An Essay called "Mental Illness and Incredible Idiocy"

Mental Illness and Incredible Idiocy

I have never heard or read anyone sensibly discuss mental illness in my life. The media discourse surrounding it is so dismal it often makes me want to end my life.[1] The majority of what people say about it makes absolutely no sense at all. Moreover, like many modern media debates, the debate over the source of mental illness has somehow become a preposterous polarity: you are either a crackpot who believes that half the population will get mental illness at some point in their life and it still makes sense to say that half the population therefore has a “chemical imbalance” in their brain[2]; or you are a crackpot of quackery and mystical malarkey. At the heart of the intellectual malaise is, I think, the strange view of a great many people (those who conform to the first camp) that mental illnesses are completely analogous with physical ones, and that if you don’t believe this you are a mystic and are helping to perpetuate the “stigma” (i.e. part of the second camp). This is an absurd fallacy. The first aim of this essay is to disabuse it.

When people are talking or writing about mental illness in the media, the phraseme “chemical imbalance in the brain” crops up an awful lot. While not an intrinsically bad phrase, it is my firm belief that this easy explicator is responsible for much of the debasement of our discourse on mental illness. Now, before you begin to panic that I am some kind of Dualist or something who doesn’t believe that neurochemistry determines behaviour, I’d like to make very clear that I am quite the opposite. I stand firmly opposed to Dualism, along with all forms of anthropocentric superstition. In any case, I am not saying that it is necessarily wrong to explain a mental illness as the product of a “chemical imbalance in the brain”. What I am saying is that, in its current state of overuse and bastardisation, this catchphrase has become a perfidious and essentially meaningless cliché that serves only to shroud the true nature of most mental illnesses, imprisoning people in a deceptive and pseudoscientific parlance. It also helps to bolster the predominant dogma about the essential nature of mental illness, namely, that all cases of mental illness are just like cases of physical illness – that social anxiety is perhaps like the flu, and schizophrenia is perhaps not too dissimilar in some ways to a really horrible disease like cancer. I submit that, when applied so generally as it is, this dogma fails badly.

Most people would agree that the so-called “epidemic” levels of mental illness we see today is not the natural state of things, but has a lot to do with our civilisation. Isolated, alienated, lonely, frightened and stressed by pressures coming from every direction, we are all of us discontents in the civilised world. We all suffer anomie of one form or another. Of course, I don’t want to get into any Foucaultian, constructionist nonsense or try to impute the phenomenon to our rapacious, pitiless governments and free-market ideology or anything. I essentially mean just to say that there are lot of pitfalls in our society: it is extremely easy in our modern world to find oneself without any friends, to find oneself without a family or caring community, to suffer under the intense pressures created by the media to conform to certain impossible standards or impractical norms, to be unemployed and lose ties with society, to become addicted to drugs and spiral into a life of crime and destitution etc etc etc. I contend that this is fundamentally different from ages gone past, and the third-world. I contend also that the fundamental reason why there are far more suicides in the first-world than the third is almost certainly that when people desperately need to fight to survive and are struggling to support their family and loved-ones, they just don’t have the time to become depressed. In the third-world, they are far too preoccupied. To be depressed would be immediately fatal. There are more important diseases to contend with for these people, and they’re all physical ones. To be sure, there are presumably people born in the third-world with serious neurological abnormalities which cause them to behave very strangely, but the important point to take away is that the amount of mentally ill people in the first-world today simply could not possibly be the natural number, otherwise our species would never have come this far. In this way, much mental illness must be a product more of our strange world than anything else.

