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University is sold as a good time–study abroad, doubly so. The all-social all-the-time, package-holiday freshers’ weeks that usher us into university life are, the story goes, the best of your life. As the years have gone by, many of even the most excitable seventeen-year-olds have stopped seriously believing this story, but the hope, and the product, remains. I passed the first year of university relatively unscathed–though many others I know were not so lucky–but it is often in subsequent years that students find their mental health deteriorates: first, as the second year of uni drags on, the fragile connections made in the compulsive collective drinking sessions that define freshers culture vanish; in the inescapable tumult of the city, of haphazard and threadbare routines structured by a bare handful of contact hours and insomniac end-of-term frenzies of work, it is easy to feel increasingly isolated.

For the increasing numbers of us who spend part of our degrees abroad–as much for the more marketable result as for the experience–‘Culture shock’ is a well-known phenomenon, and while students abroad are still very poorly supported, the sense of disorientation and the depression it can trigger are at least more strongly highlighted than they once were. But it is the continuities of the pressures of UK student life and life thrown head-first into a foreign country, moreso than the enormous differences, that are striking: there are the same social difficulties, the same feelings of alienation, and the same intractable problems with Student Finance, all while huddled with semi-strangers two-to-a-room in a Russian hostel. Starting student life can be a culture shock of its own; life in general is becoming a permanent backdrop of shocks.

The provision and support you can find at universities is not worse, but often not much better, than that you can expect ‘in the community’: prescriptions of citalopram from in-house psychiatrists that clatter in book-bags like rattlers become, later, ten-minute visits from the Home Treatment Team that may be your only social contact for many weeks. But it is not just the availability of specific services for students struggling with their mental health, nor even, by themselves, broader informal networks of social support that are essential to the recovery of anyone with a mental health problem that are at issue. The very feasibility, the very possibility, of those services and networks are being destroyed by the same forces that are dismantling the university itself. The structures that form and have formed that mythical, lucrative ‘student experience’ post-92 are those of destabilization, exploitation, and alienation–of ourselves from our accelerating city surroundings as well as from our own increasingly expensive and dubiously beneficial studies. Students are spaded into halls and buy-to-let properties, one to every room, preparing the way for gentrification and for a life of itinerant renting; the food poverty that was once considered a rite of passage is more probably now a process of desensitization to that awaiting the mass of us in un- and under-employment.

The uncertainty of our immediate and long-term futures as students and workers, the spiralling rents, ballooning debts and the ever-longer working hours we must take up to be able to eat: these are all unprecedented pressures on the mental health of the student population. Universities can try to mitigate this, but the overriding tendency of privatization and the corporatization of the management structure is to worsen it. The Gower Place Practice that provides thousands of UCL students with essential services is under threat, unaffordable student accommodation is constructed without natural light, and expansion attempts to displace and demolish the homes of entire local communities; meanwhile, our provosts flit between lucrative expenses-laden university posts and the boards overseeing the destruction of the NHS.

The direction of social, economic, and educational policy represents a threat to our health, our security and our futures. Taking student mental health seriously means taking seriously, and resisting, this threat.

Prior to a few days ago this blog subsisted in a particularly dusty corner of the internet. Even I barely used it. The last post was written under the assumption that the rather succinct elaboration of my points would be read by a few of my Twitter friends, rather than by several hundred thousand people. It was, as I said, a summary. But, what happens happens.

I do not wish to prevent anybody from sharing their experiences of violence and as caregivers for those who suffer from mental health problems.  I think it’s important people are able to share their experiences. I also think it’s important that people do that without contributing to damaging narratives about vulnerable people, who for the most part are no more likely to attack anyone than anyone else.

