Many many thanks to acb for pointing me to this — I hesitate to call it a rant because that might sound like dismissing it for being insane — reflection by John Shirley on our collective mental health. Indeed, he leads off with a candid admission of his own history of mental health difficulties, segueing into a reflection on how easy it is for the ‘sane’ to shrug off the suffering of the mentally ill, to make fun of it, to romanticize it, certainly to lack the empathic, compassionate embrace of it to which he wants to get us with his suggestion that we are all closer to mental illness than we would like to think. Clinicians, of course, know this; that in electing to join the helping profession we must, to the extent that we are going to be helpful to others, encounter ourselves as similarly defective, ‘walking wounded’. But in this brief thoughtful meditation, non-clinician Shirley manages at least to touch upon most of the crucial issues — from neurotoxins and the gutting of social services for the mentally ill to the conditions of modernity such as alienated labor, political oppression, the erosion of social cohesion and community, the deterioration of privacy, information overload, and the devolution of meaning — with which I attempt to grapple daily. (Come to think about it, not surprising from a ‘cyberpunk’ writer…)

Awhile ago, I would have maintained that an essay of this sort is itself romanticizing and trivializing the mentally ill; that likening the suffering of the chronically psychotic or neuropsychiatrically damaged patients I treat to the suggested pervasive mental illness of our entire society is comparing apples and oranges. But we know alot more than we did even five years ago about the transduction of stressful experience into brain changes and we undestand that ‘reactive’ conditions such as depression, anxiety disorders, post-traumatic stress conditions, perhaps attention deficit problems, begin to look much less like isolated episodes and more like entrained and ingrained chronic conditions, little different from the bipolar or schizophrenic psychoses. So there may be more identity to the two categories than one would like to admit. And, too, there is the perspective of evolutionary psychology which elucidates how adaptive traits become pathological under conditions of modernity. Shirley highlights, for example, our evolutionary ill-preparedness for the number of interactions we must needs have in modern life, a point that has always struck me as profound. He ends with his truest, simplest point, suggesting that by truly taking care of the psychiatrically ill we would be taking care of ourselves… and vice versa.