Posts Tagged ‘Theater’

My first encounter with Alfred Hitchcock’s work took place when I was only a child, back when the name “Hitchcock” didn’t yet mean anything to me. Each summer when I was young, my parents would send me to arts and crafts day camp. Although I probably tackled hundreds of projects during these summers, one stands out in my memory. It involved the erection of a model haunted-house out of various materials. For inspiration, our camp instructor had the class watch an excerpt from (what I now know to be) Psycho (1960). She warned us that this was a very scary movie she was showing us, and so she could only show us a very short scene. I remember watching the eerie image of the famed Psycho house on the small television box. Although it was safely contained within the four walls of the screen, it appeared to insidiously encroach upon the bright and fun-filled room around it. Further, whatever movie it was I was being shown, I knew it to be a grownup movie, and that made it forbidden. Yet, here I was at day camp being made to watch just a few minutes from it by adults I trusted. An uncomfortable feeling of disobedience soon settled over me—uncomfortable because it felt like I was breaking a rule, yet, at the same time, the breach appeared sanctioned somehow. (It will not surprise you to learn I was a very nervous child!) Suffice it to say, Psycho left quite an impression on me; this, before I ever got to watch it in its entirety, something that wouldn’t happen until many years later.

I can trace my passion for film back to early adolescence. During this time, I would often walk to my neighborhood library to rent videotapes of various classics. In fact, I can vividly recall me picking All Quiet on the Western Front (Milestone, 1930) off a rotating VHS stand. (My grandfather being an avid consumer of war films, I felt I was doing him proud by watching Milestone’s quintessential entry into the genre.) While I don’t quite remember how exactly I came to watch my very first Hitchcock film, I am fairly certain it was rented during one of those many trips to the library. In any case, my introduction to his work began with his most famous titles: Rear Window (1954), the 1956 remake of his own The Man Who Knew Too Much, Vertigo (1958), North By Northwest (1959), The Birds (1963), and, of course, Psycho. Thoroughly entertained (I wouldn’t begin to appreciate Hitchcock’s technical genius until I registered for an Introduction to Film Studies course in university), I eagerly moved on to his more obscure titles, including his very first, silent films. During his career, Alfred Hitchcock directed over 50 pictures. Since most of them weren’t readily available at the library or even in stores, I took to the Internet. My father’s trusty credit card in hand, I ordered more than 30 of Hitchcock’s movies on DVD. Of course, this was all done without his permission, since he would have (understandably) never agreed to it. Once my father recovered from the initial shock of what probably amounted to a 500$ charge on his credit card bill, he quickly fashioned the incident into what is now the most often told family story bearing my name. The story is particularly amusing since it embodies one of the rare instances of willful disobedience on my part. While I was rarely willing to break the rules, apparently breaking them in the name of culture was more than acceptable to teenage-me!

Having now watched most of Hitchcock’s films, I can definitively say my favorite film of his to be Rope, adapted from Patrick Hamilton’s 1929 play of the same name. The story is that of Phillip Morgan (Farley Granger) and Brandon Shaw (John Dall). They have just murdered their former classmate, David, and are getting ready to celebrate their “perfect crime” over dinner at their place. The guests: their victim’s closest friends and relatives. The evening’s most anticipated invité, however, is Phillip and Brandon’s old prep-school master, Rupert Cadell, played by James Stewart (Rope marked the first of four collaborations between the actor and Hitchcock). Rupert, you see, made quite an impression on our two first-time murderers back in university: he used to argue that murder is sometimes warranted, when a superior being commits it to rid the world of an inferior one. David, Phillip and Brandon apparently came to reason, fit the “inferior being” bill. Particularly proud of his accomplishment and bent on passively gloating, Phillip decides to set dinner over the chest hiding David’s body. But minutes before the guests start arriving, Bandon’s conscience starts acting up. Although he is the one who physically caused David to expel his last breath, Phillip is evidently the mastermind behind the deed. He attempts to calm Brandon down, but Brandon cannot be comforted: Phillip’s arrogant coolness unnerves him. As the evening wears on, tensions between the two men begin to rise. Noticing the discord, Rupert starts to suspect something is awry.

Rope is pure, character-driven story. There is no sense of events happening to the characters, but of characters instigating events. Indeed, Rope represents one of the more modest Hitchcock pictures, with no elaborate set pieces or unexpected plot twists. Its scope is of personal magnitude: Rope is about a man whose life is lost on account of philosophical recklessness. (Notice how the cast credits at the end are organized: characters are named according to their relationship to David, who heads the list. Indeed, Rope is less about Phillip and Brandon than it is about their victim and those ideas that led to his premature death.) Lest we forget this, Hitchcock adopts a minimalist approach that focuses all of our attention on the characters and their actions and reactions (which for the most part centre around David, figuratively and literally). Firstly, Rope is contained in both time and place: with the exception of an opening shot from Phillip and Brandon’s balcony, the film takes place entirely over the course of one evening, inside the protagonists’ apartment. (Akira Kurosawa would adopt a similar approach for the first act of his excellent thriller Tengoku to jigoku, 1963. Although, according to Labuza, 2012, the director never formally acknowledged having been influenced by the Master of Suspense, his film remains undeniably Hitchcockian.) Secondly, Rope feels very fluid, filmed to play like one long scene: to achieve this, the film counts a grand total of ten cuts. (To put this in perspective, most modern Hollywood films outnumber 5,000 cuts; Apple, 2004.) While half of these cuts consist of traditional, overt visual breaks, half of them are masked using different panning and tracking techniques.

When editors do not want cuts to call attention to themselves, they resort to what is called “continuity editing,” which seeks to unite otherwise disparate shots in a coherent manner, thereby simulating continuity between the shots. In Rope, continuity is achieved simply by keeping cuts to a bare minimum. Researching the film for this review, I was surprised to learn that it does not fare well with movie critics, who deride its (you would think sacrilegious) lack of traditional editing. In my opinion, however, the relative absence of cuts in Rope suits the emotional purposes of its sharply written screenplay, which attempts to prop audiences on the edge of their seats by rendering Phillip and Brandon’s crime less and less perfect, and their apprehension by the authorities more and more likely, as the evening progresses. Because events escalate for the most part uninterrupted visually, it is harder to pinpoint, while watching the film, exactly when each of the nails in Phillip and Brandon’s coffins are first hammered. This is slightly disorienting, creating a palatable sense of dread in the audience, who is quite ingeniously made to root for the murderers. Rope achieves this rather unlikely psychological feat by surreptitiously appealing to our morbid sensibilities, our asocial but devilishly tantalizing desire to see a wicked plan carried through with definite success. To be fair to critics, however, Hitchcock himself came to agree with them regarding Rope’s unique visual style.

Regarding why he decided to film Rope in one fell, visual swoop, Hitchcock confesses in his famous book-length interview with fellow director François Truffaut: “I undertook Rope as a stunt; that’s the only way I can describe it. I really don’t know how I came to indulge in it” (Truffaut, 1985, p. 179). He later concedes that he actually wanted to emulate the play, which plays out in real time from beginning to end, without interruptions. Hitchcock, however, eventually admits to second-guessing this decision: “When I look back, I realize that it was quite nonsensical because I was breaking with my own theories on the importance of cutting and montage for the visual narration of a story. On the other hand, this film was, in a sense, precut. The mobility of the camera and the movement of the players closely followed my usual cutting practice. In other words, I maintained the rule of varying the size of the image in relation to its emotional importance within a given episode” (p. 180). Despite this creative compromise, Hitchcock ultimately concludes, with Truffaut lightly nudging him in that direction, “films must be cut” (p. 184). At the same time, however, Hitchcock does not fully interpret his decision to film Rope the way he did as a mistake, stating that “[as] an experiment, Rope may be forgiven” (p. 184).

