When I was an undergraduate, I wrote a story about a boy who used a butter knife to cut his wrists instead of slices of bread. We were barely two minutes into critiquing the piece when my classmates forgot the character’s name, or rather, decided to forgo the notion that he had a name; instead of being a person, he became a troubled thing. The majority of my workshop (including the professor) embraced the seemingly innocuous, all-encompassing label for individuals acting outside of societally acceptable behavior: crazy. “He’s crazy,” they said. “Now we just have to pin down how crazy he is.”
A 2016 study from the National Center for Health Statistics reported that suicide rates in the United States surged to the highest levels in thirty years. The Centers for Disease Control now ranks suicide as the second leading cause of death for individuals ages fifteen to thirty-four. According to the National Alliance on Mental Illness, one in five children ages thirteen to eighteen have or will develop a serious mental illness in their lifetime. With numbers that high, and with major depressive episodes reportedly affecting three million adolescents annually nationwide, it is about time we reexamine how we talk about mental illness, what we mean when we assign casual labels and how much harm we unknowingly cause in the process.
After riffs on the craziness of my protagonist overtook any discussion on the failings of my writing, I broke the cardinal workshop rule—that the author should remain silent during critique—and yelled: “Please don’t use the word crazy to describe someone with an actual mental impairment.” Without question, I did not say this as eloquently as I would have liked to. I was shaking, my thighs were sticking to the rough plastic of my chair, my words were stuttered, breathy, and certainly, a bit accusatory, but I stand by them. My character, while fictional, came from inside me; he was a depiction of real-life depression and mental disability. He has difficulty existing among people who don’t understand him, difficulty reckoning with why we choose to live with pain; these, I believe, are inherently human, normal ways of being.
My outburst did not go over well. The professor raised his eyebrows like a cartoon character, truly, and publicly shamed my “over-sensitivity.” He then demanded I apologize to my classmates for disrupting the sacredness of critique. When class ended, after twenty more minutes of groupthink mocking ‘the crazy butter knife kid,’ the professor summoned me to his chair. I naively awaited a tempered acknowledgement that there was blame to share. Instead, he said, “I bet you say crazy four times a day and don’t even realize it.”
I went back to my apartment, ate two bowls of lemon pasta and drank an entire bottle of twist-off candy-sweet Riesling. Then I googled until I found an embarrassing picture of the professor online, printed it out, and taped it to my wall. (I won’t tell you what the picture was of, but I do credit it with saving me; it was a reminder that life can be surprising and beautiful. Now he could not hurt me.)
The professor was not right, but he was also not wrong.
The word crazy, like so many other words assigned to marginalized people, has been contorted and overused; we’ve become numb to its original reductive implications. It feels benign and mundane—which it isn’t—and that is what makes it dangerous. It is dangerous when we normalize methods of reduction, dangerous when we imply worth or wellness based upon randomly accepted standards of being.
Conceptions of mental illness, or what it means to be crazy, have varied immensely both geographically and historically throughout human consciousness. As we wake up in an America that each day feels more and more foreign, or truly dystopian, it’s worth exploring what normal means. As truth becomes more elusive, as fact blends with fiction, we ought to take notice of how we categorize people, as categorization seems to be married to suppression, to disenfranchisement. How, as a society, will we deem who is and is not crazy, under this new regime?
In Madness and Civilization, Foucault explores the fluidity of categorization, posing the question: How does society construct our understanding of madness, and further, how does that conception construct our understanding of normalcy? If we rely on dominant parties to set standards for us, to instruct us on how we are meant to function as a society, then they will also influence our judgments of individuals who exist outside of arbitrary criteria, which leads directly to ostracism.
The first publication of the Diagnostic Statistical Manual (DSM) in 1952, initiated the movement of mental classification, laying the foundation for what constitutes pathology in a 130-page booklet. Since its initial publication, there have been four subsequent editions, which have redefined, removed and reorganized disorders, as well as increased the total number listed. In his book The Psychopath Test, Jon Ronson describes the “chaotic” editorial meetings that took place from 1974 to 1980 in a conference room at Columbia University, resulting in the massively expanded, 494-page DSM-III: “Somebody would yell out the name of a potential new mental disorder and a checklist of its characteristics, there’d be a cacophony of voices in assent or dissent, and if [Robert] Spitzer agreed, which he almost always did, he’d hammer it out then and there on an old typewriter, and there it would be, sealed in stone.” Yet, sealed in stone it most certainly was not, as with each subsequent edition, diagnoses, which can be used in equal measure to both distort and understand individual experiences, were subject to potential modification, re-categorization, and/or complete removal.
