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The AbusedMind:Feminist Theory, and Psychiatric Disability, Trauma

ANDREA NICKI

I show how much psychiatric is disability informed trauma,marginalization, by sexistnorms,socialinequalities, and concepts irrationality normalcy, of oppositional moralvalues.Drawingon feministdiscussion dualism,and mainstream mind-body I a that of physical disability, present feministtheory psychiatric of disability servesto not but liberate only thosewhoarepsychiatrically disabled also themindand moral in restricted theirrangesof rational consciousness possibilities.

Much psychiatric disability is closely linked to trauma. Many people who sufferfrom mental illnesses that force them to seek help are survivorsof childhood abuse. "50-60 percent of psychiatric inpatients and 40-60 percent of outpatients report childhood histories of physical or sexual abuse or both" his (Herman 1992, 122).Freudin 1896publiclyaffirmed discoverythat hysteria in women was caused by childhood sexual trauma (Herman 1992, 122). In a reportentitled The Aetiologyof Hysteria,Freudstates, "Ithereforeput forward the thesis that at the bottom of every case of hysteriathere are one or more occurrences of prematuresexual experience" (1962, 13). Freud, infamously, later repudiatedthe hypothesis of trauma as the origin of hysteria, because of its unseemly social implicationswhich attackedproletariatand respectable bourgeois families alike, claiming that his patients' accounts of childhood sexual abuse were pure fabrications.For feminists this subsequent betrayal of women may be seen as engulfing the whole enterprise of diagnosis and treatmentof mental illness in smog (the smoke contributedby Freud'scigar), casting it as suspect and confused in thought. In this paper I am concerned with mental illnesses related not only to traumaand abuse but also, more generally,to prejudice,discrimination,sexist
Hypatia vol. 16, no. 4 (Fall 2001) by Andrea Nicki

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or socialization,social inequalities,marginalization, poverty.The latterpromote toxic social environments in which mental illness thrives. I hold to Thomas Szasz's view of mental illness as involving "difficulties social adaption" in (1975, 54), but not in opposition to the common view of mental illness as biochemical disorder,analogousto physical illness. Mental illnesses have biochemical and biophysicalaspects that may be improvedor worsenedby pharmaceutical interventions.For instance, symptomsof clinical depressioncan include slow thought-processes, negative affect, lack of appetite,or fatigue.These symptoms can be reducedor overcomeby psychiatricmedications,but this accomplishment by pharmaceutics alone does not establishan underlyingbiologicalcause of the illness. Similarly,certain treatmentsmay improveor worsen a physical illness like cancer, but this does not mean the underlyingcause of cancer is biological. Forpeople who live next to toxic waste dumpingsites and develop cancer, the primarycause of their disease is certainly not in their genes or biological makeup. That many instances of mental illness are not best understoodas having primarilygenetic or biologicalcauses in no way means that these illnesses are not real or genuine. Mental illnesses, like physicalillnesses, involve difficulties in social adaptionthat, withoutproperaccommodation,sourcesof support,and aid, can be seriouslydisabling.Just as anyone can become severelyphysically ill and disabled,so also can anyone fall severelymentally ill and disabled,with illness of both types exacerbatedin those with unequal access to health care, social resources,and support.SusanWendellarguesthat social structures based on able-bodiness, which do not integratepeople with physicalillnesses,serveto disablethem (1992, 69). Similarly,social structures basedon able-mindedness, which marginalizepeople with mental illnesses, and assume that they can simply"snapout"of their conditions, are also disabling. The case of psychiatricdisability is complex because a variety of beliefs informa social understanding mental illness and thus attitudestowardthose of who are mentally ill: that mentally ill people are irrationaland dominated by emotion; that emotion lacks directive, cognitive content and is inferiorto calm reason;and that negativebehavioralor ideationalcomponentsof mental illness can be easily suppressed overcome.Also, normsof mental health are or differentfor men and women. For instance, a woman who displaysaggression and ambition, and is not feminine, risks being labelled "mentallyill" or, if genuinelymentally ill, having her illness seen purelyin termsof her transgression against her gender. Cultural concepts of irrationalityand sexist norms of mental health marginalizepeople with mental illnesses in attacking their personhood.In attackingthe personhoodof those who aresimplynonconformist they contribute to the development of mental health problems in such people. Further,in attackingthe personhoodof those with mental illnesses to which low self-esteemis central, they promotetheir mental illnesses.

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I argue that cultural and social analysis of mental illness is important since culturaland social factorscontributeto the developmentand prevalence of much mental illness in members of disadvantagedgroups. However, in consideringhow such factorsinform many instances of mental illness, I stress that it is importantnot to reduce these instances to their cultural and social components. This reduction feeds into a mentality that blames mentally ill people for their illnesses. A mentality that blames sufferersfor their health problemshas been well documented in the case of physical illness (Overall 1998; Wendell 1996). I discusshow feminist theories of physicaldisabilityare illuminatingfor the case of psychiatricdisability,which has received much less attention in feminist work on disability.Wendell writes, "We need a theory of disability for the liberationof both disabledand able-bodied people since the theory of disability is also the theory of the oppressionof the body by a society and its culture" I (1996, 78). Similarly, arguethat we need a theoryof disabilityforthe liberation of both psychiatricallydisabled and able-mindedpeople. Whereas society's rejection of physicallydisabledpeople is based on cultural insistence on the disabledpeople stems control of the body,society'srejectionof psychiatrically from culturalinsistence on the control of the mind. Society devaluesand despisesextreme mental states that are beaten down, becomesclinical or fetteredby this rejection:intense dissatisfaction frustration illness. mania or profoundenthusiasmbecomes manic-depressive depression; I present a liberatorytheory of psychiatric disability that validates diverse mental states. It acknowledgesthe thought and behavior of people broken by personaland social harms as rationalresponsesto variousfacets of oppresdisorderis a rational response of a mind sion. For instance, trauma-related to intense psychologicalstressin the same way that cancer is a body's subjected meaningfuland intelligibleresponseto a toxic physicalenvironment,to severe physical stress. Just as we need to discard a paradigmof humanity as young and healthy against which physicallydisabledpeople will be seen as lacking (Wendell 1992, 66), we need to overcomea paradigmof humanity as mentally healthy so that those with mental illnesseswill not be judgeddeficient.Further, since a lack of social acceptance or self-acceptancedirectly promotesmental illness relatedto low self-esteem,we need to reject a paradigmof humanity as rigidlyself-controlled,moderate,dispassionate,pleasant,and conformist,with strict adherence to norms of one's gender.In effect, we need to challenge the values inherent in this paradigm,the belief that only certain human traitsand dispositionsare praiseworthy. Wendell arguesthat people with physicaldisabilitiesdesiresome transcendence of the body, of negative bodily states and limitations (1996, 166). People with psychiatricdisabilitiesalso seek some transcendenceof the mind, of negamental illnesses in tive mental statesand limitations.In cases of trauma-related

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and which depressionis common, I arguethat symptom-management recovery may requirethe realizationof values outside mainstreammorality.In orderto overcome depressionand attain more pleasant states of mind, survivorsmay need to experience and transcend other unpleasant states, such as anger or cold indifference.Feminist theory of disability is inclusive towardthose with traumaticdisordersby recognizingthe moral merit of some alternatevalues. I presenta feministtheoryof psychiatricdisabilitythat servesto liberatenot only disabledbut also the mind and moralconsciousthose who are psychiatrically ness restrictedin their rangesof rationalpossibilities.I explore severaltopics: feministtheoryand the social constructionof mental illness;mental illness and and "craziness"; biopsychiatry, marginalized people and mental states;feminist dualism,and coping with disability;and traumaticdisorders theory,mind-body and feminist ethics.
FEMINIST THEORY AND THE SOCIAL CONSTRUCTION OF MENTAL ILLNESS

