Calling someone “crazy” as an insult can contribute to stigmatisation of the mentally ill (probably)

August 9, 2016

I’ve been meaning to write something about the use and abuse of the conceptual framework of mental illness, esp in the current US presidential election, for a while now. There’s been a uptick in the past week with Trump behaving erratically and then accusing Clinton of having various sorts of mental illnesses. Also, on one of my favourite blogs (where I comment a lot), one interlocutor has adopted a systematic gaslighting (among other things) strategy to try to shut down my criticism of them. So, it’s on my mind!

This is not that writing, but rather a response to a Kevin Drum blog post entitled “Calling Someone Crazy Is Not an Insult to the Mentally Ill.” He writes:

No. Just no. There are lots of words that have both ordinary meanings as well as technical medical meanings. When I say that Donald Trump is a cancer on our society, it’s not an insult to people with leukemia. When I say that Donald Trump is stupid, it’s not an insult to the mentally retarded. And when I say that Donald Trump is crazy, it’s not an insult to people with mental illnesses.

No. Just no. (Sorry, couldn’t help it.)

How should we evaluate these sorts of claim? Before I present what he’s responding do, let’s consider some prior probabilities.

  1. Are people with mental illness stigmatised? Yes, of course they are. In all sorts of ways.
  2. Is there a lot of derogatory language which uses the idea of being mental ill as a disqualified for various activities (e.g., jobs, relationships, etc.). Yes! I trust we all agree on this.
  3. Historically, have complaints about derogatory or biased language been met with
    1. derision,
    2. nonsense claims about language (i.e., it’s not derogatory or it’s a joke or..), and
    3. hyperbole about the harms that come from opposing such derogation?

    Yes. Are there any exceptions?!

This should establish a burden of proof. 1 and 2 alone show that if you want to argue that some use of mental illness inflected derogatory language is harmless, you have work to do. 3 should make one very cautious about particular arguments for harmlessness. How does Drum’s fare? We have 3.a right off the bat. 3.b is there in the first paragraph as well. (Words have different meanings! By implication the derogatory use of “crazy” has NOTHING AT ALL to do with the “technical” meaning!!) How about 3.c?

This is the kind of thing that helps power people like Trump in the first place. Sure, a lot of people who gripe about political correctness are just upset that people get on their case these days if they call blacks lazy or Asians inscrutable or women hysterical. There’s not much we can do about this except keep fighting the good fight and wait for them to all die off.

But there are also people who aren’t especially racist or sexist, but nonetheless feel like they have to walk on eggshells around us liberals. Call someone crazy and you’re insulting the mentally ill. Talk about someone “suffering” from an illness and you get a stern lecture about not making assumptions. Ask any number of possibly dumb but innocent questions and you’re committing a microaggression. Wear a sari in a music video and you’re engaging in cultural appropriation.

This kind of hypersensitivity does little good and plenty of harm.

We can agree that people like Trump use the “PC” charge to rile up their followers. That’s evidently true. I’m more skeptical that it nudges people of good will off the ranch. After all, the core of Trump’s use of PC isn’t to attack PC per se, but as an amplifier and defence of being racist, sexist, etc. Trump, in particular, is very naked about his repugnant behaviour. It’s hard to see how people who are predisposed to find Trumps e.g., racism horrific are going to be turned back by mild requests not to use mental illness terms.

Notice as well that there’s nothing specific about mental illness terms in this litany…it immediately segues into a general PC complaint and a mishmashy one at that. (For example, if micro aggression theory is correct then there are real harms associated with those “dumb but innocent questions”. If micro aggression theory is wrong, then those complaints are misguided. But notice that Drum isn’t questioning anything here. There’s a just a presumption.)

Now, I did a super brief look at some research (via a simple Google Scholar search) and there’s at least prima facie evidence that use of terms like “crazy” as derogatory terms contribute to stigmatisation of mental illness which leads to lack of treatment or support. So, what claims was Drum fulminating against?

What I do know is that we ought to stop casually throwing around terms like “crazy” in this campaign and our daily lives….When that language is commonplace, it becomes that much harder for those experiencing mental illness to openly seek treatment that works. It discriminates, in subtle and overt ways, and extends its reach into schools, workplaces and the health-care system, where we still don’t provide routine mental health exams. When we use that word the way we have, we perpetuate the dangerous, “separate and unequal” treatment of these illnesses, and continue to pretend that the brain isn’t part of the body.

This is a pretty modest claim (by Rep. Patrick Kennedy) that seems congruent with the literature. But, let’s note that Drum cherry picked the quote. Right before it we have:

Is Donald Trump experiencing a mental illness? That’s the question making the rounds these days. The answer is: I don’t know. And neither do the commentators, tweeters and psychiatrists — both licensed and armchair — who’ve diagnosed him from afar as “crazy,” a “psychopath,” not “sane,” having “narcissistic personality disorder” and a “screw loose.”

So while Kennedy uses “crazy” as a synecdoche for the general derogatory misuse of mental illness talk in the campaign, it’s clear that he’s not primarily talking about minor positive uses “crazy weather!” “That’s just crazy awesome.” It’s not unreasonable to wonder where the tipping point is in cost-benefit for language campaigns (though people just assuming that the cost is always out of wack with the benefits are often those who don’t stand to benefit), but the mental illness talk we’re seeing in the campaign is extreme and worth opposing.


2 Responses to “Calling someone “crazy” as an insult can contribute to stigmatisation of the mentally ill (probably)”

  1. Very good written article. It will be helpful to anybody who usess it, as well as myself. Keep doing what you are doing – looking forward to more posts.

  2. When Nev told her it was someone’s life she was messing with, my mind went back to that scene in “The Shawshank Redemption” where Andy is screaming at the warden in his office “THIS IS MY LIFE! DON’T YOU UNDERSTAND?!” as he’s being dragged off to the hole by the guards. When I substituted Nev for Andy and Loyda for the warden, I couldn’t stop laughing. Methinks Nev would’ve had a good time with “The Sisters” and the poster on his cell wall to cover up the tunnel would’ve been of Cary Grant instead of Rita Heyworth.

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