A number of months ago, I read the first of Primo Levi’s two very famous Holocaust memoirs, titled If This is a Man. Unsurprisingly, the central preoccupation of this book was suffering. Intense, horrific, merciless, relentless, indescribable suffering. Dehumanisation, degradation and subjugation. Starvation and agony. It’s a bleak read. Before I started reading it, I remember being curious of what it might suggest about the difference between the kind of suffering a severely depressed person feels, or someone wracked by anxiety, and the kind of suffering experienced by a Jewish prisoner who is separated from his family, not knowing whether they are dead or alive (but assuming, against the yearnings of his heart, that they’re dead), forced to dress in the same drab, grey garb as all the other thousands of Jewish prisoners, forced to sleep in spartan, squalid living quarters, having to fight over his meagre, disgusting, nutritionless sludge and stale bread with the other desperate, ravenous, wild-eyed convicts, and then everyday getting up to perform exhausting, arduous hard labour for hours on end, all the while being relentlessly taunted, denigrated and abused and called “scum” and “vermin” by Nazi commanders to whom he must then grovel and supplicate in a usually futile quest to inveigle paltry favours. I think the average person’s intuition is probably to think that the latter is unfathomably horrific and, despite the utter horror of psychic torment, that nothing could possibly compare to that infernal, relentless torture. Since I am not the average person, I really wasn’t sure myself before I read the book. I suppose I was mostly sceptical that such completely disparate types of suffering could be compared, but I also definitely had a very strong inkling that, for the Holocaust prisoners, the torture might have been so great, so insufferable, that their ancient, primeval drive to survive kicked in, and they just concentrated entirely on completing tasks, becoming an unthinking animal, doing anything that might help keep them on the face of planet earth in a totally corporeal, automatic way. In a sense, therefore, I couldn’t help leaning towards the rather appalling view that the suffering of people like Primo Levi might even be less than those with depression today. It seemed to me that I might have identified a real paradox: the more desperate and depraved a person’s situation is, the less he suffers in any psychic way, and the more he just becomes an unconscious animal thinking of nothing more than the next meal, the next rest, how to fix a wound etc. To put it in a very pithy, dramatic, pseudoprofound way, it seemed to me that the greater the ostensible suffering the less one can afford to suffer.

To a large extent, the book vindicated this suspicion of mine.[3] Levi paints a picture of a Darwinian hell where almost all the prisoners did become animalistic and vicious, and – in accordance with the Nazis’ depraved wishes – turned on themselves rather than their pitiless, tyrannical commanders. He depicts unfathomable hardship and pain, of unendurable privations, trials and tribulations, and an unconscionable plight – yet he never mentions anyone having an anxiety attack while slaving away at the endless, mechanical labour, or anyone breaking down for any reason other than physical exhaustion or injury. Moreover, in chapter 7 of the book, “A Good Day”, we suddenly get this philosophical interpolation, written in his characteristically stilted but pretty prose:

Today is a good day. We look around like blind people who have recovered their sight, and we look at each other. We have never seen each other in sunlight: someone smiles. If it was not for the hunger!

For human nature is such that grief and pain -- even simultaneously suffered -- do not add up as a whole in our consciousness, but hide, the lesser behind the greater, according to a definite law of perspective. It is providential and is our means of surviving in this camp. And this is the reason why so often in free life one hears it said that man is never content. In fact it is not a question of a human incapacity for a state of absolute happiness, but of an ever-insufficient knowledge of the complex nature of the state of unhappiness; so that the single name of the major cause is given to all its causes, which are composite and set out in an order of urgency. And if the most immediate cause of stress comes to an end, you are grievously amazed to see that another one lies behind; and in reality a whole series of others.
[…]
At sunset, the siren of the Feierabend sounds, the end of work; and as we are all satiated, at least for a few hours, no quarrels arise, we feel good, the Kapo feels no urge to hit us, and we are able to think of our mothers and wives, which usually does not happen. For a few hours we can be unhappy in the manner of free men.

