The Diagnostic Statistical Manual is filled with pathologies. Eating disorders. Sleeping disorders. Anxiety disorders. Mood disorders. The list runs on and on. This is truly helpful in assessing and observing the phenomena of the intrapsychic functioning. But an observation is an observation. It observes certain connections. It observes certain causal relations. It is a wonderful tool for people seeking to nurture souls. But is it real?
I once asked my therapist what he thinks of the DSM IV (Diagnostic Statistical Manual for psychological assessment). He replied, “A fiction, a necessary fiction.” Chuang Tzu writes,
Now do you say that you are going to make Right your master and do away with Wrong, or make order your master and do away with Disorder? If you do, then you have not understood the principle of heaven and earth or the nature of the ten thousand things.[i]
James Hillman explains, “So long as the statistics of normalizing developmental psychology determine the standards against which the extraordinary complexities of a life are judged, deviations become deviants. Diagnosis coupled with statistics is the disease.”[ii] This is where, according to Dietrich Bonhoeffer, we have become the Creators. The story of the fall is pretty clear. Sin originated from Adam’s awareness of the knowledge of good and evil. This is perhaps the sin of our society as well. We create fashion models and make heavy people feel bad. We create social behaviors and make some feel out of place. We create dependency and call others codependent. We create civilization and name others uncivilized. We create truth and see others in untruth. The more creation, the more division. The more pathologies, the more disorders. If slim isn’t right and fat isn’t wrong then a conflict does not exist. If dependency does not necessary mean emotionally healthy and codependency, unhealthy, then tension is dissolved. The problem is, we do not like what we have and hence we create right and wrong. Reflecting on webbed toes Chuang Tzu writes:
That which is ultimately correct does not lose the characteristics of its nature and destiny. Therefore, joining is accomplished without a web, branching is accomplished without extraneousness, lengthening is accomplished without a surplus, shortening is accomplished without inadequacy. Thus, although a duck’s legs are short, if we extend them it will come to grief; although a crane’s legs are long, if we cut them short, it will be tragic. Therefore, if what by nature is long is not cut short, and if what by nature is short is not extended there will be no grief to dispense with.[iii]
French philosopher Michael Foucault would have agreed with Chuang Tzu that webbed toes becomes marginalized only in relation to the society that pathologizes it. Pathology, as we understand it today, is rooted in individual psyche. Madness expresses itself in behavioral aberration that ultimately lands a person in social isolation and alienation. Alienation, perpetuates madness itself and the cycle continues. Foucault sees this whole process differently. It is the reversal of the process, argues Foucault, that leads to mental illness. Commenting on this argument Herbert Dreyfus, professor of philosophy, writes:
In Foucault’s account, social contradictions cause alienation, alienation causes defenses, defenses cause brain malfunction, and brain malfunction causes abnormal behavior. In short: “It is not because one is ill that one is alienated, but in sofar as one is alienated that one is ill.”[iv]
To Foucault, social categories and norms create conflicts and conflicts, in turn, result in changes in brain chemistry causing various symptoms. Social alienation is based on an assumption of truth and its deviation. According to Foucault, the 19th century has brought along the concept of bio-power that aims at the betterment of human life. Betterment is possible when one can grasp the true meaning of self through knowledge. There is a self that one ought to be and through acquisition of knowledge and scientific methodologies, one can show the community what this ideal self ought to be. In an attempt to move humanity toward its betterment, power seeks to classify, quantify, hierarchize, appraise, and label.[v] With classification, evaluation, and label, we can now realize where people are and how to correct that. Now there is the mad and the not-so-mad. There is a neurotic and a psychotic. There are subtypes of psychosis with numerical identification. In his introduction to Mental Illness and Psychology Foucault points out, “The analyses of our psychologists and sociologists, which turn the patient into a deviant and which seek the origin of the morbid in the abnormal, are, therefore, above all a projection of cultural themes.”[vi]
Hence there is a self that one ought to be and webbed toes do not belong in this category. Webbed toes have to be unwebbed to belong. But without the classification or quantification for the webbed or non-webbed, there is no alienation and therefore, no pain. The problem according to Foucault is that we’ve allowed politics to defined and determined mental health and thus classified people accordingly.
Notes
[i] Chuang Tzu: Basic Writings, 102. [ii] James Hilllman, The Soul’s Code: In Search of Character and Calling (New York: Warner Books, 1997), 30. [iii] Victor Mair, trans., Wandering On the Way: Early Taoist Tales and Parables of Chuang Tzu (Honolulu: University of Hawaii Press, 1994), 76. [iv] Hubert Dreyfus, “Foreward to the California Edition,” Michael Foucault: Mental Illness and Psychology (California: University of California Press, 1976), xxvi. [v] Michael Foucault, The History of Sexuality, vol. 1, trans. Robert Hurley (New York: Vintage Books, 1980), 142-44. [vi] Michael Foucault, Mental Illness and Psychology, 63.
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