It is essential that we recognize this shape-shifting nature of diagnoses and, by extension, categorization of human beings: pathology is like a line drawn in thick chalk on an elementary school playground: it appears, at first, solid and striking against the dark concrete, but can be erased by the slightest rain, and can be purposely disappeared with enough pressure, like the base of a sneaker rubbing against the surface.
In the 1920s semi-autobiographical novel, Nadja, André Breton critiques this contradiction by exploring the intersection of love and mental abnormality at the height of French governing shifts. For the first half of the novel, Breton erects the enigma that is Nadja, a woman who does not conform to any socially prescribed norms. She rarely speaks in sentence form and is often found wandering the streets muttering language the narrator interprets as poetry. She is an entirely entrancing figure, whose every movement reads as cascades of beauty. This is, of course, until the novel turns and Nadja is institutionalized for what is declared her mental instability. With a soft flick of his brush, Breton paints over our understanding of Nadja and leaves us with a muddled portrait of impairment, negating all that he once worshiped.
Just as with subsequent publications of the DSM, which continue to move to more rigorously assign mental terminologies, 20th century France served as an exemplar for the narrative of mental persecution as there was a movement to “lock up” all who appeared to possess abnormalities. Though Breton’s narrator objects to Nadja’s confinement, suggesting that she was condemned “once she decided not to behave entirely according to the imbecile code of good sense and good manner,” the perception of those around her invades the text. While the narrator does not explicitly submit to the labeling, it is clear that he is no longer able to see Nadja as the wondrous creature he once took her for. The feelings of intense amorous devotion and intellectual stimulation become reduced to diagnostic symptoms and categorization.
The decision to shift the perception of Nadja from beautiful individual to mentally unsound soul is a fateful one. Our definitions of normative behaviors are casually defined, but enforced with vigor—and with life-altering consequences for the person diagnosed. We think of the categories of mental illness as written in stone, but they are written in chalk, transmutable, yet with consequences that are indelible.
In college, a year before I took that writing workshop, I called a suicide hotline. I sat in my dorm room desk chair, which looked exactly the same as my roommate’s desk chair, which looked exactly the same as our RA’s desk chair, which looked exactly the same as the desk chair the college would give me the following year, which I would leave an iron on, burning straight through the blue and red speckled polyester to blacken the wood. In that desk chair, I typed “suicide” into Google. I did this the same way I had typed “how to lose your love handles,” a week earlier. The same way I would type that professor’s name into the search bar a year later.
The first result was a website called “The Healthy Place.” This hit did not seem applicable. I continued to scroll. Then I saw the number, read each digit aloud, read them again, and dialed. The man on the phone asked me if I wanted to kill myself. I thought this was a stupid question. (I still do). I said: Yes. Then I said: No. Then he said: Have you thought about a method you would do? I turned to the window I had already opened and said: No.
This made the man calm. I am good at making other people calm. I said something about how I didn’t actually want to kill myself—well I did, but I didn’t actually want to die. There is a distinction. If I was able to engage in a discussion of this distinction, this meant I didn’t actually want to commit suicide, right?
After what felt like a long time, but was probably no more than several seconds, he said: Have you felt this way before? I did not lie this time. The man then read me the names of hospitals in walking distance. I hung up the phone after he mentioned the place where Sylvia Plath was frequently imprisoned. I am not crazy, I told myself. But I didn’t say the words aloud. I’m not sure I believed them.
The French writer, Édouard Levé, delivered the manuscript for his semi-autobiographical novel, Suicide, a week before he killed himself. The novel effectively serves as a public suicide note. It is written from the perspective of a man addressing a friend after he has committed suicide, to the utter shock of his wife and close friends. The disbelief associated with the man’s death is explained by his not having demonstrated the prescribed behaviors of the mentally ill. In fact, the narrator details seeing the man at a party shortly before his death and remarks on the oddity that he appeared to be enjoying himself.
The notion that the unnamed man’s display of temporary enjoyment is in contradiction with the nearness of his suicide, demonstrates the incongruities of our societal perception of mental illness. The suggestion that all who identify as mentally ill—or who experience mental illness without identifying it—act in the same preconceived manner, disregards the intricacies of human behavior, and neglects the apt possibility that the stigmas and rigid conceptions of normalcy may also cause people to conceal their inner turmoil. Further, we are complex beings, capable of happiness in one moment and despair directly following.
