"Artistic temperaments", mental health, and balance

[urocyon]

greenknight pointed out two interesting posts earlier, and I thought I'd pass them both along. One, How to keep someone with you forever, from issendai, talks about the characteristics of sick systems in both personal relationships and organizations. I couldn't help but be reminded of a couple of pieces casting the federal government (BIA in particular) in the role of abusive partner. Controlling and abusive tactics look pretty similar across the board. :-|

The second is rachelmanija's response to Robin Hobb/Megan Lindholm's recent article on mental illness and the "artistic temperament", This Is Your Brain On Drugs....

The hell of it is, both made some reasonable points.



I am pretty thoroughly fed up with the "artistic temperament" BS as it gets applied. It's too frequently used to excuse away and cover up very real difficulties people are encountering, without even trying to figure out how to help them get even minimally functional. Yeah, I was on the wrong end of that one (along with general "giftedness") a lot in school--and to some extent at home--to the point that I suspect my EF problems helped get me so firmly labelled as "artsy". That would be marginally OK if it hadn't been to the exclusion of much else in the way of skills being expected. (Situational) depression and dyscalculia*? Hardly even registered. What else would you expect from someone so "artsy"?

OTOH, I was obviously having problems to the point that the school psychologist (whom I'd never even met) insisted that I be put on Ritalin or be removed from school. Until my mother cited exactly how this was illegal. Bear in mind that this was ca. 1982, and I was a girl. I knew several boys (including one of my cousins, living in a bad situation) whose parents believed the school system could mandate medication, and who then got plonked in a special ed classroom more for segregation than, erm, education. AFAIK, nobody in that system even tried to figure out why any of us were having difficulties in the first place, much less made any attempt to work around them. (Yeah, the sick systems thing ties in here.)

Once I hit adolescence, it became more difficult to pretend that I was not having trouble coping, with depression and never-really-addressed LDs, at the very least. On one hand, it still got excused as an "artistic temperament", while on the other I got into the psych system. That did include enforced therapy (under looming threats of hospitalization) as well as medications, but the emphasis was still more on what was wrong with me than on trying to figure out what might help me cope better in my daily life. The day-to-day difficulties with EF and inertia--and never having learned much in the way of organizational skills--did not magically go away under the influence of Prozac and therapy to unearth repressed memories of trauma I did not, in fact, experience. (Based largely on autistic behaviors--such as really not wanting people to touch me unexpectedly, and flinching--and very real Complex PTSD from different sources which were not considered relevant, if discussed at all.) Very little in the way of practical help with coping skills--other than a victim-blaming stint in a social skills group when I admitted to being relentlessly bullied--was offered. I just couldn't do certain things because I was sick, and I'd better get used to that.

This pattern continued and escalated, until I completely burned out and crashed out of college. And got progressively heavier-duty meds, with no recognition that things like a lack of coping skills (much less added emotional abuse, rape, and stalking) might have helped this happen. And I am reminded of one piece, A tale of two boys, by Laurie Ahern, though my crash was rather different-looking. That does seem to rely a bit heavily on a false dichotomy, but there is a very real problem with overreliance on labels and meds in cases like this, often to the point that (competent) talk therapies are neglected.

Some medications may be useful for some people in some circumstances, but as a tool rather than some kind of magical fix. And assuming informed consent and lack of coercion**, which is one of my objections to medicating kids outside very extreme circumstances. It's still important to recognize the power imbalances involved, even if you really do think it's for the other person's own good. And balance the potential for decreasing the person's distress against the very real possibility of cognitive (and other) side effects. And pay attention if they report adverse effects, instead of just chalking it up to "resistance". And so on.


The most important thing, IMO? Recognizing that the person is running into problems, and working with them to try to figure out what will help them cope better, in a non-judgmental manner. (This may well include medication(s), BTW.) There is no magical fix, and it really doesn't help to frame the situation in terms of fixing someone else. If what you are doing is not improving the situation, it's time to reconsider how (and why) you are "helping"--and try a different approach to working with the person until you find something that does work.

The biggest overall problem, AFAICT? Universalism, to the exclusion of pragmatic approaches to helping people lead better lives (where "better" is whatever makes that particular person happier and healthier). As I described it elsewhere:

The source of the difference--neurodiversity or culture--doesn't even matter, from a universalist standpoint:

Here’s what I mean: if I have a universalist orientation, that fact alone can make me insensitive to cultural difference. If I’m universalist, I will tend to believe there’s one set of principles to live by — everywhere in the world. That is a stance that undermines what intercultural sensitivity is all about.

This shows up all over the world when universalists are present. Think of imperialism and colonialism: it’s no accident that the main perpetrators have been nations with largely universalist orientations.

Universalists can be slow to see a need for intercultural consulting, coaching and training. What value could these services possibly add, if things are the same the world over? Or, in a weaker version: if everyone in the world wants the same things?