Feminists(Chesler 1972;Millet 1990) and others (Szasz1975)have extensively discussedthe use of the constructof mental illness as a means of social control. of Certainly, many specificconstructionsor "discoveries" mental illness have servedto supportthe statusquo and to enforcethe oppressionof varioussocial groupsbasedon gender,class,race,sexualorientation,or ability.'Only recently, in 1973, did homosexuality get removedfrom the Diagnostic and Statistical Manual of Mental Disorders(the official registerof psychopathologies)as a real mental illness (Horrocks1998, 15). The use of the term "mentalillness"to denounce deviant behavior and to problematize women and other oppressed is at odds with the term'suse to validate medicallycertain instances of groups difficultiesin social adaptionas aspectsof legitimateillnesses.While criticizing the formeruse is very important,such an endeavour,by partiallyinvalidating the concept itself,throwsinto questionthe legitimacyof the latteruse. In order for mental illnesses to be conceived as real illnesses and those afflictedto be treatedappropriately, mental illnessesmustnot be seen purelyin termsof their culturaland social components. Phillis Chesler, in her classic book Womenand Madness(1972), maintains that mental illness in women is essentiallyand literally"anexpressionof female and an unsuccessfulattempt to overcomethis state"(1972, 16). powerlessness Confinement in a mental institution is a penalty for"being female,as well as for daring or desiringnot to be" (Chesler 1972, 16). Women become mentally ill as they realize to an extreme degree feminine norms of dependency,vulnerability, and helplessness in order to escape constraining traditional female roles. For instance, in the mental illness of depression,women become ultrafeminine-childlike, dependent,and helpless-seeking the help of an authori-

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tative, knowledgeableexpert to guide and watch over them (Chesler 1972, and 50). Discussingthe cases of the femaleartistsEllen West, ZeldaFitzgerald, whose intellectual creativitymade them feel intensely alienated Sylvia Plath, in traditionalfemale roles, she maintains that they became depressedin order to be released from maternal and domestic duties (1972, 15). Their mental illnesses were both protestsagainst barriers confronting them and willful selfwithin these barriers. entrapments Similarly,Susan Bordo in her discussion of anorexia nervosa emphasizes the role of culturalnorms, values, and ideals in accounting for the upsurgence and increasingincidence of the disorder, and for its predominancein women.2 While Bordo maintains that anorexia nervosa is a real illness, "adebilitating affliction" (1993, 147),she arguesthat it constitutesa protestagainstthe confining traditional female roles of self-abnegatingmother and wife (1993, 156). Women who sufferfromanorexianervosabecome ultra-female pursuingthe by feminine ideal of excessivethinness, but in carryingthis pursuitto an extreme, they reject their female bodies, refashioning them into young boyish ones, not capableof menstruationor motherhood (Bordo 1993, 160). In obsessively and rigidly monitoring their food intake and dominating their bodies, they realizemasculine idealsof aggressiveness, self-control,strength,and conquest. However, in their physical and emotional exhaustion they are reduced to feminine infantilismand dependency (Bordo 1993, 160). By directingall their energiesinto the ideal of extreme thinness-obsessively exercisingand counting calories-anorexic women have nothing left for intellectual, moral, or social developmentand achievement (Bordo 1993, 160). Bordo's workwas a responseto a relativeabsenceof culturalor social analysis in researchon anorexianervosa (Bordo 1993, 140), and contributed,alongside work by such authors as Hilde Bruch (1981) and Kim Chernin (1981), to a But of better appreciation the role of culturaland social factorsin the disorder. while a social constructionist approachto mental illness is illuminating, the view that mental illness in women is a self-contradictory protest against and to "the devalued female role" (Chesler 1972, 56) may be used to conformity underminemental illness as a legitimateillness and disability.Those educated in the role of social and culturalfactorsin the disordermay,when faced with a woman suffering from anorexia, not view her condition as a debilitating illness, perhapsunsympatheticallyattributingto her an extremelyconformist mentality or an irrationalrebelliousness. Similarly,if depressionis understoodin womenas the enactmentof a "female role ritual"(Chesler 1972, 50), clinically depressedwomen might receive the same kind of criticalgazeas might be given to anorexicwomen.Cheslerwrites: "Conditionedfemale behavioris more comfortablewith, is definedby, psychic and emotional self-destruction .... Female suicide attempts are not so much realistic 'calls for help' or hostile inconveniencing of others as they are the

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assigned baring of the powerless throat, signals of ritual readiness for selfsacrifice"(1972, 49). These ideas are interestingand insightful regardingthe in implicationof feminine normsof self-destruction promotingand sustaining mental illness in women. However,they may be used to express"ritualreadiness" to blame the sufferingvictim of illness. Such readinesshas been welldocumented in cases of physical illness, with sufferersreceiving unwelcome, reductionistexplanationsaboutthe psychologicalor behavioralcausesof their conditions (Overall 1998, 157;Wendell 1996, 97, 106). For instance, people with physical illness may be told that an unhealthy lifestyle or unresolved psychologicalissuescaused their illness (Wendell 1996, 97). The potential for victim-blamingin the case of mental illness can be seen more clearlyin the employmentof metaphorsof traveland place to illuminate the phenomenology of mental illness, as when Chesler claims that women attempt to escape confining female roles by "going crazy"(1972, 14). This expressioncarriesthe implicationthat their conditions are actively and willOn fully self-imposed. this view, women escape from one female domestic role Womentake only to enter into another,morelethal femalerole of self-sacrifice. often includes institutionalizationin a a journey into a nightmare state that to mental hospital, referred by Kate Millett as a "loony-bintrip"(in the title of her 1990 book by that name). The conception of mental illness as involving a "trip"informs and reinforces the practice of institutionalizingthose with mental illness: mental illness is a place where one goes. One goes down into its hell, brought there by one's own feminine inferiority,resignation, and helplessness-punished for femaleness-just as in Judeo-Christianreligions one is condemned to hell for evilness: "Contemporary women carrythemselves headlong down . . . to the underworld"(Chesler 1972, 22). Similarly,John fromclinical depression, refersin a metaphoricvein BentleyMays,who suffered to depression's "blackdogs"(1995). Also, JuliaKristevaemphasizes depression's "blacksun"(in the title of her 1992 book by that name). While all these authors are emphaticallyopposed to romanticizingmadness, such metaphoricalwaysof describingmental illness preserveits morbidly romantic mystique. One would not say that someone who has acquired a physical or cognitive disabilityhas "gone ill," as if her illness were a place to which she has journeyed.A hard existentialist would insist that a condition of mental illness is much more voluntarilymaintained than one of physical illness, pointing to negative factorsor events in one's life that one could have respondedto more cheerfully or stoically (Sartre 1947). But at issue here is the extent to which mental attitudes and emotional responses and the life experiencesrelatedto them are in one's control and can be freelychosen. Notably,while Cheslermaintainsthat mental illness in women is an expression of self-destructivefemale behavior,she also claims that this behavior is conditioned, or determinedby social norms (1972, 49). On her view, women