Levé’s Suicide meditates on this possibility; even before the unnamed man’s death, notwithstanding his mood oscillations, he intentionally masks his feelings of depression in an attempt to deceive his acquaintances. This decision speaks to his perception of the inelasticity of our societal notions of mental illness: if the man does not look crazy or despondent, he fits within the boundaries of normalcy. That is, of course, until Levé’s protagonist finds himself unable to continue the charade and instead of becoming ostracized from society, chooses to harness the power himself and terminate his existence.
To this day, I’m not entirely sure why it was that I did not kill myself. I suppose the important part is that I didn’t, although, in some ways, that isn’t the important part at all. The important part is what stopped me, maybe the same thing I found in that scantily clad photo of my professor (I won’t tell you anything more about it, I promise)—a strange form of hope, of possibility. That night, on the phone, at the thought of Plath, something in me broke. I, like many of my literary counterparts, have a tender, nagging place in my breastbone for The Bell Jar; it is because of Plath’s book that I am well aware of the paradox of presenting oneself as “normal,” while feeling internally inoperative.
In the novel, Plath’s fictionalized counterpart, Esther Greene, spends the majority of her young life masking feelings of desolation, which exist in stark contrast to the buoyant behavior of her peers. Both Plath and Greene are confined in mental institutions where they are ultimately tasked with having to identify as either a faction of “healthy society” or as disabled beings who are “truly crazy.” This, like much of depression, becomes a self-fulfilling prophecy. Being forced to categorize ourselves as either whole or empty, sane or crazy, happy or sad, can be daunting, inhibiting, or, at worse, completely debilitating—because, while there is great devastation in acknowledging one’s hollowness, there is perhaps an even more terrifying prospect of achieving and then losing, the feeling of complex wholeness.
For me, it is also the fear of Plath’s coined “bell jar,” the physical manifestation of madness, that once someone assigns you the label of crazy, you are contained by it, and will always be captive to your disability.
During high school, I spent a summer at a university in New York taking a creative writing intensive. This was before I had read The Bell Jar, before I knew what it meant to want to die; I was only beginning to know what it felt like for pain to be stronger than joy. The first friend I made was also the most meaningful. She was and is the closest thing to a reincarnation of Sylvia Plath I will ever find—one of the most elusive, glorious beings I have ever encountered. She is the person who taught me about depression, who let me trace the scars along her wrist, who placed my small fingers on the ridges of all the places she tried to open up her insides.
At some point in our relationship, I found a way to ask her—abruptly and without poise—when and how she got better. She held my hands to her chest for a long time, before saying: You don’t get better. You just decide one day that you don’t want to die and then you don’t die.
Society has long been the driving force for the ways in which we understand what is and is not acceptable, how and how not to be, who can and cannot be viewed as whole, or well, or sane. In her recent memoir in essays, Abandon Me, Melissa Febos interrogates the possibility of multiple selves, of existing as a multi-layered, multi-dimensional, well and unwell being. While much of Abandon Me is a meditation on Febos’s own exploration of self, she also integrates the societal depiction of her brother’s bipolar disorder:
Pathology comforts in its reductiveness, but is no true authority, just a bunch of words invented by men…My brother can be described as bipolar the same way he can be described as artist, Gemini, introvert, brother. To limit him to any one of these contextual references erases him.
Erasure is essential to consider when we use the word crazy, whether or not it is linked to a pathological condition. That word is used to discredit any person who thinks or behaves differently. While it is not always misdirected, it most certainly always has the potential to suppress ideas, silence emotions, and invalidate experiences.
Later Febos writes, “The ways in which I understood [my brother’s] madness also scared me… I understood the logic of his argument: that the conventions of modern human civilization were as crazy as any madman’s delusion, they just had a consensus.” The consensus of those men around that conference table at Columbia University: shouting out symptoms and fundamentally altering strangers’ futures. This consensus is perhaps what is so troubling, is perhaps what, given our current political atmosphere, is so very threatening. Consensus is not correctness in the same way that groupthink is not equated with intelligence. We must recognize that the DSM, which is still considered the bible of mental illness—although former NIMH Director Thomas Insel asserts, “it is, at best, a dictionary”—has already had four radical revisions. The life-defining words have been amended. With each of these publications, diagnoses are added or modified or entirely eradicated. While it may appear that the only difference is the arrangement of words strewn across a page, we are actually fundamentally altering the way a human being identifies her/his/their self and the ways in which society in turn perceives, treats, imprisons, judges, and condemns. We cannot take that lightly. The casual use of these diagnoses to dismiss individuals we see as different from ourselves are vastly misguided and can have devastating consequences.
