Tony Perkins in “Psycho”

I learned something new yesterday about the shameless little man who runs the Family Research Council: Tony Perkins does not love anyone who is suffering from mental illness.

It’s possible that Perkins does not even know anyone who is suffering from mental illness or, at least, that he thinks he doesn’t know any such person. Because if he did know such a person, and if he cared about them even just a little bit, just enough to begin thinking about what their world is like, then he couldn’t have allowed this to be sent out in his name: “Should Private Businesses Be Forced to Pay for Sexual Disorders?”

The perpetually alarmed Perkins is alarmed this time over the Paul Wellstone Mental Health and Addiction Equity Act, which says that if you’ve promised to provide health care for your employees, then guess what? You have to provide health care for your employees. And you don’t get to break your promise just because your brain hasn’t yet figured out that it’s an inseparable part of your body.

Now I happen to think that the American model of employer-based health care is, itself, insane. It arises from the convoluted, wasteful and inefficient Rube Goldberg device we’ve constructed in an attempt to pretend that a free market in health care is theoretically sound. But given the existence of that uniquely American patchwork employer-based system (“you tend the sick with the health care system you have, not with …”) the Wellstone Act is necessary. It reasserts reality in the face of the fantasy that brains and bodies are somehow neatly and easily divisible.

I would understand if Perkins opposed all such mandates, and not just those involving treatment for mental illness, based on some free-market principle. I would disagree — on the facts as well as the ideology — but I would understand. But that’s not what Perkins does here. What he does, instead, is attempt to portray the concept of mental illness itself as illegitimate. He mocks the idea that mental illness refers to anything real.

He tries to show that mental illness is either trivial or merely perverse by cobbling together a weird little list of diagnoses from the DSM-IV:

The bill uses the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as the basis for identifying conditions that must be covered. Among the more troubling diagnoses incorporated into DSM-IV are: Circadian rhythm sleep disorder (jet lag type); Caffeine intoxication; Sibling relational problem; Substance-induced sexual dysfunction; Gender identity disorder; Necrophilia; Transvestic fetishism; and Pedophilia.

The two parts of Perkins’ little list are efforts to make mental illness seem either trivial or repugnant.

Let’s take the supposedly trivial first. Things like jet lag and caffeine intoxication are included as diagnoses in the DSM-IV because they can mirror the symptoms of more substantial problems and thus need to be either ruled out or ruled in by care providers making a diagnosis. Mental health professionals have to know about such things for the same reason that cardiologists need to be able to recognize the symptoms of heartburn. Clinicians need to be able, when appropriate, to tell a prospective patient, “You’re not depressed, you’re jet-lagged. Go home and get some sleep” or “It’s not a panic attack, just lay off the double espresso.”

It’s possible Perkins doesn’t understand that, but he doesn’t come across as someone who is either that stupid or that honest. So rather than give him the benefit of the doubt and assume he’s simply a moron, I’m assuming he’s deliberately misrepresenting the DSM to deceive his readers. He is, in other words, lying to his supporters to alarm them into sending him more money.

That’s pretty much his job. And he’s good at his job.

The rest of Perkins list is harder to make sense of. The FRC, like other anti-gay groups of the religious right, is still complaining that homosexuality is no longer listed as a mental disorder in the DSM. Yet here, by mocking the DSM and by snidely listing things like gender identity disorder and transvestic fetishism alongside jet lag, he seems to be suggesting … what? That these things are not substantially different from jet lag?

The context of this whole alarming Alert! is to oppose the treatment of mental illness. Perkins then goes out of his way to say that the treatment of necrophilia and pedophila are particularly “troubling.” Is there any way to read that other than as Perkins suggesting that these disorders should not be treated? Because that seems like a very strange thing to be arguing for anyone who’s not a member of NAMBLA. I strongly disagree with Perkins on this point. I’m not a kid anymore and I’m not dead yet, but I would still like to make sure that any potential pedophile or necrophiliac is treated as swiftly and thoroughly as possible.

Part of Perkins’ problem here — or at least part of the problem he’s pandering to — is the popular evangelical notion that there’s really no such thing as mental illness, only sin. (The secular parallel to this in conservative ideology is that there’s no such thing as mental illness, only irresponsible personal choices.) In many evangelical circles, the word “therapeutic” is used only as a sneering pejorative. This arises from several of the more troublesome aspects of the American evangelical subculture: from its instinctive anti-intellectual/anti-science bias; from its neo-Neo-platonic belief in a body/mind, flesh/soul duality; from its illiteralist misreading of scripture (“they’re not mentally ill, they’re demon possessed“).

What that all adds up to, in many branches of American evangelicalism, is an attitude toward mental illness that is indistinguishable from that of the Christian Scientists.

One could try to counter this weird idea that mental illness equals sin by methodically addressing each of those root assumptions and rationally explaining the flaws of each, trying, through education and reason, to liberate Perkins’ followers from the intellectual veal pens he’s trapped them in. That approach might even be effective on some rare occasions. Most of the time, however, this idea will persist until the person subscribing to it has some direct personal experience that breaks through the illusory construct. They need to meet someone who is directly affected by mental illness. They need to love someone who is directly affected by mental illness.

Once that happens, it becomes much harder to continue blaming the victim.

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  • Froborr

    Aw, thanks, hapax. I enjoy tussling with you, too. I enjoy tussling with everybody! I’m an equal-opportunity tussler.
    Seriously, though, wow. “Relentlessly self-consistent and scientifically rigorous.” I think that’s one of the nicest things anybody’s ever said about me.
    Zzyzzygy (did I get that right?): Prior to the Enlightenment there was no real distinction between philosophy and science. After the Enlightenment, they diverged, science taking the scientific method and philosophy taking the fuzzies.

  • http://vicwelle.wordpress.com victoria

    Good news!
    The bill passed!