Truffaut, in agreement with Hitchcock’s conclusion that films must be cut, claims that because “the classical cutting techniques dating back to D. W. Griffith have stood the test of time and still prevail today” (1985, p. 184), there is no reason to do away with them. I am not in a position to argue with the man behind Les 400 coups (1959), but I will go ahead and disagree nonetheless. (If it makes me sound more credible, just imagine Truffaut’s best film was Fahrenheit 451, 1966!) To be sure, Rope is an experiment that has seldom been replicated. (Contemporary examples include Timecode, Figgis, 2000, and Russian Ark, Sokurov, 2003.) The fact that Rope does not respect tried-and-true filmmaking techniques, however, does not make it any less of a film. As I have argued, it appears to me to actually benefit from the absence of cuts. One may still rightfully wonder, however: if you’re not going to cut, why not just direct a play instead? Indeed, some have accused Rope of not being a film at all, but merely a film of a play. Stewart himself reportedly suggested to Hitchcock: “Since we [are] filming a play, we ought to bring bleachers into the soundstage, and sell tickets” (as cited in Ebert, 1984). This accusation, that Rope is more theatrical than it is cinematic, is, as I intend to show next, unfair. To understand why, we must first see how exactly films and plays differ from one another.

The Difference Between Cinema and Theater

Granted, the accusation Stewart (among others) levels against Rope is not that it essentially amounts to a play, but to a film of a play. Having said this, Stewart’s remark nevertheless begs the following question: had Hitchcock taken him up on his suggestion to bring a live audience into the soundstage, would that audience’s experience of Rope: Live have been any different from our experience of Rope: The Film? In order to answer this question, we must first examine what it is about plays that make them feel different from films, and vice-versa. In the following section, I identify those aspects of plays and films that render the experience of sitting in a theater or a cinema different. Through this examination, I hope to demonstrate that the experience of watching Rope has ultimately more in common with that of watching a movie than it does with that of watching a play.

To be sure, the distinction between cinema and theater is, in many ways, arbitrary (for a surprising argument in favor of this statement, see Sontag, 1966). Having said this, one cannot deny the fact that each of the two art forms possesses its own strengths, strengths that can thus, for all practical purposes, be considered defining characteristics. That is, what distinguishes films from plays isn’t that which either do the other cannot, but that which either do the other cannot as effectively.

In plays, time and space are not very flexible. (This may sound like an admonishment, but it is not. This characteristic of plays confers upon them a sense of immediacy and intimacy films struggle to replicate as effortlessly.) While different scenes in a play can certainly take place at different points in time and space, transitions between such points are not as seamless as in film, oftentimes calling attention to themselves. That is why playwrights generally tend to keep the number of temporal transitions and locations to a minimum. Conversely, films can easily, say, intercut scenes taking place at different points in both time and space. In that Rope takes place during one evening, in one apartment, without ever taking us out to other moments or places, it resembles a play.

While Rope only features one single space, it uses that space in a way I believe is distinctly cinematic. Films, you see, can do more than simply take audiences from one location to another in a matter of microseconds. They can also allow audiences to experience one single space in ways that would be physically impossible at the theater. In his seminal essay on Style and Medium in the Motion Pictures (1934/1995), art historian and film theorist Erwan Panofsky explains: in the theater, “space is static, that is, the space represented on the stage, as well as the spatial relation of the beholder to the spectacle, is unalterably fixed” (p. 96). Film Studies professor and author Richard Barsam (2004) expands on Panofsky’s description of the theater experience: in the theater, “your perspective […] is determined by the locations of your seat, and everything on the stage remains the same size in relation to the entire stage” (p. 4). To be sure, the spectator also “occupies a fixed seat” at the cinema, but he remains “in permanent motion as his eye identifies with the lens of the camera, which permanently shifts in distance and direction. And as movable as the spectator is, as movable is, for the same reason, the space presented to him. Not only bodies move in space, but space itself does, approaching, receding, turning, dissolving and re-crystallizing” (Panofsky, p. 96-98). Further, movies so manipulate space “in such a way as to distort, transform, and heighten a scene” (Barsam, p. 4).

This “repurposing” of reality is traditionally achieved through framing, by varying the distance, angle and movement of the camera relative to objects and actors within a given shot. For example, an extreme long shot (to be distinguished from a long take), distancing the space between the audience and a character, might on its own inspire a sense of isolation, whereas an extreme close-up, narrowing the space between the audience and the character, might on its own inspire a sense of intimacy (and perhaps even a feeling of “spacelessness”). Reality may also be “repurposed” through editing, by cutting from one shot to another and, most importantly, varying the spatial relationships between the different shots. For example, follow a long shot of two characters, say, on a date at a restaurant, with succeeding and increasingly tighter close-ups of each individual, and you might, collapsing the (physical and metaphorical) space between the two, create a developing sense of mutual intimacy.

While Rope hardly ever relies on cutting, it does take full (and varied) advantage of framing, as Hitchcock himself acknowledges in a previous quote. Indeed, the lens of Rope’s camera is able to perceive space very unlike the eyes of a spectator at the theater. (To complicate matters, even the camera in films of plays does not “see” like a spectator sitting in a theater! I will return to this later, however.) As a result, space is rendered and thus experienced in a uniquely cinematic fashion.

This is evident when the camera is active. Take, for example, the scene at the end of the movie when Rupert hypothesizes how he would lure David to his death without getting caught, were he to at that moment step into the apartment. As Rupert walks us along each step of his imaginary plan, the camera acts as if he were actually carrying out every one of them. Panofsky (1995) eloquently refers to such uniquely cinematic tactics as “substituting […] the eye of the beholder for the consciousness of the character” (p. 98). This could presumably be replicated in a play, say, using a dimmed stage and a beam of light, but I doubt the effect would be as powerful. Even when the camera stops moving and settles on a static shot, it offers a unique point-of-view that a pair of eyes “sitting” anywhere in a theater would be hard-pressed to replicate. Take, for example, the static shot of Phillip and Brandon’s housekeeper clearing the dinnerware, tablecloth and candlesticks off the chest hiding David’s body. This suspenseful, low-angle shot is masterfully composed for maximum effect: the chest and Rupert’s back stand on opposite sides of the foreground, while the dining room and kitchen occupy the mid- and back-grounds. As Rupert and the other dinner guests discuss what could possibly have kept David from attending the party, the housekeeper walks from the chest to the kitchen and back, each time taking a few more items off the chest, until it is completely bare and exposed.

Critics of Rope (not to mention one of its own actors) claim that because it does not contain many cuts, it basically amounts to a film of a play. A closer look at actual films of plays, however, helps undermine this argument. Indeed, films of plays (e.g., Hughes, 1986) actually often cut between differently framed shots: contrary to what you may imagine, they are not filmed in one static, extended long shot from a visual “sweet spot” somewhere in the theater’s main seating area. Does that mean films of plays should be considered full-fledged films? Not at all. The reason for that is intentionality in framing and cutting. In films of plays, shots are framed and cut together in no specific fashion. As we have seen, Rope may not (often) make use of cutting, but it does very much make use of framing; most importantly, it makes deliberate and meaningful use of it. In so doing, Rope remains a full-fledged film, while films of plays, despite the presence of framing and cutting, still cannot be considered actual films.

