“But the man who was afraid of the weasel had a disease”.
Who? What? Where did this come from? Aristotle doesn’t tell us. As usual, he’s not talking to us – presumably he’s lecturing to some free citizens of his city state, of which there are – what, 35,000? – who presumably all know the same gossip. With these people he can refer to “the man who was afraid of the weasel” just like you could refer, talking to people at your academic institution, to “the student who published that article in defense of sweat shops a few years back”.
I admit it: I have always been oddly curious about this example. Who was that man who was afraid of the weasel? What was the incident like? Why did Aristotle think it was a disease? For a while, whenever I met an Aristotle expert, I asked them if anything further was known about this story. They always told me that no, it is lost to posterity, and so I am left with my fantasy version of the event, no doubt influenced by my childhood in Israel: a very dark night, an Athenian military encampment, some soldiers sneaking a weasel into a sleeping man’s tent, or whatever they had back then instead of a tent, the man shrieking with terror and looking silly as he jumps to his feet and runs away. Later, the embarrassment, the humiliations reserved for a man who failed a harsh ideal of masculinity (either you are the type who is willing to die in battle, or you’re a coward!) in a tightly knit society. He wonders if he’ll ever live it down, and would not be totally dismissive of the thought that people might still read about him 2,500 years later.
By Keven Law – originally posted to Flickr as On the lookout…, CC BY-SA 2.0, Link
Sadly, we will never know what happened, but the question of what makes a fear – or some other mental state or behavior – a disease or a symptom of disease is still with us. Suppose we try to settle the question of whether someone should count as having a mental illness or not. Is this child what some anti-intellectual cultures call “a nerd”, or does she have a mild version of “autism spectrum disorder”? Is this man grieving for his late wife, or does he suffer from a “major depressive episode” triggered by her death? I wrote in my post before last that very often, we still go about answering this question in a way that has nothing to do with science or with what metaphysicians call “carving the universe at the joints”. Those who are in favor of taking the nerdy child or the grieving man to have a mental disorder argue for it on the basis of the premise that the girl or the man could receive some help if so categorized. The girl could use some breaks at school, the man could use some therapy and some compassion from his employer, say. They often cannot, in this society, receive these things if we don’t call them mentally ill, so it’s practically a moral imperative to call them mentally ill. Therefore, they are mentally ill. If the concept of mental illness or mental disorder is to be anywhere near scientific, this is a pretty bad argument. True, wanting to help is a good motive. We are not talking some evil pharma companies plotting to include the grieving man in DSM so that they can sell him pills. But it’s a bad argument, all the same.
Those who hold that the girl or the man does not have a mental disorder also use arguments that have nothing to do with science or whatever joints the universe might have, though they, too, have good intentions. “I don’t want this child to be stigmatized as having a mental disorder just because she is nerdy, it will make her feel bad, therefore she does not have a mental disorder” is one. “It is insulting to me and to the memory of my wife to call my grief a mental disorder, so I don’t have one” is another. Full disclosure: I am often intuitively sympathetic to the conclusions of these bad arguments. Calling fairly ordinary aspects of grief an illness sounds problematic to me. I have a few doubts (I do mean doubts, not certainties) about the idea of “autism spectrum”, as it seems questionable to me that a child who is so terrified of human closeness that she refuses, from infancy, to be hugged or touched by mom or dad and a child who craves affection as much as anyone but fails to make friendships with peers because he can’t figure out how one starts a conversation suffer from two varieties and/or degrees of the same problem or trait. Still, that does not allow me, or anyone else, to argue that a diagnosis is dubious simply because it’s insulting. Some people who are so depressed that they spend most of their time crying on their apartment floors are firmly convinced that their depression is due to their superior insight into the nature of the world, or the fact that they have figured out that happiness is not valuable and only shallow people think it is. Such people often take offense if you suggest that the problem is their neurotransmitters, which made them gloomy long before they could spell “nihilism”. Still, it might very well be true – spoken as a person who had pretty bad depressive episodes herself – that the insulting diagnosis is, for some of them, correct.
So what? So “mental disorder” is not a scientific concept as long as we decide who “gets” to have a disorder or not to have it on the basis of practical rather than theoretical considerations. This is a problem, because ultimately, seriously scientific research into mental disorders is the best way to help those who have them, and for that we need “mental disorder”, as well as “autism”, “depression” etc. to be theoretically respectable concepts. What has to go, I think – not that I know how to make it go! – is the medicalization of suffering. By that I mean not merely the fact that more problems are considered diseases than before – that’s a mixed bag, as it is plenty good that epileptics are viewed as sick rather than possessed by the devil. Nor do I merely mean that some problems are considered diseases which are probably not diseases. When I say that suffering has been medicalized, I mean that a person who is suffering can increasingly receive neither help nor sympathy unless her suffering is regarded as a medical problem, and “medical” suffering is somehow perceived as more “real” and more deserving of remedy than ordinary suffering. In a morally ideal world, a person whose life is a mess because she’s in the middle of a divorce could come to her employer, explain her situation, and get a bit of slack from her. In this world she needs to go to a doctor, tell the doctor exactly what she would have told her employer, and, on the basis of that, get a note that says she has clinical depression – a disorder – and needs, well, exactly the type of consideration she would have asked for. There is something ridiculous about this.
The predicament of a kid who is bullied by everyone in class or who is simply friendless through k-12 is a bad one, both in terms of experience and of impact, and should be treated seriously. If I had to reincarnate as a child and had the choice, I would take a mild bona fide medical condition over this predicament. If the nerdy girl from my example is facing it, and if there is anything we adults can do without making things worse in another way (there often isn’t), we should do it. It shouldn’t matter one iota if the problem is literally a matter of health. Health is not the only good! illness is not the only bad! If we remember that, perhaps we can approach the question of whether she is best described as having a mental disorder, or autism spectrum disorder in particular, in the spirit of inquiry unfettered by the sense that if we say no, we thereby deprive her of help or sympathy, and so yes is the only decent thing to say. Such inquiry can bring with it better help for both those with autism and those without it. But the blogger who was obsessed with the man who was afraid of the weasel finished her rant.