Pigeonhole diagnosis

Some people wonder why I want to be out at all -- if I am successfully passing and living a fulfilling life, why not just keep doing that? Part of me likes the fun and intrigue involved in my attempts to pass and the ability to hide in plain sight. Part of me is also resentful of the mental energy required for that task. I wonder what my life and brain would look like if I didn't feel compelled to mask certain things and constantly be putting on a show. If I've managed a certain level of success from without the system, what might I be able to accomplish within?

I was reading this Wired article by David Dobbs, author of the well-known article in the Atlantic comparing children to either Orchids or Dandelions (which are sociopath children? the answer may surprise you). In this article he discusses how our society treats those with mental illnesses, specifically schizophrenia:


A large  World Health Organization study, for instance, found that “Whereas 40 percent of schizophrenics in industrialized nations were judged over time to be ‘severely impaired,’ only 24 percent of patients in the poorer countries ended up similarly disabled.’ Their symptoms also differed, in the texture, intensity, and subject matter to their hallucinations or paranoia, for instance. And most crucially, in many cases their mental states did not disrupt their connections to family and society.

Watters, curious about all this, went to Zanzibar to see how all this worked. He learned that there, schizophrenia was seen partly as an especially intense inhabitation of spirits — bad mojo of the sort everyone had, as it were. This led people to see psychotic episodes  less as complete breaks from reality than a passing phenomena, somewhat as we might view, say, a friend or coworker’s intermittent memory lapses.

For instance, in one household Watters came to know well, a woman with schizophrenia, Kimwana,

was allowed to drift back and forth from illness to relative health without much monitoring or comment by the rest of the family. Periods of troubled behavior were not greeted with expressions of concern or alarm, and neither were times of wellness celebrated. As such, Kimwana felt little pressure to self-identify as someone with a permanent mental illness.

This was rooted partly in the idea of spirit possession already mentioned, and partly to an accepting fatalism in the brand of Sunni that the family practiced. Allah, they believed, would not burden any one person with more than she could carry. So they carried on, in acceptance rather than panic. As a result, this delusional, hallucinating, sometimes disoriented young woman passed into and out of her more disoriented mental states while still keeping her basic place in family, village, and work life, rather than being cast aside. Almost certainly as a result, she did not feel alienated, and her hallucinations did not include the sort of out-to-get-me kind that mark paranoid schizophrenics in the West.

This, writes Watters in enormous understatement, “stood in contrast with the diagnosis of schizophrenia as [used] in the West. There the diagnosis carries the assumption of a chronic condition, one that often comes to define a person.”


Of course I'm not stupid about wanting to out myself completely and without proper care. Dobbs goes on to describe the complete ostracizing of a Western schizophrenic from her friends and academic community upon her diagnosis. But I do wonder what effects struggling to conform to a particular societal standard of superficial normality has had on me. Perhaps I wonder so much because my family actually is really supportive, like the family of the woman Kimwana. I often credit their support for how I turned out, particularly their religious beliefs that I would not be burdened with more than I could carry. And so my sociopathy does not define me. I wonder if society were equally supportive, what a difference that might make?