In his essay, Panofsky (1995) warns: “[The] imitation of a theater performance with a set stage, fixed entries and exits, and distinctly literary ambitions is the one thing the film must avoid” (p. 96). Films, he suggests, must instead take full advantage of that which only films can achieve: Panofsky dubs one such uniquely cinematic faculty the dynamization of space, or the dynamic conveyance of space to an audience. As demonstrated in the above examples, whether Rope’s camera is being active or static, it is always telling the audience, via variations in framing, how to look at the space inhabited by its characters, in the hopes that we think or feel certain intended thoughts or feelings. Thus, despite the fact that it does very well resemble theater in terms of content (i.e., limited samplings of time and space), Rope employs the camera in such a way as to convey at least part of that content (i.e., space) to its audience in a uniquely cinematic fashion, thereby providing us with a uniquely cinematic experience. And it is this very accomplishment that, in my opinion, elevates Rope beyond a mere play rendered on celluloid to the level of legitimate film.

The Difference Between Evil Movies and Bad Movies

Aside from its unique visual style, Rope also captured my attention because it obviously features two romantically attached gay characters, in the form of Phillip and Brandon. To be sure, homosexuality is never verbally acknowledged in the actual film. Despite this seeming wariness to even speak the word “homosexuality,” the fact that Rope was a “homosexual movie” was well known to everyone involved: in fact, during production, people reportedly took to calling same-sex sexual interest “it” (Bouzereau, 2001). In the fascinating documentary Celluloid in the Closet (Epstein & Friedman, 1995; see also the more straightforwardly titled companion essay Homosexuality in Film, Sony Pictures Classics, 1995), Granger (who was bisexual) claims both him and Dall were very well aware they were playing gay characters. According to screenwriter Arthur Laurents (who was gay), the only ones out of the loop would have been the censors, which explains why Rope was able to get past them.

To be sure, Rope’s depiction of homosexuality isn’t particularly flattering, despite the involvement of queer talent. (In fact, it would take another 13 years before the first mainstream film depicting homosexual men in a compassionate light—the remarkable British thriller Victim, 1961, directed by Basil Dearden—would be released.) Both Phillip and Brandon are dislikeable, antisocial men caught in a pitiably asymmetrical relationship. Following in the footsteps of Mrs. Danvers—the seemingly lesbian antagonist from Hitchcock’s Rebecca (1940), who also comes across as deranged—the couple also meets a gruesome end: however, while Mrs. Danvers’ demise evokes religious retribution (she dies engulfed in flames), Phillip and Brandon’s demise evokes legal retribution (they are presumably tried and sentenced to death). In a sense, Mrs. Danvers’ character embodies a better indictment of homosexuality, since her malevolence directly flows from her affection for another woman. Phillip and Brandon, on the other hand, are criminals deserving of punishment, who also happen to be gay.

One could certainly make the case that Rope’s portrayal of gay people is an improvement over that of previous films. Phillip and Brandon are not bad because they are gay; they are simply bad in addition to being gay. Further, they no longer represent an offense to Religious Law, but simply to Secular Law. (It has been suggested that Norman Bates, from Hitchcock’s subsequent Psycho, is a repressed homosexual. In that he ends up, following his arrest, in the hands of a forensic psychiatrist, Bates is also portrayed as an offense to Psychiatric Law. In this way, Hitchcock’s films mirror the evolution of society’s view of the homosexual: first as a sinner, then as a criminal, and finally as a madman.) But while homosexuality and malevolence are portrayed as existing separately in the persons of Phillip and Brandon, an indirect relation between the two attributes is nevertheless implicitly suggested. Phillip and Brandon each embody certain stereotypically gay character traits, which could be interpreted as causal to the crime committed by the couple. In that he is impressionable, submissive and weak, Brandon evokes stereotypically feminine qualities, which presumably caused him to fall under Phillip’s spell and be talked into murder. While Brandon is portrayed as just short of a “real” man, Phillip gives off a more masculine vibe: he is confident, independently-minded and assertive. However, he is also highly narcissistic, thinking himself and his partner to be superior beings.

The accusation that gay people are narcissistic has been leveled against us time and again, especially in psychoanalytical circles. (Incidentally, Freud and psychoanalysis are mentioned twice in Laurents’ screenplay.) Freud (1914/1991) himself hypothesized that male homosexual interest results from, among other possible causes, narcissistic object-choice. According to the theory of narcissistic object-choice, men become gay by being so self-possessed they only seek out partners who remind them entirely of themselves. To be fair, Freud (1930/2001) later conceded that even male heterosexual interest is “a problem requiring an explanation” (p. 10), although he never, to my knowledge, ended up fashioning one (for a modern attempt, see Chodorow, 1994), or at least one that also involved unflattering causes. Freud’s (1923/1960) Oedipal complex theory comes close, because men who “successfully” resolve it become straight, while those who do not become, among other possible “pathological” outcomes, gay. Still, the theory assumes, without explaining why, that all male children begin life as straight: first for their mother, then—via, for example, anaclitic object-choice—for another woman. In fact, the complex is, in a way, more about “surviving” this period of conflict without “losing” one’s heterosexuality than it is about actually laying the behavioral foundations for it.

You may think such blatant homophobia masquerading as science is a thing of the past. Well, I regret to inform you that this is unfortunately not the case. Just three years ago, my Abnormal Psychology professor—a psychoanalytic psychiatrist—claimed that cutting-edge research had finally empirically shown that homosexual men are more narcissistic than their heterosexual counterparts. Freud’s narcissistic object-choice theory was correct: gay men love themselves so much they wish to find partners who embody every bit—and I mean every bit—of their towering greatness. (The professor conveniently omitted the reference for this supposedly game-changing study.) In a valiant and well-meaning effort to carry outdated psychoanalytic theories of homosexuality into the 21rst century, author Tim Dean (2001) attempts taking the narcissism out of narcissism: homosexual narcissism, he claims, entails not only “a commitment to sameness,” as in your run-of-the-mill narcissism, but also one to “otherness” (p. 122). Suffice it to say, Dean’s essay is an exercise in linguistic manipulation: instead of simply finally dropping the narcissism hypothesis, he opts to change the very meaning of the word “narcissism.” Gays remain full of themselves, but, you know, in a good way…

Why am I such a fan of Hitchcock’s Rope given its less than ideal treatment of gay people? I rely on film critic Roger Ebert to help me explain myself. In his 2003 review of D. W. Griffith’s The Birth of a Nation (1915)—a cinematically revolutionary film that is also steeped in overt racism—Ebert claims: “To understand The Birth of a Nation we must first understand the difference between what we bring to the film, and what the film brings to us. All serious moviegoers must sooner or later arrive at a point where they see a film for what it is, and not simply for what they feel about it. The Birth of a Nation is not a bad film because it argues for evil. Like Riefenstahl’s The Triumph of the Will, it is a great film that argues for evil. To understand how it does so is to learn a great deal about film, and even something about evil.” Art, Ebert continues, does not only serve Beauty and Truth, and neither does it need to in order to be considered great. Of course, Hitchcock’s film is nowhere near as offensive as Griffith’s. Still, it may be helpful to view Rope from a similar perspective: while it perhaps reinforced mid-century social intolerance, it did so with undeniable style. Rope might be morally misguided, but, as I sought to convey earlier, it is right on target cinematically speaking.

What do great films with questionable values teach us about film? I believe they teach us that films can transcend whatever messages happen to permeate their narrative. You could even say that films exist beyond good and evil. Indeed, the value of a film is not based on what a film advocates, but on how it advocates it. By “how,” I do not refer to whether an argument is cogently advanced, but to whether an argument (however fallacious) is woven into a skillfully written, acted, lighted, shot, edited, and scored film. For example, while I may wholeheartedly disagree with M’s (Lang, 1931) conclusion regarding criminal responsibility in the mentally ill, I would be hard-pressed to describe the film as anything but brilliant. Likewise, while I may wholeheartedly agree with American History X’s (Kaye, 1998) conclusion regarding the fallacies and perils of racism, I nevertheless regard the film as mediocre at best. Now, what do great films with questionable values teach us about evil? Well, insofar as a film’s value is immune to evil, it follows that the reach of evil is limited. Contrary to popular belief, evil does not contaminate everything it touches. Unfortunately, the same applies to good, in that the best of philosophical intentions will never, on their own a least, prevent a film from failing to impress.

References

Apple, W. (Director). (2004). The cutting edge: The magic of movie editing [Documentary]. United States: A.C.E., British Broadcasting Corporation, NHK Enterprises, & TCEP, Inc. 

Barsam, R. (2004). Looking at movies: An introduction to film. New York, NY: W. W. Norton & Company.

Bouzereau, L. (Director). (2001). ‘Rope’ unleashed. United States: Universal Pictures. (Available on the 2001 DVD of Rope.)

Chodorow, N. (1994). Femininities, masculinities, sexualities: Freud and beyond. Lexington, KY: University Press of Kentucky.

Dean, T. (2001). Homosexuality and the problem of otherness. In T. Dean & C. Lane (Eds.), Homosexuality and psychoanalysis (pp. 120-143). Chicago, IL: The University of Chicago Press.

Ebert, R. (1984). Rope. RogerEbert.com. Retrieved October 1, 2012, from here.

Ebert, R. (2003). The birth of a nation. RogerEbert.com. Retrieved October 1, 2012, from here.

Freud. S. (1960). The ego and the id. New York, NY: W. W. Norton & Company. (Original work published 1923)

Freud, S. (1991). On narcissism: An introduction. In J. Sandler, E. S. Person, & P. Fonagy (Eds.), Freud’s “On narcissism: An introduction” (pp. 3-32). New Haven, CT: Yale University Press. (Original work published 1914)

Freud, S. (2001). Three contributions to the theory of sex. Mineola, NY: Dover Publications. (Original work published 1930)

Hughes, T. (Director). (1986). Stephen Sondheim’s “Sunday in the park with George” [Theatrical Recording]. United States: Image Entertainment.

Labuza, P. (2012). Dial K for Kurosawa. Indiewire. Retrieved October 1, 2012, from here.

Panofsky, E. (1995). Style and medium in the motion pictures. In L. Irving (Ed.), Three essays on style (pp. 91-128). Cambridge, MA: The MIT Press. (Original work published 1934)

Sontag, S. (1966). Film and theatre. The Tulane Drama Review, 11, 24-37.

Sony Pictures Classics. (1995). Homosexuality in film. Author. Retrieved October 1, 2012, from here.

Truffaut, F. (1985). Hitchcock (revised ed.). Toronto, ON: Simon & Schuster.

Philosopher Daniel Dennett lamented: “There’s nothing I like less than bad arguments for a view that I hold dear” (cited in Martin, 2004, p. 222). To some, Peter Shaffer’s controversial play Equus (1973) may be guilty of such a crime: disenchanted with Psychiatry’s view of human behavior, Equus adopts an alternate perspective that unfortunately commits the same mistakes as the target of its criticism. At the same time, however, “[a] philosopher who prefers a good argument for a bad cause to a bad argument for a good cause is an immoral or amoral philosopher and a bad person” (Szasz, 2004, p. 114). In this way, Equus should be commended: although it stumbles while making its point, the zeal with which it sets out to slaughter a modern behemoth ripe for criticism elevates it above those endeavors that mindlessly defend Psychiatry.

In Equus, Alan Strang, a 17-year old stable boy, has gouged the eyes of six horses under his care. Thanks to a well-intended, but misguided, court magistrate, Strang is spared from prison and instead committed to a psychiatric hospital, an often worse fate. He is appointed to psychiatrist Martin Dysart, who attempts to deconstruct his patient to remake him into a “proper” member of society. During therapy, Dysart visits Strang’s memories, from childhood to the recent past. We find out that horses have special meaning to Strang: all that is equine is also…erotic. Enamored by Strang’s passion, Dysart comes to doubt not his ability to rid his patient of his deviant sexual interest, but his moral right to do so. Psychiatry, he uneasily realizes, is a cruel and merciless executioner, whose ordained mandate is to sacrifice all those who are different at the altar of its king and sovereign, Normality. Shaffer’s play pointedly asks: as professionals in “Mental Health,” are we willing to commit the sort of moral crimes required to sustain our hungry profession?

My boyfriend and I saw Equus on stage during the Segal Center for the Performing Arts’ past season in Montreal. Impressed with the Center’s previous productions of Arthur Miller’s A View from the Bridge (1955) and Martin McDonagh’s The Lieutenant of Inishmore (2001), we had high hopes for the production that were not disappointed. In fact, my boyfriend claimed it rivaled the recent Broadway revival, featuring Richard Griffiths and Daniel Radcliffe. The set design was a visual treat, mixing sleek, modern curves with organic elements. I was mesmerized by the tall, thin beams sprouting from the floors of the psychiatric hospital: smooth and clinical metal at the base, crude and natural wood at the tip. Background video-projections of Strang’s memories also hovered above the hospital floors, serving as a bridge of sorts between the static space and the animated actors. These visual details served to evoke a sense of infiltration: either Strang’s memories of the earthy horse stables are replenishing the stark psychiatric hospital with life, or alternatively, the hospital walls are slowly closing in on and restricting his roving mind. Despite various levels of stage experience, actors performed their roles with both skill and resonance. Some of their British accents seemed to come and go, but that is a minor quibble since the lines were delivered with intent and honesty.

As suggested by the stage design, there are two disparate worlds at the center of Equus. When the psychiatrist and patient’s worlds converge, however, there is little overt conflict. Rather, something in Strang incapacitates Dysart. He cannot bring himself to impose his medical worldview on Strang, something he has probably done with countless other patients. There is an unmistakable humanity to Strang’s predicament, despite his victims being a different animal. This contradiction provokes a philosophical shift in Dysart: when the cold, clinical touch of Psychiatry can no longer relieve the suffering mind without compromising the mind’s spiritual integrity, what is a psychiatrist to do?

As a clinical psychologist in training, I identified with Dysart’s struggle. Because my educational development has been so influenced by Psychiatry’s view of human (mis)behavior, disposing of psychiatric shorthands when attempting to understand others remains a challenge. In a powerful speech, Dysart eloquently articulates his crushing realization:

“The Normal is the good smile in a child’s eye—all right. It is also the dead stare in a million adults. It both sustains and kills—like a God. It is the Ordinary made beautiful; it is also the Average made lethal. The Normal is the indispensable, murderous God of Health, and I am his Priest. My tools are very difficult. My compassion is honest. I have honestly assisted children in this room. I have talked away terrors and relieved many agonies. But also—beyond question—I have cut from them parts of individuality repugnant to this God, in both his aspects. Parts sacred to rarer and more wonderful Gods. And at what length … Sacrifices to Zeus took at the most, surely, sixty seconds each. Sacrifices to the Normal can take as long as six months.” (Shaffer, 1973, p. 65)

In Aldous Huxley’s Brave New World (1932/1994), The World State has confounded language so that its citizens have come to mistake being controlled for being free (see Bernard Marx and Lenina Crowne’s conversation on freedom; p. 81-82). They have become happy slaves. Psychiatry has achieved a similar feat in our own society: we have come to mistake being abnormal for being sick. Many of us even welcome diagnoses of mental illness! This is regrettable, but not surprising: as existential psychologist Ernest Keen remarks, “[the] possibility that a person might be reassured by medicalizing her distress […] testifies to the extent to which our culture has trained its members that human stresses and distress can be solved by expert scientific attention and that people and their problems need not be taken seriously in their own terms” (2011, p. 67). Since we use language to describe our experience, language matters. It is a testament to Psychiatry’s unique power that by simply labeling a behavior and publishing its definition in a manual, it is able to transform a challenging human experience into a disorder requiring professional attention.

