One of my biggest musical heroes, Ron “Bumblefoot” Thal, has two albums exploring truth and beauty about being and music called Normal and Abnormal. In these albums we get to witness texts and music abundant with rich human experience. I am sure some will find the songs at times too much, but that is what life is like — often simply too much. As a musician I am in awe of the musicianship on the albums. As a phenomenologist I am grateful for the lived experience.
The line between normal and abnormal in human experiencing is fully arbitrary. Yet psychiatric diagnoses make the call of what is abnormal seemingly objectively. But I do not believe there is an objective truth about human experiencing. And Lauri Rauhala would point out, that a discourse based on analogies from somatic medicine is inadequate for our conscious life. Talking about mental disorders is a category mistake. People have hard lives, and experience strange experiences that may result in behaviour that does not adequately meet the realities of a life. But is that a disorder, or is it a life-management issue that cannot be treated with medication, but should be addressed by learning adequate coping strategies and changing too stressful situations to more favourable ones? I am not dismissing medication altogether, and have had to resort to psychiatric medication myself, but the core issue is often human experiencing, not a brain disease.
Psychiatric diagnoses are agreements between a select number of medical professionals on what is abnormal. They are nothing more, or nothing less, even though they have massive impact on how people are seen, and how people are supported, say, through health insurance. It is good to remember that homosexuality was a psychiatric diagnosis for decades. Something disagreeable to a small number of heterosexual medical professionals at the time was coldly labelled as pathological. Now the whole notion seems wholly absurd, because we have as a culture, luckily, advanced.
It is tragic how psychiatric language creeps into our everyday thinking. We throw around concepts like “narcissist” or “borderline” or “anti-social” too lightly, without real clinical knowledge or even proper reflection. Psychiatric diagnoses are difficult stigmas, that can make a life already hard even harder. It is well-known that people with psychiatric disorders get less help for their somatic issues than those who do not have those labels.
And psychiatric diagnoses create self-stigmatisation that limits our self-understanding. For years I saw myself as someone with several disorders, nothing more. When you are broken down in your own eyes, how could you change?
Internal Family Systems and Polyvagal Theory — both presented in my upcoming book A Good Life Despite Everything — offer ways to think about even extreme experiences in a non-pathologising way. IFS helps us see difficult emotional states as understandable protective mechanisms. And, importantly, it gives us a language and a toolset to work with these psychological dynamics, when they are not extreme.
Polyvagal Theory, on the other hand, helps us see how dysregulated nervous systems create sometimes extreme experiences of stress, like full shutdown or dissociation. And it offers us coping tools, even though obviously, many extreme states need professional intervention.
We really do not need the labels people are given, from a purely philosophical perspective, but every support system is built around them, so for now, we have to live with them. It is important to understand that the critique against psychiatric diagnoses does not only come from outsiders, or those who suffer. It comes from inside psychiatry as well, as exemplified by Allen Frances’ “Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life”. It is recommended reading for anyone thinking about these issues.
As long as our help systems lean on psychiatric diagnoses, I wish we could as human beings see each other without pathologising attitudes. Think of dissociation. You can either see it as a sign of a disorder, or as a natural tendency to turn off reality, when reality is too much. I choose to do the latter.
Human experiencing is a wonder of nature, even when it takes unusual forms. Or perhaps exactly when it takes exotic forms. We should give everyone the benefit of the doubt: there is a reason and logic for extreme experiences. If we look for that, we can see the meaning in suffering.
Thank you God for all these choices
In the boundaries of your game
Through the silence and the voices
All my love will never change
It was so nice to be normal
To be normal for a change
So strange…
It was so nice to be normal – but what’s normal, anyway?
Bumblefoot, Shadow, from the album Normal. Lyrics by Ron Thal. Reprinted with permission
Arctic Search for Meaning 