Book about “mental disorders”: What is man?

“Among the crazy, you say “du”” is the title of Lea De Gregorio’s book about all those who are considered abnormal. They suffer from “mental disorders”.

As a young adult, Lea De Gregorio was placed in a psychiatric hospital. There, others made decisions about her Photo: Photo: PaulaWinkler/Ostkreuz/SV

If it had been up to Lea De Gregorio, the doctor, you would not be reading this text. Lea De Gregorio would not have studied and she would not be working as a journalist today. She would not have acquired the tools to write a book about the problems of psychiatry. De Gregorio ignored the warning that all this would be too much for her, the woman with the diagnosis. Her book “Among the crazy people, you say “du”” was recently published. It is the “story of self-empowerment.”

Because as a “madwoman” she is the subject of analysis and evaluation by others, the “professionals” of psychiatry, who on the one hand often believe that “madness” is the result of genetic predispositions and physical causes, and on the other hand characterize psychotic episodes as “senseless experiences.” Her book begins with her admission to an acute psychiatric ward in Berlin. Before that, she had not slept for nights because she had so much to think about.

“I was overworked and a lot had happened in the previous year, my head was overflowing with questions about life. Everything was soaked in emotions and I no longer understood the world around me, everything was different than usual. You could say I was in the middle of a life crisis, I was afraid and I hoped that the man in the lab coat could help me.” But the content of her episodes arouses little interest.

“Among the mad, you say “Du”” begins like a memoir, but immediately breaks down the boundaries of the genre. De Gregorio conveys the current state of psychiatric theory and practice and philosophizes about what happens during psychotic episodes.

She carefully asks whether there are any connections between today’s psychiatry and Nazi science, “racial hygiene” and social Darwinism, and discusses ideas and proposals that have been developed in the psychiatric-critical movements of the past decades. She fights against the stigmatization of people who are treated as non-normal and appropriates the term “madness”. She seeks advice from thinkers and allows scientists and people with experience in psychiatry to have their say.

From the margins to the centre of society

De Gregorio concludes that the aim must be to “bring the topic of psychiatry from the margins to the centre of society and not to judge ‘mental disorders’ or ‘unusual behaviour’ as abnormalities, but rather – similar to the term neurodiversity, which many people with ADHD and autism in particular increasingly use today to describe themselves – to judge them in a value-free manner as different from the quantitatively predominant part of the so-called majority society.”

For statistical reasons alone, it cannot be described as “abnormal”. Nationwide, more than one in four adults meet the criteria for a mental illness over the course of a year, according to the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology. So we are all confronted with it in one way or another.

From De Gregorio’s perspective, however, such being different does not appear to be a qualitative difference, but rather one of intensity, which – when it occurs episodically – often results in those affected having difficulty coping with everyday life. This is also not considered normal and often frightens them and their relatives.

Psychiatry not only takes on the role of institutional defence against the other in society, but it also produces and stages a space filled with fear, “a threatening backdrop to act as a deterrent for everyone,” as psychologist Robin Iltzsche writes, “to be a place where no one wants to be and from which everyone wants to get away if they should ever find themselves stranded there.” So it is not surprising that De Gregorio asks himself: “To what extent are we madmen an oppressed minority in our society to this day? And what role does psychiatry play in this?”

Experiencing existential questions throughout the body

Psychiatrist Neel Burton provides an answer: “The fact that the course of the disease is generally more favourable in traditional societies may be related to the fact that mental disorders are seen there as a part of life rather than as a sign of illness or failure.”

De Gregorio adds his own theory to this: “In the smoking room, we madmen chattered about the big questions among ourselves. ‘What can I know? What should I do? What may I hope for? What is man?’ I believe that many serious psychological crises are implicitly or explicitly concerned with these four famous questions by Immanuel Kant, which, if you do not ask yourself them in the same rational way as usual during the madness, you experience all over your body.”

De Gregorio argues that the feelings and thoughts that are considered to be ill do not appear out of nowhere, “but are always connected to events, an attitude, a need, a grievance, in short: a meaning, even if this meaning may not always be immediately apparent.”

The term “mentally ill” is harmful

The American psychiatrist Thomas Szasz goes so far as to question the validity of psychiatric diagnoses. He considers them to be stigmatizing labels that are formulated in such a way that they “resemble medical diagnoses and are applied to people who irritate or do not fit in with their fellow human beings.”

Matthias Seibt, who has experience in psychiatry, believes that the term “mentally ill” is harmful. He gives an example to justify this: “So someone has been the victim of a violent crime and is suffering mentally as a result. That is an appropriate reaction when someone is feeling bad, so why should that be a mental illness?” But even if the psychiatric definition were to be removed, the suffering for those affected and their families would still be real.

De Gregorio therefore also deals with the question of medication and with new models with which reform-oriented psychiatrists try to support people during acute episodes in environments that are not as frightening and characterized by power hierarchies as acute wards and clinics.

The issue of violated human rights plays just as much a role in De Gregorio’s considerations as discrimination, which she sees as intersectional. A Muslim man who does not speak like an academic may be more discriminated against as a “mentally ill person” than a white woman with a university background.

Always subtle humor

Teachers, judges and psychiatrists also suffer from mental disorders, although this does not give the latter a reputation for having more expertise on the subject than their “healthy” colleagues. Meanwhile, in some places, people with psychiatric experience are being trained to bring this experience into psychiatric institutions.

In addition to all the negativity, pain and oppression that one can experience on an acute ward, the charming thing about these places is that everyone comes together there. “You can learn so much about human existence there, in such a brutal and direct way as perhaps nowhere else. I sometimes missed the conversations in the smoking room on the ward later on,” writes De Gregorio, who describes herself as having a cheerful attitude.

Her clever book, which can also be read as a handbook for those affected, is full of subtle humor. She reminds us and herself of how little we still know about “being crazy.”