Basically, I think this passage corroborates my thoughts, particularly that bit about the “definite law of perspective”, which I find a beautifully grim idea. It seems quite clear that the more common forms of mental illness must be the result of a world where most of us don’t actually have to contend with mortal danger or true terror, where there are very few real predators – mostly imagined ones and their abstract “pressures”. But as I claimed, these disorders can still be truly hellish. Consider, for example, DFW’s tremendously emotive descriptions of extreme psychic torment, the first from his early short story “The Planet Triphallon as it Stands in Relation to the Bad Thing” and the second from somewhere in Infinite Jest:

I'm not incredibly glib, but I'll tell what I think the Bad Thing is like. To me it's like being completely, totally, utterly sick. I will try to explain what I mean. Imagine feeling really sick to your stomach. Almost everyone has felt really sick to his or her stomach, so everyone knows what it's like: it's less than fun. OK. OK. But that feeling is localized: it's more or less just your stomach. Imagine your whole body being sick like that: your feet, the big muscles in your legs, your collar-bone, your head, your hair, everything, all just as sick as a fluey stomach. Then, if you can imagine that, please imagine it even more spread out and total. Imagine that every cell in your body, every single cell in your body is as sick as that nauseated stomach. Not just your own cells, even, but the e. coli and lactobacilli in you, too, the mitochondria, basal bodies, all sick and boiling and hot like maggots in your neck, your brain, all over, everywhere. In everything. All just sick as hell. Now imagine that every single atom in every single cell in your body is sick like that. Sick, intolerably sick. And every proton and neutron in every atom...swollen and throbbing, off-color, sick, with just no chance of throwing up to relieve the feeling. Every electron is sick, here, twirling off balance and all erratic in these funhouse orbitals that are just thick and swirling with mottled yellow and purple poison gases. Everything off balance and woozy. Quarks and neutrinos out of their minds and bouncing sick all over the place bouncing like crazy. Just imagine that, a sickness spread utterly through every bit of you, even the bits of the bits. So that your very...very essence is characterized by nothing other than the feature of sickness; you and the sickness are, as they say, "one." 

(And now an excerpt from Infinite Jest).

The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.

When I read this stuff, I actually have no idea what he is talking about. I can’t help feeling that he must be exaggerating at least a little. But I don’t think he is…

In case you’re somehow still not convinced of the very important environmental element of mental illness – the clear link between the peculiar, very recent phenomenon of widespread mental illness and the peculiar, very recent phenomenon of modern civilisation – consider another mind-boggling fact that I discovered last year: many vets and zoologists think most/all animals also get depression, but only in zoos. If you want evidence of this claim, check out this great article, which also testifies to most of the other arguments I’ve made: http://www.nytimes.com/2014/07/06/magazine/zoo-animals-and-their-discontents.html?_r=0.

Now that I have concluded that relativistic discursion, I am anxious not to stray into full-blown postmodern nonsense. We must not be fooled into thinking that mental illness should be dealt with unmedically. Most people with mental illnesses do not have brains that are exactly the same as those of ebullient, sunny people. We must also be wary of allowing this article to become yet another crude, tendentious perspective on this issue. We are not going to be pulled towards one pole or the other. And it is important that we be anti-magnetic, since it is in this intermediate space between the poles that the truth about mental illness lies. Indeed, the hopelessly neglected fact of the matter is that mental illness is complex, that the relationship between the medical and the non-medical is highly ambiguous, and that mental illness is not a precise, coherent term for a set of fairly uniform conditions, but a very broad term for a whole host of very different disorders.

In order to make sense of this, let us return to our favourite platitude, “chemical imbalance in the brain”, and its relation to the bigger term, “mental illness”.

Illness in general (mental or physical) invariably stems from some sort of abnormality, disorder, damage or imbalance. This is a truism, and I don’t think anyone would dispute it. Flu is the result of a virus entering your body and wreaking havoc with your respiratory system – an abnormality which results in damage. Obesity is the abnormal and unhealthy state of being very fat. Irritable Bowel Syndrome results from abnormal bowels functioning improperly. Heart Disease results from an innately or environmentally damaged heart malfunctioning. All cancers are the product of cells suddenly turning malignant, proliferating madly and rampaging throughout the body, ravaging all in their path. Etc.

In one sense, mental illness fits this schema perfectly. Certainly when we limit ourselves to the more extreme forms of mental illness, like schizophrenia or severe depression, there is absolutely no problem whatsoever with lumping the mental along with the physical. In the case of people with such mental diseases, the abnormalities in the brain are almost as obvious under a scanner as any abnormalities in, say, a liver are under a microscope. More importantly, the link between the detectable internal abnormality and the external manifestation of the symptoms of such mental illnesses is basically analogous with physical illnesses or diseases. We can all spot a really insane person, for example: they either have wild, animal, unseeing eyes, or they’re huddling in a corner, rocking back and forth, or they’re muttering to themselves – you get the picture. And we recognise someone with a physical illness like bronchitis in much the same way: they look grumpy and they cough thickly, expectorating prodigiously, and they suffer headaches and sore throats and speak in a croaky voice. Nevertheless, I question whether the analogy really holds when one considers the more common mental illnesses – the ones that are supposedly at epidemic levels. In fact, contrary to popular opinion, I think the answer is definitely closer to “no” than “yes”.

One thing I have always found really pretty risible are the Beyond Blue statistics about mental illness. According to that big campaign that has been going for a long time, including on fridge magnets and Subway billboards and the like, one in eight Australians has clinical depression. Yes, that’s right, one in eight Australians is fucked in the head. And get this: apparently, one in two Australians will suffer from depression in his or her lifetime. Now, I have no reason to doubt either the provenance or veracity of these statistics. No doubt the basic numbers are based on medical records and then reasonably extrapolated to account for the entire population. But I find something deeply strange about the notion that one in two people could really suffer from a diagnosable illness. Just imagine how weird it would be if one in eight adults at any given time had some kind of cancer. Imagine if one in two adults suffered from Ebola or AIDS during their life time. This would be more than an epidemic of these diseases; it would be a cataclysm. It would basically be inconceivable. This begs some important questions. If such wildly different types of conditions can both be called illnesses and be diagnosed as such, just how meaningful is the word? Does it really make any sense that one in eight people could have a “chemical imbalance”? If one in eight people have a chemical imbalance, does that not mean that the chemical imbalance is actually within the natural range of balance, and is not an imbalance at all? And given how common non-severe depression and social anxiety are, how can the ascription of the word “illness” to them be justified?

It seems to me that the heart of the ambiguity lies in the different origins of mental and physical illnesses: more specifically, how much the environment plays a role in each. I have already established that the epidemic proportions of common mental illness in our world must in large part be due to the deeply strange world in which us first-world human beings find ourselves, with disrupted circadian rhythms, fractured kinships, lonely lives and all sorts of intangible social and cultural “pressures”. Intuitively, that seems to mark a considerable contrast with most physical illnesses. Dangerous bacteria have been plaguing humans forever, as have viruses, parasites have been around since time immemorial, cancer is an eternal blight on living things and age has always wearied us. Moreover, when Joe Blow is tracing a diagnosis of depression, he doesn’t think, “Oh, well, my depression was inevitable since I came out of the birth canal”. Instead, he looks for historical reasons to explain why he now has a “chemical imbalance” or how the “chemical imbalance” worsened: I was a very lonely child, I was bullied in school, I had an extremely troubled adolescence and fell in with the wrong crowd, my parents got divorced and I felt unloved, my entire life has been one unbroken chain of tragedies, etc. That’s why Joe Blow goes to his therapist. Correspondingly, the relationship between genes and most physical illness seems to be a hell of a lot more clear-cut than the relationship between genes and most mental illness. Haemophilia is a condition that would have been passed on through humans over many generations and, no matter the environment, always manifested itself in the afflicted. However, the oft-mentioned genetic “predispositions” to depression would likely never have manifested themselves in, say, Palaeolithic humans, with their mortal concerns and constantly active lives. They are only “predispositions” after all, not genetic determinants. As I suggested before, there’s a good evolutionary reason why a strong gene for depression could not exist widely among the population: depression would be a death sentence in the natural world.