  • borealys

    Depressed people are aggressive; they’re aggressive towards themselves as well as others. They’re just full of negative emotions; where those emotions get directed depends on the moment. It’s not an either/or, self/other thing. The negative emotions go all over the place.
    As someone who’s been clinically depressed, I have to say, this is the single most elegant, accurate description of what I went through that I’ve ever seen. One day I forgot to make a completely unimportant phone call and proceeded to savage myself — quite energetically — over it for hours afterwards (until I got my father on the phone and he calmed me down). Two days later I was on the phone with my boyfriend, shrieking at him about how massively, undirectedly angry I was with everyone I knew, including him.
    I’ve known a few people who’ve had depression. Some have crumpled in on themselves and never gotten noticeably angry, just very quiet and anxious and withdrawn. Others have gone the opposite route, lashing out, picking fights, laying guilt trips, and generally blaming their problems on every person they’ve ever known who ever did something as innocuous as not wanting to see a particular movie with them. People cope with their negative feelings in different ways, and in a world where admitting to having a mental illness is considered shameful, sometimes convincing yourself, on some level, that the real problem is that everyone around you is a jerk, makes those bad feelings a little less difficult to accept.
    V. V has aphasia (difficulty forming words), dysphasia (replaces words for even simple items with the wrong ones), echolalia, and tactile sensitivities.
    Erk. I really, really hate to do this given the apparently highly personal context where this was said, but…
    I’m a speech-language pathologist, and those are very bad definitions of aphasia and dysphasia, which actually come very close to being two words for the same thing (though the term “aphasia” is more commonly used with adults with acquired brain damage, while “dysphasia” has been more commonly used in the case of developmental language disorders).
    The terms “aphasia” and “dysphasia” both refer to a difficulty in the comprehension and use of language at the level of vocabulary, grammar, and, in some cases, pragmatics. Substitution of an incorrect word for the one that was intended is one of the most common symptoms of aphasia. The technical term is “paraphasia,” or, more specifically, “semantic paraphasia” (as opposed to phonemic paraphasia, which involves mixing up only some sounds rather than the whole word). Difficulty forming words can also be a symptom of aphasia, if that difficulty occurs at the level of remembering the word or concept. If it’s a difficulty in forming the actual sounds of the word, however, it’s a motor speech disorder, such as apraxia of speech or one of many varieties of dysarthria.
    (End neurolinguistic nerditute. It’s just that speech and language disorders like aphasia and apraxia of speech are right up there with mental illness as disorders that are poorly understood and unfairly stigmatized. I suffer from a mental illness. I work with people who suffer from speech and language disorders. I feel compelled to educate anyone who is willing to listen about both. Anyone who likes may humour me by going to ASHA to learn more.)

  • LL

    RE “If the boss is able to maintain his job and his intimate relationships and he doesn’t feel there’s anything wrong, then you’d have a hard time making a case that he’s got a real illness.”
    I guess it depends on what you mean by “maintain.” As for the “he doesn’t feel there’s anything wrong,” there are tons of people who are, to put not too fine a point on it, fucked up, but THEY don’t think there’s anything wrong with them. They are mistaken. I guess for their own peace of mind or ego or whatever, they have to feel they’re doing OK, it’s everyone else who has the problem, but that doesn’t make them less fucked up. Example: George Bush. He doesn’t understand why people have a problem with him. He doesn’t have a problem with the way he runs things, so why should anyone else? He’s not wrong (in his mind), it’s our failure to agree with him that has created his difficulties, not the ill-advised policies he put into place. If only we agreed with him, then everything would be A-OK. I don’t think Bush is yanking his hair out, howling at the moon crazy, but I do think he’s fucked up, ie, mentally ill. Maybe not mentally ill like the guy on the subway who screams at pigeons, but mentally ill by my reckoning.
    I’m not disagreeing with Fred, BTW. I do think mental illness is real and should be treated.

  • http://mikailborg.livejournal.com/ MikhailBorg

    Prior to the Enlightenment there was no real distinction between philosophy and science.
    When Hamlet says “There are more things in heaven and earth, Horatio, / Than are dreamt of in your philosophy.” (Act 1, Scene V) he was definitely including what we’d now call science in that criticism.

  • http://www.kitwhitfield.com Praline

    Yay for the bill passing! In your face, Perkins! Seriously good news.
    I’d like to say thanks to everyone on this board who’s experienced depression and has said nice things about my remarks from a non-depressed-but-loves-some-depressives perspective. It’s such a sensitive topic, I was a bit concerned about offending people, so I’m relieved to find I don’t seem to have.
    On reflection, I thought it might be helpful to, well, somebody, maybe, to give a bit of an explanation as to the depressed person’s logic in the dialogue I posted above, (which I’ll repost here for convenience); knowing about depression helps fight it, so in case some nice person here later encounters the monster, maybe it might be of some use. If the idea strikes you as boring, well, sorry, you can skip this post, because the boredom is about to begin… starting NOW!
    – So, did you enjoy the movie?
    – No. It was crap. I don’t know what’s wrong with you, thinking I’d enjoy something that stupid.
    – But you said you liked the work of that director. I was hoping you might have nice evening. I just wanted to cheer you up.
    – Bullshit. God, you’re stupid. How am I going to have a nice evening, watching a crappy movie with someone as stupid as you?
    – Don’t call me stupid, it’s mean.
    – Oh right, now I’m the bad one. You’re the one who wasted the whole evening on this crap, and money for the tickets as well, which we can hardly spare, you know my job pays shit working for that bitch, you know all that, and you still talk me into this crappy evening, and now you’re blaming me? You are such a selfish person, I can’t stand you.
    – (Starts to cry)
    – Don’t be so fucking manipulative.
    – You’re being horrible to me.
    – I’m being horrible to you? Great, now the emotional blackmail starts. I can’t stand you. I don’t know why I ever married you.