Thus, we voluntarily flock to Mental Health Care facilities, seeking treatment for our so-called “conditions.” But, could it be—at least, in some situations—our “mental health” needs no “care” at all? In a 2010 article, Allen Frances, the psychiatrist who chaired the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) task force, admitted with regret: “Our net was cast too wide and captured many “patients” who might have been far better off never entering the mental health system.” Frances and Dysart are, then, in agreement: when psychiatrists choose to—and are encouraged to—overstep certain boundaries, their actions can be devastating. Still, the net has landed firmly: mental health professionals proudly defend the authenticity of their psychiatric categories, while clients voluntarily submit themselves to these classifications. Happy slaves are very hard to free…

Frances predicts that the upcoming DSM-V will only serve to “extend the reach of psychiatry dramatically deeper into the ever-shrinking domain of the normal.” To satisfy the Normal’s insatiable appetite, we must eventually begin to transform more and more behaviors into deviant behaviors. As mentioned, this is achieved through language. Ironically, though, the more “normal-turned-abnormal” behaviors we sacrifice to the Normal, the less “normal-to-begin-with” behaviors are left. In this way, Normality may consume itself out of existence: I can imagine a future where Normal has become a mere hypothetical, an ideal to strive for that no longer aptly describes any part of reality.

As Frances observes, we are conceptualizing an increasing number of traditionally normal behaviors as abnormal. Of course, there is inherent subjectivity in these terms, normal and abnormal. In fact, there may exist no such things at all. Think, for example, about the exercise that psychologist-philosopher William James (1901-1902/2002) proposes:

“Conceive yourself, if possible, suddenly stripped of all emotion with which your world now inspires you, and try to imagine it as it exists, purely by itself, without your favorable or unfavorable, hopeful or apprehensive comment. It will be almost impossible for you to realize such a condition of negativity and deadness. No one portion of the universe would then have importance beyond another; and the whole collection of things and series of its events would be without significance, character, expression, or perspective. Whatever of value, interest, or meaning our respective worlds may appear endued with are thus pure gifts of the spectator’s mind.” (p. 168; italics in original)

In other words, nature is neutral, uniform. But while we may view everything through our spectator’s mind, that is not to say we are wrong to conclude that some ways of living are more limiting than others or possess features that deserve careful attention. Introducing his now famous study “On being sane in insane places,” psychologist David Rosenhan (1973) assures us: “To raise questions regarding normality and abnormality is in no way to question the fact that some behaviors are deviant or odd. […] Nor does raising such questions deny the existence of the personal anguish that is often associated with “mental illness.” […] But normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be less substantive than many believe them to be” (p. 250-251).

The tension between our desire to describe the world objectively and the inevitable fact that some subjectivity will always leak into any such attempt underlies a pair of comments by philosopher Bertrand Russell. On the one hand, “[what] we think good, what we should like, has no bearing upon what is.” At the same time, however, “we cannot be forbidden to value this or that on the ground that the nonhuman world does not value it” (1957, p. 54).

Thus, while normality and abnormality may not actually exist in nature itself, that does not mean we cannot divide reality into “that which is normal” and “that which is abnormal.” However, it is important to realize that if normality and abnormality indeed do not exist, it follows that how behaviors are divided is determined by systems that are artificial (some of which are, presumably, superior to others). Psychiatry embodies one such system, unique in that any behavior it defines as abnormal is also considered “sick.” Also, because there may not exist a physical boundary between normality and abnormality, it is only sensible that we investigate and acknowledge the value system that leads us to draw a clear-cut line between the two. That is, we must confess our positive and negative attitudes toward various ways of living.

What is Normal?

Dysart worries that ridding his patients of their abnormal behaviors entails stripping from them parts of their individuality, all in the name of Normality. But, there are many ways to be normal. Thus, contrary to what Dysart may believe, humans do not bow to one single God of Normal, but to a host of deities. Taking this into account, a close reading of the play suggests that the tormented psychiatrist is, in reality, only worried about sacrificing a) one particular subgroup of patients to b) one particular God of Normal.

Who are the Gods of Normal? To determine exactly which deities Psychiatry answers to, let us peruse the DSM-IV-Text Revision (TR; American Psychiatric Association [APA], 2000), a previous edition of which likely adorned Dysart’s bookshelf. I would argue that one can distill the behaviors listed in Psychiatry’s nosological compendium into three qualitatively distinct, but sometimes overlapping, categories. Each of these categories includes behaviors that offend (at least) one particular God of Normal.

One of the principle reasons why some are considered mentally ill is that they appear to be exceedingly miserable. Thus, one criterion for what counts as abnormal is the presence of suffering. I here refer mainly to psychic suffering (e.g., anxiety, fear, sadness), which I consider distinct from strictly physical suffering (e.g., a stinging wound). That is not to say, of course, that psychic suffering does not possess physiological qualities, nor that it may not arise in response to predominately physical suffering.

That being said, it is important to keep in mind that there exists no one-to-one connection between mental illness and internal suffering; as we shall see, many mental disorders entail no such thing at all. It is nonetheless true that some disorders refer entirely to behaviors that involve the experience of pain: for example, the depressive and anxiety disorders. But is it truly fair to characterize suffering as pathological? This belief suggests an indiscriminately positive outlook on life. Indeed, excessive sadness and anxiety can only be disordered if we accept that nature does not “mean” for us to ever be so emotionally incapacitated. I wonder, though: is not misery an integral part of life, right alongside pleasure? Arguing against a happy, optimistic outlook on life, which he refers to as healthy-mindedness, James (1901-1902/2002) reminds us:

“[There] is no doubt that healthy-mindedness is inadequate as a philosophical doctrine, because the evil facts which it refuses positively to account for are a genuine portion of reality; and they may after all be the best key to life’s significance, and possibly the only openers of our eyes to the deepest levels of truth. The normal process of life contains moments as bad as any of those which insane melancholy is filled with, moments in which radical evil gets its innings and takes its solid turn. The lunatic’s visions of horror are all drawn from the material of daily fact. Our civilization is founded on the shambles, and every individual existence goes out in a lonely spasm of helpless agony. If you protest, my friend, wait till you arrive there yourself!” (p. 182-183)

Following this passage, James goes on to describe in evocative detail several instances of natural horrors—for example, predators tearing the flesh off of a living victim—as evidence of the “evil facts” we must contend with in our world. To James, the widespread existence of meaningless suffering demonstrates that pain is an intrinsic part of nature, rendering any perspective that does not acknowledge this facet of reality inadequate.

You may be thinking: well, if pain is so integral to life, should then what we call “physical disease” not be referred to as pathological? It is true that many if not most physical disorders involve physical suffering. In the case of physical disorders, however, pain is merely a symptom of disease; it is not the disease itself. Take, for example, sexually transmitted infections, which are often asymptomatic: the infection continues to exist whether the infected person experiences discomfort or not. Thus, when pain occurs, it is a messenger; it signals the presence of a disruption in the regular functioning of the body.

Conversely, in the case of psychological disorders, suffering, when present, is often the disease itself. For example, there is no such thing as asymptomatic generalized anxiety disorder. If there is no anxiety, there is no disorder. Thus, when it comes to mental illness, without symptoms, there is no disease. Psychologist Gary Greenberg (2010b) explains: in medicine, “the symptoms of the disease are only the signs of the disease, not the disease itself. Except in psychiatry, where the symptoms constitute the disease and the disease comprises the symptoms” (p. 63-64). In other words, while in medicine disease and suffering remain separate (albeit related) phenomena, in psychiatry the two are one and the same. It is with this equation of suffering and disease that I object to: suffering can be a sign of disease, but not a disease in its own right, as Psychiatry insists.

But, could it be extreme psychic suffering (e.g., overwhelming anxiety or sadness) is actually a symptom of some as of yet undiscovered physical disease? At present, evidence for underlying pathology is not nearly as conclusive as some would have you believe. The APA itself rather candidly admits that “the field of psychiatry has thus far failed to identify a single neurobiological phenotypic marker or gene that is useful in making a diagnosis of a major psychiatric disorder” (Kupfer, First, & Regier, 2002, p. 33). Even were we to identify such an entity, there would still remain the problem of demonstrating that it is morbid, preferably independently of the negative qualities we assign to its behavioral product. After all, even behaviors not considered psychiatric disorders involve neurobiogenetic processes.

There are, on a fundamental level, many problems in likening psychological pain to physical disease. Should we assume psychic and physical suffering belong to the same category of human experience, that deep sadness about one’s self-worth is no different from an exercise-induced muscle cramp, and that the two are thus subject to similar modes of explanation? Can it be psychic suffering, like its physical variety, is existentially meaningless, that it has nothing whatsoever to do with our experience of a sometimes cruel world, and that it is merely an artificial product of brain chemistry gone awry? Are we to believe we were never meant to suffer that much at all, that humans have evolved in such a way that demands contentment be our status quo? To put it bluntly, to accept the idea that psychic suffering can ever be reduced to aberrant biology is to accept a “felicitous coincidence,” that we are “an organism designed for happiness in a land dedicated to its pursuit” (Greenberg, 2010b, p. 314).

It is true that there are instances of psychic suffering being caused by physical disorders. For example, Kottler (2000) relates the case of a client presenting with panic spells. No improvement came from psychotherapy, though not for lack of effort on either the therapist or the client’s part. It was later revealed that the client did not suffer from an “emotional coping skill-deficiency,” but from gas intoxication due to a furnace leak in his house. Situations such as these, though, only serve to show that behavior is grounded in biology, not that a given behavioral symptom amounts to a psychiatric disorder under ordinary, non-disease-induced circumstances. In essence, upon discovering the true cause of his panic spells, the client ceased to have a psychological disorder and was correctly diagnosed as having a physical disorder. This begs the question: in the case where behavioral patterns are explained entirely by a physiologically pathological cause, what value does Psychiatry provide? In fact, to discover a brain disease underlying all instances of, say, Panic Disorder would serve to discover a medical disorder, not validate a mental one. The disorder would exit the domain of Psychiatry, and enter that of Neurology (Szasz, 2007).

The poet Yevgeny Yevtushenko counseled his readers to reject “the vulgar, insultingly patronizing fairy tale that has been hammered into your heads since childhood that the main meaning of life is to be happy” (cited in Dawes, 1995, p. 277). Using science to make a similar point, psychologist Richard Bentall published in 1992 “A proposal to classify happiness as a psychiatric disorder.” The abstract to his article announces: “[The following review of the literature will show] that happiness is statistically abnormal, consists of a discrete cluster of symptoms, is associated with a range of cognitive abnormalities, and probably reflects the abnormal functioning of the central nervous system” (p. 94). While Bentall’s tongue rests comfortably in cheek, his writing remains straight and scholarly. This is a clever choice, leaving it up to the reader to decide whether happiness should be classified as a psychiatric disorder, or unhappiness declassified.

When we suffer, rarely do we do so for no reason at all. Often, suffering is a normal reaction (e.g., persistent nightmares) to an abnormal situation (e.g., a wartime experience). Simply, life has gotten the better of us. In fact, I would be worried if a client came to me having survived a brutal victimization, yet appeared completely unfazed.

Take, for example, the nameless, almost hidden disorder, numbered 302.9.3, which ends the DSM-IV-TR’s Sexual and Gender Identity Disorders chapter. Should the lure of the subsequent Eating Disorders chapter prove too great, you might just miss it. It is a disorder meant strictly for those upset by their sexual orientation. (In fact, before it became nameless, it was listed in a previous edition as “Ego-Dystonic Homosexuality.”) In this way, the DSM continues to pathologize same-sex sexual interest, despite having removed general Homosexuality from its pages in 1973. After all, it is certainly not heterosexual men and women that psychiatrists had in mind when inventing this modern variant of the retired disease. Let me be clear on this: those who suffer on account of their sexual orientation are not sick; the problem does not reside within them but within the environment continually taking aim at them. Since Psychiatry is so fond of labeling abstract entities, it should instead try its hand at society.

Suffering often arises from lack of skills. For example, depression may stem from rigid negative thinking. In fact, therapy seeks to impart clients with the type of abilities that allow them to overcome life’s challenges and participate in life actively, in the hopes that this will assuage their suffering. Sometimes, however, lack of skills itself is labeled a mental illness: for example, Attention-Deficit/Hyperactivity Disorder, or any learning disability. Thus, another criterion for what counts as abnormal is incompetence.

Is it fair to characterize incompetence as pathological? After all, “[we] do not expect everyone to be a competent swimmer, golfer, chess player, or marksman; nor do we regard those who play games poorly as “sick.” The activities that comprise being a student, parent, worker, etc. are, in many ways similar to the activities that comprise being a golfer or chess player. Yet, we act as if we expected everyone to play his own life games competently; and we regard those who play poorly—at being husband or wife, mother or father—as sick, “mentally ill”” (Szasz, 1973, p. 90). Further, lack of skills (e.g., poor math ability or bad hygiene) is rarely a problem in and of itself, but only becomes one when a person lacking certain skills finds themselves in a situation requiring these skills (e.g., at the bank or on a date). In other words, the problem lies not in the individual, but in the relation between individual and society.

To summarize, the DSM-IV-TR defines suffering and incompetence as abnormal. We have thus successfully discerned the first two Gods of Normal: Happiness and Competency. I have argued that while neither suffering nor incompetence is an ideal behavior, neither deserves to be considered diseased. This does not mean, of course, that we should not attempt to overcome unhappiness (without forgetting there is more to life than pleasure) or master the skills we happen to lack. Because I doubt Dysart is uncomfortable helping clients become more satisfied with and more proficient at life, it is unlikely he wishes to deprive the two aforementioned Gods of nourishment.

Rather, I think Dysart’s problem is exclusively with the third category of abnormality: social deviance. To clarify, the DSM-IV-TR does not officially recognize social deviance as abnormal: “Neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual” (2000, p. xxxi). Despite this statement, many of the behaviors included within the manual’s pages are just that: deviant. Besides, as Moser and Kleinplatz (2005) rightfully point out, the “unless” clause—a major clinical cop-out—allows psychiatrists to disregard what came before and interpret “deviance or conflict” as sickness.

Is it fair, however, to characterize social deviance as pathological? After all, many socially deviant behaviors, while offensive to some (including those exhibiting them), are not inherently harmful to the self or others. Some men and women, for example, so identify with the opposite gender that they wish to be the other gender. While same-sex sexual interest is no longer considered disordered, psychiatrists nevertheless continue to stigmatize gender variance (Lev, 2006). Incidentally, the British Broadcasting Corporation (2011) reports that the Australian government has recently added a third gender category on its citizens’ passports: “indeterminate.” Thus, while the DSM-V Sexual and Gender Identity Disorders Work Group is hard at work on the new Gender Dysphoria disorder, the rest of society is busy normalizing it!

Likewise, many of us consider delusions and hallucinations as signs of pathology. In fact, the term “crazy” is often used to refer to those of us who have lost touch with agreed-upon reality. Yet, reviewing the literature on psychosis-like experiences within the general population, Bentall (2003, 2004) found that a considerable number of people not only report experiencing hallucinations and delusions during their lifetimes, but also living fairly happy lives without treatment. Thus, although unshared sensory experiences and unusual beliefs are more rare—but not as rare as we thought—than common, these deviant behaviors results in no harm to the self or others for many of those who exhibit them. Relatedly, social psychiatrist Marius Romme and researcher Sandra Escher (1993; see p. 7-10), who together instigated The Hearing Voices Movement, have suggested that there is nothing inherently problematic in, say, hearing a voice that reminds you of your failings as a person; the difficulty, instead, lies in one’s ability to cope with self-conversation (or what Szasz, 2002, calls minding) that involves not only silent, but also audible thoughts (for differences between copers and non-copers’ strategies, see Romme & Escher, 1989, and Romme, Honig, Noorthoorn, & Escher, 1992).

But, what of socially deviant behaviors that entail purposefully harming the self or others? Should we not consider those pathological? Back when the DSM-IV was being revised, Moser and Kleinplatz (2005) published an article pleading for the removal of the paraphilias (e.g., Exhibitionism, Frotteurism, Pedophilia, Sexual Masochism and Sadism) from the update. In it, the authors argue that while sexual behavior can certainly qualify as antisocial, it can never be sick. In other words, social deviance is never pathological, no matter how much harm it may pose on the self or society.

The Substance-Related Disorders chapter of the DSM-IV-TR represents one of the most glaring examples of the diseasing of antisocial behavior. (It is thus probably not surprising that it also represents the manual’s longest section; Greenberg, 2000b.) Let me state clearly: excessively and narrowly partaking in any single activity is not a sign of a balanced lifestyle. However, neither is this a sign of illness.

There is evidence that addiction, despite everything we know about “addictive substances” and their effects on the brain, may be more of a choice than we think (for a review of research negating the “irresistible impulse” hypothesis, see Fingarette, 1989, and Schaler, 2000). But even that is beside the point. The problem—and a particularly damning one at that—is that what counts as addiction in the first place is not a question of biology, but social values. The APA’s own values become more apparent when we consider that the following disorder is omitted from its manual’s pages: “psychotropic medication-related disorders.” I am not talking here about those of us who illegally consume mind-altering drugs, but those of us who are prescribed them by our family doctors or psychiatrists. After all, psychotropic drugs alter experience in the same way illicit varieties do. Why, then, does abusing the former render one “in treatment,” the latter “sick”? When we strip away the clinicized façade (i.e., state-endorsed, ritualized drug-intake), the prolonged consumption of psychotropic drugs becomes one more form of misuse, right alongside other less recognized, less supervised forms of misuse. It is only social values that make us decide whether one or both categories of excessive drug intake amount to mental disorders. Simply, we prefer the nature and consequences of one drug “addiction,” but not the other.

To reiterate, the DSM-IV-TR defines social deviance as abnormal. We have thus successfully discerned the third God of Normal: Social Convention. In so doing, we have also come across different subgroups of social deviants that offend this deity: those who cause neither harm to themselves nor others (e.g., transgendered individuals), those who voluntarily withstand harm or only cause harm to consenting others (e.g., drug misusers and sexual sadists), and those who cause no harm to themselves and harm to non-consenting others (e.g., child molesters). While I do not believe that any of these suffer from any sort of sickness, the third group strikes me as metaphorically sick: concerned with only their own needs and desires, at the expense of others’ welfare, members of this group are selfish and inconsiderate. However, they are only “sick” the way an economy can be “sick”: they represent the reality that egocentric and careless behavior will, more often than not, lead to harmful consequences.

Because I doubt Dysart is uncomfortable protecting society from harm, this leads me to conclude that he is most worried about a) sacrificing members of the first two groups of social deviants to b) the God of Social Convention. As we shall see next, Dysart’s worries are, in Strang’s case, unwarranted, because he has mistakenly categorized him.

Some of you will argue that I have been unfair in my treatment of the DSM-IV-TR, that many of the disorders I have mentioned cannot be diagnosed without the presence of distress or impairment in interpersonal, social or occupational areas of functioning. In other words, perhaps it is not the behavior itself that is the problem, but the fact that it causes negative consequences.

That is very considerate, but somewhat misguided. A host of behaviors can cause both distress and impairment but have not made it into the manual: engaging in extreme sports, being a social activist, living with parents as an adult, immigrating to a new country, eating fast-food every day, being in a relationship, starting a business, vowing celibacy. The only difference is that these behaviors are generally approved, or at least considered part of the “human experience,” and so the associated distress and impairment are considered acceptable fallout. Thus, it is not distress or impairment that signals psychopathology and warrants a given behavior’s initial inclusion into the DSM, but distress or impairment arising from behaviors we consider undesirable to begin with. Further, some disorders—for example, Delusional or Brief Psychotic Disorder—do not even include distress or impairment in their diagnostic criteria. Even when they do, and a given behavior refers to internal events (e.g., voyeuristic sexual fantasies), sometimes merely acting upon these can take diagnostic precedence (Moser & Kleinplatz, 2006). And so, it is no longer the distressing or impairing consequences that are the problem (since there might not even be any), but the behavior itself.

What of the many behaviors that involve suffering, incompetence or social deviance, yet are not considered disordered? I suspect psychiatrists shy away from applying their very own principles consistently, because carrying their conceptualization of abnormality to its logical conclusion would mean the end of their profession. Psychiatry would become the laughing stock of the Sciences, ultimately loosing its “franchise on our psychic suffering, the naming rights to our pain” (Greenberg, 2010a).

Dysart’s Mistake

Dysart is worried about sacrificing social deviants who cause no harm to others to the God of Social Convention. While his worries are legitimate, they do not apply to Strang. Dysart has committed a category error: he has incorrectly assigned his new patient to the former group, when he truly belongs to the group of social deviants who harm others.

I agree with Dysart: social deviants are not sick. Appropriately, the psychiatrist avoids medicalizing his patient’s behavior. For example, while Strang is tormented by his attraction toward horses, Dysart does not interpret Strang’s distress as a symptom of his “sexual disease.” After all, who among us has never been tormented by love? Whether or not love is directed toward an appropriate subject has absolutely no bearing on the authenticity of our distress when that love disappoints us. Unwilling to rely on psychiatric terminology to conceptualize Strang’s presenting difficulties, Dysart is thus faced with a challenge: how, then, should he describe Strang’s strange sexual obsession?

While searching for an alternate way of conceptualizing Strang’s difficulties, Dysart commits a common mistake: he romanticizes the difficulties instead. He idealizes Strang to the point of jealousy: he confesses he wishes he could know the passion his patient has felt. Strang’s sexual attraction toward animals, however, is not worthy of admiration. It is, after all, comparable to attraction toward children, in that in both cases the object of attraction is incapable of consenting to sexual activity. While most child molesters are probably quite passionate about children, I cannot say I would ever be jealous of such passion, even if I could somehow tease apart the feeling from the source.

In romanticizing Strang’s sexual interest, Dysart inadvertently transforms social deviance into its very own God (of Ab-Normal), describing Him as rare and beautiful. However, neither acceptable nor deplorable behaviors should be revered, for the simple reason that they merely constitute humans’ attempts to master life with the innate and learned tools at their disposal. As such, adding unnecessary levels of meaning to these behaviors, be they psychiatric or romantic, is simply foolish, not to mention un-parsimonious.

When seeking to make sense of his patient, Dysart had at his linguistic disposal a third option, favored by psychiatrist Thomas Szasz (1973): the type of plain language spoken by the educated layman, or secular humanistic language. The behaviors of those who choose to engage in sexual intercourse with children or animals are not sick, but terribly misguided and destructive. Their behaviors are not pathological, but illegal and immoral, since they do not involve relationships between consenting adults (of the same species). Child and animal molesters have no respect for the objects of their attraction, manipulating them to satisfy their own wants. I understand it must be terribly hard to curb one’s sexual interest, especially when there is no socially acceptable outlet for one’s particular brand of impulses. Nonetheless, there is no reason to believe that deviant impulses are, in and of themselves, any harder to regulate than normal ones (Szasz, 2007).

Of course, those entities espoused by speakers of humanistic language (e.g., “good” or “bad”) no more exist in nature than those espoused by speakers of psychiatric or romantic (or religious) language. Humanistic language is arguably superior to these alternatives, however, because it conceptualizes behaviors and relationships in terms of human needs, relying on a framework of secular morals that specifies what hurts us is bad and should thus be spoken of using derogatory terms, and what does not hurt us is good and should thus be spoken of using favorable terms. This approach would flip a medicalized statement such as “Eating disorders are highly comorbid with mood and anxiety disorders, and require intensive treatment” into “Those of us who over- or under-indulge in food are likely struggling with overwhelming emotions at the same time; one should strive to resolve these difficulties, since they distract from participating fully in life.”

Humanistic language is primarily practical: because our core concern as humans is to survive and thrive within reality, it is helpful to define the behaviors we use to orient ourselves within reality according to these needs. Such language is also parsimonious, avoiding any reliance on metaphors, which often taint our observations with superfluous (medical, quixotic or superstitious) content that distracts from what we really mean to say. (Of course, medical and quixotic language is warranted under certain circumstances; namely, when dealing with objects under the jurisdiction of medicine and the arts, like human bodies or bodies of art.) Another benefit of humanistic language is that it acknowledges human subjectivity: as its name implies, humanistic language is based upon our own subjectively human experience of the universe. No less, no more.

Dysart worries he will cause undue harm onto his patient’s individuality if he seeks to “cure” him of his sexual attraction to horses; and this, simply because he is different from the majority. This is honorable. Yet, as we have seen, there are at least three different types of social deviants. Dysart does not realize that his particular patient happens to fall into the group that constitutes a menace to others’ safety. When deviance harms, I believe it is our responsibility to help those acting upon their destructive brand of impulses to fulfill in pro-social ways whichever needs their actions are meant to fulfill (for a model of life change, or “rehabilitation,” based on such a principle, see Ward & Maruna, 2007). If we insist, we could even describe therapy whose aim it is to convince such individuals to adopt this same goal, and to teach them how to do so, as a necessary evil: necessary because it is the least restrictive strategy we have to protect vulnerable others, yet evil because it still restricts the freedom and autonomy of the harmful deviant.

Final Thoughts

At the beginning of Equus’ second act, Dysart asks himself: “[What] am I doing here? I don’t mean clinically doing or socially doing—I mean fundamentally! These questions, these Whys, are fundamental—yet they have no place in a consulting room” (Shaffer, 1973, p. 76; italics in original). It is essential to the integrity of our craft, professional helping, that we think long and hard about a) how we describe our clients’ behaviors, b) whether these behaviors deserve to be considered abnormal in the first place, c) whether, when reasonably deserving of the descriptor, these behaviors should also be considered pathological, and d) which of these “pathological” behaviors should be altered or downright eradicated. Ideally, these issues should be clarified before we even step into the consulting room. Psychiatry has weighed in, but has it painted humanity for what it is? While Equus may add a few unnecessary brush strokes of its own, it answers with a resounding No.

References

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

Bentall, R. P. (1992). A proposal to classify happiness as a psychiatric disorder. Journal of Medical Ethics, 18, 94–98.

Bentall, R. P. (2003). Madness explained: Psychosis and human nature. London, UK: Penguin Books.

Bentall, R. P. (2004). Sideshow? Schizophrenia as construed by Szasz and the Neo-Kraepelinians. In J. A. Schaler (Ed.), Szasz under fire: The psychiatric abolitionist faces his critics (pp. 301–320). Chicago, IL: Open Court.

British Broadcasting Corporation (2011, September 15). New Australian passports allow third gender option. Author. Retrieved April 29, 2012, from here.

Dawes, R. M. (1996). House of cards: Psychology and psychotherapy built on myth. New York, NY: The Free Press.

Fingarette, H. (1989). Heavy drinking: The myth of alcoholism as a disease. Los Angeles, CA: University of California Press.

Frances, A. (2010, March 01). It’s not too late to save ‘normal.’ Los Angeles Times. Retrieved April 29, 2012, from here.

Greenberg, G. (2010a, December 27). Inside the battle to define mental illness. Wired. Retrieved April 29, 2012, from here.

Greenberg, G. (2010b). Manufacturing Depression: The secret history of a modern disease. Toronto, ON: Simon & Schuster.

Huxley, A. (1932/1994). Brave new world. London, UK: Flamingo.

James, W. (1901-1902/2002). The varieties of religious experience: A study in human nature. New York, NY: The Modern Library.

Keen, E. (2011). Emotional narratives: Depression as sadness—Anxiety as fear. The Humanistic Psychologist, 39, 66–70.

Kottler, J. A. (2010). On being a therapist (4rth ed.). San Fransisco, CA: Jossey-Bass.

Kupfer, D. J., First, M. B., & Regier, D. A. (Eds.) (2002). A research agenda for DSM-V. Washington, DC: American Psychiatric Association.

Lev, A. I. (2006). Disordering gender identity: Gender Identity Disorder in the DSM-IV-TR. Journal of Psychology and Human Sexuality, 17, 35–69.

Martin W. (2004). The best liberal quotes ever: Why the Left is right. Naperville, IL: Sourcebooks.

Moser, C., & Kleinplatz, P. J. (2006). DSM-IV-TR and the paraphilias: An argument for removal. Journal of Psychology and Human Sexuality, 17, 99–109.

Romme, M. A. J., and Escher, A. D. M. A. C. (1989). Hearing voices. Schizophrenia Bulletin, 15, 209–216.

Romme, M. A. J., and Escher, A. D. M. A. C. (1993). Accepting voices. London, UK: Mind Publications.

Romme, M. A. J., Honig, A, Noorthoorn, E. O., & Escher, A. D. M. A. C. (1992). Coping with hearing voices: An emancipatory approach. British Journal of Psychiatry, 161, 99–103.

Rosenhan, D. L. (1973). On being sane in insane places. Science, 179, 250–258.

Russell, B. (1957). “Why I am not a Christian” and other essays on religion and related subjects. New York, NY: Touchstone.

Schaler, J. A. (2002). Addiction is a choice. Chicago, IL: Open Court.

Shaffer, P. (1973). Equus. Toronto, ON: Penguin Books.

Szasz, T. (1973). The second sin. Garden City, NY: Anchor Press.

Szasz, T. (2002). The meaning of mind: Language, morality, and neuroscience. Syracuse, NY: Syracuse University Press.

Szasz, T. (2004). Reply to Fulford. In J. A. Schaler (Ed.), Szasz under fire: The psychiatric abolitionist faces his critics (pp. 93–117). Chicago, IL: Open Court.

Szasz, T. (2007). The medicalization of everyday life: Selected essays. Syracuse, NY: Syracuse University Press.

Ward, T., & Maruna, S. (2007). Rehabilitation. New York, NY: Routledge.

%d bloggers like this: