The Myth of Normal 193

bound with life experience and emotional development, slaps the “disease” label on them, and calls it a day. Little in the training of doctors prepares them to wonder about their patients’ lived experience, much less to seek the sources of their malaises therein. Simplistic explanations, which require little time or emotional energy, are an attractive fallback position. Many doctors are intensely uncomfortable facing their own hidden sorrows and wounds—what Carl Jung called our shadow side. And not only doctors: as a well-known colleague told me, “Patients play into this as well. They don’t want to look at their lives, either. It would involve getting into recovery, changing something. It’s enormous work to recover from our childhoods. It’s incredibly worthwhile, but it’s a lot of work.” The gospel of genetic causation shields us from having to confront our hurts, leaving us all the more at their mercy. If anything, this limitation is especially calamitous in the realm of mental suffering, and even less justified. After all, unlike in cancer or rheumatoid arthritis, no physical findings, blood tests, biopsies, radiographs, or scans can either support or rule out psychiatric diagnoses. That statement may surprise many readers, so it bears repeating. There are no measurable physical markers of mental illness other than the subjective (a person’s description of their own mood, say) and the behavioral (sleep patterns, appetite, etc.). Like all concepts, mental illness is a construct—a particular frame we have developed to understand a phenomenon and explain what we observe. It may be valid in some respects and erroneous in others; it most definitely isn’t objective. Unchecked, it becomes an all-encompassing lens through which we perceive and interpret. Such a way of seeing can say as much about the biases and values of the culture that gives rise to it as about the phenomenon being seen, whether a religious concept like “sinful” or a biomedical one like “mentally ill.”[3] In some cultures, for example, people with visions may become prophets or shamans. In ours, most likely they would be deemed insane. One wonders how a Joan of Arc or the medieval saint and composer of sacred music Hildegard of Bingen would fare at the hands of the contemporary mental health system. I once speculated out loud, in front of an audience of hundreds, what would happen if I strode up to the prime minister