Portrayals of Mental Illness
Psychology & the Movies
M Night Shyamalan’s movie Split (2016) was widely panned for deriving its thrills from inaccurate portrayals of a psychological condition — dissociative identity disorder (DID). Despite becoming a financial success, the movie was criticized for perpetuating the myth that persons with DID are predisposed to violent and erratic behaviour, and lack empathy for the suffering of their victims.
Such portrayals stigmatize those with mental illnesses as they are rarely accurate. Contrary to depictions in the media, persons with DID are rarely violent or aggressive, but they do have a history of chronic abuse or trauma — as the victim — and are at a higher risk of self-harming than non-dissociative patients.
Psychological horror–themed movies have been a pop culture staple, often amalgamating mental illness with religious themes (such as demonic possession) to exploit the audience’s discomfort with uncertainty and the unknown. Think The Exorcism of Emily Rose (2005), American Psycho (2000), Misery (1990) etc.
Closer home, Hindi cinema has also been including mental illness or neuroatypicality in their narratives. Movies such as Fashion (bipolar disorder), My Name Is Khan (Asperger’s syndrome), Barfi (autism spectrum), and Bhool Bhulaiyaa (DID) portray mental illnesses in a caricatured manner.
Taare Zameen Par (2007) depicted eight-year old Ishaan’s journey from being considered academically sub-par to an artistic savant diagnosed with the developmental learning disorder dyslexia. The film follows Ishaan’s deteriorating mental health and self-esteem as he fails to live up to the benchmarks set for him by his parents.
A pivotal scene in this movie emphasizes the importance of role models. When success and achievement are narrowly conceptualized as class performance, number of friends, and overt confidence — exacerbated by a dismissal of children’s inner lives and imagination as being unimportant to attaining these goals — the presence of role models similar to the nauroatypical child can help them feel empowered. At the end of the movie, Aamir Khan’s character reveals that he too is dyslexic, while epitomising a happy, functional adult.
Notably, when labels like ‘lazy’, ‘duffer’, and ‘idiot’ were used to belittle Ishaan (then undiagnosed), the film-makers recognised the exclusionary and ableist manner in which using intellectual disability as ad hominem attacks has become normalized.
Language & Mental Illness
Language is political. Words do not exist in a vacuum, but operate within psychosocial frameworks that help construct our experiences of the world. The way we use them establishes and persuades perceptions about various social groups. It is a potent tool in describing sociopolitical power dynamics.
To illustrate, historically, eugenics has been propagated as a form of manually engineered social Darwinism. It sought to segregate, institutionalize and force-sterilize those deemed ‘feeble-minded’ or ‘mentally deficient’. This was done based not on accurate science, but persuasive labels. Literature on the subject alludes to eugenicists’ fear that the ‘mentally degenerate’ (characterised as belonging to the socially, racially and economically underprivileged) would out-populate the white, upper-middle class, Protestant groups to which eugenicists tended to belong.
In several European countries, eugenics was propagated with the sanction of both Church and scientists, and conservatives and the radical left alike. The science behind it was decidedly lacking, as ‘feeble-mindedness’ was not well defined and imprecise measures of intelligence included those even with a moderately low intelligence score.
True to its etymology, eugenics (“of noble birth”) was a political tool to suppress the downtrodden under the guise of paternalistic compassion, rather than a tool to selectively breed and evolve a superhuman with perfect mental and physical capacities.
Mental Health Nomenclature in India
In India, this cross between racial and ableist prejudice based on misappropriated labels manifested in a similar manner. The establishment of the earliest mental asylums under the British rule occurred amidst tumultuous political conditions. These were purposed to serve ‘insane’ British soldiers and Indian sepoys under the East India Company.
The Lunacy Act (1858) was formulated with the objective of segregating ‘lunatics’ away from society, for the ‘safety of neighbours’. European inmates were also accommodated separately from Indians, like in the asylums of Colaba, Mumbai (erstwhile Bombay). Further, as if to cement the notion of the mentally ill as locked-away criminals, control of mental hospitals was entrusted to the Inspector General of Prisons.
The India Lunacy Act (1912) was relatively more evolved than its predecessor, in that its focus shifted from institutionalization to humane treatment of inmates; albeit, as a consequence of public attention to the miserable conditions in mental asylums, and not compassion for the mentally ill.
