It is probably no mere historical accident that the word person, in its first meaning, is a mask. It is rather a recognition of the fact that everyone is always and everywhere, more or less consciously, playing a role…It is in these roles that we know each other; it is in these roles that we know ourselves.
The above quote by sociologist Robert Ezra Park demonstrates the idea of personhood as performance, the way that social roles and individual selfhood can both be linked to a conscious performance. How does this idea pertain to a person’s individual and social identity in the context of mental illness? Perhaps the most obvious connection between mental illness and performance is the idea of performance as intentionally deceptive, wherein people perform “wellness” even when they are not well. The common example is that someone responds that they are “fine” to the question “how are you?” regardless of whether they are actually well. But crucially, performance is also about how mental illness is socially defined, and the resulting ways that it is individually communicated or concealed. Appearing mentally “well” requires both conscious and unconscious performance: Individuals reflect, construct, and reinforce a socially normative image of mental wellness and mental illness. In other words, society not only influences but also helps define whether or not a personal is mentally well, and people perform a certain way in response to it.
In the most common socially normative image, wellness means being “fine,” and thus appearing emotionally invulnerable to the real challenges of life. Wellness means not expressing anger at larger social systems. Activists are often depicted as “crazy”—the “crazy feminist” or “crazy environmentalist,” for example. The double use of the word “mad” suggests their close positioning in the social sphere. To be well means to be productive, to be able to work and thus produce goods and services for others; a Marxist might even argue that wellness is about one’s ability to commodify one’s labor and one’s fitness as fodder for the capitalist system. To be well means to not be an outlier, to not disturb others, and thus to conform. It is generally in line with the status quo and the interests of those in power.
This does not mean that social obedience and mental wellness are the same, nor that oppression and mental illness are the same. It is important not to conflate mental illness and the suffering of those who experience it with social struggles, although the two are in fact tightly linked. For example, scientific research suggests a stress-diathesis model in which social harm triggers underlying genetic or chemical vulnerabilities. Thus, although anxiety, depression, bipolar disorder, and schizophrenia have biological components, they also appear to have environmental and significant social causes as well. Poverty, loneliness and alienation, child abuse, and trauma can all play important roles. Whether one receives good help is of course also socially and economically influenced, if not determined.
Nevertheless, the social nature of mental illness does not mean that it is the same thing as social oppression. It is rather that the performance of mental wellness is extremely similar to the performance of socially acceptable behavior. This serves a dangerous double purpose. It silences the suffering of mental illness by making it socially unacceptable, while simultaneously placing those who may suffer from social ills (regardless of whether or not they are in some objective sense mentally ill) in the category of “crazy,” discrediting what they may have to say about our social system.
This link is particularly strong for women. There is a strong performative link between masculinity and wellness, and conversely femininity and illness. Part of this stems from the culturally-accepted binaries of female and male, rational and irrational. These binaries are deceptive, both in their apparent exclusivity (the idea that one is either feminine or masculine, rational or irrational) and in their apparent antithesis, where (female) irrationality becomes a danger to (male) rationality. Femininity has been linked to dangerous irrationality for ages: The most common linguistic example is “hysteria,” which comes from the Greek word for womb, or perhaps the idea that women having “PMS” are irrational. There is an underlying fear of women as dangerous to male rationality, manifested both in their sexual influence over men and the male undesirability of being woman-like.
Thus, performance is often about choosing between these binaries, playing up one or the other, reifying them intentionally or otherwise. I might try not to act too passionately in defending my intellectual beliefs, lest I be seen as an unreasonable, fanatic feminist. The idea is that one can be polluted by “irrational” emotion. And this idea is often part of a larger power structure where rationality is assigned to those in power as “right”-ness, rendering the emotion of the less powerful illegitimate. PMS is, arguably, not a real biological phenomena, and is almost certainly not nearly as dreadful and irrational as it is so often held to be. Rather, it likely has been used at least as much as messaging about how women’s bodies are oppressive, making them weak and irrational and not to be taken seriously. It is important to see the ways in which this is constructed—to recognize, as that great mother of feminism Simone de Beauvoir put it, that “Woman is determined not by her hormones or by mysterious instincts, but by the manner in which her body and her relation to the world are modified through the action of others than herself.”
How do these gender roles influence the performance of mental health here at Harvard? First, there is a familiar double-edged sword with mental health where men, forbidden from expressing deep emotion or vulnerability, are hesitant to ask for help and instead live in mental anguish. Sometimes even when they do ask for help they still struggle to receive it. One of my male friends in agonizing mental pain simply could not bear to stay in therapy at Harvard—he felt like none of the therapists could understand him because they were women (he also felt estranged by the class and race differences between him and the therapists). My friend was not “wrong” to feel this way; I think it is genuinely more difficult to accept the kind of intimate advice and guidance mental health providers grant from someone you cannot identify with.
At the same time, I also wonder if part of his estrangement is due to the way that men are already discouraged from acknowledging their own vulnerability. I often think of the very famous movie Good Will Hunting, in which a poor boy is discovered to be a genius and begins to study at MIT. He goes to therapy at first because it is his alternative to jail. Not only does he consider this treatment almost as bad as jail, but also to the extent that the therapy is successful, it generally happens in a distinctively “male” way: his male therapists lectures him, challenges him, even watches him to be aggressive and violent. The underlying message is that Will is vulnerable, but he can only express this through a hyper-masculine conversation style, with dramatic risk-taking tempered by Hollywood-style sentimentality. Creating a real-life version of this kind of treatment can only be much more difficult. Men are done no favors by this set of gendered expectations, where they are expected to be strong by being impervious.
Nevertheless, the notion of mental wellness as imperviousness is likely even more harmful to women. First, because it is gendered such that women are generally seen as less rational and reasonable, even the smallest action by a woman is likely to be interpreted as a sign that she is not well. Many of my female friends at Harvard expressed how they struggled to never show strong emotions to their professors, lest those professors take them less seriously. Crying was especially taboo. In reality, people can be traditionally “masculine”: very “rational” and “strong,” with aggression and emotion that demonstrates their active participation in life rather than their inability to handle it. It is also true that people can be traditionally “feminine”: emotionally vulnerable, and just as they acquire many illnesses in their lives, they will also experience many forms of anxiety, depression, pain, and even delusion. Although men may be culturally discouraged from showing vulnerability, they can be more assertive or aggressive without worrying that they will appear “crazy.” This demonstrates how men can be more emotionally expressive in certain ways because it is not viewed as irrational or unacceptably confrontational. Women’s “wellness” is accordingly more linked to compliance.
At Harvard, there is the urge to constantly appear very busy yet simultaneously well. The first pressure reflects, among other things, capitalism, the “right” use of privilege, and a certain kind of competition and insecurity. The latter is our need to do all of these things without difficulty. The result is a sort of false consciousness, where we pretend that we can abstract ourselves from social pressure and be invulnerable to it. It’s the very common and problematic belief that mental illness is only for some people, the weak ones, and that most people are strong enough to withstand the pressures of life, however insane the life we’ve chosen is. This is problematic because it equates illness with weakness, and because it doesn’t allow us to acknowledge our own vulnerability or see ourselves in others.
The way that our concept of mental wellness is gendered is also destructive because it cuts the truth in half, bestowing one of two important aspects of human nature on each sex exclusively. But these two parts of human nature, contradictory as they may seem, are fully compatible with one another in practice; they inhabit the same people without making each other less true. So often our performance of mental health means pretending otherwise, especially pretending otherwise in relation to our gender. If we could step beyond these binaries, we’d find a richer, wider world, friendly to our authentic selves in all their various and contradictory forms, well and unwell in all our stages in life.