    Depression has its own logic, but it makes little sense to non-depressives. But it’s useful to know about. So, here’s an attempt at explaining why the depressed one, let’s call him/her D, is being such a jerk to the well one, let’s call him/her W…
    D didn’t enjoy the movie because the depression makes it impossible for him/her to enjoy anything. D is also aware that W was hoping D would. So, when W asks about enjoyment, D feels pressured to provide impossible happy emotions, guilty for not having enjoyed it, and resentful of that guilt, so lashes out.
    W gets upset; D feels guilty again, and now has some evidence that W is being critical as well; the resentment rises. Feeling so bad already, D is too deafened by his/her own feelings to have any space left for empathy with W, so sees W’s distress purely in terms of implying D is an unsatisfactory companion, and thus a bad person. W’s attempt to defend his/her own motivations is seen by D, whose illness puts the worst possible interpretation on any event, as purely an argumentative strategy. At this point, D feels more or less like W is picking a fight with him/her for not having enjoyed the film.
    D’s depression is already calling D a bad person night and day. Now in depressive overdrive, other bad thoughts arise by association – the price of the tickets leads to the idea of wasted money, which leads to how D earns that money, which leads to other discontents, until D is stewing in a familiar cesspool of all the stresses and strains that seem so difficult to cope with, every worry assaulting D at once. Between his/her own low self-esteem, the embattled sense of life being too malevolent to cope with, and now W ‘attacking’ him/her for not enjoying the film, D feels like W has ganged up with the entire cosmos against D.
    Fear and pain overwhelm D like an unbearable din, drowning out any possible openings for awareness of W’s actual feelings or motivations. Any further protests W makes feel to D like prodding an open wound, and D will strike out defensively, like an animal in a trap biting the hands that try to free it. Very possibly, in the course of striking out D will say some things that hit W’s weak points, as, in happier times, their intimacy has given D a good knowledge as to the areas W is sensitive about, but the hurtful remarks are less malicious than a flailing attempt to do anything to drive away the person D’s now hysterically and incorrectly convinced is the source of the pain.
    In this situation, W cannot possibly win, because D cannot accurately perceive how W is really behaving. The best solution is to try to say calmly, ‘I’m sorry you didn’t enjoy it; you know I love you, right?’, because D, for all his his/her bad behaviour, desperately needs W’s love and is terrified of losing it. But without some kind of medical intervention, there’s not much else W can do except hunker down and give up the expectation of being heard until the disease passes.
    Here endeth. Have a nice day. :-)

  • Tonio

    Hapax, I find the tussling satisfying as well, but only because I perceive it as standing up for myself. I find the concept of belief threatening because I do not want to be defined according to anyone else’s beliefs. While their beliefs are certainly not about me, it’s the willingness to judge things according to belief that is threatening. Similarly, I have an almost instinctive horror of people who harshly judge others, people who are impossible to please, people for whom nothing anyone else does is good enough. That’s because I could potentially be their target. One of my deepest horrors is living in a world defined by such a person. Harlan Ellison once said that his older relatives still thought of him as the boy who took a hammer to his uncle’s piano. The fact that the incident never happened, that his uncle never even owned a piano, did not diminish the apocryphal truth of the legend for these relatives. That is what all belief feels like to me – the potential that I would be defined not by my words and actions but by others’ preconceived notions, and I would never be able to prove myself to those people in a way that would dislodge the notions.

  • Caravelle

    Insults and unpleasant behavior don’t need that much energy, really.
    If anything they require less energy than being nice, which involves being careful that your tone is polite and not aggressive, refraining from making the easy sarcastic comments and biting retorts that come instinctively when you’re in a bad mood and so on.
    Being nasty does often require more energy in the long term just because the conversation lasts longer and you’re more involved emotionally in it (as opposed to “Yes dear. Yes dear. Sure dear.”), but when you’re in a bad mood you’re not necessarily worrying about the long term.

  • hapax

    Fear and pain overwhelm D like an unbearable din, drowning out any possible openings for awareness of W’s actual feelings or motivations. Any further protests W makes feel to D like prodding an open wound, and D will strike out defensively, like an animal in a trap biting the hands that try to free it. Very possibly, in the course of striking out D will say some things that hit W’s weak points, as, in happier times, their intimacy has given D a good knowledge as to the areas W is sensitive about, but the hurtful remarks are less malicious than a flailing attempt to do anything to drive away the person D’s now hysterically and incorrectly convinced is the source of the pain.
    Sorry for the long snip with nothing to add but applause, but, omigod, yes. Exactly.

  • Caravelle

    Also, it was not Napoleon who created modern Paris. It was his nephew(?), Napoleon III, with the help of Haussman.
    Ah, so that’s where all those “Haussmannian Building” I see in the ad descriptions for apartments come from. Thanks Luthe !
    Jeff : I was too tired to eat and too hungry too sleep, and too “what difference does it make anyway” for either.
    Which, as everyone knows, is the second-best way to kill a Sim.

  • http://www.kitwhitfield.com Praline

    Being nasty does often require more energy in the long term just because the conversation lasts longer and you’re more involved emotionally in it (as opposed to “Yes dear. Yes dear. Sure dear.”)…
    I’d say that ‘Yes dear. No dear’ can demand a lot of energy, if ‘dear’ is saying something you don’t agree with. Biting your tongue works the muscles pretty hard.
    Having a go at someone, on the other hand, lets you unleash the instinctive desire to have your feelings recognised, unchecked by the usual restraints. It’s like rolling down a hill rather than picking your way carefully: it does more damage, but it takes a lot less patience.

  • Caravelle

    I’d say that ‘Yes dear. No dear’ can demand a lot of energy, if ‘dear’ is saying something you don’t agree with.
    Usually when someone is telling me something I don’t agree with but I’ve decided not to argue with them, “yes dear” does take less energy because it means I’m just not paying attention anymore. So I’d say it depends :p (it also depends on whether it succeeds as a stragegy to cut the conversation short, or fails miserably)

  • http://bifrosts-edge.blogspot.com Jon

    I’ve known a few people who’ve had depression. Some have crumpled in on themselves and never gotten noticeably angry, just very quiet and anxious and withdrawn.
    That’s definitely how things went for me, though I did feel angry, pretty much 24×7. However, I would have felt guilty if I lashed out at people, so to avoid that, I withdrew. On the occasions on which I did lash out, I was usually drunk.
    It wasn’t until I dealt with the drinking that I was really able to deal with the depression, and that was a rather painful process during which I did start to lash out at people (while in rehab I made a lot of cutting remarks to people, even going so far as to make several of them – all male – cry). I was struggling to find a balance between biting my tongue and holding everything in and just saying whatever came to mind – no matter how nasty – in order to keep from internalizing my anger and adding fuel to the fire.
    I still kind of struggle with finding that balance. I have difficulty managing the whole “assertive” thing and finding a way to express myself without coming off as aggressive. This is why I tend to be fairly passive and non-confrontational most of the time.