The most recent revision, the Mental Healthcare Act passed in April 2017, focuses on property and guardianship rights of the mentally ill person and differentiates between an intellectually disabled person and a person with mental health conditions bereft of any developmental conditions. Importantly, it also updates its terminology from ‘nursing home asylum’, ‘lunatic’, and ‘criminal lunatic’ (Indian Lunacy Act, 1912), to ‘psychiatric hospital’, ‘mentally ill person’, and ‘mentally ill prisoner’ (Mental Healthcare Acts of 1987, and 2017), respectively.
Although such revisions could hardly be called path-breaking, these are notable due to the use of contemporary language, signifying a shift towards better cognizance of mental health conditions and the mentally ill.
Words words words
Speaking of etymology, even within medical nomenclature, words evolve after gaining regressive and exclusionary connotations. For instance, the phrase ‘mentally retarded’ was considered a politically correct improvement over ‘imbecile’, ‘idiot’ and ‘moron’, which were originally descriptors for degrees of intellectual disability in intelligence tests until the 1960s, after which the pejorative connotations of these descriptors overshadowed their original meaning and intent.
Currently, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has replaced ‘mental retardation’ with ‘intellectual disability’.
Denying the utility of such political correctness, Harvard psycholinguist Steven Pinker coined the phrase ‘euphemism treadmill’. Euphemism treadmill is the process by which words acquire new connotations by virtue of their association with a concept already deemed a certain way.
His assertion is that the “name becomes colored by the concept; the concept does not become freshened by the name”. The implication is that new words describing old concepts will not become free from negative perceptions, but that the new words will soon be deemed pejorative as well, owing to their association with a negative concept.
Such an assertion makes for an apt critique of political correctness when it is not accompanied by authentic intentions of the speaker. However, being politically correct and meaning the things one says while being politically correct are not mutually exclusive. If anything, the euphemism treadmill makes for an excellent reason why political correctness should be accompanied by cultural changes that reify the politically correct diktats.
We must remain mindful of the culture within which words are used, their histories and context, all of which are instrumental in the evolution of their meaning and future usability.
Neurodiversity is the idea that certain neurological conditions (such as those that exist on the autism spectrum, attention-deficit/hyperactivity disorder [ADHD], and dyslexia) are natural variations in the human genome, and should not be pathologized as these have traditionally been.
Looking Ahead
Analogous to cultural diversity or biodiversity, neurodiversity was borne out of a need to change the narrative regarding how we address mental health conditions, without legitimizing the specific needs of people with these conditions.
Neurodiversity is an example of ‘reculturing’ of conversations and contexts surrounding mental health conditions and neuroatypicality. It suggests that some of the advantages in the mental capacities of neuroatypical persons might be because of (and not in spite of) their uncommon neural configurations.
For instance, people with dyslexia are able to recognize patterns easily, can decipher peripheral visuals with greater acuity than the general population, and have a higher than average ability to manipulate visual imagery in 3D, compared to people without dyslexia, although empirical evidence for this last claim remains inconsistent. Persons on the autism spectrum tend to be visual thinkers as compared with those who are not. Persons with Asperger’s syndrome, a high-functioning variation of autism, have a higher than average propensity to see details.
Studies on relatively known mental health conditions, such as depression and anxiety, are also being investigated for biological underpinnings that would aid treatment, as well as correlations with intelligence, tendency to ruminate and its possible utilities.
In addition to structural support for the neuroatypical — currently lacking in South East Asia — living conditions and quality of life can be leveraged by systematising inclusivity cultures. This matters in particular to vulnerable groups most severely affected by lack of such support.
Women, and caste and class minorities have a history of institutional subjugation, exacerbated by disability, which cyclically predicts economic decline.
Additionally, healing premised in politically sanctioned but scientifically unsupported ideologies interact with minority group memberships uniquely to exacerbate or stagnate their conditions.
To revert to our original discussion about Split and DID, it has been argued that instead of contributing to a narrative that stigmatizes persons with DID, the condition itself can be interpreted as a form of resilience in the aftermath of extreme trauma. A symptom of fissioning personalities in the face of threat might be evidence of the brain’s persistence in adapting to self-preserve.
