It seems to me that therapists have been seduced into this game. We no longer want to help people become remarkably ordinary, we have started to believe that remarkableness is everyone's birthright. If somebody is ordinary, then let's help them to be remarkable, even if their remarkableness is the kind of remarkable obstacle they have in their way by virtue of their diagnosis. It's the next best thing we can offer.
Tim Barry is a psychologist and consultant in private practice in Pietermaritzburg, South Africa.
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