The broken continuum thesis or they are not like us

Some arguments are such that I feel compelled to answer them. Such was my feeling after reading social work lecturer Ken McLaughlin’s lecture, The unhelpful myth that we’re all a bit mad. I imagine him to be more comfortable with the myth that most of us are quite sane. Given the state of the planet earth after much human interaction on it, I find that myth highly questionable myself.

One argument put forward by several participants was that to understand mental health/distress it was necessary to view it as a continuum, with mental health at one end of the continuum and mental distress at the other. We are all placed somewhere on the continuum and we will all, at some point, move along it, for better or worse, in one direction or another. In other words, there is no rigid divide between mental health and mental illness; therefore, to classify some people as mentally ill sets up an ‘us and them’ situation, with ‘them’ being stigmatised and oppressed. The continuum model is one that is advocated by many in the mental-health field today, and one which seems to make sense. Yet in truth, it is a flawed and unhelpful model which does little to help those in need but much to categorise us all as mentally vulnerable.

I’m not sure counterpoising mental health to distress is a particularly fruitful parellell to make. I do think it might be better to compare more distress with less distress. More distress tends to find itself pathologized while less distress doesn’t tend to find itself pathologized quite so often.

I don’t, by the way, think the view “that we’re all a bit mad” is really an “unhelpful myth”. In fact, I don’t think it a myth at all. A big misunderstanding occurs where people forget that people experiencing distress are human beings, too, just like they are. Alienation, after all, is a big factor in the distress that many people experience. Alienation has a human face even if that face sometimes resembles a mask.

Another weakness in the continuum proponents’ case is that, in reality, they themselves do not believe it. Many of them frequently make decisions as to who is ‘different’ to the vast majority of the population. For example, even the most radical and progressive mental-health resource programmes, such as therapeutic communities and user/survivor asylum and support interventions, make assessments as to who should and who should not access their services. In other words, they operate eligibility criteria, making a distinction between people on the basis of their mental state. They may reject the medical model of classification and treatment, but they themselves classify and differentiate. Whatever model of mind is used to make the distinction, the end result is the same: the continuum is broken.

I don’t know that anybody is arguing that there is not a point on a continuum where a person would receive a psychiatric label, or when the person’s condition might be seen as pathological. I don’t see any broken continuum. I don’t see a broken continuum because I believe recovery from life crises is possible. This recovery would put a person on a continuum that would allow proceeding from a state of more distress to a less distressed state. Where this continuum is broken, as far as I’m concerned, what you would be dealing with is sub-human, or people for whom the same rules don’t apply as are generally applied to the species homo-sapiens.

Mr. McLaughlin sees a continuum of weakness or vulnerability being applied here but, frankly, I don’t see why we couldn’t just as easily envision a continuum of strength and determination applied, within limits, of course. At one end of the continuum is strength, and at the other end is weakness. Good mental health I assume would probably be more pervasive at the strong end of the continuum rather than at the “wrong”ed end of the continuum.

In an attempt to avoid such reactions to this piece I shall misquote the singer Carly Simon: ‘You’re so vain, you probably think this article’s about you.’ It’s not – but there is a pressing need to stop blurring the lines between everyday troubles and genuine mental distress.

Alright, is this article about “everyday troubles” or is this article about “genuine mental distress”? In either case I think it touches everybody. My feeling is that Mr. McLaughlin is a convert to the biological medical model religion of psychiatry, and that his conversion explains the linguistic camouflage he uses to disguise that bias. The church of psychiatry firmly believes in the brokenness of the continuum Mr. McLaughlin uses to illustrate his argument. I, in the interests of recovery and humanity, happen to favor the tunnel of an unobstructed continuum over any such abrupt and fatal cave-ins. The problem I see with his theory is that a broken continuum is a continuum nonetheless. It is just a continuum in need of repairs, or “healing” as some people put it.

3 Responses

  1. Brilliant analysis!

    • Thanks. I have always had issues with the kind of marginalizing thinking Ken McLaughlin was espousing. The few, in my opinion, are not so very different from the many. I had the expression, “nothing human is alien to me” in my mind as I wrote my post. Looking for the origin of the phrase took me to the original latin: “Homo sum: humani nil a me alienum puto” (Terentius, “Terence”, ca. 190-160 BC). Roughly it translates, “I am human: nothing human is alien to me.” It is Terence’s most famous quote. He was a Roman playwright, and it comes from one of the plays he scripted.

  2. Isn’t it amazing how obvious universal truths seem to have been discarded? Thanks for sharing the historical reference too! I really appreciate your perspective.

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