Who is crazy? Who is normal? Describing somebody as "not normal" has serious implications for this person, can destroy her life. From an anthropological perspective, there is nothing called normal. What we have are endless ways to lead a more or less meaningful life. Principally, everybody is as crazy as everybody else. The distinction in normal or crazy is artifical - it has to do with culture, history and politics, and is therefore an interesting object of study.
In this sense, anthropologist Roy Richard Grinker has written an important book that was just released: Nobody's Normal: How Culture Created the Stigma of Mental Illness.
In this book he explores the roots of mental illness stigma around the world - and reveals how our prejudices and notions of mental illnesses and ‘normality’ reek of cultural biases that stop many from seeking help.
According to a very interesting review by Claudia Wallis in Spectrum News, Grinker shares Sigmund Freud's wish that mental illnesses would be viewed “like the common cold, something everyone gets from time to time,” and that people “might eventually feel no shame in seeking psychological care for their problems.”
So why do people in the so-called West, and increasingly everywhere else as well view mental illnesses differently? And where does the stigma come from?
Grinker traces the stigma back to industrial revolution and capitalism in in late 17th-century Europe, Claudia Wallis writes:
With industrialization, people with intellectual disabilities, schizophrenia and other serious brain conditions were moved out of their homes and into asylums, along with criminals, debtors and addicts — basically anyone viewed as incapable of being a productive and self-sufficient worker.
Once institutionalized, people were sorted by their caretakers into categories: “idiotic” and “insane,” “probably curable” and “probably incurable,” and eventually more specific, medicalized terms. The words “normal” and “abnormal” were borrowed from mathematics and statistical averages.
As new categories of sickness and perceived deviance were added — mania, melancholia, dementia, masturbation (an actual diagnosis!) — the number of people consigned to asylums exploded in England and the United States. “Experts were at a loss to explain the apparent epidemic created by illnesses they themselves had invented and were now counting,” Grinker wryly observes.
In an interview with Psychology Today Grinker provides more details:
When capitalism took hold, we started to value individual autonomy and productivity for everybody. Before that, we didn’t hold a person responsible for all of their differences and all of their successes and failures
In the U.S., the hero is the individual. People with disabilities aren’t necessarily always able to be independent. By the very nature of capitalism, the person who depends on others, who lives with others, or who isn’t an efficient worker is considered to be a failure.
As a contrast he provides an example from rural Namibia:
A man I’ll call Tamzo, who lives in rural Namibia, has what we would call schizophrenia. He walks 20 kilometers to the village once a month to get antipsychotic medicine. The Western doctor there writes down his diagnosis as schizophrenia.
But at home he is thought to be the victim of a curse that somebody placed on their village that settled randomly on Tamzo. In his family and his village, as long as he is not hearing voices, he’s not considered at all to be sick. Whereas in the clinic, it’s “once labeled, always labeled.”
The anthropologist does not deny the existence of mental illnessess, Virginia Hughes writes in her review in the New York Times. But for the past few centuries, Western doctors have been fixated on distinguishing normal from abnormal. And those bright demarcations have made it easier to stigmatize people.
Grinker does not believe that a focus on the precise genes and biological mechanisms behind brain conditions such as autism and schizophrenia will reduce stigma. Neuroscientists hoped this would make mental illness more equivalent to for example heart disease:
Grinker disagrees. He notes that in some parts of the world a genetic basis becomes even more stigmatizing, as it casts doubt on bloodlines. And he believes that mental illness can never be entirely reduced to biology. As with hypertension, osteoporosis, hypercholesterolemia, obesity and many other conditions, the line between healthy and not healthy is constructed, or, as he puts it, “drawn more by culture than by nature.”
Check also his website, his texts in Psychology Today with titles as The Racist Origins of the Modern Concept of "Schizophrenia" and his Ted Talk:
Reading about his book, I remember a useful concept that the Norwegian researcher Ivar Morken introduced - in Norwegian he called it "normalitetssentrisme" - in English it might be normalcentrism. He thinks it would be fruitful to talk about nornalcentrism in a similar way as we talk about ethnocentrism.
Mental illness and normalcentrism has been topic before, therefore: