[Article] Why Pathologization is equivalent to Criminalization! (WRT to CTB)

[TAW122]

Recently, I made a connection between how the medicalization and pathologization of certain behaviors, actions, and conditions is akin to that of criminalization of a certain act, behavior, or condition. This is quite a bold statement indeed, but such a realization is quite important. Even though theoretically people claim the act of CTB is not a crime, which they may be correct in the legal sense (as in the fact that you aren't charged like that of a suspected criminal), you are still treated like a (pseudo) criminal in practice. IANAL, but just given the fact that one is treated like one, irrational and/or not of sound mind until proven rational and/or sound of mind, it might as well just be one. Two different systems (criminal justice/legal system versus the medical/healthcare system), but both are similar in their effects and consequences, and both are paternalistic, but more on that later.

So why do I equate the pathologization of certain behaviors, actions, and thoughts to that of criminalization? This is because if one (who is innocent in the eyes of the law) exhibits or has any of those behaviors and signs that are deemed irrational, pathological, and/or otherwise deemed unhealthy, they are de facto treated like suspected criminals and even given sentences similar to that of convicts. Consider this, instead of jail/prison sentences, they are given involuntary (or voluntary – but in reality the patient/person is coerced into accepting it!) sentences and their civil rights (temporarily) suspended, revoked, relegated to that of an infant or unable to make their own decisions over their bodily autonomy and life.

Just like the decriminalization of certain drugs and such (including other similar movements with other social issues), we must strive towards to demedicalizing and depathologizing CTB and other similar things so this way people who have done nothing illegal cannot have their rights violated and reduced to that of an infant or those of unsound mind/unfit to make decisions on their own. I believe that if the demedicalization and depathologizing of CTB itself as 'solely a health issue' and also 'as an action that only irrational actors can take', then that would be one of the first steps towards advancing the right to die as a civil right and personal choice. Furthermore, I believe that psychiatry has gone too far in the pathologization and medicalization of natural responses to injustice, dissident opinions, going against the grain, and more, but that would be saved for another thread.

My personal anecdote and roots of woes
As a personal anecdote (and a mini-story), when I was a young kid, when I was learning about consequences, it troubled me when I learned how that even though I didn't do anything wrong (or illegal) I could still face consequences, especially those that temporarily suspend my rights as an individual and be relegated to that of a criminal even though there has been no crime nor illegal act committed. It just never sat well with me, the incongruity, hypocrisy, and more. The incongruity and hypocrisy lies in the fact that I was taught to follow the law and there will be no trouble, but of course, as parents and authority figures often like to indoctrinate the young to become a productive member of society, little did they say (perhaps even by deception) that trouble could come in many forms, not necessarily legal troubles (which one would either figure out on their own or learn from their peers, or just common sense), but other kinds of troubles. I was always under the impression (and perhaps due to my own naivety too) that as long as I did not do something that is illegal (aka follow the law) then there would be no 'trouble'. Little did I know that one could get into trouble if their behavior, albeit not illegal, but concerning and too deviant from what is socially acceptable could be pathologized (categorized as a health issue and thus if severe enough – result in the temporary suspension of civil liberties) and action taken against said individual(s).

A slightly tangential example (with regards to the legal system and health system)
Ironically is that despite one being non-compos mentis (not being of sound mind) would technically not be held criminally liable (away from the legal system), yet when the same said person decides to possess a firearm while being a prohibited person (as a result of being adjudicated mentally defective, aka non-compos mentis), they are then deemed criminal (possession of a firearm as a prohibited person) and end up dealing with the legal system, even if they are originally deemed mentally incompetent to be held accountable. (this is the irony – unless there is some exception to the rule). The irony only exists due to how the law is written of course..

I stand with existentialgoof's definition on mental illness, taken from one of his many reply posts on Reddit (linked here)

"Mental illness IS a social construct."

Furthermore, in addition to the linked post and many more of EG's posts, I agree with many of his other points. These points include the following:

Psychiatric 'illnesses' are 'diagnosed' by looking at someone's behaviour or signs of distress and then seeing if they deviate from some arbitrary normative standard. If there is sufficient deviation, that's a mental illness. There is no objective and agreed upon demarcation between sadness and clinical depression, for example, and where psychiatry chooses to set the threshold varies from one iteration of the DSM to the next.

