(Content note: mental ableism including ableist slurs, normalization of mental ableism in pop culture, personal account of discrimination)
I play a whole lot of video games. Between twenty and thirty a year or so, on average. Every year the Steam Summer Sale wipes me out completely and I've never once felt bad about it. I love games as a storytelling medium. It's quite unique in that way, because the interactivity alone sets it apart from all other storytelling formats. I'm not interested in quibbling about whether they're art or not. They just feature very prominently in my arsenal of tools that facilitate escapism, adventure games especially. There's some absolutely wonderful stories to be had there, and for all the crap video games rightly receive for their gender politics, adventure games do amazingly well with great female protagonists. But I like psychological thriller/horror/mystery stories especially. Like this game:
If you can't watch that, here are the pertinent quotes from the developer:
We're taking full advantage of the asylum setting. It's not a game about zombies, it's a game about patients and their craziness. They're criminally insane people so you never know what to expect from them. They might attack you, but they might also let you live for a little while. [...] What we want to do is scare the shit out of players, so we'll do whatever is necessary to achieve that goal. Whatever works.
I spent over half of my life (the fist half, regrettably) being clinically depressed, and a small chunk of that time voluntarily institutionalized. I can confidently say that, at sixteen years old, this was without a shadow of a doubt the kindest thing I have ever done for myself. I finally got the help I needed, medication that worked for me, therapy from kind people, and I was surrounded by people who were going through the same thing I was and were endless wells of support, kindness and strength. Back then I didn't understand the shock and hand-wringing of the people around me that went with that decision. I was sick. I needed to go to the hospital to get better. What's the big deal?
I understood it even less from my fellow patients. All of them, to a man, told me that I should never, ever, under no circumstances admit to having been institutionalized. And again, I was confused. I really didn't see what the big deal about getting medical care was. Well...
Something started to dawn on me when we went for a walk with my therapy group and a car slowed down to throw empty cans and slurs at us and laugh at the crazies. They followed us until the nurse called the police. But still, isolated incident, right? Assholes are everywhere these days. I still didn't see the problem. In my estimation my fellow patients could tell or not tell, no skin off my nose, but I sure as hell wasn't going to be coy about having received medical help for a medical problem, because, like, seriously, right?
Since then I've lost and missed out on jobs, been avoided and gossiped about, had to leave school because I couldn't deal with being bullied about my depression on top of my depression, and so on. Most damaging to me personally was being denied the education I wanted, because we can't have icky loonies around young children. I will never be able to do well in a job interview, because I can't explain those months with anything other than the truth that I was in a mental health clinic, and I can't explain my lack of experience with the truth that I've been discriminated for that ever since. That setback of my early youth is going to follow me around for the rest of my life. Not because I'm still suffering symptoms, because I barely am. I can deal with my past illness perfectly, but weirdly enough, other people can't. This is somehow my problem and not theirs.
So I've come full circle. I still don't think I have anything to be ashamed about. I still think getting professional help for medical problems isn't exactly the shocking lunacy people make it out to be. But then I will never, ever, under no circumstances admit to having been institutionalized. I actually had to go back to the hospital to take their course on how to communicate about mental illness to loved ones and potential employers. The illness itself and the effects it had are firmly in the past now, a rough start to a life that through great privilege (supportive family, enough money for treatment, time off for recovery) has turned out to be a rather pleasant affair so far. But I don't think the world will ever get tired of reminding me what an inhuman, violent, miserable, dangerous and downright animalistic wretch I was in those few months I spent taking care of my mental health in a place designed to help me do that.
I brought up video games because here's some quotes from two games I played just this week.
There's more egregious examples, a whole lot of them, but it struck me that in just one week of playing games, I came across this several times. (There's several more from the same week, but I didn't take screenshots.) Neither of these games take place in or refer to the past, by the way. Both were made and take place in the 21st century. Only one of these statements (the first) was made by a character the player was supposed to dislike, and the main character never gave any indication of disagreeing.
It's a fact of life that if you like mystery/horror/thriller/detective games like I do, mental illness is going to be brought up, usually to explain something "evil" in the plot. Smart money says you're going to visit an asylum too. It's not just video games. I have only very, very rarely seen mental hospitals, professionals and patients being treated fairly on the big or small screen either. Genre fiction especially can suck my hairy ass with this. Hell, I pointed out on this very blog that a show that isn't even airing yet already seems committed to the creepy asylum/ECT-is-torture two-fer of bigotry in its trailer.
Because it absolutely is bigotry, and it's a horrifyingly safe and prevalent kind. Here's some figures from a 2008 study by Canadian Medical Association:
- 46% believe that a diagnosis of mental illness is merely an “excuse for poor behavior and personal failings”
- 10% think that people with mental illness could “just snap out of it if they wanted”
- 42% would no longer socialize with a friend diagnosed with mental illness
- 55% would not marry someone who suffered from mental illness
- 25% are afraid of being around someone who suffers from serious mental illness
- 50% would not tell friends or coworkers that a family member was suffering from mental illness. 72% would discuss cancer, and 68% diabetes.
- 50% think alcoholism and drug addiction are not mental illnesses
- 11% think depression is not a mental illness
- 50% think that depression is not a serious condition
Certainly fits my experience. Don't you know that the key to overcoming depression is not being so depressed all the time? Like, doy. I was really sad when my cat died, but then I got over it, you know. Have you tried getting over it?
The reason I'm drawing pop culture into this should be obvious. With patients being pressured into keeping silent about their condition due to stigmatization, harassment and discrimination, the only look at mental illness and health care most people ever get is the reductive stereotypes shown in popular media.
Asylums are where evil doctors experiment evilly on barely lucid victims. It's where Video Game Protagonist goes to either run away from the psychos or pump them full of bullets, depending on which genre you prefer. In horror shows and movies it's where lunatic ghosts of the patients alternately haunt and kill. Did I mention the evil experiments? All therapy is torture, basically. ECT is when they hook up screaming innocents to a car battery and fucking let loose with it. How often does it turn out that the bad guy is bad because insanity I guess? A lot. It happens a lot. Crazy is what crazy does. And don't even get me started on the nurses. And straight-jackets. And the chains. My god, the chains.
Basically, when it comes to pop culture, the perception got stuck in a caricature of the very early days of psychology and never saw the need to move beyond that. Because of my experiences, I've gotten pretty good at spotting people in a similar situation, and I'm a safe person to confide in. I really, honestly can't count or even remember all the times when I had to reassure people who really needed help that no, they weren't going to get chained up and shocked and force fed against their will. Abuses of power and medical malpractice absolutely do exist in mental health circles, but the reality of even those things is very, very different from what's presented in pop media.
Because on TV, in movies and in video games especially, there's always the Psycho Switch. Some people are just troubled and sad, because they are human and I'm human and I can relate to that. They don't need to be hospitalized, because they're sane, just a little bit sad and nutty, just like you and me. But once you flip the Psycho Switch, all bets are off. Then they're violent, murderous, inhuman. The crazies we alternatively shoot or run from in video games aren't human. The monsters in genre shows aren't human. The miserable, incurable, sobbing wretches aren't human. They're... like, crazies. They flipped the Psycho Switch. Once that happens, they are little more than rabid animals. The biggest kindness you can do them is to put them down. There's no coming back from that.
It's worth noting that almost all of these representations take place in the modern day. The history of mental health treatment is a disturbing and horrific one at best, but this is rarely acknowledged. A game like Blackstone Chronicles is basically a guided tour through the history of mental health, but it's still a horror game, and it's still about the eeeeevil doctor whose in it for the torture basically. (I really recommend that game, by the way, but be advised that it can be very triggering. Use your discretion.) That's the other side of the coin. When we aren't shooting them, running away from them or poking them with sticks, we're supposed to thank our lucky stars that we aren't pathetic, sobbing, victimized but equally not-human wretches like they are.
So there's your choice: you're either sane and just a little troubled, but a fully functioning human being who just needs a nudge in the right direction. Or you flip the Psycho Switch, at which point you are either a monster or a tortured victim. Take your pick. (Because you can absolutely choose to be sane and normal. You're just a wimp if you don't.)
The presentations of various illnesses themselves are equally reductive, in that there are none. You don't explore different wards or interact with/watch patients with different mental problems. There's no distinction made between people who are hospitalized for depression, burn-out, PTSD, schizophrenia, postpartum, psychopathy, trauma, it's all just generically "crazy." Lump them all in pile, throw away the key, you're done. Some lip service is paid to the fact that mental illness comes in verious stages of severity, but only in the most reductive way possible (see: Psycho Switch.)
There's also no such thing as voluntary admission. Because come on, who would want to go to a horrible, evil, scary place like that? You'd have to be crazy or someth- Oh, wait, shit.
When very rarely a character does voluntarily admit themselves, this is usually the worst (and last) mistake they ever make.
When the villain of the story is the one suffering from mental illness, don't expect any more exposition than that. There's usually some attempt made to explain how the villain came to the point where the Psycho Switch was flipped, but after that point no humanity is left in them. "Insane" villains usually seem to suffer from an ill-defined and reductive caricature of psychosis and/or schizophrenia, but do not operate like human beings. They do not doubt themselves, they don't have moments of lucidity, they can't be reached, they are simple conduits of insanity which equals evil. After the Psycho Switch is flipped, they abruptly and immediately embody the illness 100% and are defined solely by its symptoms, the most prevalent symptom being stabbingfolksitis.
So the doctors are evil sadists, the patients are either broken and incurable victims or bloodthirsty monsters, and the hospitals they all work and live in are horror game settings, but all that is small fries compared to the role medication plays in all of this.