  • Tonio

    My version: D liked the movie, but waits until W expresses an opinion before saying anything. If W expresses a dislike of the movie, D questions his judgment and worries that expressing disagreement will lead to an argument. So D expresses halfhearted agreement with W and tries to change the subject. Or else D expresses a like of certain elements of the movie and a dislike of the others.

  • http://www.kitwhitfield.com Praline

    Not sure what you mean by ‘my version’, Tonio, but that sounds more like insecurity than anything else, to me at least.

  • Izzy

    Caravelle: Certainly the ol’ nod-and-smile routine was less effort for me, back when I was working with craptacular customers, than actually paying attention to anything they said past the point where I could help. Especially when I was a temp receptionist at the Division of Insurance: we’d get a bunch of crazy ranty people (I’m a temp. I’m a receptionist. My powers extend to “calling someone from the back”. No, I don’t know when they’ll get here. No, I don’t know what they’re doing. GO AWAI.) and a lot of people who thought they’d, I don’t the hell know, bring sunshine to my day or something by making small talk (I’m perfectly cheerful. I have the Internet. It’s more amusing than you are. SHUT UP.)
    So lots of “Mmm-hmm? Mmm-hmm. Huh.”
    Worked great, except one time when I nodded and smiled when I should have been nodding and frowning: Crazy McRantLady was going off about something troubling or other, and I apparently seemed to take mass murder lightly. “No, ma’am, I don’t think it’s funny. I just wasn’t listening to you.”

  • lonespark

    Praline!
    That is a really wonderfully detailed description. I applaud the effort you put into it. Expression of depression also depends a lot on personality I think. Both my husband and I have experienced depression. He is a more assertive person who not so uncomfortable being thought of as an asshole, so he presented as the angry type you described.
    Whereas, for me, I kept in everything I felt, because I felt like lashing out, but I did perceive that he hadn’t actually done anything wrong, or at least nothing that justified the depth of my rage and despair. But I couldn’t respond in a positive manner, and I’d often try to get by with evasive lies to avoid confrontation. I lived so much in my head, and I couldn’t sort out the different stressful and negative thoughts, so I could hardly get around to communicating anything to anyone that required more emotional involvement than ordering a hamburger.

  • lonespark

    And…the bill passed! Wooo! Exactly the sort of thing that makes me proud to be a liberal. Taking care of your citizens is the right thing to do.

  • http://www.kitwhitfield.com Praline

    Personally, I’d like to applaud the courage and honesty of all the people who’ve suffered from mental illnesses who are talking about it on this thread, spreading understanding and telling the truth. Among other things, it surely stands as a refutation of Perkins’s stupid belief that mental illness only affects Those Nasty Weirdo People Over There, rather than nice normal people who haven’t somehow done something to deserve it. The sheer number of people on this thread alone that mental illness have hit ought to show how common an issue it is, and how urgent it is for civilisation to get to grips with it and stop stigmatising.

  • Anonymous

    The best solution is to try to say calmly, ‘I’m sorry you didn’t enjoy it; you know I love you, right?’, because D, for all his his/her bad behaviour, desperately needs W’s love and is terrified of losing it.
    The best solution for whom? It reads to me like enabling D’s assholish behaviour, which amounts to emotional battery. You wouldn’t say ‘Sorry’ to a husband that punches you in the face because he doesn’t like the TV programme you chose to watch, after all – even if he claimed to really love you and only did it because he was afraid you’d leave.
    My advice to W would be to walk away as soon as he/she realizes that D is not going to seek or continue with medical treatment, and that W’s life is therefore going to be constantly being bullied, belittled and possibly battered. W only has one life, and should not feel obliged to remain with D, living in fear and gradually losing the will to live themselves.

  • Chris

    Anonymous: this is not a case of someone bullying their partner because they like doing that. It’s a case of a person who is suffering, yes, suffering enough to lash out at anything that comes in their way, and the partner who understands that should give them some leeway with their emotions, just like they would someone who is in enough physical pain to be unable to function normally.
    I too applaud Praline’s description and put myself on the list of people who have battled mental illness. I’m no longer suffering from depression, but I have anger issues, and that description rings true for me right now: it’s not that I’m an asshole, it’s that stress and other badness wears on me until it’s scraping away on my raw flesh, and *that’s* when I lose all self-control and maturity and snap at people (unfortunately those close to me, because they’re the ones who take an interest – thank heaven, they also know me well enough to understand) like a trapped animal.
    And yes, I’m seeing a counsellor. I don’t *enjoy* acting like this.

  • lonespark

    Anonymous, we don’t all abandon our family members because they’re sick. And we don’t always know ahead of time when they’ll be acting sicker. Neither I nor anyone who knew me understood that I was depressed, for years. We all thought I was just lazy and unreliable. It took irrationality on a massive scale in front of medical and legal personnel to get it sorted out, and I was still initially badly misdiagnosed. Once you start treatment, you still have good and bad days, and you may have to change drugs and therapies several times to get a combo that works well for you. You may also have to change your job, your living situation, your hobbies, if they require behavior you can’t handle. But we hope to avoid that.

  • lonespark

    I’m not saying anyone should have to put up with abusive behavior. But that doesn’t mean you have to stop associating with your loved ones who are sometimes abusive, or that that would help them realize what kind of help they needed. It’s likely to confirm their irrational certainty that everyone around them hates them and/or they are a worthless person.

