Tuesday, May 07, 2013

Starlets, mental illness, and autonomy

Cathy Reisenwitz at Sex and the State has a post on the call for a conservatorship for Amanda Bynes (who appears to be the latest controversial starlet). Conservatorship is normally used to take control from patients suffering from severe dementia or Alzheimer's, but is better known for giving control of Britney Spears' money and life to her father.

I'm not sure this special treatment is being suggested for Bynes because she is a woman acting without propriety as Reisenwitz suggests, but if that's why it's being suggested, it's been made possible by growing acceptance of the ideas that people who act differently should be explained through diagnosis of mental illness, and that anyone who is mentally ill is unfit to make their own decisions.

Thomas Szasz was a controversial figure because of his belief that all mental illness is manufactured. That's too strong an assertion,* but cases like Bynes' make it more understandable. This young woman may benefit from counseling if she's serious about changing her life. She may find that she prefers to be on some sort of medication. But these are choices she should make - there is no evidence that she needs to have her decision-making ability taken away on what may become a long-term basis. If she's breaking the law then punish her, but it should end there. It's unfortunate that Szasz pushed his assertions about mental illness as far as he did, because his arguments for patient autonomy should be taken very seriously.

Those concerned with individual liberty in particular would do well to call forward Szasz's main concern - that unusual or inconvenient behaviour diagnosed as mental illness (justly or not) is used to strip people of autonomy, dignity, and responsibility. It's a mistake to treat someone acting irresponsibly as an invalid - a mistake rooted in unwillingness to accept decisions that we don't agree with.

This is dangerous to autonomy. It trivializes the plight of those who are truly debilitated by mental illness. It may be becoming dangerous to women's rights. It deserves our attention and discussion.


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*Before this devolves into a fight about me denying the existence of mental illness, I want to make it clear that I do believe that mental illness exists, but that we would do better starting with the assumption that patients can help themselves with assistance through highly personalized treatment than we do with the blanket assumption attached to many diagnoses of an inability to improve or manage one's life at all or without mandatory prescription of (often debilitating) medication as first-round, permanent treatment.

These are assertions I make based on close personal relationships with people struggling through the mental health system and not as a trained psychological or psychiatric professional. 

Friday, May 03, 2013

The unknowable future and Girls

Like the author of One Good Thing, whose blog post inspired this one, I like Girls. For those not familiar with the show, it is:
created, written, and directed by New Yorks’s current wunderkind, Lena Dunham [...] Touted on release as the new Sex and the City, Girls observes the lives of four tightly-involved 20-something-year-old women carving out their existences post-college in Brooklyn, New York. I should point out that any similarities drawn between SATC and Girls were obviously made by reviewers who had either not seen the former or the latter show, because they are nothing alike whatsoever. Both shows include four female friends in New York City. Same same different. The end.
One of the most interesting things about Girls is that it demonstrates the polarizing nature of the shift into the world the show's characters are fumbling through, learning to live in. When I say that I love Girls I've received exasperated looks accompanied by demands for an explanation of my tastes and I've received expressions of affinity so enthusiastic they seem cathartic.

A lot of the show's appeal lies in the viewer's ability to relate viscerally to its characters, but the concerns it raises are more broadly based. It's aimed at a generation for whom the world has changed so dramatically that we can't look to our parents to see what to do next. This has made our parents (and a lot of us) apprehensive about the future: 
As Dunham explains in Yen magazine (Issue 61): ‘We are the first generation that has been totally raised on the internet and social media, IM-ing and Twitter and communication like that — trying to learn email manners, that kind of communication, plus the torture of waiting for a text message, and I think that also my generation all graduated from college — or not — during a recession, so, as my dad once said, which made me sad but felt true, “This is the first time in America that you can see that my kids are not going to do as well as I did.”‘
Unlike Dunham, I don't think we're going to be worse off than our parents, but we will have to build and discover a future that we don't totally understand yet. It's new and it's different and it's scary to people who grew up believing (and raising us to believe) that you go to school, you graduate from university, you get a job (with a pension!) and then you're basically set. Many of us are so nostalgic for the knowable past that we ignore its flaws, hoping for a future we feel we can foresee. And it's no wonder when we're so often told that the absence of the opportunities of the past is the same as the absence of opportunity.

There are plenty of opportunities, but they are new, less planned and many of them are still unknown. To conclude that because our generation faces such a rapidly changing future we will be worse off than our parents requires forgetting to see that the processes and outcomes of human interaction are astonishing. There's destruction of old ways because room is being made for creation. Perhaps this is why second-wave libertarianism is such an overwhelmingly optimistic movement: we haven't forgotten to wonder at the potential of human interaction. In the uncertainty around us we see not danger, but opportunity. In certainty we see stagnation.

We cannot look to previous generations - and especially not to politicians, who are incentivised to enforce the status-quo - to make our futures all they can be. Our changing world is sometimes scary, but it's an amazing, amazing time to be alive. That's worth the rest of it.