In recent months we have discussed a lot on the subject of “mental health” thinking of keeping the issue alive, convinced as we are that it is more necessary than ever to reactivate interests and research. We asked Franco Rotelli to use this text published in “Which psychiatry? Notebook and lessons”. Let’s start today to keep this thread.
What is mental health
by Franco Rotelli
It may be that sanity is the opposite of insanity. As far as I’m concerned, I imagine that being crazy doesn’t mean taking yourself too much or too much (or completely) seriously. If it is on the contrary, mental health can only be identified with the exercise of emptiness, of the insignificant: in short, the complete realization of being in bad faith and of undergoing the dull flatness of inertia.
Fortunately, between these two extremes there is a reasonable dose of anguish that almost everyone carries with them and a reasonable dose of foolishness and falsehood that does not allow the former to overwhelm our unstable balance. Who knows how desirable, who knows how much mediated balance, made such by a social contract which, measured in goods and products, constitutes our commercial formation that surpasses everything and decides on inclusion/exclusion.
The real question is then when and why the production of feeling, and a shared doing associated with it, are possible, credible, dedicated to other utilities than goods. Real socialism has taught us that away from goods there is cheating, illiberty, the institutionalization of an abstract power made up of ideology that becomes concrete and pervasive violence: the state.
One could imagine that mental health lies where a subject can exist with others, communicate about himself through language, be able to speak of himself through acceptable differences, constitute himself through partial singularity and partial commonality. Constituting oneself and being constituted where inclusion/exclusion tend and risk each other, on the limit on which others can hold you back, you can hold yourself back and together you can find a common feeling, a common practice, an interrelated project.
If it is probable that only language can save us, if it is probable that in madness there is I don’t know if a choice but a sure complacency, a continuous coddling, a seduction undergone, a racket caressed, an extreme identity whatever, the other becomes even more decisive than your future. If only the other can save you from you, can hold you here, can perhaps even push you there or leave you, abandoned and shipwrecked, unrelated, only this is useful to talk about.
I don’t know much else. Then I know that, when the limit is exceeded, the social contract provides that someone must somehow take care of you by profession and service, by state duty. And we have also seen what can happen there and we see every day what happens and risks happening. How exclusion can be cemented there, your unhealthy illness judged and objectified (although it is also necessary to be aware that it is perhaps better to be “sick” than possessed by demons or the like, with reasonable doubt thinking that it is better for you to take care of the supposedly doctor rather than a supposedly exorcist and perhaps better a hospital than exile on the edge of the village).
It will be a question of better understanding whether from there it is possible for the threads of inclusion to be re-knotted or the burden of an often irreversible and irrevocable exclusion only ever worsening through dedicated professions and services.
If it is clear that health and sickness are often present together in the body and in the soul, if it is more difficult to say here where one, health, begins and the other, sickness, is grasped, it is difficult to escape the feeling that the words do not indicate anything that really happens here. The inadequacy of the word pertains to their rationalizing nature which seems really inadequate to the peculiarities of the irrational. Using language to enter madness is like using a meter to measure a liquid. But is the language then adequate to talk to us about what mental health is, what ingredients a healthy mind feeds on and health in whose eyes? Of the others who observe and judge me or of me who turn in my sleep or when I am awake to face the warrior threats that are addressed to me every day and thus try to keep myself healthy?
And furthermore, will the secession from the world which is built-in exclusion, internalized and self-validated aggression, be the extreme sign of madness or the last remnant of mental health, defended to the bitter end and against all evidence? (We should then ask ourselves about this strange destiny: that is, whether it is destiny that we have to spend time defending ourselves against “competition”).
But the real question remains whether it makes any sense to ask what mental health or illness is within a social organization that decides what one is and what the other is. The almost total social control means that, from the family to the health or social system, the “taking charge” of the presumed mental disorder, the judgment on the lack of mental health of an individual, are generally precocious and lightning-fast. It could be sanity to be free from competition, from the need to produce more and better, from the risk of exclusion due to inadequacy with respect to the laws of the market (which may include knowing how to fish, hunt, knowing literature and theatre, being smiling and witty , knowing how to sing and dance, being full of initiatives and fantasies, casual and sommelier, upright and up-to-date, computerized and muscular and in any case producers of any fashionable commodity). Mental health could be the infinite fun of finally recognizing that we are all different and not therefore unequal (I don’t want to go looking in the library if the same root of “diversity” and “fun” has a reason to exist, I just think about it and I like it ). What actually establishes this deadly equivalence between mental health and approval, if not our fear of getting lost in the non-recognition of my counterparts? Even literature, art, food, poetry, theater are by now pure consumer products, objects of futile conversation around the quality of beauty creams and stocks of designer stuff. Own thinking no longer exists as recognizable, an object of irony at best, the transformation of the world now being an empty concept of men and ideas. If the only shared project is Development (and consumption) there will be the indicator of mental health or at best in the little house in Tuscany where the garden and the sweet pea are grown, never where the fatigue of living takes its toll risk and its finitude, it discovers man in his infinite misery and however assumes the burden.
The obvious obviousness of what I’m saying has a singular lack of recognition in ninety percent of the practices of mental health production professionals, the sciences “psy” dislocate elsewhere and organize thoughts, models, practices and concepts of a completely different nature, superimposing author and author in a long monologue without end, a powerful soliloquy because it constitutes corporations of power-knowledge, because it is a commodity that accumulates and capital that reproduces, unverified, free, mostly self-referential, intangible for crusading consensus.
Psychiatry has been (and still is in various places) a sort of instrument of terror understood as the zeroing and attribution of an unbearable identity.
“Basagliano” will then become sensible thinking (now unobtainable), inspired action with minimum ethics, decent practice of institutions and institutes, an action endowed with that minimum of criticism of the scientific vacuity established in the appropriate societies of which Psychiatry Forensics is the apogee, deinstitutionalizing prejudice, relativizing all judgments, respecting that taking oneself so seriously, with this perhaps being able to break down the walls, for a desire for democracy that can somehow reduce the obligation of bad faith as the only defense against folly.
Having autonomous projects, having a partner in this, accomplices here and there, build together a sentence of which we only knew a few words, someone or something that doesn’t get tired of your discrepancy. What if we were even capable of constituting the other in value? Perhaps we (psychiatrists) would have begun to do our job. It will always be late.
2006