  • Anonymous

    I’m not saying anyone should have to put up with abusive behavior. But that doesn’t mean you have to stop associating with your loved ones who are sometimes abusive, or that that would help them realize what kind of help they needed. It’s likely to confirm their irrational certainty that everyone around them hates them and/or they are a worthless person.
    [I’m going to stick with D as ‘Him’ and W as ‘Her’, although it could easily be the other way round.] W may well decide to spend her life putting up with shit from D, with frequent abuse, and those constant little digs that gradually make W too feel that she is a worthless person. That might make D feel better, partly because W is an easy target, whose only response is to encourage D’s emotional battery by not withdrawing her love.
    But what is W getting out of it? Spending the day wondering what mood D will be in when he gets home, what little thing he will pick on tonight, never being able to have a relaxed conversation because she always has to watch her words, and keeping away from friends and neighbours in case they attract D’s anger. There is no way W can ensure that D gets the treatment he needs – any suggestion that D needs any sort of treatment is going to be another spark into the powder-keg that is their relationship. Discuss it with the doctor? What can he do? If D finds out she’s been talking about him – he feels totally betrayed, but still can’t be made to seek help.
    Guilt-tripping W isn’t going to help D. Maybe nothing will, but advising W to bail out as soon as possible at least gives her the chance to have a fulfilling life as a valued person.

  • Froborr

    Anonymous: This is not a one-size-fits-all situation. If D is getting treatment, and W wants to get back to a good relationship they once enjoyed, that’s W’s choice. There is a difference between D actually being a jerk, and D suffering from a treatable disorder that causes him to act like a jerk on occasion.
    Have you never said lashed out and said something hateful to a concerned loved one when you were suffering? Should they have abandoned you? Sometimes you make allowances for the people you care about. That doesn’t mean you have to be a doormat; “sometimes” means “not always”, and when you don’t is a personal judgement call.

  • W (formerly anon)

    My point is that D is not getting treatment, cannot be persuaded to get treatment and yet is not so sick that treatment can be thrust upon him. Praline’s advice – and others here – seems to be based on what is best for D. I am merely putting the other point of view – that W too is a person with feelings. If staying with D is going to drive W to depression, to the feeling that actually the life she is leading is pointless, and that all there is to look forward to is more years of suppressing her own feelings, before dying…
    Is it too much to suggest that perhaps another, younger W should not be pilloried because she put her life first? Or must she too destroy her life because everyone says she has no right to ‘abandon’ her abusive husband?

  • http://www.kitwhitfield.com Praline

    I’m entirely sympathetic if W wants to leave. I wasn’t suggesting W should apologise, as W hasn’t done anything wrong and there’s no merit in ennabling irrational opinions. The ‘I’m sorry’ should never be more than an expression of sympathy, not a false admission of wrong-doing. It’s the ‘best’ solution in that it’s most likely to end the conversation with minimum fighting – that is, it’s a short-term solution. Long-term, the only best solution is treatment.
    There’s no question that D is putting W through hell, and the fact that D isn’t doing it maliciously doesn’t diminish the fact that W is going through terrible, undeserved suffering. Depression isn’t constant in behaviour, so it’s possible that D sometimes acts nicer than this, but should W stick around?
    It’s always going to vary from situation to situation. If D refuses to get medical treatment, or if the depression proves too resistant, then W may well go to ‘sauve qui peut’ and leave. If W does, then that’s not a bad moral choice: in the worst case scenario, it means at least one person gets out of the relationship alive. Nobody should have to stay in a relationship they find unbearable, and mental illness is not an exception to this. People can get trapped in intolerable realationships with abusive depressives because they feel responsible for the disease, but that’s wrong: if D doesn’t make the running to get him/herself cured, then nothing W can do will have any impact on the disease, and W is completely entitled to think about leaving. And nobody should pillory W for it either; nobody has any right to demand somebody stick around for endless unhappiness.
    If, on the other hand, D can get treatment, there are other options.
    As it was my fictional scenario, I’m going to presume to contradict your saying ‘D is not getting treatment’. What I was positing was a situation in which D has undiagnosed depression. That’s one of the most hellish parts of the illness: the depressed person is suffering horrendously and spreading it around with a big spade, and nobody knows what’s going on. That’s the main reason why I’m putting up this whole little scenario: I’ve seen the effect unrecognised depression can have, on loved ones as much as on the depressive, and if anyone reading this is helped to identify depression in their own lives, then thank God.
    But you’re right when you say that W’s feelings are as important as D’s. Depression sufferers have tremendous difficulty getting their heads around that fact, and the world is full of books that blithely advise loved ones to be patient, and be supportive listeners, and try to raise your concerns in a non-confrontational way (and then duck for cover, is the bit they don’t add), and all sorts of stuff that’s a load of crap if you’ve ever seen real depression. A lot of advice about being supportive that gets ladled onto the caregivers of depressives, in fact, is the kind of stuff that would be good advice if they were dealing with a reasonable person – but of course, depression isn’t reasonable. The best advice for W, long-term, is to say, ‘Either you get treatment and stick with it, or I leave.’
    D isn’t being a jerk on purpose, and with treatment, may revert to the lovely person s/he was before. But that doesn’t mean W has to be a martyr. Depression is very good at hassling loved ones into ennabling it, but that’s siding with the illness, which is D’s enemy as much as W’s. Limits are as important as understanding. So I share your concerns for W: it’s very important to recognise that depression hurts more than one person when it strikes.

  • Lauren

    How do you know D “cannot be persuaded to get treatment”? This is depression, not addiction. How does W know D cannot be persuaded unless she tries, and how should she try besides saying, “You know I love you, right?”
    The question is not should W stay and tolerate D’s abuse forever, the question is should she stay for longer than 15 minutes. What does “advising W to bail out as soon as possible” mean? As soon as she can hail a cab, get home, and pack her bags?