Basically, don't ever take your medication. Just don't. That's just giving in to The Man, man. How will your troubled spirit ever soar free if it's being numbed by, like, chemicals? Chemicals are evilbad. Everyone knows that. I can't even count the coming-of-age bullshit stories that hinge on the troubled protagonist regaining happiness by flushing their meds and just getting over it and appreciating the beauty of the world and whatnot, usually under the spirited guidance of a Manic Pixie Dream Girl. The late nineties and early two-thousands adored that shit. It's the get-over-it mentality that plagues and haunts people suffering from depression exemplified. And trust me, that's an attitude that absolutely can and will set back recovery. After all, if everyone else can just get over it like it's no big deal, the sufferer must be an unbelievably weak and pathetic and egotistical specimen to wallow in hurtfeels like they do. So get over it, and don't you fucking dare take medication. Medication is a shortcut for cheaters. Just nut up. Because depression medication is "happy pills." You take them and then you're happy, and fair enough, but it's not real dammit! You gotta find happiness outside of the pill bottle like god intended!
I personally like to think that if there was a pill any person of any physiology could take to instantly become happy, it'd be kind of a big deal.
It's sad how commonly accepted all of this is. That game I referenced above is Murdered: Soul Suspect, released about two weeks ago, set today. It's about the ghost of a detective trying to solve his own murder. Despite that silly premise, it's actually a realistic game set in modern times that very much takes place in the world you and I inhabit (plus some ghosts and shit.) One of the locations this atmospheric supernatural thriller takes you is of course the yawn asylum. This isn't a location that gets any backstory. There's no big reveal of evil doctors or haunted history or anything of the sort. Nothing gruesome is revealed about it during the course of natural play. Nothing bad happens to anyone within its walls that the players can see or hear about. We're just there because we need to talk to a witness whose been admitted because of severe PTSD. I can't stress enough that it's never introduced as a place where bad things happen or where bad people do bad things. It's just a mental hospital.
|"Metal hospitals. The one place where torture is considered for your own good. If their experiments ever succeed in restoring a person's sanity, they better hope it was at the expense of the person's memory."|
It's really almost funny, the fact that we're just supposed to go with that without missing a beat. The game never gives a reason why its protagonist might feel that way. (In fact it's established that his wife suffered from depression, so you'd think he'd be more sympathetic, not less.) The game never gives the player any reason to think that mental hospitals are bad in its own universe either. They just are. It's fact.
The rest of the chapter is a race against time to save the witness because SHE'S SCHEDULED FOR ELECTROSHOCK THERAPY IN FIFTEEN MINUTES!!! ZOMG and crickey! Panic with me!!! If this atrocity is allowed to happen, she will certainly... be taken back to her room? Gently wake up? Probably feel a little better? What are you hinting at, game? That if we don't hurry up and save the girl, all that will remain is a charred corpse with a car battery hooked to her nipples? Seriously, what?
To be fair, you do see some other patients in the hospital besides the witness. They are walking around, watching TV, chatting in the common room, reading a book- Fooled you! Yes, of course they're all lying on their beds twitching and cackling about invisible roaches.
This is how normalized this perception is. The game assumes (and is very confident that players also assume) that mental hospitals are bad and evil places where incurable lunatics get tortured. Fact. Straight up. At least most horror games try to give some limp justification for why these places are so bad. In Outlast the patients were all involuntarily committed because of violent crimes. In Phantasmagoria 2 they were part of a hallucination by the protagonist. In Murdered: Soul Suspect, well, it just is. That's just what it's are like. Everyone knows that.
I wasn't tortured. I was restrained against my will once. It wasn't pleasant, but it also prevented me from fucking killing myself, so I consider that a very sound decision on the part of my doctors, and I'm glad they did it. To go back to the criminally insane psychos of Outlast, one of the people in my ward was involuntarily committed after a violent crime. He was one of the kindest and well-behaved patients in the ward who really benefited from therapy and experiencing kindness and support for the first time in his life. I'm very happy no horror game protagonist broke into our ward and shot him in the face, because he's doing much better now and hasn't hurt a fly since his original incident. I met several people with the same illness I was there for and wouldn't you know it, they were all very different people dealing with different symptoms in their own way. It was almost like they had other traits besides crazy. It was a transformative and liberating experience, especially at my age, to see naked and raw humanity like that, to feel so supported and safe, to meet all these wonderful people who were all so very unique even in their common illness.
But I'll tell you the one single thing we all had in common, the psychos, the maniacs, the schizos and the losers, one generalization I'll allow, one common experience: when that car full of dudebros followed us around on our walk to point and laugh and throw garbage at the loonies, when we got back from that, every single one of us cried. The violent psycho who beat up and nearly killed his childhood abuser, the 14-year-old mom with postpartum depression, the schizophrenic boy who was waiting for his alien friends to take him home because they were the only ones who were kind to him, the former heroin addict now struggling with depression, the thing we had in common wasn't that we were all "crazy." It was that we were all human.