When Andrew Solomon writes that people “attribute their pain to external factors” (347), sometimes they’re right, poor or not. I’m highly skeptical of this idea that the problem is always internal; claiming that changing the internal will change the external is usually true but we also need to be very careful (a lot more careful than Solomon was, in my opinion) not to start blaming the victim since that’s where this line of thinking can go all to easily. One thing I will agree with, though, is that “we have been trying to solve the problem of poverty by material intervention at least since biblical times and have in the last decade tired of such intervention, realizing that money is not a sufficient antidote” (360). What is? These people, part of the “When Helping Hurts” team have some ideas.
Some of his language is beautiful and inventive; some of it is verbose, clunky and insensitive. He actually writes, “On the other hand, the ugly truth is that paraplegics can’t be baggage handlers and fat girls can’t be super models” (366). In or out of context, this is in extremely poor taste and seems to trade on the same idea that saying “I’m just being honest” or “no offense!” allows you to say whatever you want. That a book containing this type of arrogance won the National Book Award goes to show what we condone in this society – the infantilizing of women (it’s much more common to say “men” when referring to men and “girls” when referring to women) and the physical beautiful of women, to name a few.
Sometimes, despite his gentle demeanor “in person” (I’ve only seen him on Youtube videos and Ted Talks), he can even come off as arrogant. He was visiting a mental hospital and he relays the patients’ experience as subjective and his as objective (386) even though he was a visitor. This is not only patronizing, but it reinforces harmful notions of mentally ill people and makes me question why he is doing all this research. He also seems unscrupulous in stating his observations. Does he really have the qualifications to be saying who needs treatment and what kind and who doesn’t or when someone is in the best health they could possibly achieve (386-8)? He claims to have “developed an us-and-them” mentality (388), but I think he brought it in with him. His description of those patients in the mental institutions he visited only contribute to the stigma of mental illness, offer no new or helpful information and, just as he claimed that “someone forgot to grant these people adulthood” (388), he forgets to grant them dignity. He actually says that patients need “protection” from the outside world and their “frightening inner selves” (388), which promtes the current and incredibly damaging opinion that all mentally ill people are dangerous to their core and are basically children who need sheltering from the real world (just as much as the real world needs sheltering from them). It also contradicts what he says a page later: if “depression is an illness that sits squelchingly on top of personality,” (389) how is okay to characterize all mental-hospital patients (especially if 40% of them are, like Solomon claims, in for depression) as having scary inner selves? Honoring this kind of thing with a National Book Award isn’t surprising, given the current structure of power, but that doesn’t mean it in its entirety is revolutionary, healing or helpful.
There are several institutions, situations and relics of mental health care that Solomon doesn’t really question in a way I believe he should. For example, a system in which you can escape the pursuit and attention of caring professionals only by “recovering” such as developed in Pennsylvania (392) is not as healing as it seems: so only “sick” people get attention? I’m disappointed by the lack of questioning whether reintegration into society is a good goal – after all, it is no measure of health to be well-adjusted to a sick society. And I’m more than disturbed by his statement: “There is such a thing as sanity and such a thing as madness…ultimately, there is a politics of what one asks of one’s own brain and the brains of others. There is nothing wrong with this politics. It is an essential part of our self-definition, a cornerstone of the social order. It is wrong to spot collusion behind it…” (393). Why support this “social order?” And why – exactly – is it “wrong” to suspect foul play behind the definitions of “normal” and “crazy” from which a few benefit and many become more deeply entrenched in suffering? There may indeed be “sanity” and “madness,” but I think it is wrong not to question where these definitions come from; given who benefits most from the “treatment” options we currently have, I can’t imagine these delimits come from something as innocent as “self definition.”
He makes you think he’s going to question the unbridled capitalistic system that is likely responsible (indirectly or otherwise) for much of the proliferation of mental illness of those who are being crushed under its “invisible hand,” but all he admits to is being “uncomfortable” with the “epitome of corporate America high on its commodities” (395) that was the launching of a new pharmaceutical, that it was “harmless,” merely “anomalous for the promotion of a product for people suffering from a terrible affliction” (395). If that concept – that shameless promotion of a pill, complete with disco parties and unfettered emotional manipulation (the promotional effort he neutrally describes is appalling, even, ahem, mentally ill – though not shocking for America these days) – is not worthy of Solomon’s questioning, then I find him worthy of mine. He does ask good questions, like “If depression is a disorder that affects as much as 25% of people in the world, can it in fact be an illness?” (397) and the conversation about who, in fact, is ill (397-398) is quite compelling. But then he says stuff like “The SSRIs are not fatal or dangerous even in extreme doses” (398). Did Big Pharma pay him to write that? It’s irresponsible to say something that because it’s wrong. If you think links like that (or, for a more personal touch, this) aren’t valid, do your own research but do not unquestioningly trust any claim about a pharmaceutical drug without extensively looking into it yourself (you’d think Solomon, researcher that he claims to be, would have done so; but he’s pretty pro-pill so it’s no surprise that he didn’t here).