But then again, haemophilia also couldn’t exist widely among the population for the same reason. Perhaps some form of schizophrenia is analogous to haemophilia: there could easily be a kind of madness that stretches back many generations and mostly lies dormant in the gene pool. And this hurls us back to the standard position: are mental and physical illnesses really so different? I claimed that a unique feature of much mental illness seems to be that it seems largely to be the result of one’s life and experiences and environment rather than biological predestination. But isn’t obesity the same? What about heart disease? What about skin cancer, or lung cancer (or most cancers in general)? People have “predispositions” to these, too, but whether one contracts them seems to depend more on lifestyle than anything else. Just as having a tight-knit circle of friends and confidants reduces one’s possibility of becoming a depressive or developing social anxiety, keeping fit, eating healthily and staying out of the sun reduce one’s risk of contracting some of the diseases aforementioned.  In this way, the basic nature of the predispositions seems the same. And perhaps the fact that minor mental illnesses appear to be less ancient disorders than the physical ones is ultimately irrelevant.

There’s only one problem with concluding that there’s no substantive difference between the two and, unfortunately, it’s a rather big one: the brain is vastly different from every single other organ in the body, and the physiology of the “disorders” is far, far more ambiguous.

Perhaps the most significant idiosyncrasy of the brain, in comparison with the other organs, is that every person has a very different one. It is an obvious fact that the meaningful, natural variation between brains is far greater than the meaningful natural variation between any other organs.[4] It goes without saying that there are many, many different kinds of people: there are extroverts and introverts, flibbertigibbets and hermits, thugs and pacifists, altruists and Objectivists, idiots and intellectuals, atheists and evangelicals, rednecks and hipsters, maths nerds and literati, philistines and aesthetes, gamers and bookworms, party-animals and teetotallers, nymphomaniacs and prudes, gays and straights – this list could almost go on forever, and without descending into tautology. Importantly, a large reason for this huge diversity must be that the brain is far more plastic and environment-sensitive than any other organ. This is not to say that the brain is really just like a “blank slate”. I am no postmodern wanker: I have no doubt that we are born with certain proclivities and predilections, and that our personality and IQ (and so forth) are largely genetically determined. But it is also very clear that one’s life experience affects one’s brain in a major way. Perhaps people find themselves with no friends because they have a difficult or unattractive personality, or because they’re weird, but there is no doubt that having no friends tends to amplify what quirks and neuroses one already has. Perhaps people who are diagnosed with anxiety in adulthood always had a latent form of it, but it is equally possible that they never would have developed it had they not been constantly called fat during their teenage years and spent half their adolescence worrying about how hideous they were. And here we confront some interesting problems. Is it necessarily the case that all people diagnosed with mental illness actually do have a discernible chemical imbalance – one that is noticeably outside the norm? And even if this were the case, does it really make sense to use a lazy, one-size-fits-all phrase to describe both the mental conditions of wackos, and people who basically only have a disorder because of a troubled past? Should there not be a distinction between the truly mentally diseased and the merely eccentric? Between the neurologically fucked up and the deeply lonely? And are those who can trace their diagnosis to a clear causal chain really be regarded as “ill”, with all the connotations that word has? Should they really be so thoroughly medicalised?   

One of the things that really pisses me off about the contemporary discourse around mental illness is that people so rarely even acknowledge these issues. I have never heard anyone discussing mental illness in the media make an effort to capture the complexity of the subject, and draw the many distinctions between the many types of mental disorder. Clearly, there are many different types of depression, for example, and not all of them can be reduced to facile medical explanations. I personally think it would be insane to medicalise the grief and listlessness of a woman who loses her husband. I think it would be dangerous to just give her some pills and say, “Now be on your way, these’ll fix you up”. It is perfectly natural to grieve; it is the sign of a rationally functioning, emotional brain. It is a fundamental part of what makes us human. But if you look at the current guidelines of many of the psychiatrists in the world today, the predominant attitude to grief seems to be that it is in some way a mere “medical condition”. This is a truly perverted state of affairs. Given the Beyond Blue statistics, I know that if I myself went to a psychologist and regaled them with the miserable tale of my life and told them how I often feel and how I spend my time, I’d almost certainly be diagnosed with depression. But I am 100% sure my brain is not malfunctioning.  When I feel sad or anxious, most of the time it’s with as good a cause for feeling sad or anxious as anyone has. And no, there’s nothing romantic about insanity, but it’s also true that almost nobody who did anything good was a so-called “neurotypical”. Eccentrics and recluses – people who would today be diagnosed with some sort of condition (Asperger’s, depression or anxiety) – have been responsible for just about every great intellectual advance in human history.

It is for this reason that I am very much in favour of the “neurodiversity” movement. I don’t want to say that we should medicate depressed people less – I mean, if medications work without destroying the person’s personality, then go ahead, Bob’s your uncle – but I do think we should avoid calling people with Asperger’s “diseased” and I really think that to diagnose a huge chunk of the country with some kind of mental illness and claim that we have an “epidemic” is insane. We need to be much more sophisticated and discriminating about how we discuss neurology.

A couple of pages back, when making a brief list of different types of people, I included the “gays” and “straights” binary as my last example. I think another very interesting reason why we ought to revile the current rabid medicalisation of neurological difference and advocate neurodiversity is that the current regime has rather sinister implications for the queer and trans community. When you think about it (which few people do, obviously), the current stats on depression and mental illness logically imply that trans people are also mentally ill. The fact is if we regard one in eight people as clinically depressed and mentally ill, then neurological and hormonal abnormalities that much smaller segments of the population possess must be regarded as mental illnesses, too. Gender dysphoria is the medical name for both transsexuality and transgenderism, and, if far fewer than one in eight people have it, then logical consistency would dictate that it must also be a mental illness or disease. After all, it is probably mostly mental in origin (and partly hormonal) and it is an obvious abnormality. Clearly, the trans community and their advocates would be horrified by this view.[5] But here’s the thing: mental illness is fundamentally ambiguous. A good way of showing this is to look at the different way we treat trans people and those with arguably very similar mental conditions. It is unquestionably true that gender dysphoria must be one kind of body dysmorphia. After all, body dysmorphia refers to any discontent with one’s body. Yet, while there’s obviously a massive transgender-rights campaign, there’s no great social justice campaign to recognise the rights of people with anorexia – to endorse people starving themselves to death and to promote tolerance of people with “unusual” body image. Is there a good logical reason for this? Was there even a good logical reason why Rachel Dolelzal was universally lambasted by progressives for her “deranged” and “racially insensitive” impersonation of a black woman, while Caitlyn Jenner was exalted and lionised by progressives for transitioning to a woman?

Now, clearly people can adduce sensible reasons and advance coherent arguments for why we treat these situations differently. The obvious difference between anorexia and transgenderism or transsexuality is that anorexia is a fundamentally dangerous and destructive condition, whereas being trans isn’t injurious – or at least, it wouldn’t be if there wasn’t such pervasive oppression and stigmatisation of trans people. Nonetheless, in purely logical, medical terms, both would have to be seen as illnesses. Not to be too controversial, but I think the difference between the cases of Rachel Dolelzal and Caitlyn Jenner is actually more tenuous than that. Most people were saying that the difference between the two cases is that transsexuality and transgenderism are natural, whereas “transracialism” (as it was quickly dubbed) is not. But what does natural mean? As I’ve already said, very few people in the population have gender dysphoria – far fewer people than have depression, according to the statistics. It is probably about the same fraction of the population that suffers really severe depression as has gender dysphoria. Is severe depression “natural”? Do you mean by natural that there have always been trans people, throughout history, and before it? Well, many people think that’s the case with gay people, and trans people are, it seems to me, effectively some kind of exaggerated version of gay people.[6] But even if that is the case, it’s impossible to point to a human society where more than a tiny fraction of the population was trans. Gay or bi, yes,[7] but not trans. This suggests that even if gender dysphoria is “natural” in some weak sense, it has never been normal, in a meaningful sense of that word. I think, therefore, that that argument is pretty feeble. After all, you could also make the argument that some kind of transracialism is “natural”, in a similar weak sense. Black people in colonised countries who aspired to high status and “gentility” would impersonate white people, including dressing like them, talking like them and treating their compatriots as inferior like them; many people in Korea and Japan have been trying to imitate Western culture and white people for a couple of decades, even to the extent of changing their appearance – undergoing surgery to obtain more European noses and penises[8]; and, most pertinently, many young adolescent white people have for twenty years been imitating black culture and its people, through slang[9], dress and even mannerisms.  Sure, Rachel Dolelzal took this further than most people, but I just don’t think this argument from “naturalness” is that strong. Another argument used by those trying to insist on the difference is predicated on Dolelzal’s insensitivity. Proponents of this view claim that Rachel was basically exploiting the black community through her fraudulence, that she was “appropriating” their culture, that it was a fundamentally “offensive” thing to do to black people and was basically racist. Now, I deny none of these charges (although I think most of them are basically just vague buzzwords, and that you have to make a case more precisely than that), but the fact is that many women do have a similar view of Caitlyn Jenner. Many believe that Caitlyn Jenner is merely acting out a “pantomime” of womanhood, that she contributes to the objectification and fetishisation of the female body, that she embodies a plastic, mannequinlike image of womanhood, and find offensive her purport to have truly become a woman when she knows nothing of what it’s like, and the discrimination and injustice that all women have had to face since birth. This article basically expresses this view, in fairly guarded, tactful rhetoric: http://www.nytimes.com/2015/06/07/opinion/sunday/what-makes-a-woman.html

