Mental illness is a complex and perplexing subject to talk about; it is bound to be, for it has been, determinedly and persistently, forced shut behind padlocked gates for generations. It is only now that it is venturing out, slowly, but with temerity; bold in its assertion.
To be clear, mental illness and persons with mental illness may have been kept veiled, but ‘artistic’ expression, in one way or the other, has been able to present the issue for (popular) public consumption. Whether it be through Munch’s famous series of “The Scream” or through more voyeuristic images of unkempt men and women in straight-jackets staring menacingly at the world (often used as terror inducing movie plots or for comedic effect), we have, without a doubt, been introduced to the issue.
So much so, we use it in our daily communication, without giving it much thought or importance. There is a need to question the, so far, unquestioned and continued references to mental illness and persons with mental illness to connote inferiority; perpetuating the stigma around mental illness and people affected by it. Maneka Gandhi’s uninformed statement on the inability of a ‘schizophrenic’ to hold a job is a good example of the kind of prejudice persons with mental illness live with and the importance of language in steering conversations. Prejudice becomes harder to fight when pejorative comments are made by people in authority and policy makers who are responsible for countering the exact bias that they endorse. There is, therefore, a need to also create awareness about the meaning and content associated with these references and the role they have played in the social exclusion and public humiliation of people with or without mental illness.
Labels of exclusion
It is truly remarkable how frequently the issue finds mention in our language but is mostly absent from any conversation. Words like ‘idiot’, ‘mad’, and ‘crazy’ are regularly used as labels to establish, temporarily or permanently, a certain sense of inferiority in others. Indeed, these labels are frequently and effectively used as tools to exclude and alienate people from peer groups and communities. How many times have we not complained about someone being ‘crazy’, to discount what they are saying, or called someone ‘mad’ to dismiss them? Even ‘idiot’ has a history indicative of prejudice. ‘Idiot’, especially, is used so frequently and so easily that in its constant usage it may very well have lost its original meaning and, more importantly, intent. However, historically, ‘idiot’ has been a reference to people deemed considered to have little or no ability and capacity to understand conversations and ideas, and who, by implication, are either looked at as entertainment or are deemed not fit to participate in society. It cannot be emphasised enough how successfully these labels have been used to mock and insult people and reduce them to objects for stones to be hurled at for fun, and to banish them from social and community life. I do think that these words have, for the most part, become just expressions of daily use without much content. And yet, the more I think about it the more uncomfortable I get. These words do have meanings and implications, which cannot be ignored.
The exclusionary tone of language continues to accompany mental illnesses, especially severe mental illnesses, which have been given names, mostly for ease of identification and treatment. However, it may have unwittingly made it easier to identify certain features of a person and turn them into subjects of mockery leading to stigmatisation and alienation. For instance, behaviours associated with Obsessive Compulsive Disorder (OCD) are often made the butt of jokes. OCD, when not managed, can severely affect the daily functioning of a person and can be highly debilitating; it is no joke for the person who has OCD. Whether a person has OCD or not, the language and the general conversation associated with it creates an atmosphere of shame and stigma which may make it difficult for a person with OCD to lead a public life. Contrary to their purpose, these names have become labels used to invoke images and meanings which are to be laughed at or be scared of.
Labels have also created a much subtler but very pervasive habit of automatically assuming that the illness defines the person; that the person is the sum total of her illness. For instance, labelling me as bipolar is very different from acknowledging that I have bipolar disorder (which I do). The implication of the labelling is that my existence and my illness get merged into a unidimensional entity. The latter, however, suggests that bipolar disorder does not define me (which it doesn’t) but still plays a part in my life. This distinction is extremely important in order to understand that the person must come first. The various aspects and experiences of the person define her in conjunction with and in harmony with each other. This is not a matter of semantics and language syntax but about recognition, and however innocuous the difference may appear to be there is a deeper meaning to it. Identifying a person only as “mentally ill” is a refusal to acknowledge their experiences and a refusal to assign the same validity and legitimacy as is assigned to the experiences of those who are not “mentally ill”.
These words and phrases sit so comfortably in our daily language that replacing them is, indeed, extremely difficult, and inconvenient. I have found myself interrupting people mid-sentence and quite often the interruptions have met with exasperation, impatience or confusion. The lack of any prejudicial intent may make the objections seem trivial and even superfluous, but they are necessary. The ‘lack of intent’ argument may be valid when there is lack of information, but its validity drops a few notches in the presence of knowledge. The ‘lack of intent’ then actually becomes, for the most part, carelessness or forgetfulness or inconvenience, which is what requires constant protestations.
Language has tremendous influence over how we behave with each other in our communities and society and what we make of one another. Exclusionary as well as inclusionary behaviour is, in so small part, a result of the prejudice created or negated by language. The power of language needs to be harnessed to change the tenor and content of conversations around mental illness and to bring about a positive change in the false perception of persons with mental illness.
Maitreyi Misra is an Associate at the Centre on the Death Penalty, National Law University, Delhi