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are conditioned to be depressed,full of self-doubtand guilt, in the same way that they are conditioned to diet, attract male attention, or find husbands. However, although feminine norms of self-destructioncontribute to mental illness in women, their mental illnesses are not merely realizationsof these norms-women being "simplyunhappy and self-destructivein typically (and approved)female ways"(Chesler 1972, xxii). Chesler does concede that a minority of women who have psychiatric or "careers," who undergocontinualpsychiatrictreatment,experience"genuine states of madness"(1972, xxii). However,it is not clear, in Chesler'saccount, what a woman must sufferor sufferfrom in orderto be consideredgenuinely mentally ill. Given that self-destructivebehavior is debilitating, the woman who engages in it is obviouslydisabledby it. Whether one arguesthat she is willfully mentally ill as a resultof female conditioning that she does not resist or is mentally ill because of factorssomehowmore beyondher control, mental illness is not something she desires or finds desirable.Women who commit suicide are not simply "tragically... outwitting or rejecting their 'feminine' role"(Chesler 1972, 49). Rather,they are judgingthat their lives with mental illnesses and the social sources of these illnesses are not worth living. Nonetheless, the misuse of the term "mental illness" applied to those who are mentallyhealthy deservesfurtherexplorationso that this misusecan be clearly distinguishedfrom the term'sproperuse. In the next section I will investigate the relation between the two uses and whether the term'smisuse has any bearing or impacton those who are genuinelymentally ill.
MENTAL ILLNESS AND "CRAZINESS"

throughoutthe worldhave often been the first Notably, social revolutionaries to be labelled"mentallyill" and forciblylocked up in asylumsor, as in Stalinist Russia,in state mental hospital prisons. Perhapsbecause of the associationof mental illness with political fanaticism,the termhas come to denote extremity, intense passion, or a lack of accessible meaning. This seems especially true Like when seen as synonymouswith the term "craziness." the label "mentally is ill," the label "crazy" also used as a tool to control people who are simply nonconformistand not genuinelymentally ill. is A person called "crazy" judgedto be irrational,off the chariot of reason, her speech and behaviorthought offensivelyaimlessor stupid:thus the phrase as "crazy a loon"appliedto wanderingvagrantstalking to themselves.A person when believed to be dominated by wild feeling, may also be termed "crazy" radicals." causedby emotion takingthe reins,as in the case of those called "crazy feeds on and expresses various beliefs: that strong The insult of "craziness" or intense emotion is devoid of meaningful, directive cognitive content; that people with mental illness are irrational;that they are cognitively impaired;

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and that they arefrightening.The labelof"craziness" directedat peoplewho are nonconformistor who challenge the statusquo, without seriousinquiry simply into their mental health, derives its power from prejudicedviews of those genuinely sufferingfrom mental illness as irrational,disordered,cognitively impaired,and frightening. For instance, MarilynFryedescribesan exchange she had with an angered black woman in a discussionon white privilege:"One Blackwoman criticized us very angrilyfor ever thinking we could achieve our goals by workingonly with white women.... She seemed to be enraged by our making decisions, by our acting, by our doing anything....What she was saying didn't seem to make any sense. She seemedcrazyto me.... I backedoff. To get my balance, I reachedfor what I knew when I was not frightened"(1983, 111-12).The black woman'sangerand unfamiliarassertionsfrightenFryeand lead her to initially becausethe other is dominatedby emotion, her speech seems judgeher "crazy": to lack sense, and she provokesfear;Fryeconcludes she is "crazy." People suffrom mental illness may be irrational,disordered, fering cognitively impaired, or frightening,but no more so than those not sufferingfrommental illness. In the case of irrationality,it depends on how irrationalityis being defined and what frames of referenceor value systems are being invoked; as Frye writes, aftershe reconsidersher initial response,"Ihave been thought crazyby others too righteous,too timid and too defendedto graspthe enormityof our difference and the significanceof their offenses"(1983, 112). Further,while mental illnesses in which depressionis presentinvolve a diminishedcapacityto think or concentrate, many persistingfactorsin mentally healthy people'slives can cause cognitive impairment,such as self-centeredness arrogance,whereone or has difficultydistinguishingbetween where one'sself ends and anotherperson begins, between one'sown interestsand those of others.3Finally,in the case of women who are mentally ill, given that, as Chesler argues,the feminine norm of self-destructiveness informswomen'smental illnesses, they most often only pose a threat to themselves (Herman 1992, 109). Many women with traumarelateddisordersfrequentlyinjurethemselves (Herman 1992, 109). Such selfinflicted injurymight be thought of as irrational,or senseless. However,from the perspectiveof those engaging in it, it is a method of self-preservation that substitutesphysicalpain for unbearableemotional pain and producesa sense of calm (Herman 1992, 109). The derogatorylabel of "craziness" serves to silence communicationof differences in ideas or intensity of emotion. Calling someone "crazy" keeps that or person and her differencesaway,but it also reinforcesthe belief that "crazy" mentally ill people are less than fully human and not deserving of respect. It was because her initial view of the black woman as crazyexpresseda lack of respectfor her opinion that Fryereconsideredit. throws at her the same kind of verbal abuse as Calling someone "crazy"

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or cow."4 The latterterminologydrawson calling her a "mentalretard" "stupid and serves to reinforcethe oppressionof cognitively challenged persons,who are thought to be less than fully human, and of animals,who are thought to be subhuman.One might arguethat while some uses of these termsare explicitly meant to reduceor criticizeanother,other uses are more"fun-loving," when as one calls another "crazy" jokinglyforhaving done something silly or foolish or for or "piggish" sexualpromiscuity abundantfood consumption.But even these uses are problematic,like the term "bitch"used in a light-hearted "fun-loving" way between friends. Here I am not advocatinga total policing of all language,putting the tongue in chains, but rathersimplypointing out that uses of languagethat derivetheir meanings from systems of oppressioncannot be divided into good and bad uses, as if a bucket lowered into the same polluted well could obtain clean water. Perhapsa term like "bitch"used between women to secure bonds of female friendshipcould serve as an antidote to help destroya patriarchalwell of significance.The same may be said for the term "crazy" between mentally ill women. But that would only be to claim that uses of languagethat express and reinforceoppressioncan be used for other, good or bad ends-to enliven or diminish. While a woman is laughinglycalling her friend a "bitch"she is also telling her she is more animal than human, only that she could use and is using her animal nature to her admirableadvantage.Similarly,in the case of the use of the term "crazy" a woman sufferingfrom a mental illness to by refergood-heartedlyto a kindred sufferer, woman is saying that she finds the where others typically find it offensive (as the other's"otherness" delightful, in: "Those people in the state mental hospital are reallysick,"a woman says, her voice drippingin disgust). She is affirmingthat her friend is other, only in that this is acceptable,even praiseworthy her eyes.5 or whether intended good-humoredly not, with The use of the term "crazy," its variouspejorativeconnotations, servesto sustain mental illness in sufferers by enforcing their marginalization.Further,the application of the term to, on the one hand, people who are mentally ill and, on the other, people who are simply nonconformist or who challenge the status quo, and who are not actuallymentally ill, also servesto promotemental illness in those afflictedby through association. reinforcingtheir "otherness"
BIOPSYCHIATRY, MARGINALIZED PEOPLE, AND MENTAL STATES

The marginalizationof mentally ill people and nonconformistpeople occurs of alongsidethe marginalization another group,that of "mad,starvingartists." This group has been subject to much biopsychiatricmystificationwhich has served to obscurethe connection between marginalizationand much mental illness.