The target of the post was not the author of the article personally, but the values and politics with which and into which she injected her article. As a result, it seems, of the fact that I spent no time in the post directly acknowledging the validity of the mother’s perspective and experiences (it was a summary of objections, not an overall appraisal), many took its tone and brevity for denunciatory rudeness. There was talk of my “shaming” and “silencing” discussion. In response I wish to distinguish (albeit problematically) between the “experiential” and “political” content of the article. It is entirely possible to share one’s experience without inserting it into a political narrative connecting mental illness and other issues directly with senseless, murderous violence, and making assumptions about the experiences of recently murdered people to whom you attach your own. And when you write an article and put it forward into the public sphere where it frames the terms of subsequent debate, you are responsible for how you do it. It may be the case that the way Liza Long’s son was projected in the article was adequate and appropriate to her experience, but in an article that wants to talk about mental illness, this projection taps into stigmatizing practices that marginalize those who have mental illness. This was my point in 2). There were some issues with my quoting, which was indeed paraphrasal and not direct quoting, but it used words from the article. To those asking how anyone could possibly have insight into the son’s inner mental life, there is a very easy way: ask, as though you really want to know, and then listen.

Criticism is not shaming, and my “values” are not a privilege that I must sympathise with people for not possessing. There is a public discourse to which someone contributed and to which I, in the event, also seem to have contributed. I do not consider my contribution “shaming” any more than criticisms to this effect are “shaming” me (they are not). Many posters accused me of having limited or no experience of mental illness, the mental illness of loved ones, fear of my own death, fear of death of a loved one, violence from a mentally ill person, “seeing the look in the eyes of someone who is about to xyz” and so on. None of these claims have a basis, apart from in bafflement and incredulity that anyone could have experience with any of these things and hold my position, and in fact all of them are false.

One comment claimed that Zyprexa is FDA-indicated for disruptive behaviour/autism in children. I can find no evidence whatsoever that this is the case, but even if it were, the issues of long-term damage and dramatic increases in use, of the questionable, sometimes criminal actions of pharmaceutical companies in promoting unapproved uses of their drugs and suppressing evidence of their inefficacy (Zyprexa in particular was promoted illegally for dementia-related uses) remain. I did not claim that antipsychotics are not prescribed to children:  they are, and in alarming amounts. Indeed, some reports about antipsychotic prescriptions to children in foster care and other vulnerable people are extremely worrying and should be the focus of serious scrutiny. These are the problems I was referring to.

It is true that the fact that most mass killers have no history of contact with mental health services does not prove they were not mentally ill. But the fact they have no history means, especially if they are dead, that there is no evidence that they were beyond the fact of their crime. This just isn’t enough. The unfounded, sensationalist speculation around the lives of those concerned in these sorts of crimes is usually futile, often counterproductive, and sometimes completely flies in the face of the facts. Liza Long’s connection of herself and her son with the unknown and unspoken lives of those she placed her experiences alongside was just one example of that—point 1).

Soon after the killings were first reported abusive tweets poured in to the account of a Ryan Lanza wrongly identified as the “Ryan” Lanza who committed these murders; he’d posted depressed and suicidal tweets and people retweeted these thoughts as though to demonstrate: look! It all makes sense now. The lead was a completely false one. The tweets continued nonetheless: even if he wasn’t the killer, he “fit the profile of the killer”, he was fucked up, he should get help before he does kill someone, and so on. People, including Liza Long, deserve to be protected from abuse and violence. In a climate where a torrent of abuse and violence can be visited upon vulnerable people based on misconceptions and assumptions about mental illness, I think it’s utterly necessary to challenge things that contribute to that climate.

Thanks for your comments guys.

Edit: a post subsequent to the response to this one can be found here.

After this blog post was republished on Huffington Post, I thought it necessary to summarise the main reasons why it’s a terrible springboard for further conversation on the subject.

1)      The suggestion that this woman’s son is of the same type of person who would or will commit a “rage murder”, without any real evidence to back up this suggestion.

2)      The article doesn’t divulge, or even acknowledge, that its subject might have his own perspectives, beliefs and motivations that are worth mentioning. His mother’s perspective, mainly on his ‘evil eyes’ with their ‘calculated pupils’ is the only one given. Thus the child is presented solely as a problem, or at best, as a two-dimensional contradiction of his “behavioural problems” and his “intelligence” and not as a person with any more than shallow emotions. By reducing ‘mental illness’ to ‘outward behaviour’ the article dehumanises the mentally ill and completely glosses over the inner mental life and experiences of those with mental illness.