So, if there is indeed a logical reason why we treat the two people very differently, I think it’s by no means ironclad.

What is mental illness, then? As was my aim, all this exposition has greatly complicated this question. I’ve argued that reductive explanations and analogies to the physical just don’t stand up to scrutiny, and that the popular discourse around it – so dominated by both these intellectual vices – is in a deplorable state of mutilation and decrepitude.

Unfortunately, I don’t expect this to change any time soon. You see, there’s a lot of neurodiversity among homo sapiens, but most of it resides on the stupid side of the continuum.    

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[1] Topical.

[2] I.e. only half of the population has a “balanced” brain, and half of the population is deformed. ???

[3] I am a philosopher king.

[4] I should clarify what I mean by “meaningful”. I am not saying that livers and stomachs and intestines and hearts and penises and labia and skin don’t vary a great deal in size and form; they do, obviously, and this is part of what makes us all unique as human beings (and is also part of what predisposes us to certain physical illnesses and not others). However, the variation between brains is, I believe, far more meaningful because small physiological changes equate to huge changes in behaviour, personality, identity – the things we regard as central to what makes a human being human – and thereby make defining “disorder” or “abnormality” far harder than it is for other organs. Unless you’re outside the natural range of variation, your heart will beat regularly to pump blood around the body, your skin will keep out pathogens and toxins and the like, and your kidney will process urine. But within a natural range of brain variation, you may have completely different interests, aptitudes, skills and behaviour to, say, a work colleague, and there may be a third person working in the IT department completely different to either of you (but who still just fits within the normal range).   

[5] Admittedly, this is partly for the reason that a lot of progressives and the great majority of queer and trans people subscribe to the ridiculous, Butlerian view that all gendered traits have zero biological origin, and that the sexually unusual are therefore exactly the same, innately speaking, as anyone else. Trans or queer people of this ilk would even object to the very claim that a combination of their brain and their hormones is responsible for their psychological difference – which is insane.

[6] Since gay men are very often camp (which equates to feminine) and lesbians are often very butch (which equates to masculine), I think this is a fair claim to make, even though it is again inflammatory.
[Retrospective correction: many men who desire to become women or complete the transformation are heterosexual and typically masculine. According to Ray Blanchard's bipartite "typology" of transsexualism, this is because these men have a kind of paraphilia he has dubbed "autogynephilia". Incidentally, since Caitlyn Jenner does not have the history of the typical "homosexual transsexual" (meaning the standard type of transsexual, the extremely camp man who has always felt like a woman inside), this typology implies he must have autogynephilia.] 

[7] Athenians and Spartans, for example.

[8] Look this up.

[9] “Dope”, “squad” etc.