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KayRedfieldJamisonargues,referringto numerousstudies, Biopsychiatrist that there is a strongcorrelationbetween mental illness and artistic temperaillness. Presentingcharts ment. She focuses particularlyon manic-depressive of familyhistories characterized generationsof memberswith the illness or by illness is "indisputably significantaspectsof it, she arguesthat manic-depressive such as Jamison,insist genetic"(1993, 16). Those committed to biopsychiatry, on a genetic and biophysicaldeterminacyof mental illness perhapsas a way to gain acceptance for it as a legitimateillness no less seriousthan cancer,with a potentially fatal outcome.6Without drugtherapy,Jamisonclaims, a condition of manic-depressiveillness will inevitably worsen, with an increased risk of suicide (1993, 16). One can sympathizewith a sense of frustrationbehind Jamison's insistence on a pure, unalloyedgenetic and biophysicalbasis of mental illness in general in a culture where mental illness has become a flippantlyused catchphrase: "I'mmentally ill. You're mentally ill. We'reall mentally ill. People aren'tsick; society is."However,notably,afterlisting manyprominentwriters,artists,and or composerswith probable,undiagnosedmajordepression,manic-depression, cyclothymia (mild manic-depression),Jamison admits in a footnote, "Many of [these] had other major problemsas well, such as medical illnesses. . alcoholism or drug addiction ... or exceptionallydifficultlife circumstances" (1993,268).7Their mental illnessesweresurrounded otherproblemsin social by influencedtheir illnesses. living. These problems,one could argue,unavoidably Thus Jamison'sreductionof their illnesses to their genetic, biochemical, and biophysicalcomponents is not convincing. The manic-depressiveillness of poets is related not only to their social but of marginalization also to the marginalization mental statesassociatedwith mania. One problemwith arguingfor the recognitionof an illness like manicdepressionas a genuine illness and disability is that mental states central to the condition can be socially advantageous.But their very extraordinariness makes these also social liabilities.For instance, in the manic phase of manicdepressiveillness, there is a rapidincreasein goal-directedactivity (socially,at work,or at school) and an increase in the productionof ideas, with high selfesteem and enthusiasm (Jamison 1993, 262). However,all planes must land, and because a person experiencing mania does not want to come down she will experience landing as crashing.She crashesdown into a world that has outlawednaturalstates of intense exhilarationand exaltation, preferring that these statesbe inducedand controlledthroughartificially engineeredproducts that are dangerousand illegal. It is a worldthat has outlawedmanic thinking, or "divergent thinking" (Jamison1993, 106), which often precedesor informs such pleasure-thinking which spins off into a variety of differentdirections and is not content with a box at the end of a question, as if there is only one conclusion or answer.It is a worldthat does not recognizethe beautyof colors,

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often keenly appreciatedin mania, where those fashioning beautifultableaux of color cannot earn a living doing so and have to pay to rent places where others can come to enjoy them. It is a world where abilities heightened in mania-fluency of thought, verbalfluency,and ideationalfluency,or the ability to rapidlyproduce relevant, original, or innovative ideas-do not cause or appreciation admirationin othersbut, rather,distress,fear,or anger.Running a mile a minute is seen as commendable;talking a mile a minute is not. Kate Millett, who was diagnosedwith manic-depression, refersto the social rejection of mania: "Depression-that is what we all hate. We the afflicted. Whereas the relativesand shrinks, . . . they ratherwelcome it: you are quiet and you suffer ... Forwe could enjoy mania if we were permittedto by others around us so distressedby it, if the thing were so arrangedthat manics were safe to be manic awhile without reproachor contradiction,the thwartingand harassmenton every side that finally exasperatesthem so that they lose their tempersand are cross, offensive,defensive,antagonistic-all they are accused of being" (1990, 72). Wendell argues that fear of "the other" is at bottom a fearof oneself, of one'sown vulnerabilityor susceptibilityto the object of one's response(1992, 73). As Millet exclaims:"Howcrazycrazinessmakeseveryone, how irrationallyafraid.The madnesshidden in each of us... The more I fear my own insanity the more I must punish yours"(1990, 68). People who exhibit the extraordinarytraits found in mania are berated for them, treatedas children and punished, force-fedmedicine "fortheir own voice has an odd manic quality. me good":"Accusing of mania, my eldersister's 'Are you taking your medicine?'A low controlled mania, the kind of control in furious questions addressedto children, such as 'Will you get down from there?'... [A friend's]hand approaches mouth so fast I hardlysee it; she is my forcingthe pill between my lips, her other hand reaching to hold my chin, as one forcesa child to take pills, even a dog"(Millett 1990, 32-58). Women who vulnerableto others'abusesince, as Cheslerclaims, are manic are particularly womenareconditionedto be filledwith self-doubtand insecurityratherthan to have the opposite,inflatedself-esteemor grandioseenthusiasm-traits that are seen as normal and encouragedin men. Women who are denounced for their abilitiesor behavior,a denunciation mania are rejectedfor their "unwomanly" internalize:"Youshould shut up because you talked too much that they may before, you should close down all your capacities because you were boastful and extravagantaboutthem before"(Millett 1990, 72). Conventionalfeminine behavior involves quietness, self-effacement,and cautiousnessthat does not activitieslike sexual affairs give rise to manic, riskyinvolvementin pleasurable in activitiesthat arecondoned, even applauded, men. or financialinvestments, mania are doubly deviant, defying norms of femininity Women who display and challenging an Aristotelian paradigmof humanity as self-controlledand moderate, occupying a mean between extremes. Women who exhibit levels

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of self-confidenceand initiation that would be seen as normal or averagein men risk being labelled "mentallyill."Further,they might applythis label to themselves, judging themselves mentally ill for self-praisesor brilliant ideas, especiallyinsights into women'soppression(as in: A woman talks passionately and tirelesslyabout radicallyfeminist critiquesof cultureand wondersif she is As "crazy."). a resultof this denigration,imposedby othersor self,womenmight become mentally ill. Persistentinsecurityand self-doubtdevelopsinto clinical depression,just as genuine mania, throughothers'incessantberatement,turns illness. into manic-depressive In the absenceof anyculturalor social analysis,we riskapplyingthe category of "mentalillness"to people who aresimplynonconformist,therebypromoting more mental illness. Unless attention is given to the culturalor social aspects of genuine mental illnesses, we risk giving these illnesses overlypersonalized and explanations-"bad genes,"faultybiochemistry, so on-and viewing them as purelypersonalproblems,in no way social. This is not to deny that there are cases of mental illness that have primarilya biochemicalor physicalcause. For instance, Wendell sometimessuffersfromseveredepressioncausedby chronic fatigueimmunedysfunctionsyndrome(1996, 174),and people maybe afflicted with mental illness as a result of brain injuryor damage.But the reason that membersof oppressed groupsforma high percentageof mentallyill people is no Mental illness is found predominatelyamong such groupsas women, mystery. homosexuals,the poor, unemployed,or homeless, the physicallydisabled,the In and or raciallymarginalized, the elderly.8 societieswith rampant prejudice dissocial inequalities,violence againstwomen and children,unequal crimination, access to health care, low-payingjobs, unsafe workingconditions, technological domination, chemicallycompromisednaturalenvironments,waste, greed, egoism, and so on, membersof oppressedgroupswill be more likely to become disabled,with their chronicallyor perpetuallyphysicallyand/orpsychiatrically minds overwhelmedwith the negative realitiesin their lives.
FEMINIST THEORY, MIND-BODY DUALISM,
AND COPING WITH DISABILITY

Understandingthe role of social and culturalfactorsin physicaland psychiatric disability includes understandingthe contributionof mind-bodyhierarchical dualism to social and environmental problems.According to this dualism, mind and body areseen as oppositionaland the mind is valuedoverand against the devaluedbody (Warren1998). The devaluationof the body includes the devaluation of entities associated with it, such as emotion, women, nature (Warren1998). However,in a society based on mind-bodydualismand other hierarchical dualistic conceptions, such as able-bodied/disabledand ableminded/disabled,people with physical and mental disabilities are forced to

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conceive of their struggles to some extent according to a norm of valuehierarchicalthinking. Coping with disability requireslearning to work with rather than against a negative body or mind. In this section and the next one, I show that because of varioussourcesof oppressionand social pressures, an oppositional relationshipbetween self and body or self and mind can be difficultto transcend. Wendell discussesthe feminist preoccupations with challenging mind-body dualism,which has fundamentallystructuredpatriarchaltheories throughout the ages,and with affirmingthe value of the body and bodily experience (1996, 165-69). She arguesthat feminist theoristsneed to take into account struggles that people who are physicallydisabledhave with their bodies as sources of pain and frustration.The body can be confused and confusing, providing informationthat is false and misleading,as in the case of chronic pain which is meaningless and does not, as with acute pain, signify immediate danger (Wendell 1996, 173). For people who experience their bodies as intractably negative, the ideal of bodily transcendencehas appeal (Wendell 1996, 166). Feminists'celebrationof the femalebody has been accompaniedby celebration of the female mind which patriarchaltheoristsdenigratedwhen they cast women as other,body and mind, morebody than mind. However,in the case of people with psychiatricdisabilities,some transcendenceof the mind is desired. Just as the body can be deceptive and misleading,so also can the mind. For people with psychiatricillnesses the mind is sometimesexperienced as other, as untrustworthyand disordered, and certain thoughts, ideas, and negative or morbidbeliefs need to be transcended.9 instance, a person sufferingfrom For clinical depressionis plaguedby negativejudgementsregarding own worth her or abilitieswhich are not accuratebut which if not overcome may lead her to abandon or sabotage important projects.Some women have ceased to trust their mindsbecausethey have been subjectto gender-based violence-because they have been experiencedas so infuriatingly"other"-just as a woman might become physically disabled after a male lover beats her. In this case they might be torturedby ideas of self-blamethat make them believe that they are unworthyof respectfultreatmentor that resistanceis futile. Negative thinking might extend far and wide. Everything is caught up in it; there is no help, comfort, or sanctuary perceived in anything or anyone; everywhere seems horriblyunsafe. The kind of transcendence that Wendell favorstowardthe negative body involves a sensitive attunement to it, learning to adjustto its differencesand changes. Wendell gives an example of such attunement when she claims that if her body tells her she must rest, she curtails her activities, explaining that ignoring her body'sneed to rest could result in a worseningof her condition (Wendell 1996, 173).Similarly,sensitive attunementto a disabledmind would also mean workingwith its differencesand changes. This could mean, in the

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case of those with traumaticmemorysyndrome,that they should not push for the recollection of memoriesif recollecting is causing too much distressand intensifying their symptoms,producingnightmares and intrusive flashbacks such sensitive attunementcould also mean avoidthroughoutthe day.Further, ing situationsor people that might triggertraumaticmemorieswhen survivors are feeling emotionally drained from other sources of stress. Survivorscould monitortheir responsesand feelings towardothers so that they do not become entangled in relationshipswhere they will be exploited and their recovery threatened. But just as the state of one'sbody or one's mind is not underone'scomplete control, likewisesensitive attunementto a negativebody or mind is not always overburdened possible,nor can one alwaysrespondappropriately. Particularly and overstressedpeople, such as women with multiple roles-self-abnegating mother and wife and full-time workeroutside the home-may not have the time or the necessarysupportsthat would allow them to pay attention to their bodily and psychologicalneeds and respond accordingly.Notably, Christine Overall relayshow people regardedher illness of viral arthritismistakenlyas the resultof intense and constant exertionto hold her place in academia(1998, 157). However,she remarkssignificantlyin a footnote that such greatexertion was necessary because of the prevalence of sexism in academia,specifically, the belief that women are less able to hold positions, and the higher standards for women'sperformance(1998, 157). As Wendell states, people who look for purelyinternal causes of someone'sillness have a myopicview of the sufferer and her condition, wonderingonly what she must have done to get herself in that state (1992, 72). Heavy children on a mother'sback could very well wear her down physicallyand/or psychologically. While, as Wendell claims, "health and vigour"are not "moralvirtues"(1992, 72), these can be better obtained the more socially privilegedone is (just as financial generosityand liberality are easierfor the wealthy to achieve).
"NORMALCY," PSYCHIATRIC DISABILITY, AND THE WORKPLACE

Social arrangements which do not accommodatepeople with disabilitiesintensify their disabilities.In this section I show that modifyingthe social environment of the workplace,and the norms of behavior and personal interaction that structureit, can serve to liberatepeople with disabilities(Wendell 1992, 69). Towardthis end of liberation,it is importantto challenge a paradigmof humanity as invulnerable,happy, and carefree. Cultural pressureon people with depression-centered mental illnesses to be cheerful and to completely deny their illnesses promotesin them an unhealthy oppositionalrelationship with their negative minds. In implying that people who sufferfrom clinical depression really suffer from negative personality traits, such pressurealso

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supportstheir low self-esteem.I stressthat sound understandingof psychiatric disabilitiesis importantin makingchanges in the workplacethat supportthose who are psychiatrically disabled. Wendelldiscusseshow Westernsociety is structured the assumptionthat on is physicallyhealthy and strong, that everyone can work smoothly everyone and efficientlyat the same rate, managing with the same numberand length of breaks (1992, 69). Overall emphasizesspecificallyhow the environment of academiacan be both physicallyand socially inhospitable to people with physical disabilities (1998, 151-60). Overall talks about how she was, as a to temporarily physicallydisabledperson,subjectto "pressure pass for normal" Some faculty and students continued to make demands on her (1998, 155). with full knowledgeof her weakenedcondition as though she were not really or seriouslyimpaired(1998, 156).10 the case of people with psychiatricdisIn the obstacles in the social environmentare in some ways similarbut abilities, in others different.Overall relaysLois Keith's (1996) point that the pressure to pass as normal brings with it a requirementthat one appear cheerfully pleasant at all times, and not at all affected by pain (Overall 1998, 166). This is a requirementimposed on the abled and disabledalike. There is a cultural insistence on cheerfulness;we are alwayssupposedto appearas though life werehappyand carefree(Aries 1974).While, as Overall states,underlyingthe insistence on cheerfulness in disabledpeople is the fear that they are needy and demanding (1998, 168), a culturalinsistence on cheerfulnessin everyone expresses the fear that everyone is needy and demanding. This is the fear of one's own vulnerabilitywhich the "othering" disabledpeople expresses of (Wendell 1992, 74). The culturaldemand of cheerfulnessis also supportedby the requirementof social conformityand acceptance of the status quo. Overall claims that the pressureto seem happy at all times affects the psychologicalharmony of disabled people (1998, 167), forcing them to deny feelings of discomfortand pain and so reject their disabilitiesas true parts of themselves.The pressureon the disabledto be cheerful is particularly intense forpeople afflictedwith mental illnessesto which depressionis central,since for them the pressure be cheerfulrequiresa full-fledged to denial of their disorders. Peoplesufferingfroma physicaldisabilitycan explain their lackof cheerfulness by referenceto physicalpain or weakness.They may encounter many people who find this explanation inadequate,who tell them that they simplydo not want to get better or that they have not tried all possible treatments,perhaps from a lack of effort (Overall 1998, 157;Wendell 1996, 97). People suffering from a psychiatricdisorder,on the other hand, may receive no sympathyor concern whatsoever,or only concern from those who have sufferedfrom the condition themselves,or who had a friendor relativeso afflicted.1 Those who have no familiaritywith the worldof psychiatricdisabilitymay not only be dismissiveof explanations of psychiatricillness, not seeing it as

