CAUTION CRAZY!!!

When you think of the word crazy what are the images that come to mind?  Padded rooms and straightjackets, serial killers with a maniacal laugh?  How about the girl next door, your mom, or even yourself?  Even more important than the image itself is how do you feel about that image? Do you feel fear, curiosity, dismissive - someone else’s problem, or how about compassion?  Answers to these questions are as varied as the meanings of crazy.  Crazy is defined both in a formal context and informal context.  Dictionary.com provides the formal definition as being “mentally deranged, senseless, totally unsound”.(1)  As a slang term Dictionary.com defines crazy as “intensely enthusiastic, very enamored, intensely anxious”.(1) Even among these types of definitions there is a sense of extremeness and being absolute.  Another thing all these definitions have in common is that crazy is used to describe or explain the source of emotional and/or behavioral attributes.  These definitions for the term crazy are relatively new and how the term is defined has changed over time.

          Historical definitions also vary I found definitions from “full of cracks and flaws from 1580’s” to “a slang term used in the jazz scene to mean cool and exciting from 1920’s”.(2)  In centuries past being labeled crazy could mean various things from an individual being possessed by a demon, morally repugnant, or of a criminal nature.  These meaning to the label crazy conjured up feelings of fear and people labeled crazy often ended up in prison.  In the United States, one of the founding fathers, Benjamin Rush who was also physician, started to see being crazy as a mental illness. Not proof of possession by demons, a characteristic of criminals, or flaw in character.  He thought of mental illness as a type of physical aliment to be studied and treated like other physical ailments.  Below is a picture of Rush’s “Tranquilizing Chair” an invention he came up with to treat symptoms aka emotional states and/or behaviors that deviated so much from acceptable social norms they were seen as signs or indications of mental illness.  Because of his revolutionary view of what it means to be crazy and the sources he is considered the father of American Psychiatry by the American Psychiatric Association.(3)  The term crazy, once seen as a sign of criminality, moved to being a medical term but has come full circle back criminality. 

 

  

Some differences in using crazy to define criminality now compared to the past is that the wording of the label changed slightly to ‘criminally insane’ and the criminal justice system looks to so called medical experts when labeling someone criminally insane.  No one particular group owns the word or control over how it is defined.  As a result no one particular group can be blamed for the consequences of being labeled crazy. 

Everyone uses the term crazy whether as a slang term or a formal diagnosis.  However, certain groups use it more and shape how it is defined.  Some of the main players are; the criminal justice system, the medical community, and pharmaceutical companies.  How the term crazy is defined may benefit some people while at the same time stigmatizing and hurting others.  In the criminal justice system people who commit heinous acts against their fellow man may benefit from the label by avoiding execution and instead being sentenced to a hospital/prison for the “criminally insane”.  I don’t mean to imply that this is wrong or that people labeled ‘criminally insane’ are trying to get one over on the system.  I believe that can be the case sometimes, but I don’t think that is usually what is going. This is simply an observation of who benefits and how by being labeled crazy within the criminal justice system.  So who benefits from being labeled crazy by the co-owners of this term, the medical community?

          When looking at the medical community I think it is a little more complicated than the criminal justice system.  The kinder phrase ‘mental illness’ is typically the term used within the medical community, but this doesn’t mean the connotations are any kinder.  This term is used by the medical field as a whole but is used more and has heavier connotations within the specialization of psychology and psychiatric medicine.  For the patient being labeled crazy can be a double edged sword.  It can benefit a patient seeking treatment for pervasive emotions and behaviors that the patient sees as problematic or disruptive to daily life.  However, when it comes to that crazy patient’s overall healthcare the diagnosis can be problematic.  If the patient labeled crazy goes to a doctor complaining of serious symptoms that seem to have nothing to do with the patient’s mental state their mental state is still taken into consideration.  Especially if the doctor they go to can’t come up with a diagnosis to throw pills at.  The patient in this situation is not taken seriously and told in not so many words, that their problematic symptoms are just all in their head.  Although I have no studies to show how often this happens and would love to study this problem further, I do know from experience this does happen.  Patients can benefit from the label but can also be hurt by the label so who are the real winners in the crazy game?

Pharmaceutical companies benefit most from behaviors and emotional states being labeled as mental illness.  Once a behavior/emotional state is labeled as a symptom of mental illness they are given large amounts of money for research.  This research is not to cure the patient but to formulate a drug to manage the symptoms.  Then these companies market the drug through advertising of vague symptoms to the American public, but don’t worry just take this pill for what they hope will be the rest of your life.  This results in elevated diagnoses and increased profits for both the pharmaceutical company and the doctors the patient has to see for the prescription.(4) With this problematic system based on profit margins in place everyone is susceptible to being labeled crazy at some point in their life so why is it seen as a pejorative term? 

Whether the term is used in the formal way or as slang it is used to describe extreme states of being or behaviors.  With the implication of extremeness comes fear, fear of possibly going too far away from social norms.  The difference between the formal usage and slang usage is that as a formal definition it is an overtly pejorative term, but when used in slang the same term becomes a covertly pejorative term.  One of the reasons there is so much fear and stigmatization around this term is because it is seen as a chronic condition.  As Rosenhan stated “A psychiatric label has a life and influence of its own.”  Once labeled crazy it is near impossible to remove the label.  You can be viewed as in remission or managing symptoms well, but once you are labeled crazy that becomes your master status among those who know your diagnosis.  This comes with expectations of future symptoms, breakdowns, or episodes.  These expectations feed into fear, anxiety, stress, and self doubt for the patient.(5)  The stigma attached to the label needs to be removed but this cant be done simply through telling people that it is a physical disorder like other physical disorders. The stigma remains because it is seen as something that doesn’t go away – there is no cure.  Also people have different feelings about the brain compared to other parts of the body.(6)

There are mixed opinions on reclaiming the word crazy.  It can be empowering, but the context in which the word is used is a very important consideration to be taken before using it, even if it's meant to be in a reclamatory fashion.(7,8)  This is definetly a topic I will expand on.  As someone who has dealt with a mental illness label for 22 years I know the deviant label of crazy is a complex issue.  The label and how as a society we use it intersects with other deviations from the socially construct ideal of race, class, gender and sexuality.   

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REFERENCES
1. Dictionary.com. 
 http://www.dictionary.reference.com/browse/crazy

2.    Online Etymology Dictionary. http://www.etymonline.com/index.php?term=crazy

3.    Brooks, Mike. “Benjamin Rush: Revolutionary Psychology.”  http://historymike.blogspot.com//2005/08/benjamin-rush-revolutionary-psychology.html

4.    Smith, S.E.. “Pharmaceutical Advertising & Messaging About Mental Illness.” https://lms.wsu.edu/section/content/default.asp?WCI=pgDisplay&WCU=CRSCNT&ENTRY_ID=1E37BB054E3C46C2A62E056B3753C45D

5.    Rosenhan, David. 1973. “Being Sane In Insane Places.” Pp133-137 in Readings In Deviant Behavior, edited by A. Thio, T.C. Calhoun, A. Conyers. Boston: Allyn & Bacon.

6.    Wyckoff, Whitney. “Despite Deeper Understanding Of Mental Illness, Stigma Still Lingers." https://lms.wsu.edu/section/content/default.asp?WCI=pgDisplay&WCU=CRSCNT&ENTRY_ID=1E37BB054E3C46C2A62E056B3753C45D 

7. Not singing the bi-polar blues blog. "Call Me Crazy Please" posted Sept. 2011. http://notsingingthebipolarblues.blogspot.com/2010/09/call-me-crazy-please.html 

8. This aint livin' blog. "Reclamation: Marginalized bodies, Self Labeling and Empowerment" posted April 2010. http://meloukhia.net/2010/04/reclamation_marginalised_bodies_self_labeling_and_empowerment.html

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