On Disorder and Suffering
When someone is having a rough time mentally, well-meaning people will often draw an analogy between mental and physical illness. “It’s just like having a broken leg”, someone might say. “You wouldn’t beat yourself up over having a broken leg, so you needn’t beat yourself up over having such-and-such mental condition.” This is always meant in a spirit of helpfulness, and it can sometimes be helpful. It can help de-stigmatise mental illness, and it can give the sufferer a potentially useful framework through which to view their predicament.
However, I sometimes find the analogy (or even the identification) between mental and physical health to be problematic. I have in the past been diagnosed with numerous acronyms, some of which involve the letter D, which stands for ‘disorder’. As highlighted above, viewing mental illness as a disorder might be extremely helpful for some people. It allows them to feel that it is not their ‘fault’, just as having a broken leg or some other physical disorder might not be their fault. To me, however, ‘disorder’ suggests that my mind is broken, and this can make me feel even worse. Walking around feeling like I have a disorder, or disorders, makes me feel like my mind isn’t working properly. It makes me feel like a machine that’s missing some mechanisms that are essential to its correct functioning.
Calling something a ‘disorder’ might be useful inasmuch as it directs someone towards an appropriate course of treatment. It is useful to label a leg ‘broken’ because this points us towards something we might do to ‘fix’ it. The advocated course of treatment for the disorder might work very well for some people. However, I want to suggest that the mind is disanalogous to a leg in the sense that each mind works in its own unique way. We are each made up of a constellation of mental attributes that is entirely our own. To label something a ‘disorder’ implicitly suggests a similarity between everyone to whom the label is applied. This does a disservice to the fact that we are all entirely idiosyncratic individuals with our own mental universes.
If we don’t use the word ‘disorder’, what should we use instead? I’d like to propose the word ‘suffering’. Regardless of what someone’s diagnosis is, when we talk of ‘illness’ or ‘disorder’ we are saying that a person is suffering. Some people suffer in ways which are indeed similar to other people, and the taxonimically-minded among us might lump these people together under the heading ‘disorder’, but I think each person’s suffering is unique, just as each person’s mind is unique. As the psychoanalyst Lionel Corbett states, “ [w]e cannot objectify or measure suffering; suffering is best viewed from within the individual’s perspective, because people with the same diagnosis can suffer in unique ways.” A broken leg might be much the same as another broken leg, but no two people’s suffering is exactly the same.
So where does this leave us? I think we can draw solace from the fact the we all, to some extent, suffer. Acknowledging this enables us to empathise with each other, and to feel a sense of solidarity. But the truth that we each suffer in our own way has as its corollary that a one size fits all ‘treatment’ for a so-called ‘disorder’ might work for some but not others, even if, as Corbett states, they have the same diagnosis. Instead, I think we need treatments that acknowledge that each person is an individual, and that we can’t carve off the ‘disordered’ part of a person’s mind from the rest of it – it is part of a web that constitutes their individuality. Basically, treatment should not be from a manual. We might use a manual to guide us, but we should be equally free to toss the manual aside if this is what’s necessitated by the distinctive suffering of the individual in front of us. When we treat a broken leg, we treat a leg, but when we treat suffering we need to take the whole mind, the whole person, into account.
I’m not a medic, or a psychologist, or a psychotherapist. I have no formal qualifications in the field of mental health. But I have been in therapy for a long time, and have invested huge amounts of money and energy in the effort to understand my suffering, to attenuate it where possible and to live alongside it where not. I am exasperated by the dogmatism of many in the mental health field. I am weary of the lack of open-mindedness. I am sick of people who say that only CBT works and who decry psychoanalysis. And I have also borne witness, first hand, to the crucial role of the therapeutic alliance in dealing with suffering. And this can’t come from a manual; it has to be developed over time by two committed people. ‘Disorders’ can be cured with pills and manuals; suffering must be dealt with in healthy, loving alliances.
Now I’m not saying pills and manuals can’t be part of one’s mental health journey. They have both certainly been part of mine. But I am not a broken machine. I am not a computer with a missing bit of code, or a radio that has been wired incorrectly. I suffer, yet I am whole and loveable and OK as I am. I am not disordered. I do not need to be fixed or patched up or made to work properly. I am worthy of love, and capable of giving love, just as I am. I suffer, but I am not defined by my suffering. I suffer with other people, but my suffering is not the same as other people’s. I am wholly myself, and yet at one with everything. I am running out of profound statements. Anyway, peace and love to you all, wherever you are on your journey.