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real illness, but outrighthostile towardthese explanations,seeing an afflicted person as emotionally immature,self-centredand self-indulgent(focusingtoo much on her own problems),attention-seeking,or morallyor spirituallyweak (not able to cope with life). Of course a mentally ill person could be all these things, but such traits do not in themselves inform or reveal mental illness. There is no inherent correlationbetween these featuresand mental illness. A personwho tells others she is sufferingfroma mental illness such as depression may be told, like a person sufferingfrom a physicalillness, that it is "allin her mind."Her condition and symptomsare perceivedas imaginary,as if she were not really depressedbut just thinks she is. Or her condition is thought to be self-imposed,as though she were willfully depressed(perhapswith the view that she is conforming too strongly to a female role of self-destructionand helplessness).But in the case of a person sufferingfrom a mental illness, the claim that her illness is "all in her mind"would be in one sense correct. Her condition is fundamentallyconstitutedin her mind, in negativethoughtsabout herself, about her worth and value, about her life and future, possibly about others and their lives, or about the world in general as hopelesslyevil. These thoughts are like the eyes of stormsof sad or angry emotion by which others may feel resentfullyengulfed. Insisting that a person sufferingfrom clinical depressionbe cheerful, they demand that she not only hide her illness-her tearfulor ragingnegativity-but that she immediatelyovercomeit in orderfor them to continue to respect her as a person. If a person cannot control her mind-that which allegedlydistinguishespersonsfromanimals-the assumption is that she must be mentallydefective and so not deservingof full human respect.'2 People suffering from clinical depression risk becoming more depressed their illnesses. becauseof the hostile and confusedattitudesof othersregarding Those who insist that people sufferingfrom depressionbe cheerful ignore the state of unwelcome realitythat depression,for those afflicted,is an undesirable thoughts and doubts that fill every corner of the mind-the thought of death the worstintruder.If those afflictedcould so easily overcometheir conditions, they would. Notably, Millett concludes her book by displaying a speed of thought, a wonderfulflightof ideas-a denigratedstate of manic consciousnesswhich she reclaimsand champions:"Wedo not lose our minds, even 'mad'we areneither insane nor sick. Reason gives way to fantasy-both are mental activities,both productive.The mind goes on working,speakinga differentlanguage,making it its own perceptions,designs, symmetricalor asymmetrical; works.... Why not hear voices?So what?"(1990, 315). In this passageMillet is directing her the argumentsagainst,specifically, culturaltreatmentof people diagnosedwith mental illnessesas criminalsto be treatedwith forcedhospitalization, drugging, methods"(1990, 314). However,as Millet claims electroshock,or other "savage

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earlierin her text, whereasmania is desirable(except for mania in an irritable form, which can be highly unpleasant),severe depressionis not. Further,the poet Anne Sexton (a survivorof childhood sexual abuse), who heard voices telling her to kill herself, experienced these hallucinations as invasive and coercive,as her mind workingagainsther, speakinga languagethat was hostile to her and that she could not silence (Middlebrook1991,16).There is a certain fantasticalsoarto Millett'sclaimsthat forgetsaboutmental illness as a response to oppressive life circumstances, about a mind fettered by trauma, cruelty, neglect, prejudice,or discrimination.Millett writes, "Ifwe go mad-so what? We would come back again if not chased away, exiled, isolated, confined" (1990, 314). Certainly,there is much that is wrongwith aggressiveapproaches and medical treatments concerning mental illness.'3But mentally ill people are disabledby their illnesses and have difficultyfunctioning from day to day, with adverseeffects on variousaspects of their lives. Betterunderstandingof psychiatricdisabilityhas greatsocial and economic importance. If others perceive a mental illness in a co-workersimply, and as the problem, lattermaybe fired,not re-hired, unsympathetically, a personality of or not promoted.While understanding psychiatricdisabilityis importantfor and good communicationin the workplace, forthe avoidanceof misunderstanda personsufferingfroma psychiatricdisabilitymight keep her condition a ings, secret for fear that others might be unsupportiveabout its backgroundcauses. Some common psychiatricdisorderssuch as "borderline personalitydisorder" are disorder" stronglylinked to histories of childhood or "multiple personality sexual abuse (Herman 1992, 97). Because of the strength of this link, some psychiatristshave proposeda new diagnosisfor survivorsof childhood abuse stress disorder"(Herman 1992, 120). For the called "complexpost-traumatic disclosuresof these traumaticdisorderscan amount psychiatricallyeducated, to disclosuresof abuse. Thus, in making their diagnoses public, the afflicted risk putting themselves in the very vulnerableposition of having possiblytwo stigmatized identities, that of "disabled"and that of "abusedchild of 'bad blood"'(shamefulparentsand "defectivegenes,"as in, "Herownfamilyabused her"). Makingthe work/socialenvironmentmorehospitableto peoplewith psychiand atricdisabilitieswouldinvolve challenging a lot of prejudices conventional of thinking that blame victims and judge individualsin terms of family ways backgrounds,including, of course, class and racial backgrounds(as in, "She must be lying about the abuse; her parents are highly respected people"). It wouldalso requirea greaterplace for the personalso that disabledpeople could openly discussand explain their conditions and limitations.