  • W

    How do you know D “cannot be persuaded to get treatment”? This is depression, not addiction. How does W know D cannot be persuaded unless she tries, and how should she try besides saying, “You know I love you, right?”
    The question is not should W stay and tolerate D’s abuse forever, the question is should she stay for longer than 15 minutes. What does “advising W to bail out as soon as possible” mean? As soon as she can hail a cab, get home, and pack her bags?

    For a W not locked into a long-term relationship, who spots an abusive partner early enough – yes, get out now, do not bet your life on D’s changing.
    As for my D – well, half my life is quite a bit longer than 15 minutes, and I’m still counting. As for the rest, been there, done that and, as Praline says, ducked for cover.

  • borealys

    I will admit to having bailed on a friend who, I’m fairly sure, was suffering from undiagnosed depression. Over time, she became more and more aggressive, more and more hypersensitive, and completely unable to acknowledge that maybe, just maybe, she had a serious problem. At the time I knew her, I had been through a few bouts of mild depression myself, and was more than willing to be understanding about it, but after a while, yes, I just ran out of compassion. Her behaviour toward people who had always stuck by her as her friends became nothing short of psychological abuse — she even went through a phase of seriously creepy, stalkerish behaviour — and eventually, it reached the point where we had to make a choice. If she couldn’t bring herself to get help for her problems, we weren’t going to wait around until she decided to start smashing our windows in the middle of the night. (Not an exaggeration. If things had kept on the way they were, I have little doubt that it would have escalated to something along those lines before long.)
    Yes, I regret the way it turned out. Very much. I wish I could have done more to help her. At times, I’m ashamed that I didn’t. But the fact is, sooner or later, if someone’s mental illness is leading them to hurt you, you have to take a step back and say that if they won’t even try to get better, you’re going to have to leave.
    It’s one of the saddest things about depression and other mental illnesses, that they can destroy, beyond all hope of salvage, even your most important relationships. That they can push you into hurting people who don’t deserve it, and hurting them badly. It’s just one more reason why it’s so important to raise the level of awareness about what mental illness is and what it isn’t, to make the symptoms recognizable, to take away the stigma, and reduce the likelihood that people who need treatment will resist getting it.
    (Of course, some people will always resist. That’s true of every disease. I’ve encountered people who’ve ignored, sometimes for years, scary things like progressive voice loss, breast lumps, and constant bleeding from various places that aren’t supposed to bleed. Denial is a powerful, and very destructive, thing.)

  • hapax

    W, I cannot speak to your personal situation, and I am deeply sympathetic to whatever hell you have gone through.
    I think Praline’s point, though, and the point of this whole thread, is that mental illness is like any other illness, in its toll upon the victims and those in relationship with them.
    Suppose D didn’t have depression, but I dunno, undiagnosed herpes or migraines or lung cancer. Should W immediately pack his/her bags and leave? If she wished to, that’s her choice, of course. But there is nothing innately wrong with staying in a loving relationship with D, pointing out his symptoms, encouraging him to see a doctor, helping him with treating a chronic condition.
    Now if D should say, “Screw it. I’m not wearing a condom when when we have sex!” Or insists on driving while having migraine-induced hallucinations. Or refuses to quit smoking. Yeah, that’s abusive behavior by D — both of W and of himself. And that’s the point where W needs to take a good hard look at the effect of the relationship on both of them.
    But it isn’t a question of hard and fast rules. Or of assigning guilt and blame. It’s a question of helping sick people get well, and helping well people stay that way.

  • Anonymous

    Hapax, the difference between pointing out that those sores might need treating, and suggesting that your partner is suffering from a common mental illness is considerable. And once you have suggested it, and they retort that no, it’s you, W who are sick, that you must be sick to say such things, and no doubt your clever friends suggested it, he never trusted them… You don’t just encourage him to see a doctor, the mere suggestion that it might be a good idea for him to see the doctor about these moods is an assault on him.
    The tone in some of the comments is that D is sick, so he is entitled to have W’s support. W should make allowances, should not abandon him. I am speaking for W, who is also entitled to love and support, and sometimes doesn’t get it.
    Possibly the good times do outnumber the bad, if you counted up the days. But it would have been better still without the bad days.

  • hapax

    Anon, I suspect you’ve never had to suggest to someone that they might have an STD.
    D is sick, so he is entitled to have W’s support.
    I haven’t heard that at all. What I have been hearing is that If W chooses to offer D support, there are helpful and un-helpful ways to do so.
    I am speaking for W, who is also entitled to love and support, and sometimes doesn’t get it.
    Absolutely W is entitled to love and support. And if W chooses to end the relationship with D because D cannot offer it, that is a valid choice. The point people have been making is that D doesn’t offer it because D can’t (any more than D could carry W’s heavy baggage if D had a bad back), not because D wilfully chooses to be a dick.
    Unfortunately, to go back to the original post, that’s what far too many people assume about victims of mental illness.

  • Ryan

    Who are D and W anyway?
    Whenever there’s trouble you
    Call DW

  • borealys

    I would argue that we should be cutting people who have mental health issues a certain degree of slack — it isn’t their fault, after all, even the denial is often an integral part of the disease — but not so much that we end up putting our own health and well-being at risk.
    After all, even if I were inclined to be a martyr, sooner or later that abusive behaviour would damage my psyche so badly that I wouldn’t even be able to offer any real support, and what would be the point of it all then? No one saved, and one more person scarred and miserable. To put it another way, anyone here ever take a first aid or lifesaving course? Rule one: Protect yourself first. You can’t save anybody if you’re dead.
    It’s important to have compassion. It’s important to understand that it isn’t their fault, that they aren’t choosing to act the way they do. It’s only fair to give them a little more leeway than you’d give a healthy person who just happened to be an ass. But there does have to be a limit.
    And all of this discussion raises a very important point. Support to the families and friends of those with mental illness is every bit as important as support to the ill person him- or herself. To any and all Ws out there, if you haven’t sat down with a social worker to talk about the situation and how it’s affecting you, not your depressed loved one, but specifically you, please do. I say this as someone whose sickness probably led to a fair bit of stress for the people who loved me. Take care of yourself as best you can. If the D in your life were able to think clearly enough, s/he would want that.