Last year I ran a writing workshop at a facility in New York for adults living independently with various degrees of mental difference. Each week, when I arrived way too early to teach, whoever was at the front desk asked which program I was looking for, because there is no way to distinguish teacher from student, in the same way that mental illness knows no race, no gender, no sexual orientation, no religion, no body type, no class affiliation. There is no reason I was not there seeking treatment or community. I have battled with depression silently, and haven’t sought formal treatment due to a blend of fear and arrogance, but more so, I believe, because somewhere deep inside of me, I fell for the stigma. I harbored a sensation of shame, of the idea of a self-fulfilling prophecy, that by acknowledging that not all my characteristics are ideal, I could never be a whole, successful, independent being.
Most of my students were far older than me, had advanced degrees, had life experience greatly exceeding my own, but for some strange, beautiful reason, each class they showed me nothing but kindness and regarded me seriously. I’ve often wondered if they could feel my nervousness, if they saw my feelings of deep inadequacy, or if they understood implicitly what we had in common.
One night, during a nasty thunderstorm, I read them this Lucille Clifton poem:
won’t you celebrate with me / what i have shaped into / a kind of life? i had no model. / born in babylon / both nonwhite and woman / what did i see to be except myself? / i made it up / here on this bridge between / starshine and clay, / my one hand holding tight / my other hand; come celebrate / with me that everyday / something has tried to kill me / and has failed.
One of my students stood up, slapped her hands together and shrieked with joy. A feeling, not unlike the moment an electric current makes a bulb glow, spread from person to person. come celebrate / with me that everyday / something has tried to kill me / and has failed. Those lines seemed to join us around that wooden table, seemed to bounce back and forth between those grey walls, seemed to take a little of the sadness we keep tucked inside, seemed to put it out on the surface, seemed to say: this is me, I have this too, but I am still here.
That is resilience, I said. Now let’s take a few minutes to write about that feeling. Before the words had even fully left my mouth, there was a shift, like the closing of a door; my students started to fidget. One looked down at her notebook, another stared straight ahead, at nothing at all. My clapping, jubilant student, said: What does that mean?
Only one person in the room was familiar with the word resilient, but she had never considered it in relation to herself; she had only thought of it in terms of productivity, of work. Many of my students have excellent vocabularies; their being unacquainted with that word was not about formal education, or about intelligence, but about the permission to consider the nuances and shades of grey of being a human, particularly being a human who identifies as someone with a mental disability. To me, resilience is everything. Resilience does not mean whole, it does not mean better, it does not mean healed, or solved, or fixed, and it certainly does not mean perfect. Resilience means we have overcome something; we have in our most dire of times, as my dear friend once said, just decided one day that we don’t want to die and then we don’t die.
I explained to my students that resilience can look small like getting out of bed in the morning and putting on clothes, or it can look large, like continuing to raise a child when you have lost a loved one. We are all resilient, I told them. We were all there, in that room, wanting to put our feelings and thoughts and ideas onto paper, all choosing to face the things that haunted us. That motivation, by its very nature, is resilient. In the minutes that followed, we wrote about small things, about spilled coffee cups, about burying mothers, about learning how to cook after an eating disorder, about not feeling brave, about transience.
Resilience—like joy and pain—is not a permanent state, but an accomplishment, and one that should be celebrated.
Admittedly, as that undergraduate professor predicted, I do use the word crazy, even now, and with a frequency that feels like a curse. Whenever I utter it, I hear that professor’s voice, I hear his accusations that the fault is my own, that my discomfort with that word is a problem for me to solve, that it is not the broad perception of individuals across our nation, our President included, who mock people with mental disabilities, who demean and ostracize people they feel exist outside of their realm of traditional normalcy. I’m not advocating for our relinquishment of that word, as I believe those efforts are futile and fail to tackle the actual issue. Instead, I wish to move away from the belief that one is either crazy or a person, that one can be disabled or successful, but not both. I believe in multiplicity. At the end of college, I was in a jewelry shop and stumbled upon a necklace with a pendant of a small silver butter knife (it has delicate grooves and a slab of butter still on the tip). I now wear that necklace as a reminder that I am both crazy and not crazy, that there is no shame in feeling deeply, that I am here, and by virtue of that small fact, I am resilient.
My acceptance is not a permanent thing. It is not easy or seamless, but I am doing it and am not ashamed. I am here with the millions of people across our nation and around the world who experience mental illness, with those who have language to name their pain, and those who do not. My hope is that by learning to look at myself as both broken and unbroken, I will begin to stand in my multiplicity and will refuse silence.
It is not that I have gotten better. It is that I have chosen to live regardless.
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Rumpus original art by Elizabeth Schmuhl.