(EG post 1)

Homosexuality was taken out of the DSM, but not because there was any breakthrough empirical evidence that proved earlier ideas wrong, but because it was no longer politically acceptable to keep it in there.

(EG post 2)

"Mental ill health" is a social construct that is used to insinuate that, if someone is suffering psychologically, it's because there is something inherently defective in their brain, rather than a natural and proportional reaction to circumstances in their life. It's a way of stigmatising marginalised groups and discrediting them before they've had the chance to speak, by weaponising the connotation of "insanity".

(EG post 3)

So from the 2nd​ post example by EG, with regards to homosexuality being in the DSM, it is de facto criminalizing homosexuality itself and because in the 70's with counterculture and other shifts in societal views and understanding of homosexuality itself, the APA (American Psychiatric Association) decided to remove homosexuality from the DSM, thus decriminalizing it. Furthermore, some of the replies and posters are insinuating that he is ill (ad hominem) for even trying to have a good faith discussion and dialogue about how pathologizing illnesses and using psychiatry as a weapon to silence those who disagree with the establishment is nothing short of oppression of the individual's voice. The fact that this kind of treatment and response is acceptable in greater society is disturbing as it is another form of censorship, by discrediting and delegitimizing people who don't agree with the status quo.

So in conclusion, pathologization of behaviors, actions, and certain thoughts, especially with respect towards CTB, is in de facto criminalization of CTB. It is alarming and shocking that not many people see the connection between the two and even more disgusting that there are even people picking and fighting over semantics and subtle details, such as CTB is not illegal. It may not necessarily be illegal in sense of it being a 'crime', but the consequences of planning and attempting to CTB (and failing due to personal error or intervention) results in a temporary, indefinite, undetermined amount of time where one's negative liberty rights are suspended among other consequences. So in the end, because CTB itself (both the subject and the action) are pathologized, it is defacto criminalized, just through the mental health system instead of the criminal justice system.

@RainAndSadness @Forever Sleep @SilentSadness

 

[Forever Sleep]

Overall, I do agree with you. I certainly don't like how heavy handed the system is at the moment. That said, the practicalities of dealing with 'mental illness' or behaviour different to the norm can become a bit complicated.

I think the issue lies in whether people ever hurt themselves or others during some sort of temporary psychosis. I imagine that in some cases- they do. How are the first responders to a scene supposed to judge whether that person is of sound mind or not? They can't- so- I think initially, it's kind of inevitable that they will be sectioned.

I suppose it's beyond that that I think things ought to change. I don't think that everyone who tries to kill themselves is acting out of a temporary psychosis. I'd hazard a guess that it's probably a smaller proportion of people who are. Some people might welcome being helped. They may be in that position because they feel like no one cares and no one will help them. It's really how that help is provided though. I certainly don't think it should be forced on people. Plus- I think people who are clearly of sound mind should be able to exercise their own choice and will.

I guess the other issue is criminal behaviour though. I knew of two instances where I used to live where mentally unstable people were let out into the community, resulting in terrible results. One attacked and killed a person in a park. The other set fire to a block of flats- miraculously- no one was hurt. Where do you draw the line? Society does need to be protected as well. If someone is displaying behaviour that suggests they may be a danger to others- it becomes very tricky.

Self harm- including suicide is more problematic because 'treatment' can so easily infringe on our rights. The manner in which people are treated- eg. sectioning, forced medicating also makes many of us secretive about how we truly feel because- we don't want all that shit! It's a very unhelpful cycle really at the moment.

I think- opening up and talking about suicide could actually help a lot of people. Not just suicidal people either. It would give their families and loved ones the chance to support them. Plus- if nothing works, it would actually mentally prepare them for it happening. As it is though- people often seem to freak out and act too heavy handedly- which has actually made things worse for people sometimes. So- people feel discouraged to tell anyone. The current system really doesn't do anyone any favours.

 

[SilentSadness]

Mental illness is when someone is incapable of making rational decisions, but suicide could not be irrational because it prevents suffering. Suicide is of course illegal, it just uses prisons intended for mentally ill people instead of criminals. It is very saddening to have to live in a society that persecutes people for being suicidal, but I don't expect it will change soon. The attitude most people have is so closed and apathetic.