  • http://www.TheGoldenDance.com Michele

    Anon @ Mar 06, 2008 at 05:11 PM

    [I’m going to stick with D as ‘Him’ and W as ‘Her’, although it could easily be the other way round.] W may well decide to spend her life putting up with shit from D, with frequent abuse, and those constant little digs that gradually make W too feel that she is a worthless person. That might make D feel better, partly because W is an easy target, whose only response is to encourage D’s emotional battery by not withdrawing her love.
    But what is W getting out of it? Spending the day wondering what mood D will be in when he gets home, what little thing he will pick on tonight, never being able to have a relaxed conversation because she always has to watch her words, and keeping away from friends and neighbours in case they attract D’s anger. There is no way W can ensure that D gets the treatment he needs – any suggestion that D needs any sort of treatment is going to be another spark into the powder-keg that is their relationship. Discuss it with the doctor? What can he do? If D finds out she’s been talking about him – he feels totally betrayed, but still can’t be made to seek help.
    Guilt-tripping W isn’t going to help D. Maybe nothing will, but advising W to bail out as soon as possible at least gives her the chance to have a fulfilling life as a valued person.

    OMG, you just perfectly described my first marriage.

  • Jesurgislac

    Hapax: Absolutely W is entitled to love and support. And if W chooses to end the relationship with D because D cannot offer it, that is a valid choice. The point people have been making is that D doesn’t offer it because D can’t (any more than D could carry W’s heavy baggage if D had a bad back), not because D wilfully chooses to be a dick.
    I was involved for a short while with a woman whom, I regretfully concluded, was mentally ill. She was functioning – she paid her bills, she held down a job, she had a social life – but she had a level of unacknowledged self-loathing such that, if a person she loved loved her back, she moved rapidly to the conclusion that as she was a completely hateful person, a person who expressed respect, affection, admiration – or worst of all, love! – for her, must be a liar and untrustworthy and had to be tested rigorously – which “testing” involved denigration, abuse, and unreasonable demands. Every relationship she had – she got involved with a couple of friends after she and I split up – ended in one of two ways: Either, in sheer self-protection, as I did, they left her: or, they stayed with her and accepted her denigration, abuse, and threats of suicide, because there really was a lot about her that was likable and lovable.
    I never once thought her behavior towards me and others was her fault: it was all too evident that she couldn’t help it. (She could, I suppose, have gone for counselling: but part of the problem was that she didn’t acknowledge that there was anything wrong with her: I heard a lot about awful people she’d been previously involved with, in fact that was one of the danger signals I became alive to, because someone who’s never had a past relationship with someone they remain fond of/see good in, is… well, I knew what she was going to start saying about me as soon as we broke up.)
    She’s dead now, or I would not be writing this, but though I never blamed her for how she treated me, I could not have stayed with her: I could not have made a commitment to someone whose idea of making a commitment to me was to subject me to abuse to “prove” my commitment to her. (I spoke to her last boyfriend once on the phone: I remember vividly the flinch in his voice as he spoke to her to say who had called.)

  • http://www.kitwhitfield.com Praline

    And once you have suggested it, and they retort that no, it’s you, W who are sick, that you must be sick to say such things, and no doubt your clever friends suggested it, he never trusted them… You don’t just encourage him to see a doctor, the mere suggestion that it might be a good idea for him to see the doctor about these moods is an assault on him.
    Yep, that’s pretty severe depression. And if it persists, W has every reason to get out. No obligation to go down with the ship.
    If we’re talking about ending relationships because of mental illness, I think love has to be a big factor. In the people I’ve known, it’s varied, and even the most loving partners saying stuff like ‘I want my husband/wife/partner back!’ – because depression has stolen away the part of the person they fell in love with.
    If you’re going to stay, you need to still love the person. What you love may be the part of them that illness is currently concealing, the part of them that’s in there somewhere but that depression is drowning out, and if you can reach a point where D also knows that the depression and his/her personality are not one and the same thing, you can declare depression a common enemy, D can fight it for W’s sake as well as for his/her own, and you’re getting somewhere. If, on the other hand, the depression is so fixed it seems to have supplanted the personality W fell in love with – or, worse, was always a part of the personality W fell for, but has overmastered the other bits – then the person W loved may not be there any more.
    When it comes to abuse, I think it’s always an individual decision: how much bad behaviour does it take to wear out your love? How much before you start to think the person you loved is not coming back? Because in the end, I think it comes down to a basic human fact that applies to well and ill people alike: nobody wants to stay in a relationship with someone they no longer love. If the mental illness ends up killing your love for them, it’s time to pack your bags: relationships without love don’t work for either person.
    Both D and W deserve a lot of sympathy. This doesn’t mean that their interests are one and the same; sometimes what’s good for D and what’s good for W are opposed – and in that situation, it’s not up to W to sacrifice herself. I don’t think D is entitled to W’s support. If W loves D, she may want to support him. But if she’s simply out of love with him because of all the crap he’s put her through, then nobody has the right to demand she supports him.

  • http://www.kitwhitfield.com Praline

    Incidentally, W, my deep condolences on having gone through what looks like a hellish relationship. Have you read ‘Depression Fallout’ by Anne Sheffield? http://www.depressionfallout.com/ She’s a writer who both suffered from depression herself and had a depressed mother, and she’s refreshingly blunt about what a nightmare depressed loved ones can be.

  • W

    Incidentally, W, my deep condolences on having gone through what looks like a hellish relationship.
    Thank you Praline, but I suppose it isn’t that bad. I’ve been picking out the bad bits – did I mention the phone calls to my work, or when he was at work, accusing me of plotting with his colleagues, my friends, our neighbours? – but no violence. And the really bad times – the retreat to the spare room times – have been interspersed with really good times, and a lot of low-grade mumbling and swearing and difficultness, which in some ways are the worst times, because I can’t do a thing right, but there’s little to gripe about (except for the repetitive annoying things, like extra loud music).
    I’ve stood it for more than 20 years, and can probably manage now until the end. But I would still advise someone on the brink of becoming an emotional punchbag to get out.

  • http://www.kitwhitfield.com Praline

    Sounds pretty rough to me. I’d recommend you check out the Anne Sheffield site – she runs a support board for families of depressives, and it sounds like you could use a bit of support! :-)

  • W

    From the Anne Sheffield site: ARE YOU SUFFERING FROM DEPRESSION FALLOUT?
    The answer is YES if your husband, wife, lover, parent, child, or close friend is one of the more than 20 million Americans who suffer from depression or bipolar disorder.

    So the answer is clearly “No, I’m not suffering from it.”

  • Chris

    It will certainly get easier to get sufferers to accept counselling and treatment when the general conclusion stops being that psychiatric treatment is for those crazy people who aren’t like us in any way.

  • Tonio

    Not sure what you mean by ‘my version’, Tonio, but that sounds more like insecurity than anything else, to me at least.
    Possibly. Interactions with anyone who has power or authority over me bring out fear in me. Not necessarily fear of the person, but fear of doing something to displease the person.

  • Jeff

    Or must she too destroy her life because everyone says she has no right to ‘abandon’ her abusive husband?
    I’m reading the saga of D & W as two family members — how do you quit your family, especially when the abuse is of the sort originally posted. It’s easy to say “Leave him / her”, harder when it’s a spouse, and much harder still when a mother or a father, who have always been loving, seem to have developed a totally different personality (which may not manifest all the time).
    Nobody should have to stay in a relationship they find unbearable, and mental illness is not an exception to this.
    True, but abandoning your brother because his schizophrenia causes major problems is a LOT easier said than done!

  • http://www.kitwhitfield.com Praline

    Yeah, when it’s family it’s different again; I only meant ‘relationship’ as in ‘romantic relationship’. Ugh. Mental illness is horrible.

  • W

    After that flip response – but for Heaven’s sake, it doesn’t only happen to Americans! – I have looked at the site. Here too I get the feeling that there is a base position that W (to stick with the simple imagery Praline gave us) ought not to leave, to ‘abandon’ their D. Her numbered points on the stages of Depression Fallout ends:
    * Stage Five can be avoided, but unless you take positive steps to counter it your desire to escape the source of your unhappiness – by distancing yourself either psychologically or physically from your depressive or manic depressive – will become a negative constant.
    See – you have to counter your desire to escape, because that’s being negative.
    I’d like to see it from the other side. Escaping is the first ‘coping strategy’. Doing so is not failing at some task that the world has set for you, something cowards end up doing after failing at all the other coping strategies, and having been made to feel a worthless piece of shit by D. That really is a very negative way to start the rest of your life.
    Every day you do remain with D – that you defer taking that first option – is a victory. It may all work out, or it may not, but you can fight on, keeping hold of that metaphorical card that says “Get out of jail free”. And deciding one day that you’re not going to play any more, whether it’s after one week or 20 years, is a decision that is taken by a victor, quitting while they’re ahead with their wooden sword and an untarnished shield, not a loser crawling away to lick their wounds.
    I started this strand because I wanted people to think about how they were defining W’s ‘duties’. I spoke about me because that way I can talk with experience – and not 15 minutes, either. But I have managed to fight on so far, and will probably keep doing so. Grumbling occasionally, maybe.

  • http://www.kitwhitfield.com Praline

    Oh, I wasn’t assuming depression only happens to Americans. For one thing, I’m English, and the US interchangeability of ‘American’ and ‘person’ gets right up my nose as well.
    I think she’s actually trying to argue that positive steps involve recognising that the problem is depression rather than just a mean spouse, and seeking help accordingly – but I agree, it’s not put as clearly as it might be. If you read the book, she actually argues that leaving isn’t the only solution; she gives a case history of two couples, one of whom broke up and the other of whom stayed together, and says that both spouses were right in their actions, because their situations were different.
    I don’t think anyone here is seeing W in terms of ‘duties’, more as practical suggestions if she decides not to leave the relationship. Probably there are some numbskulls out there who think a wife’s duty is to stick by a husband however sick or nasty he is, and that life as an unpaid psychiatric nurse is the highest calling, but I don’t think any of them are commenting on this thread.
    But I don’t think anybody with any sense would say that they know better than you do how to handle your own relationships; that would be stupid of them.

  • hapax

    W: but I suppose it isn’t that bad. I’ve been picking out the bad bits – did I mention the phone calls to my work, or when he was at work, accusing me of plotting with his colleagues, my friends, our neighbours? – but no violence.
    Dear God in Heaven. I don’t remember where I read the story of the survivor of an abusive relationship earnestly explaining to her friends that “He never hit me. I want you to know he never hit me.” And one of them commenting what a horrible epitaph that was for a marriage.
    W, we’ve talked around here before about the perils of diagnosis over the internet, but I dearly pray that you are finding support — professional support — for you situation. “Fighting on” and “sticking it out” are strategies for the battlefield, not a way to live your life.

  • W

    Sorry, I’ve been whinging a bit, to get over the point that Ws have to consider their own needs, and that categorizing them as ‘abandoning’ D, or failing to give D leeway, or not making allowances for D’s illness, if they decide to prioritize their own needs is unhelpful. It’s as though the stigma is shifting from D to W. I think I’ve made my point – W should not be made to feel guilty or cowardly if she packs her bags and gets out. And it’s a damned sight easier to do that after fifteen minutes than after 15 years.
    But on the other hand I haven’t abandoned him, I do make allowances for the fact that he is mentally ill, and recognize those actions that arise from that illness. I have also successfully lived my life, achieved my goals and had a lot of fun with him. So does that make it ‘an abusive relationship’? Or just living with someone who needs a bit of leeway?
    On the third hand, I don’t recommend the life to any fledgling Ws, that’s all.