3)      The article complains about mental illness stigma while reinforcing it by explicitly tying it to violence, and in particular, mass killings. The reality is that there is no such observed link: “after analysing a number of killers, Mullen concludes, ‘they had personality problems and were, to put it mildly, deeply troubled people.’ But he goes on to add: ‘Most perpetrators of autogenic massacres do not, however, appear to have active psychotic symptoms at the time and very few even have histories of prior contact with mental health services.’” And most people with mental illness are not violent, although they are far more likely to be victims of crime (see here, for instance).

4)      The article, with this link established, implies a desire to stop violent crime allegedly perpetrated by those with mental illness should motivate better care and provision for those with mental illness, and not, say, the lower life expectancy, unemployment, isolation, suicidality, homelessness, victimization or in general the suffering endured by those with it. The continual disregard for this reality perpetuates stigma on all levels of society and further exposes those with mental illness to harm.

5)      Antipsychotics and antidepressants are not designed for children and most of them are not indicated for disruptive behaviour in children. Zyprexa, the prescription given to the child in the article, is not indicated for disruptive behaviour or autism in the US.  This sort of willy-nilly prescribing with little real knowledge of or regard for the long-term consequences, particularly for those whose brains are not fully developed yet, is potentially extremely damaging, and it’s not unlikely that a forever-changing cocktail of unwise psychotropic prescriptions contributes to worsening psychological problems. However, there is no criticism of psychiatric or pharmaceutical practice in the article: merely a cry for more of the same.

6)      You are NOT Adam Lanza’s mother. The sort of quasi-solidarity expressed in “We are [oppressed people]” or “I am [dead person]” appropriates the experiences of people who are unheard, in this case the victim of a mass homicide, and uses that to bolster a narrative that doesn’t even attempt to discover or represent the experiences of those they claim to speak for. Don’t do that.

The antipsychotic is almost the defining drug of psychiatry. Along with lithium, typical antipsychotics, or “major tranquilisers” (considered a misnomer but largely quite an apt description of both their use and their effect*) were a critical advance in psychiatric practice and paved the way for the deinstitutionalisation of psychiatric patients. The antipsychotic’s stupefying effects are employed on- and off-label for a menagerie of symptoms and behaviours; for psychotic disorders (including psychosis caused by antipsychotics), for affective disorders whether or not there is psychosis (particularly for the so-called ‘treatment-resistant’ cases; on-label for acute manic episodes and largely off-label as a prophylactic), for ‘symptoms’ of ‘personality disorders’ such as ‘aggression’ and ‘impulsivity’ (off-label), for insomnia (very off-label), as well as for ‘irritability’ in children with autism and other developmental disorders. Indeed, the list of behaviours for which you can be treated with an antipsychotic is almost as long as the list of side-effects of antipsychotics.

This context of the antipsychotic (with its lengthy wake of physical complications) as a treat-all, administer-everywhere miracle drug is important to bear in mind when considering its experiential and behavioural operation and effects. But it is only a small part of what forms the context in which drugs act: that of the person, the self, subject to antipsychotic treatment. And this is already a formation of lifelong activity and social participation. The self and selfhood** are products of collective labour as it is understood on all levels – biologically, materially, socially, psychologically. The images, sensations, the ‘contents’ of experience, as well as the awareness of that experience, are, therefore, fundamentally subject to the productive and discursive forces of the whole of society, as much as they are able, in their complex assemblies of agency, to participate in and shape those same forces.

This is by no means an attempt to simplify the development of persons, and correspondingly of brains, and gene expression and whole body-systems, into talk of economics and machines. More it is the condition for understanding the organisation of images, intuitions and cognitions in society in general – and individuals in particular – beyond that level. From birth a proliferation of relations in all their forms, gestures, exchanges, consumptions, thefts, carnivals, orders, suggestions, validations, intimations, form the whole context for bodily development. It is this same context, not merely of neurotransmitters and neurones but advertisements and value-forms, wherein the psychoactive chemicals of both the hospital and the rave have their stage. It is thus important to recognise not the prescription, or the ritual of consuming, but the chemical action of a drug on the brain as not simply a biological and a material event but a social one as well: it is an intrusion into the production and exchange of sensations in a subject, into an entire structure of being; it is a gesture, and the exertion of power; a way of augmenting and ‘correcting’ anomalies in that structure. It is for this reason that the experience of that process is where one must originate an analysis of the function of the drug in its full context.

And what is that experience? The first neurological blow an antipsychotic usually deals is sedation. It is (sadly) not the rather pleasant relaxation of benzodiazepines, but rather a crippling, thick fog. The antipsychotic I take was, and to an extent remains, responsible for inducing the most devastating and complete stupor I have ever experienced: a sleep which is like death, a void in time which wipes out entire days of life and which dogs you for hours after waking. The second is even stranger than that, but is, apart from the dry mouth or the increased appetite or the dozens of other side effects, its other major ‘therapeutic’ effect, which it seems is the effect for both psychotic and affective experiences.

This experience of “detachment” is as disturbing as it is flattening. It is dissatisfaction without frustration, introspection without searching, estrangement without fear. Your awareness becomes a separate presence within a presence. Emotions, thoughts, things, and events all become the same dull class of inert objects, things which occur in front of you, things which you are aware of but which are fundamentally apart from you. In short what occurs is, ironically, the disintegration of experience; the dislocation of awareness from at least some of its internal components.

* The antipsychotics olanzapine and haloperidol (or the benzodiazepine lorazepam, possibly in combination with an antipsychotic) are recommended for forcible tranquilisations in the United Kingdom. 

Reality, to be clear, is an ism; no less an ism than any other. Capitalist realism, that ideology whereof normativity is comically, perhaps purposefully belied by its name, is an ism which, like all isms, has its detractors and defenders. It is the ideology of the grim acceptance of the “negative externalities” of the modes of existence in liberal democracies, without ever really meeting with them; the ideology of realpolitik masquerading as liberal internationalist [mis]adventure; it is “collateral damage”, “conflict management”, a sanitised and standardised reality. When the dirty, ugly practices of oppression are circumscribed with the sanitised, standardised words of this sanitised, standardised “ism”, “ideological” struggles are struggles for the territory of reality.

But if realism is reality, then anyone in opposition to it must logically be a fantasist; a criminal transgressor must equally be a psychically sick person; those who would look for alternatives in a world where there is no alternative are fanatics as well as time wasters. So what happens when “reality” is invaded by its detractors? What happens when, say, a Telegraph journalist, a purveyor of finest “reality”, is confronted with a manifesto of unreality? What happens when the careful constructs of realism are shaken in a way that has not been applied for and granted, on a route that has not been pre-agreed by the relevant authorities? How, in short, to police reality?

The reaction to Trenton Oldfield’s unexpected appearance in the middle of the televised (and, we’re told, universally enjoyed) annual boat race was, predictable, and indeed predicted with perfect concision here. But as much as the ‘event’ began and continued as events of this sort tend to (much as the pie in the face of News International), there was nonetheless much revealing about the trail of media copy the lone swimmer left in his wake. For this reason, quite apart from any evaluation of the content or conduct of the act itself, it is an interesting case:

Despite being supportive of the stunt when he thought it was against vivisection – in other words, when he thought he could understand it – pretend historian Tim Stanley hummed a different tune on reading the real motivations for the act: “The man who disturbed the boat race is simply a disturbed man”, he smugged on finding this unpleasant information; his manifesto is “dappy” and his theory is “balderdash”. Quite what about this new information justifies the sharp about-turn displayed in this later article is unclear probably at the very least to Stanley himself, but here we can offer a sketch of a suggestion.

The first question to be asked is: what about his actions “reveals” the mental illness? Clearly it is not the act itself, the act whereof a realist often simply cannot conceive of a meaning, partially because meaning for them consists simply of circuses, of Olympics after boat race after show trial; partially because rather than investigating what a particular event or spectacle might be understood as signifying, they seek meanings that revolve only around those they already readily accept. Should they discover someone accepts radically different meanings from them, this appears to come to them as an astonishing surprise, and almost self-evidently indicative of mental incapacity.

Clearly, then, it is in the justification for the act, the presentation of prospective unreality as a driver of action in the present dungeon of realism. The presentation of unreality, of alternatives, of unapproved events, in the face of realism is a question – a question the vocabulary of realism cannot answer. The dynamics of politics then take on the dynamics of diagnosis. The content of speech is not analysed as bequeathing others with its own information, but is a kind of raw material for which one searches for clues indicating other things, more or less divorced from the actual communicative intent of the speaker. The subject becomes no longer an opponent but an object of particularly medical scrutiny. It is not necessary to engage a patient in argument – it is not necessary, either, to engage a madman in argument. In fact, the definition of someone as mad completely removes even the possibility of engaging them; it places the madman as the originator of this impossibility, impenetrable because unintelligible. The function of realism as originating the countless “impossibilities” it denies is thus obscured: the collapse of realism into reality takes place. The brief and logically bereft treatment given to the “bizarre ramblings” of the “disturbed” is a result of this diagnosis, rather than the opposite. 

For what about being “disturbed” is at all “simple”?

i was going to copy-paste some old poem or “prose-poem” as i liked to call the short stories i started but never finished, or truthfully, the short stories i had only half an idea about when i began them in the first place.

 

and that’s the reason i didn’t – my creations were only ever the execution of -half- an idea. these days i don’t have even half of one, the world is exhausted for me, drained of all colour; i used to use words to pervert the world; i squeezed and contorted it like plastiscine into florid masks, parodies of description. that’s a very generous assessment of my output. but creation, like a mine, has depleted. the need and wish to remake the world in gardens of high-register latinate jargon has diminished. but what has replaced it? i feel, more than ever, nothing.

 

creation is like a dream – it’s a dream state, most certainly. your imagination is a hallucinating machine, turning objects into animals, multitudes of animals, catastrophes; turning gestures into crimes. it is the great exaggerator, the great psychotic genius. without it the dull, industrialised prison of life becomes you, you are ossified, made a crass cog in a grey machine, “a caged lion turned strange with the grim constance | of an iron world” (that’s one of mine! i quote it on my facebook. the poem it’s from is old, and shite).

 

the imagination at work is in a state of excitedness, of frenzy and love – it’s not tired or in some kind of tranquilized reverie. one pauses to write at inopportune times, ignores the essential to notice the inconsequential – a leaf, or some hunched-over figure, or the wrinkles on someone’s hand. and words start to spin. things turn into other things, blossom and balloon; the wet clay world takes a strange shape. these days things are depressingly stationary.

 

- that’s not altogether true. these days i attempt to create these excitations in the real world; sometimes i even succeed. i disappear, start to believe i am a ghost, wonder if i might at any point fall out of this dimension and into a static void, being able to speak only mutedly, reaching out for others and being walked straight through. i dream such anxieties. my nightmares invariably involve helplessness, an ability to speak or move. i sit in silent halls, a trembling insomniac, and the walls and sparse furniture and plants dissolve in the corners of my eyes, disintegrating into persecuting figures, creeping towards me, or a floor tile jumpstarts and becomes a scorpion for a split second – was it really a scorpion? i’ll never remember. the dark shadows of the bedroom at night loom darker and darker, begin to dance. these disintegrations are not the work of words; they do not admit themselves to iambs. nor are they much more than a product of fear – fear that as i cannot, anymore, create anything new, the old will melt away too. indeed, in my desperation for a distorted, imagined world, i am willing to latch on to the merest, most commonplace aberration.

 

i don’t know what has died in me. i’m a realist with 20-20 vision, gazing glumly into the abyss. the abyss, for your information, is grey… very, very grey.

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