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TRAUMA-RELATED

DISORDERS

AND FEMINIST ETHICS

In the case of people with trauma-related disorders, discussingtheir conditions could involve explaining behaviorand decisions relatedto their recoverythat express values outside of mainstreammoral thought. People with traumatic disordersmay need to realizealternatemoralvalues for their recovery.In this section I arguethat feministethical theory can be inclusivetowardpeoplewith psychiatricdisabilitieslinked to abuseby affirminga wide rangeof moralpossibilities, and not simplyones that expresslove, compassion,and interdependence. Wendy Donner criticizes Karen Warren'sethic of care for, in cherishing an ideal of interdependence,essentiallymarginalizingpeople with difficulties relatedto histories of abuse (Donner 1997,385-88). She exploresthe case of (1988) about her experiElly Danica, a woman who wrote an autobiography ences of incest and emotional abuse, her sense of entrapment in marriage and childcare,her subsequentdeparturefrom her husbandand child, and her solitary existence. As Donner argues, Danica achieves a better life only by realizingselfishnessas a moral value and severingall ties with others: "Ihave no energyto bring anyone with me. No energyfor relationships,not even with a cat or a goldfish.... Soul dwelling:found. Self: found. Heart: found. Life: found. Hope, once lost: found..... The mind, Free. Freedom.Bestowedfrom within. Self... I am" (Danica 1988, 91-95). Only by caring for and loving herself in separationfrom others can Danica be able to properlylove others (Donner 1997, 338). According to Donner, Warren'saccount recognizes as moral values only pleasant dispositions like compassion,kindness, empathy, and sensitivity.However,as other care ethicists argue,in a sexist culturewhere women's self-sacrificethrough caring is wrongly extolled as a moral virtue, women'sselfishnessthroughnot caringcan be morallygood (Fisherand Tronto 1990, 35). Women should value their own well-being rather than abusive relationshipssustained by a love that excuses those who severelyharm them (Tronto 1987,660). Forsurvivorsof violence, like Danica, realizingunpleasant dispositionssuch as anger,callousness,insensitivity,and indifferenceas moral values is necessaryfor their recoveryand moraldevelopment-for them to be capableof compassionand love. It is simplynot realistic to maintain that one can move from a very low level of self-devaluation, from feelings of worthlessness and self-hatred,to a level of free-flowinglove and compassionfor others, where one generouslyand warmlysupportsothers' lives. Other, intermediate steps, which are markedby unpleasant dispositions, are needed to get to a higher moral level. The outward expression of hostility is particularlyimportant in people with clinical depression.As theorists,such as Freud,have traditionallyargued, clinical depressionis hostility turned inward.Hostility that could or shouldbe

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directedoutwardin responseto abuse and injusticesis turned against the self. Marilyn Frye claims that anger "implies a claim to domain," a claim that one's projects,activities, and interestsare worthyof respect (1983, 87). In the case of women sufferingfrom traumaticdisordersas a result of chronic abuse from batteringpartners,achieving unpleasantdispositionssuch as anger and callousnesstowardtheir abusersmay be necessaryfor their survivaland moral growth. As Claudia Card claims, a woman who ends an abusiverelationship "maybe growingethically in overcominga sexist training to put others'needs consistently ahead of her own" (1996, 88). To forcefully escape an abusive relationship,a woman may need aggressivetools, which include the emotion of anger.Severalfeminists (Card 1996, 88; Cuomo 1999, 272) have referred to the inevitabilityof "dirtyhands"in moral endeavour,where one is not purely an oppressedbut also an oppressor. Sometimesthe best one can do is to choose the least harmful option and, after acting, to leave the situation with slimy feelings of regret for having to cause harm at all (Card 1996, 88). However, sometimesone can only become "cleaner"-morally better-by dirtying oneself, as when one rubs sticky hands through dirt to get them clean. Dirtying oneself maybe seen as partof the projectof "gettingcleaner," moreableto freely express compassion and love. A feminist ethical account that does not marginalize people with certain psychiatricdisabilitiesshould not underestimate or undervalue the ideals of autonomy and independence. Feminist ethicists have been criticalof traditionalKantianidealsof autonomyand independence, arguing that these lie outside female identity, which is based on ideals of connectedness and interdependence (Wendell 1996, 144). Wendell upholds these critiquesas expressingsensitivitytowardthose who areunableto achieve ideals of autonomy and independence because they need a great amount of help from others (1996, 145). On her view, alternate ideals of connectedness and interdependencevalue the lives of the disabledin valuingthe relationships of dependency and interdependencyso central to them (Wendell 1996, 145). However,as Donner argues,accounts that emphasizeconnectedness must be careful not to ignore the lives of severelyabused women for whom a strong sense of disconnectedness, of being separateand apart, is necessary in their strugglesto manage, overcome, or survive their mental illnesses (1997, 385). Forpeople like Danica, fromseverelyabusivefamilies,connectedness is a great source of despairand self-hatred(Donner 1997,385). Further,while the ideal of autonomy may present an unrealistic demand for people with disabilitiesin general,who need a great amount of help from others,this idealmaybe acutelydemandingforpeoplewith multiplepersonality disorder.Such people may not be able to achieve a unified personality and continue to rely on different personality fragmentsor modalities to express different emotions and behavior. Moreover,in addition to undervaluingthe lives of people with multiplepersonalitydisorder,the ideal of autonomycould

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who do serveto undervaluethe lives of people sufferingfrommanic-depression not have a tightly unifiedself which they can regulateand control. Peoplewith widelyvarying moods, thoughts, ideas, or feelings, whose inner lives contract, expand, or fly across personal boundaries,will have their lives devalued for coursingand receding like waves.4Thus, while feminist theory of psychiatric disability should not neglect the moral value of selfishnessexpressed in the ideals of autonomyand independence,it should be awareof the limitationsof disabledpeople. these ideals to cast value on the lives of psychiatrically linked to the ideal of autonomyis the ideal of detached rationalFinally, ity. Kantian philosophers maintain that moral agents have self-respectand are reasonable,acting accordingto principlesmutuallyagreedupon by other reasonableagents. These claims marginalizepeople with trauma-related psychiatric disabilitieswho have fragile self-respectand who, because they have mental illnesses, are necessarilycast as unreasonable,as explored earlier.In her essay "MoralFailure," Cheshire Calhoun presents a Kantian conception of moral agency.She claims that there are fourbasic commitments,including the principleof character,involved in attemptingto engage in moral action: "abeing with moralcharacter... will cultivate and expressthe virtues"(1999, bad 84). She arguesthat with "sufficient luck, our morallives can fail because they arecharacterized abnormally by frequentunintelligibilityto others"(1999, 84). In stressing the predominant social and moral understandings,which those who challenge so-calledjust social systems, regardmoralrevolutionaries, as perverse,Calhoun concludes that the lives of moral revolutionaries will be partially"moralfailures"(1999, 97). Wendell maintains that in societies that certainhuman idealsas very important,those who cannot achievethese regard idealswill feel inadequate(1996, 145).Calhoun'sconclusioncan only diminish the self-esteemof moral revolutionaries, as her belief that the cultivation just and expressionof traditionalvirtues is necessaryfor moralcharactercan only fail to cast value on the moral achievements of people, such as traumatized women, who may need to realizealternatemoralvalues for their survival.l5
No FINE MADNESS,ONLYMIND

In ethical discourse(and philosophicaldiscoursein general)there needs to be less talk of failuresto realize ideals of rationality and autonomyand human of paradigms normalcyand intelligibility.Rather,there shouldbe moreemphasison the achievementsboth of those challengingoppressive social systemswho are typicallyseen as "crazy radicals" of those with abuse-related and psychiatric disabilities who have been told far too many times through actions, words, or silence that they are worthless.Abuse-relateddisordersare complex, with psychologicaland behavioralcomponents that others find bizarreand incomin prehensible.Survivorsof childhood abusearefrequentlymisunderstood the

