Defining "Dysfunction"
Notes on mental health and society, part one
This is the first of a three part series where I discuss issues surrounding our understanding of mental health. These reflections have been adapted from my previous writings on the matter, particularly those I’ve already posted on social media.
A local representation of mental distress is Sisa, the madwoman in Jose Rizal’s novel, who lost her children to the corrupt Spanish colonial officials. To lose your sanity is to break your bait, a word that means both “goodness” and “reason.”
Perhaps Heaven had granted some hours of sleep while the invisible wing of an angel, brushing over her pallid countenance, might wipe out the sorrows from her memory: perhaps such suffering was too great for weak human endurance, and Providence had intervened with its sweet remedy, forgetfulness. However that may be, the next day Sisa wandered about smiling, singing, and talking with all the creatures of wood and field.
—Rizal describing Sisa’s descent into madness, from his novel, “Noli Me Tangere”
The loss of Sisa’s sanity didn’t come out of nowhere. If you’ve already read the book, consider everything that happened to her up to that point. Today, an imbalance of power forces many Filipinos to be “resilient,” to survive from one day to another. Mental health is tied to societal issues, and as long as the Filipino has to rely on diskarte (strategies) and lusot (slipping through) in order to survive, then well-being is actually a luxury.
There is a lot of stigma surrounding mental health in the Philippines. Among them, the fear of being called “baliw”, or crazy. We often emphasize the personal responsibility of an individual to take care of their mental health through faith and resilience. Those suffering from mental conditions are often told that they simply lack prayer or mental discipline. This invalidates their experience and discourages them to seek professional help—or, at the very least, peer support. While it’s true that spirituality can help a person cope with difficulties, and resilience is an important protective factor in developing a stable sense of well-being, we must still respond to others with empathy and use appropriate psychological interventions. Sadly our limited perspectives ignore the fact that our standards of mental health are defined by sociocultural expectations.
Am I “Dysfunctional”?
Being considered “dysfunctional” in a society implies that there is a proper way of doing things—that is, how to be a “functional” member of that society. If a society prioritizes “productivity,” then the unproductive person is considered “dysfunctional.” If this is medicalized, then the goal of their health system would be to address the symptoms that are preventing the person from participating in society—not necessarily to “fix” the system, since “well-being” is defined by the system. In a 2003 paper on how “madness” is defined, Casey and Long point out that psychiatric diagnoses are based on a person’s life experiences, which are linked to sociopolitical contexts—they are not purely and objectively scientific.1 That is not to say that we should just give up evidence-based solutions—all this says is that it is just as important to place all of that in context.
So, in the context of a society focused on production and consumption, our most modern definition of “mental illness” seems to be the inability to function in a productive society. As Joanna Moncrieff aptly put it:
Disturbed and disruptive behaviour is not just a social nuisance, however, it potentially affects the processes of production that form the basis of modern societies. The individual who is acutely paranoid or severely depressed, for example, is unlikely to be able to work, or at least to work efficiently, and family members, too, may be prevented from working because of the disruption caused to their lives. Moreover, someone who is severely mentally disturbed may frighten and upset those around them, preventing people from feeling secure and motivated enough to satisfy the requirements of labour, and potentially jeopardising the whole system of modern production.2
Thus if you can’t function, you can be diagnosed as “mentally ill.” If you don’t align with socially acceptable standards of “being” (which is, essentially, the ability to produce and consume), you can also be diagnosed as “mentally ill.” There is stigma associated with dysfunction, as well as consequences for not being able to be “productive” in a society that treats being busy as a moral value.
In the next part of this series, I will be discussing how our individual problems are rooted in larger societal issues.
For those who want to learn more, I’ve released a special mental health primer focused mainly on concepts and frameworks in Filipino psychology, exclusively for members of the Sikodiwa Circle—you’re welcome to join us!
B. Casey & A. Long, Meanings of Madness: A Literature Review, 2003.
J. Moncrieff, The Political Economy of the Mental Health System: A Marxist Analysis, 2022. Frontiers in Sociology, CC-BY.