It’s just nerves

The tendency [is] always strong to believe that whatever receives a name must be an entity or being, having an independent existence of its own.
– John Stuart Mill

It is almost a standard joke that psychiatry has pejorative or “put-down” words for every human emotion, as “euphoric” for happy, “fixated” for interested, and “compulsive” for determined.
– Alan Watts

Physicians think they do a lot for a patient when they give his disease a name.
– Immanuel Kant

In the midst of the serene world of mental illness, modern man no longer communicates with the madman… There is no common language: or rather, it no longer exists; the constitution of madness as mental illness, at the end of the eighteenth century, bears witness to a rupture in a dialogue, gives the separation as already enacted, and expels from the memory all those imperfect words, of no fixed syntax, spoken falteringly, in which the exchange between madness and reason was carried out. The language of psychiatry, which is a monologue by reason about madness, could only have come into existence in such a silence. – Michel Foucault

When I was a kid in the 60s people didn’t have mental illnesses. They had nerves.

There were fully fledged loonies about of course, though I never actually saw one. Mostly they were kept locked away. Except for the ones featured in newspapers and horror movies. We’d all heard stories of what happens to people whose cars break down near an asylum.

But the people who screamed or ranted or behaved unpredictably from time to time without attacking you with an axe weren’t crazy. They had problems with their nerves. If things got really bad they might have a nervous breakdown and have to go into hospital for a while.

So when old Benny shouted incoherently for hours or became completely withdrawn, fashioning models of  native wildlife from cigarette foil as he’d done in the camps, it was his nerves from the war.

When Miss Smith went on a sudden corporal punishment binge, caning up to half her class of six year olds in a day and screaming at the rest, it was her nerves (though us kids leaned more to the theory that the biological basis of her temperament was her flaming red hair).

Mrs Hanbury took too much medicine and got her stomach pumped because she had bad nerves.

Mr Whelan sometimes closed all his doors and curtains and stayed inside for weeks because of nerves from when his wife died.

And when the bruises on my classmates or their mothers didn’t match the stories they told about them it was because the man of the house suffered from nerves.

Like I said, there was no mental illness when I was a kid. A few crack-pots. Some retards. The odd spastic. And lots of people with nerves.

I don’t know how many of them were getting treated for their nerves. Bex and benzos were popular back then. I expect most of it was due to nerves.

The accepted wisdom was that people with nerves were pretty much the same as everyone else except when they had an attack of nerves. In some cases the attacks supposedly had known triggers – dietary, behavioral, conversational … – that needed to be avoided. But mostly you treated people with nerves pretty much like you treated everyone. Nerves weren’t stigmatising like craziness. We all recognised they could happen to anyone. Mind you, people with nerves could be a pain in the neck so it was understandable if you avoided them when their nerves were acting up.

In Crazy Like Us, Ethan Watters says Californian Hispanic people often use the term nervios to refer to a wide range of emotional and behavioral disturbances that their Anglo American counterparts would describe as anything from a vague disquiet to full blown schizophrenia. The term apparently makes it easier for non-professional family carers to offer support than would a more technical, pathologizing word from the DSM. And by treating the behaviors as what they are rather than as symptoms of some underlying disease it decouples the patient’s identity from the illness and makes them better able to participate in the community according to their capabilities. According to researcher Janis Hunter Jenkins, the nervios person is seen as just like everyone else, only more so. Jenkins also found that such families have lower levels of expressed emotion directed towards the sufferer who in turn has a better prognosis for prolonged or complete recovery.

Maybe there’s no need to try to force all human deviance into the slots provided by the Diagnostic and Statistical Manual. Maybe it’s time psychiatry gave up its efforts to sew the world a straitjacket and trim us all to fit. Maybe if we admit to ourselves that we all know as much about madness and how to respond to it as the ‘experts’ we can  take back responsibility for it in ourselves and in others. And maybe we’ll stop putting medicalised labels between ourselves and our fellow human beings.