If ‘mental illness’ has failed as a metaphor for psychic distress, as I’ve argued, how do we explain the obvious fact that some people have so much trouble with their minds? Whether we speak of an adolescent hearing voices and drifting out of touch, or a young woman paralyzed by anxiety, or an older man with no desire to live, we see mental problems all around us. Why raise a fuss and argue against the widely accepted notion that these are illnesses?
The problem is perception. If by ‘illness’ the psychiatric world meant something akin to a cold or flu, something transient and healable, I would raise no objection. But instead the authorities speak of ‘brain disease,’ which invokes comparison to progressive disorders like Alzheimer’s dementia and Huntington’s chorea. They insist that expensive psychiatric medications are needed by the ‘mentally ill’ the way insulin is needed by diabetes. And everyone understands diabetes to be a lifelong condition once acquired.
The ‘illness’ metaphor as currently used robs hope from those suffering mental distress. And if there is one thing we need when our minds are in turmoil, it’s a sense that things can get better. The expectation of a little improvement at the cost of drug dependence and awful side effects will not suffice. We need to believe in the possibility of a grand and glorious transformation from constricted misery to expansive joy. The ‘brain disease’ metaphor rules out such optimism.
Although it’s been criticized as too simplistic, I like David Dobb’s metaphor of ‘orchid’ versus ‘dandelion’ temperaments. His well-known Atlantic Monthly article focuses on the effects of upbringing. In Dobb’s opinion, ‘dandelion’ children are like weeds. Hardy and resilient, they come out much the same whether nurtured in a conservatory or neglected in a junkyard. They may not rise to the heights of creative genius, but they perform competently and reliably. ‘Orchid’ children, in contrast, will grow into unique and spectacular people when brought up in a loving and enriched environment, but will end up stunted and wilted if conditions are more challenging.
I’m no expert on child rearing or behavioral genetics, so I can’t speak to this model’s accuracy in its description of how we get formed. I suspect that in some cases a challenging childhood may actually spark creativity, whereas a safe one may lead to greater happiness but less expressiveness. But that’s not my main concern in this post.
What I’d like to suggest instead is that our fate isn’t sealed after we grow up. Why do I think even orchids can overcome a rotten upbringing and learn to thrive? Because I’ve seen such transformation in my own life and the lives of others. And how is such decisive improvement achieved? By reshaping the inner, mental environment from a bleak junkyard into a lush and fertile landscape. When we do so, our ‘inner orchid’ blossoms with passion, contentment, and purpose.
So how do we clear out the cold and barren junk and invite warm tropics into our mental life? By using helpful rather than harmful metaphors.
Tell me my mind is like an orchid. Explain how my nervous system is sensitive and needs gentle attention. Remind me that I was traumatized and that bleak and harrowing memories may sometimes haunt me. Gently suggest that I’m more emotional than average. These are accurate and useful statements.
Yes. Tell me I’m outside the dandelion norm, tell me I need to attend to my thoughts and behavior, but don’t tell me I’m diseased. If you do, you’re not helping.
‘Disease’ is a harsh concept. It raises the specter of contagion, degeneracy, and quarantine. It sets us apart from the supposed ideal of the mainstream. It’s pessimistic, insulting, and disempowering.
And before the psychiatric community can legitimately call some of us diseased, it needs to grow a little healthier itself. Breaking free of the corruption of drug profiteering would be a good first step in its own transformation from junkyard to jungle.
I am more like an orchid than a germ. I take responsibility for tending my mind’s garden, but I reject conventional psychiatry’s insistence that my brain suffers from a permanent illness. This idea may promote pharmaceutical sales, but it inhibits full blossoming into passionate, hopeful life.
Let’s choose our metaphors more carefully.