 

[TAW122]

Overall, I do agree with you. I certainly don't like how heavy handed the system is at the moment. That said, the practicalities of dealing with 'mental illness' or behaviour different to the norm can become a bit complicated.

I think the issue lies in whether people ever hurt themselves or others during some sort of temporary psychosis. I imagine that in some cases- they do. How are the first responders to a scene supposed to judge whether that person is of sound mind or not? They can't- so- I think initially, it's kind of inevitable that they will be sectioned.

I suppose it's beyond that that I think things ought to change. I don't think that everyone who tries to kill themselves is acting out of a temporary psychosis. I'd hazard a guess that it's probably a smaller proportion of people who are. Some people might welcome being helped. They may be in that position because they feel like no one cares and no one will help them. It's really how that help is provided though. I certainly don't think it should be forced on people. Plus- I think people who are clearly of sound mind should be able to exercise their own choice and will.

I guess the other issue is criminal behaviour though. I knew of two instances where I used to live where mentally unstable people were let out into the community, resulting in terrible results. One attacked and killed a person in a park. The other set fire to a block of flats- miraculously- no one was hurt. Where do you draw the line? Society does need to be protected as well. If someone is displaying behaviour that suggests they may be a danger to others- it becomes very tricky.

Self harm- including suicide is more problematic because 'treatment' can so easily infringe on our rights. The manner in which people are treated- eg. sectioning, forced medicating also makes many of us secretive about how we truly feel because- we don't want all that shit! It's a very unhelpful cycle really at the moment.

I think- opening up and talking about suicide could actually help a lot of people. Not just suicidal people either. It would give their families and loved ones the chance to support them. Plus- if nothing works, it would actually mentally prepare them for it happening. As it is though- people often seem to freak out and act too heavy handedly- which has actually made things worse for people sometimes. So- people feel discouraged to tell anyone. The current system really doesn't do anyone any favours.

Agreed with the point about forced help, it hasn't helped every single person (while there are some who may be grateful for it, there are quite a few that aren't and the reason people aren't reporting the dissident cases are because it goes against their atavistic beliefs and world view), and it should be abolished (that could be for another thread topic though). Yes, not all CTBs are the result of a 'temporary psychosis' nor 'impulsivity', but a fair amount are well planned, deliberated throughout a long period of time of which the person has suffered, and it's wrong for many people in the field to lump ALL CTB as the same, and it is quite insulting to insinuate that even.

With regards to criminal behavior, I do think that if proven that one is of sound mind and understand their actions, then yes, they should be held accountable and face legal consequences for their actions.

I agree with you on the fact that the current way that society and authorities handle self-harm and CTB is definitely heavy handed and not the best way to handle things. I do believe that forced intervention should NEVER be a thing unless it is a direct (and imminent) threat to others, which of course may even involve the legal system as well (presuming their actions were criminal in nature).

Finally, yes being able to talk about CTB without the fear of repercussions (not the present day and mainstream destigmatization efforts - which focuses on tightly controlling the narrative and is a sham!) is what is needed. By that I do mean something akin to true confidentiality (with very rare, exceptional limits - possibly being a danger to greater society or other third parties). So until such a safe place exists (similar to SaSu but more mainstream and accepted), sadly, there are going to be surprise consequences for people who discover those who CTB, often in unwanted, unexpected circumstances and continue to be psychologically scarred that way. It is ironic how many pro-lifers resent and hate the consequences of CTB, but yet refuse to reject an prohibitionist society in which CTB is so stigmatized and the consequences of getting caught in ideation, planning, or attempting is just barbaric. They (the pro-lifers) cannot have their cake and eat it at the same time!

Mental illness is when someone is incapable of making rational decisions, but suicide could not be irrational because it prevents suffering. Suicide is of course illegal, it just uses prisons intended for mentally ill people instead of criminals. It is very saddening to have to live in a society that persecutes people for being suicidal, but I don't expect it will change soon. The attitude most people have is so closed and apathetic.

Sadly true, and as my reply to ForeverSleep, I still stand by claiming that pro-lifers cannot have their cake and eat it at the same time. Good analogy though as both systems are paternalistic and authoritarian in nature, just different kinds of paternalism.