Friday, 7 March 2014


The absolute key here is that, when you are talking about real people, especially in reportage or descriptive prose, you talk about the person first. These guidelines for journalists and other media workers from Time to Change are a good resource, especially the Mind Your Language page, but if you take one thing away from this post it should be this: a person who suffers from an illness is not defined by that illness and you have no right to so define them when you refer to them. If an illness or condition or whatever is essential to an article or to a point that is being made then, with their consent, you should describe someone using a formula along the lines of '[person] with [diagnosis]', otherwise, there's just no need to mention it.

Of course, it gets more complicated than that, so I'm going to delineate a little bit my own position and some of the issues around it. But, if you are in any doubt remember that you're talking about people so your default position should be one of respect and compassion. (That goes for all issues of representation and terminology, actually, not just when talking about health issues.)

If you follow me on twitter you may have noticed that in my profile I call myself a 'depressed games blogger', in stark contravention of my advice above. This is partly because it's my space and I can do what I want within it. Part of what I use my twitter account for is to talk about my depression and my games blogging about being depressed so it is a relevant introduction to what you might find in my feed. Bios like that are always invented personalities, highlighting what the (auto)biographer considers relevant and informing the reader as to the implied author for a given body of work. The definition-first convention that has appeared in many social media  profiles is also, I think, part of that process of negotiating the constructed nature of people's online personalities. This is not to say that these constructs are false or artificial either, just that they are in effect an edited highlights package for a particular (implied) audience. By bullet-pointing self-definitions you can unobtrusively set out what sort of person you intend to be within a given online space, in lieu of the visual and social cues that might be available to you in an offline space.

There are for example a number of other mini-bios for myself floating around out there and in the majority of those I don't mention depression because it isn't relevant to what I use those spaces to talk about. Which leads into another important point about self-definition in distributed and discrete spaces; just because you see someone use a term (or allow a term to be used) to describe themselves in one context it doesn't automatically make the term relevant in all contexts.

Mental Health terminology should not be used pejoratively. That really ought to go without saying, but unfortunately it still needs repeating. Terms like 'psycho' and 'schizo' are stigmatising and inaccurate, while even the correct terms, for example schizophrenic, need to be handled with care. This is especially important considering the tendency for people to use those terms within a moral framework; i.e. when discussing criminality and evil or unpleasant acts. Having a mental illness is not a reliable explanation for these acts and as such mental illness diagnoses should not be used as synonyms for them. Similarly, saying someone did something that you dislike because they are 'insane' is damaging because it suggests that the insane are inherently dislikable, whilst simultaneously normalising your own preferences under the banner of 'sanity'.

On the other hand, I'm not sure I agree with the (extreme) position in mental health advocacy and discourse that would like to excise words like 'mad' and 'crazy' from the language completely. That should be at least partly clear from the title of this blog, as well as from the way I talk about those concepts. There are two main reasons for my view on this. The first is that I think the concept of, especially, madness is one that goes beyond the concept of mental health and that to lose it would be to inescapably fall into the diagnostic trap I have talked about elsewhere in this blog. It's not that the diagnosis and categorisation of mental states is a bad way of talking about these concepts, on the contrary, it is just that it should not be the only way. The second reason is more personal, in that I like the explanatory power of the terms; I am sometimes crazy, and I have had days that, objectively, have felt insane.

There is a fine line between stigma and description here, but I think that in this particular case it is a place for negotiation rather than proscription, but I cannot speak for everyone.Recently, Zoya Street asked the following question on twitter:

I think that the responses that he got are instructive and it is worth clicking through to the tweet to see the entire discussion. You can see as well how my gut response changed as the nature of the context in which the word was being used came out. I also think that the term sociopath, similar to the term psychopath which I discussed in a previous post, is a slightly different case to the diagnostic labels I mentioned a few paragraphs ago anyway. As I understand it it is, even more so than most psychiatric labels, a cultural construction for talking about certain types of behaviour and is less likely to be used in a clinical setting than popular culture would have you believe. I still don't think it's healthy to label someone a sociopath just because you don't agree with them or they don't care about you, but it can be useful when you need to talk about emotional response, and there remains a useful fictive power in the idea.

Given that this is my position, I'm not always going to get things right, although I do think carefully about my usage of various terms in my writing. As this is a space where I write both descriptively and polemically I sometimes use constructions that cut close to the bone for emotional or political effect rather than comfort. Provided that the space is one where that sort of use can be reasonably expected, and the clear intent is to challenge rather than uphold stigmatising or offensive power structures then I would argue that this kind of use is legitimate. Again, however, it should not be considered a licence to throw around insults in any given situation or to describe real people in ways that they would not want to be described.

Except, in a blog that deals with fictions and artworks a lot of the time we are not going to be discussing real people, and that again changes the outlook somewhat. For a creator of fictional people the advice remains the same: they should be a person before they are a diagnosis. But when dealing with pre-existing characters, although you may try your best to view them as a person, sometimes they are clearly written only as a diagnosis. In this case, especially if you are focusing on the textual aspects of the character then you may find that you have no choice but to engage with them as the diagnosis. This is, in my opinion, fine as long as you remain aware that you are dealing with a fictional character and that if they are written that one-dimensionally then what they might be able to tell you about real people with the same condition is almost certainly very limited. And if you love that character and want them to be more than they are then my advice: kill that author, get metatextual and start writing fanfiction, even if it's just in your head.

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