Barry’s Blog # 375: Dionysus Looks at Mental Illness, Part One of Seven

What is madness but nobility of soul at odds with circumstance? – Theodore Roethke

Divide us those in darkness from those who walk in light. – Kurt Weill

Dionysus was the ancient Greek god of wine, drunkenness, masks, frenzy, ecstatic joy, paradox, suffering, tragedy – and madness. Wherever he appeared, he subverted the classical Greek consensus of reason, exalted discourse, and refined culture. He posed annoying questions upon king and philosopher alike, tore down the walls of the isolated ego and insisted that everyone was fundamentally animal, social, instinctual, sexual and irrational.

In terms of Depth Psychology, he represents the paradoxical archetype of the Other. He is an aspect of nature – and human nature – that is both outside the boundaries of the known, familiar and acceptable, but also deep within, at its very core. Since he confronts us with the mystery behind the reconciliation of opposites – male/female, active/passive, light/dark, mortal/immortal, sacred/profane – we can only define him by what he isn’t. Simply by showing up at the gates of the city (or the mind), he threatens our carefully built sense of who we are. He reminds us that identity is constantly shifting.

Consequently, patriarchs and authoritarians have attempted to repress the Dionysian impulse for well over two millennia. However, his modern incarnations persist in our imagination as the Other. He is everything that America has cast into the shadows: women, gays, non-bindery or transgender people, people of color and poor people. But this happens at a great cost. By denying this innate archetype, we deny much of who we are, because, as Walt Whitman taught us, we all contain multitudes.

If Dionysus were to speak to Psychology and the medical establishment in the Age of Covid, economic instability, Black Lives Matter, climate change and a collapsing American empire, he might ask certain annoying questions, such as:

Is a child molester a criminal, a sinner or a sick person? Why do we think of a terrorist or a tyrant as evil rather than sick? Why are convicted murderers not considered insane? Why do we punish criminals instead of rehabilitating them? Why does America demonize its children simply because their parents are poor? Why are we so violent? Why are the mentally ill disproportionately female and poor? In a dysfunctional culture, what is a dysfunctional family? What is functional? Why do we take so many drugs, legal or otherwise? Why, in these maddening times, isn’t everyone running through the streets raving and grieving? Isn’t willful innocence a form of madness?

Perhaps all these questions can be rolled into this one: Why are Americans so Freaking Crazy?

Invoking this god as my guide, I want to circle around these themes in a Hermetic, Dionysian, soulful, non-linear manner, showing more interest in surprising connections and brief liftings of the veil than in logical proof. In his realm, the questions are more interesting than the answers.

Dionysus

The god of madness lives in our asylums and halfway houses and among the homeless. And at home: In any given year one in four adult Americans suffers from a diagnosable mental disorder. Six percent are seriously debilitated; and half will develop a mental disorder at some time in our lives. Depression has doubled since World War II, with each generation showing increasing rates. It now impacts twenty million American adults. One in ten women and six percent of children take antidepressants.

Nearly half of young people have been diagnosed with some sort of psychiatric condition (counting substance abuse), and almost twenty percent have a personality disorder that interferes with everyday life. Eighteen percent of college students take prescription psychological medications, and fifteen percent are clinically depressed. Suicide is the second leading cause of death among college students. 

Although the percentage of Americans confined to mental hospitals has declined since the 1960s, the numbers of those seeking professional help has increased. Still, nearly three-quarters of those with serious psychiatric problems never get professional help, turning instead to alcohol and other forms of self-medication.

The statistics indicate that many of us are going crazy. But, asks Dionysus, who defines sanity? For decades, Benjamin Rush’s nineteenth-century definition prevailed: “…an aptitude to judge of things like other men, and regular habits, etc.”

But for those considered abnormal, Rush, the father of American psychiatry, advised, “…TERROR…should be employed in the cure of madness…FEAR, accompanied with PAIN, and a sense of SHAME, has sometimes cured this disease.” His name evokes the history of the brutal treatment of the mentally ill, in which all manner of torture was used well into the 20th century, including mustard baths, application of hot irons, “punishment chairs,” bleeding with leaches, electroshock and “refrigeration therapy.”

Freud saw sanity as the abilities to love and work. This meant fitting in with one’s cultural norms. One of his disciples stated that the goal of psychoanalysis is “the eradication of mystery.”

The libertarian psychotherapist Thomas Szasz, however, insisted that most mental illness is composed only of behaviors that psychiatrists – white, middle-class men – disapprove of.

Dionysus also asks, who should die because they commit crimes even though they know right from wrong? America no longer executes the mentally retarded, and Psychiatry has drawn the I.Q. line at 70. Paula Caplan, however, argues that I.Q. testing is notoriously inaccurate:

Like ‘intelligence,’ ‘retardation’ is a construct. Why should anyone decide that a prisoner who scores 69 on an IQ test should live but one who scores 71 should die?

We know what is acceptable by identifying those who, as John Jervis writes, “contradict the official self-image, disturb its clarity, question its necessity.” “Female” behavior has long been the baseline. Doctors committed nineteenth century women to asylums for such “symptoms” as flirting too much, refusing to marry men chosen by their fathers and excessive religious fervor. Asylums, writes Phyliss Chesler, functioned as “… penalties for being “female,” as well as desiring…not to be.” The gender imbalance still exists, even if such behaviors are no longer valid excuses for institutionalization. It remains safer for women to turn their dissatisfaction inward through depression rather than outward through violence (more typically male behavior). One in eight women will be diagnosed with depression during their lifetime, and they are twice as likely as men to receive electroshock treatment.

Middle-class women utilize private therapy, but often consider hospitalization in midlife (if they can afford it), when they are both overworked and beginning to feel sexually and maternally expendable. Chesler claims that, prior to 1970’s feminism, most women simply gave in to mixed expectations of their social condition, which provided them few options. Now, single, divorced, and widowed women all have lower rates of mental illness than married women, and the reverse is true for men. Poor women, however, have few options but the penal system and state mental hospitals.

If “female” behavior – collective, emotional, “hysterical” – defines the shadow of our value system – and of the prejudices of psychology – then the perspective within the pale is American radical individualism, which emphasizes the individual differentiating out of the family – the heroic ego, as James Hillman described, in a hostile world.

Read Part Two here.

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