If everyone is assumed to be perceiving things in the same way, reacting to them in the same manner, expressing the resulting (same) emotions in the same way, while motivated by the same considerations in any given situation--any deviation from the expected pattern may well be interpreted as a sign of poor mental health. This has happened to me, and to family and friends.

Especially in the US these days, the response to a perception of mental illness is frequently to medicate the person, without really trying to find out what is going on. Nor what coping skills and/or support might help them live the kinds of lives they want. Situational distress is sometimes assumed to be a lifelong, biologically-based mental illness, though the symptoms may go away when the person's stressful circumstances change and/or they learn some better ways of coping with what's going on in their lives. (Of course, people who really do fit criteria for mental illnesses also benefit greatly from this!) A medicalized, universalist approach to human diversity seems to be what Robin Hobb/Megan Lindholm is protesting--and taking it way too far in another display of insulting universalism.

Everyone is different. Every situation is different. It's important to bear this in mind. The "oh, that's just how s/he is" approach, while very useful up to a point, can be taken to the point of the absurd (as in common usage of the "artistic temperament" idea). When has it gone too far? When you are more interested in cramming someone else into the "artistic temperament" (or similar) model than in paying attention to what very difficulties the real human being in front of you may be experiencing. If you can't do things like make sure your bills are paid on time, that's a problem, right there--and it can be worked around and/or some kind of support put in place.*** It's just the flip side of the "you can't do X and Y because you're mentally ill" coin. Binary, universalist thinking trumps actually helping the person, in either case. It's dishonest and disrespectful, besides just not being useful.

Which brings me right back around to the themes of balance and pragmatism, honesty and respect, and pretty much all the rest of the stuff I talked about in Happiness, Part 4: Seeing beauty. What has helped me the most is working on figuring out what I really want and how my brain works, doing away with a lot of the universalist "shoulds"--and working with that to find strategies that help me do what I want/need to do.


_____________

* Some of the other autism-related stuff was just evidence that I was lazy and uninterested, the classic bored underachiever. (It couldn't have been that I was overloaded, overwhelmed, and on the verge of shutdown or meltdown most of the time in that environment.) Which could also be expected under the circumstances. :-|

** Be it of the "you will swallow this in front of me or go straight to the hospital", "this is your only option, if you want to have any kind of decent life and show an iota of consideration for yourself and other people", or "your questioning the treatment plan I have laid out is a sign that you are very ill indeed and lacking insight" varieties. Yes, I have personally encountered all of these, and more. (While mostly just depressed.) And none of it is right.

*** I have enough other things to try to deal with that it's sooo much better if someone else (or automated online payment setups, if possible) can handle certain tasks. Note that there is a huge difference between recognizing that this takes a lot of different kinds of spoons which could be better used for other essential tasks, and the abusive twins "oh, she's just artsy" and "it's laziness/craziness/stupidity, pure and simple".

Comments

[urocyon]

I left out one coercive cluster which is very relevant in this context: the good old "Questioning the treatment plan I have laid out after five minutes' consultation proves that you are a neglectful/uncaring/generally bad parent/caregiver who does not want what is best for the person under your (horrible) care". That one didn't occur to me straight away, not having run up against it directly. But I have heard it used.

[green_knight]

I've had a GP feel very offended that I was questioning the treatment plan she drew up after consulting the results of a blood test. I, on the other hand, was offended that anyone would prescribe potentially lethal medication without even seeing the patient.

We did not get off to a great start.

(People in authority rarely take well to having their authority questioned, myself included, and I consider myself an authority on my body and my experiences.)

[astrophe]

Gah.

I didn't agree with what that first person was saying about medication. But reading the responses to her were 400% worse at the least.

"If you get through it without medication it wasn't REAL mental illness."

Oh yeah? Well what the €%*^ was it then when I was having to go minute by minute fighting suicidal impulses all the time? But since I don't do well on antidepressants it wasn't REAL because I survived it without them (with massive amounts of practical help including friends who would take me to their houses for suicide watch since I couldn't use the psych system.

I am starting to get really fricking sick of reading stuff by people who manage to view themselves nearly exactly the way the system wants them to, take their meds, go to the "hospital" obediently, and declare anyone who can't share that lifestyle either an oppressor or an idiot who doesn't know what they're talking about. I've got no problem with how they live their life but I'm sick of them acting like they know a damn thing about mine.

[rachelmanija]

I certainly didn't mean to imply that "If you get through it without medication it wasn't REAL mental illness." What I did mean to say is that if you are happy and successful and content with your life, you either don't have a major mental illness or you are treating it in some way, whether by medication, therapy, lifestyle adjustments, or some other method which works for you. If you were suicidal, you were not living the perfect happy life Hobb describes!

I didn't realize that my post would be linked as much as it was (which was carelessness on my part) and wrote it with the assumption that readers knew a little bit of my backstory. I am aware that many people don't have access to medication, can't take medication, or choose not to for various completely valid reasons. I do not take psychiatric medication myself, though I have in the past; I've found it helpful but I've found other treatments to also be helpful.