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mental health system,accusedof manipulationor malingering(Herman 1992, 123). Typicallythey receive many differentdiagnosesbeforebeing understood as having a complexpost-traumatic syndrome(Herman1992, 123).The failures that one should speak of are failuresin others to open the windows of their own closed worldsof intelligibility and dare to venture into other worldsof meaning. Calhoun asks, "Would we think it tragic that a life devoted to doing the right thing was incomprehensibleto others or vilified as perverse, I irrational,or immoral?" (1999, 97). This question she answersaffirmatively. preferthis question rephrasedas, "Wouldwe think it tragic that others could not appreciate moralexcellence of a life and vilifiedit as perverse,irrational, the To or immoral?" this question I respondaffirmatively. Similarly,it is important that others try to appreciatethe difficultiesand strugglesof those with abuserelated disordersinstead of seeing them as irrational and seeing necessary selfishnessduringtheir recoveryas a sign of moralinferiorityor moraldamage16 It ratherthan as a sign of blossomingself-respect. is tragicthat the predominant worlds cannot appreciatethe meaningful worlds of those with meaningful psychiatricdisabilitiesand accept them, therebylessening their suffering. Feminist theory of physicaldisabilityfocuses on society'soppressionof the body, of the alternate bodily states found in the physicallydisabled (Wendell 1992, 78). Similarly, feminist theory of psychiatric disability concerns the oppression of the mind by a society that rejects and despises the alternate mental states found in the psychiatricallydisabled. The history of Western thought has not trulybeen about the glorificationof the mind. Trueappreciation will come when there is no more oppressivetalk of some mental island to called "madness" which one in illness goes, no moremorbidromanticization of oppressionand abuse-of "madstarving artists"-or scientific of offshoots mystificationof fetteredminds. Let there be no more beliefs that partitionthe complex wheel of the mind or that enforcethe isolationof those sufferingfrom oppressionand mental illness.

NOTES

women's arts a des I wouldlike to thankLe CentreDArtisanal Femmes, non-profit where and womenin Montreal, for and craftsorganization underemployed disabled with me in of as I worked an instructor the summer 2000.The womenI metshared The treatment. central with abuse,mentalillness,andpsychiatric theirexperiences and with artistsAndreeBlackburn of arguments this papergrewin conversation
of Giovanna Parente.I wouldalso like to thank the three anonymousreviewers Hypatia who providedvery constructive feedbackon a much earlierversion of this paper. 1. See Paula Caplan (1995) for a fascinating discussion on the formal processes used by the psychiatric establishment to determine legitimate categories of mental

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illness. She arguesthat judgmentsregarding proposalsof categoriesof mental illness are sometimesfraughtwith biases and assumptionsthat supportthe status quo. 2. Ninety percent of anorexics are women (Bordo 1993, 140). In 1973, when a suicidal Ellen West stopped eating, anorexia nervosa was relativelyrare (Bordo 1993, 140). In 1984, however,roughly"onein every 200-250 youngwomen between thirteen and twenty-twosuffer[ed]from this disorder" (Bordo 1993, 140). 3. See Frye (1983) for a discussion of the cognitive impairment involved in an arrogantperceptionof others. 4. See Joan Dunayer(1995) for a discussionon sexist, speciesistlanguage. 5. Similarly,Claudia Card, in discussing the stronglynegative meanings of "lesbian" in heterosexist society, writes, "It is absurdto think that you can change the meaning of something just by intending a differentmeaning when you use it yourself or with yourfriends"(1996, 150). 6. Notably, Wendell writes that people with unrecognized physical illness may be "sociallyisolated with it by being labeled mentally ill" (1992, 78). Psychologicalor psychiatricexplanations of seriousphysical illnesses serve to invalidate these illnesses partiallybecause mental illnesses are not seen as real illnesses. 7. It is not surprisingthat female poets, for instance, would be especially prone to mental illness or that their mental illness would be sustained through their work, notwithstanding their social marginalization.As Germaine Greer (1995) argues,the female norm of self-destructivenessis exemplified in criteria for "the great female poet."On Greer'saccount, the most celebratedfemale poets of the twentieth century are women who killed themselves and who documented the course of their selfdestructivenessthrough their creations (Greer 1995, 390). Plath'sblazingfinal poems about dying and self-contempt(for example, "LadyLazurus," and her poem "Daddy") entitled "Edge" about self-completion,which recordsher final acts before her suicide (for instance, of leaving her children with bottles of milk) are literally scriptsfor her self-destruction. 8. For instance, 50 percent or more of the institutionalized(neglected or abused) elderlysufferfroma mental illness (Smyer 1995, 164). Regardingratesof mental illness found in homosexuals,Joan Callahan relaysthat "roughly percent of gay teenagers 30 report attempting suicide, and roughly 40 percent of all attempted teen suicides are connected to real or perceivedhomosexual orientation"(1999, 263). 9. Inasmuch as perceptions, ideas, and evaluations are informed by and inform emotional states like despair,rage,and hatred,which partiallyconstitute some psychiatric illnesses, people sufferingfrom these will desire some transcendenceof emotion, which patriarchaltheorists have devalued with the body. This view does not affirm a rigid mind-bodydualism, as it recognizes the cognitive content of emotion and the emotional affect of cognition. 10. I do think, however, that the pressurethat non-disabled persons impose on disabledpersons to pass as normal does sometimes stem from a fully aware,shameful sense of the true nature of their behavior;yet they believe that this behavior,though unfairand unreasonable,is unavoidable.Forinstance, a teaching assistantwho is taking a prolongedlength of time to markessays,albeit for a good reason, might compromise the health of the course, because students need feedbackon their workfor upcoming assignments and the professorneeds an assessmentof student comprehensionbefore

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This case illustratesthat a teaching assistant's makingany courseadjustments. difficulty in passing as normal may disturb an academic balance that is fragile because of a strong general insistence that everyone be continually normal when this insistence is unreasonable.By not taking into account the potential of a compromisedcapacity to function, this insistence jeopardizesthe health of the academicenvironment. 11. This, of course, is not an argumentthat those with psychiatricdisabilitiesare worseoff than those with physicaldisabilities,or that the formerdeservemoreconcern than the latter.Here I am simplyexploringdifferencesin social attitudestowardthose with psychiatricdisabilitiesversusthose with physicaldisabilities. 12. Notably, in the Frenchlanguageone might say of a mentally ill woman, "Ellea this expressionmeans she seems "crazy," l'airbete." While figuratively literallyit means that she seems like an animal, "bete" Further,the expression translating as "animal." as "crazy a loon"also reinforcesboth the oppressionof animals and that of people who are mentally ill, in invoking a negative image of an animal to insult a person who is (or judgedto be) mentally ill. 13. For a critique of modern pharmaceuticalinterventions in mental illness, see Breggin (1994). 14. A patchworkquilt is called a "crazyquilt" because of its multiple, disparate elements. 15. Calhoun's view of moral failure involves the notion that expressions of selfrespect in membersof subordinategroupsmay be misunderstoodby others as displays of arrogance,as when they condemn membersof dominant groupsor express moral outrage concerning injustices (1999, 86). Her conception of a moral revolutionary does not include an individual who might in her struggle toward moral perfection realizeas virtues what are usuallyconsideredvices. In my account, on the other hand, interpretationsof selfishness, and not appropriatepride, in members of subordinate groupsmay in some cases be correct, and this selfishnessmaybe morallygood, because it furthersmoral growth. 16. In The Unnatural LotteryClaudiaCardarguesthat oppressiondamagesvictims, making certain virtues difficult for them to achieve (1996). On her view, traditional vices are justifiablefor self-defense,but this justificationdoes not make them virtues (1996, 53). She writes: "Those who tell just the right lies to the right people on the right occasions may have a useful and needed skill. But it does not promote human good, even if it is needed forsurvivalunderoppressiveconditions"(1996, 53). However, such behaviorpromotesthe human good of the survivor.

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