How 'mental illness' is like and unlike the old concept of 'sin'

The concept of mental illness has quite simply replaced that of sin, with which it is incompatible.

A different idea of moral responsibility results. One is now responsible primarily not for what they do but what they are. Evil is reduced to risk factors stemming from behavioral dispositions that are normally neutral (not good but also not bad) and also innate. For mental illness is thought to be a biological, and rooted at least partly in inherited congenital traits. These only dispose one to actions that are held to be wrong; circumstances that are essentially social will determine their expression, but theoretically evil actions are worrisome possibilities of all and only persons who are judged ill by innate disposition.

In this respect it shares some of its defining traits modern anti-semitism, which is linked to nationalism (which is also proposed most widely as the solution to the problem, hence Zionism) and the biological determinism that developed through the appropriation of Darwinian evolutionary theory, and to a politics of annihilation (thus genocide), sometimes through a logic of identitarian inclusions and exclusions, and a rhetoric of purification that displaces morality onto ideals of health (in other words, Nazism and the broader phenomenon of concentration, 'humanitarian' refugee, forced labor, or extermination camps).

This is like sin considered as original, and allowing salvation, the alternative to damnation. But it is without virtue and happiness. This has the consequence that there is nothing you could learn that would mitigate the determination that you are sick in your dispositions to cause or suffer evil. Causing evil and being the suffering victim of it are not much distinguished as far as the attention of the professionals caring for the sick-minded; either way, one is "at risk" and so in need of protective, preventive, and punitive attention.

Virtue and happiness are essentially unknown to the mental health system; they lie outside its purview. The concept of health implies that of sickness, and medicine concerns itself with the treatment of the sick, not the healthy, except in terms of preventive medicine, which does not promote the good except by limiting or warding off the bad, illness.

The responsibility now of the mentally ill is to 'assume the position' of being sick, or having a demonic 'illness' inside of one's mind, potentially driving one's behavior.

You will be expected to report regularly to an officer of health who conducts a surveillant observation of your negative dispositions, to crime or unhappiness, which are equally sanctioned.

The terminology is a medical and not legal one, and that is why the connection with sin is both maintained (particularly in the form of sin's 'originality') and abandoned (because it is no longer linked to a will that makes one responsible not just for answering to their unfortunate condition, and the directives of the doctors and social workers, but for actually being disposed towards good or bad actions, or even for the responsible choice among entirely positive potentialities.

Creativity as a generally shared human trait does not interest psychiatry. Your doctor has little interest or ability to assist you in maximizing your happiness. Psychiatry does not aim at the good, except by limiting and controlling the bad.

This makes its biopolitical character thanatopolitical. It makes being in the world a condition of misery that must be recognized as sad, with therapies aimed not at a pursuit of happiness but the control of unhappiness. Instead of good and bad, there is now normal and bad. Normal is not happy, but is plagued by the fears of badness. This tends to produce a subjectivity that knows its actuality to be unhappy and the only solution to this condition being death. There is no heaven, only a desperate fear of hell. Perhaps being in the world of medicine as that kind of subject who can only assume responsibility for being the object of medical and therapeutic treatment is, by way of this treatment having the character of a sad approach to the management of sadness, can be called purgatorial. At the end of the purgative process, there is only the dull boredom of normality. The sadness and death-driven character of this should, upon being recognized, motivate people to refuse the whole schema and concern themselves with joyful activities that the present order of things is unable to well tolerate because they threaten it.

This results in part from the fact that treatments of people that aim at normality must refuse transgression. But transgression is at the root not only of evil but of saintly love and creativity.

This logic may indicate a grounds for hope of the kind Hölderlin spoke of in saying that where danger lies, there too may be found the saving power.

It is impossible to eliminate evil, and only a totalitarian social project could attempt that. The results can only be horrible. The potentiality to not do or experience evil is dependent on the potentiality to do or experience it. Our administrative states with their logic of control aim to so perfectly manage the social world that all disaster is avoided. Nothing truly horrible will happen - if the right measures are taken. And nothing that does happen, at least to yourself as an individual, can truly be intolerable, for terrible things might happen and you have to accept them, and can only manage the disaster by changing your attitude; hence, cognitive therapy with its Stoic and Buddhist ethics. These things are being said at the very moment that global disaster is imminent, likely to occur in a single generation from now, if adequate measures are not taken. Our global police states do not and cannot aim to promote the good. The good is produced through creative efforts, but creative production is performed by labor, even if this is done under the direction of capital. Capital's need for policing does not stimulate more creativity; it is only designed to limit destruction. So far, it has failed, and we must wonder if it is bound and destined to fail. Today, how many workers are employed to police other members of the class of persons who serve as labor power and the power to consume and pay for products and services? Capitalism has stimulated great productivity, but it has always limited it to a minority. Under its rule, most people must live lives of quiet desperation, not of creative joy.

Joy is no stranger to rage, which is unlike anger in that it cannot be surrendered or cured with adjudication and forgiveness, but involves totalizing rejection. Rage is not hatred but is beyond hatred, which is resentful and fearful, despairing at the impossibility of change; rage is sovereignly joyful, delighting in its transgressions. Rage is the complement to despair that is also the alternative to it. It involves courage, and refuses compliance, which is constantly being demanded, in a therapeutic world whose managers are always trying to supplement the sad procedures for managing a life that it supposes can only be sad (consider in this regard the recorded ‘music’ that customer service telephone lines subject people to, a sonic equivalent of an intravenous drip) with the false solicitude of polite acknowledgements of discontent and frustration. We need the courage to refuse the conditions that make life profitably unendurable, the courage to face and name disaster, in favor of a strange and novel hope.

The fight against the regime of mental health and illness is therefore central to the struggle for a post-capitalist society. The problem is not with the existence of medicine and doctors, but their use in policing, to try to control the populace through management of dissonant affect or disaffection. They are called upon to manage the society; happily, this is contradictory enough that it may be supposed or found impossible. But faced with the anxiety of the impossibility of policing the world, the managerial elite can only adopt increasingly desperate measures to manage the global crisis. For those of us in opposition, the aporias of impossibility need to be promoted, as we work at a thinking that takes aim not at individual persons but at the society, and assume the risks of change where the managers will try to control them.

This means also that a socialist politics that only seeks to give everyone what they need, including care for the illnesses ascribed to and provoked by an economy of artificial scarcity that consigns most people to boring work, is bankrupt and of little interest.