Anyway, I apologize for offending you and any others whom I offended.

[astrophe]

I don't think it was you I was replying to, sorry about not making that clear. It was a commenter. You had mostly good points from what I remember.

[eriktrips]

These are complicated issues, and so I can't really speak to them adequately in a comment, but I will say that the Hobb/Lindholm article was a very frustrating read. I have no idea what her daughter is actually going through and whether or not she would be happier and more able to function on medication, but to so glibly say that we have to be ourselves is to ignore the real-world effects of what is called mental illness and/or neurological disorders. It's fine for her if she manages her mood swings, but that does not give her the moral high ground from which to argue that nobody should take psychoactive medication for any reason, which she seems to be doing.

I really have no idea if kids are overmedicated these days. Lots of people seem to argue that they are, but most of them, in my experience, not only don't have kids but they do not have experience with any disabling or maladaptive condition--physical, mental, neurological, or any other imaginable type. Which would be fine, but as you say, universalism is the assumption that everyone experiences the world exactly as you do, and it is rampant in Western culture at the very least, and it often causes those who are not significantly affected by whatever they perceive as their own mental disorders to assume that therefore no one could possibly be, in fact, disabled by anything vaguely similar--and beyond that, conditions much more disabling than theirs are seen as simply a myth.

This is one of those moments where I want to scream "Don't tell me what my experience is!!" and "Don't tell me who or what I should be according to your rosy ideals!!" I hope, if she really would be helped by medication, that her daughter is soon old enough to make her own decisions and will be able to transcend her conditioning enough to do whatever she needs to do to function optimally. Nobody can tell anyone else how best to realize their own potential; not even Mom who thinks she is bipolar but apparently has manageable cycles.

Is it wrong of me to sort of wish the author could experience a psychotic episode to see why it is that van Gogh's life was cut tragically short, and why, when he was sick, he could not work?

[megabitch.livejournal.com]

I'd comment on rachelmanija's post, but she has restricted comments to DW users only *shrug* Robin Hobb needs a bloody good slap and the truth about ADHD and bipolar disorders explained to her in excruciating detail. Her article was insulting and offensive. Guess who's not getting any more royalties from me?

[urocyon-c.livejournal.com]

Yeah, that was pretty close to my reaction. It was very disrespectful. There are a few of hers on the shelves here, but I'm not inclined to add any more. :-|

[urocyon-c.livejournal.com]

I left out one coercive cluster which is very relevant in this context: the good old "Questioning the treatment plan I have laid out after five minutes' consultation proves that you are a neglectful/uncaring/generally bad parent/caregiver who does not want what is best for the person under your (horrible) care". That one didn't occur to me straight away, not having run up against it directly. But I have heard it used.

[singingnettle.livejournal.com]

I cringed through Issendai's post, because it's basically my life with my husband. And apparently that was OK with me when I met him 15 years ago, but it's not now. But I truly don't want to get divorced. What I'm not sure is how to change the system. Merely saying, "OK, I'm not going to do these essential tasks anymore" is NOT going to work; it genuinely will mean that those tasks don't get done, and I'm not willing to live in squalor or destroy my credit rating or let the bills go unpaid...because I've tried that before, and that's all that happens.

It sucks to fall in love with someone who's mentally ill if you're also somewhat ill yourself, and if one of you wants to get better and the other one doesn't.

I might have to move on but I don't want to have to make that choice, because there are many genuinely good things here. But I don't know if they're good enough to have a tacit agreement to maintain this system.

[singingnettle.livejournal.com]

You know, in reading all these posts, I've come to a decision that I have to find a professional support system myself. What made me think I could successfully live with someone who has ADHD, biopolar disorder, paranoid depression (the treating of which conflicts massively with the bipolar), PTSD, fibromyalgia, and a hideous upbringing, without help and support and sanity-checking for myself, I don't know--other than my own somewhat sick background that predisposes me to think I'm supposed to be Superwoman. (A Superwoman with mild PTSD, fibromyalgia, CFS, and early body-wide arthritis who has been in and out of a wheelchair for the past year, to boot. What am I, nuts? Well--obviously, yes.)

Thank you.

[singingnettle.livejournal.com]

I apologize for cluttering up your post...it's just different things keep occurring to me. Let me clarify that when I say "get better," I don't expect my partner's neurochemical things to get "better" and go away. He doesn't make a choice to have ADD, etc., and these neurochemical issues are always going to be part of his life. The sick part of it, that I'm helping to maintain, is my being the solution to "everything I can't or won't do successfully." That's the part I want to break and he doesn't. Who wouldn't we all have a 24/7 personal assistant/housekeeper if we could? But...on the other hand...I don't understand wanting that from your life partner. You want a personal assistant...hire one so your partner can go have a life. (Now, how we pay one...that's another good question.)

[urocyon-c.livejournal.com]

No worries about cluttering things up. :) I'll get back to responding in a while, when I've got the time to concentrate.