What Breaks Your Heart
by William Munro
We shouldn’t give creatures names. It’s the name that breaks your heart. — Rose Tremain, Sacred Country, 308.
My name is William; I’m sick; I’m dangerous. I was twelve years old when I was first determined to be “mentally ill”. An authority figure gave my vague desire to suffer and die ignobly a name: Major Depressive Disorder. As I matured I was given more names: at fourteen, Generalized Anxiety Disorder and Social Anxiety Disorder, at seventeen, Borderline Personality Disorder, at twenty-one, Attention Deficit Hyperactivity Disorder, and when the medication prescribed elicited a panic attack, Panic Disorder. “Disorders” became an intrinsic part of how I constructed my identity. Being given a name for my suffering validated it, yet perpetuated it; my suffering wasn’t real unless an external, paternal, authority figure gave it a rigorously defined name. The names others give us have tremendous power, both to oppress and liberate; the names we give ourselves too often have none. A rose by any other name might not smell as sweet. If you called it a “shit blossom” it might internalize that name, and start smelling like shit because that’s the normative, expected thing for it to do now. The nomenclature of mental illness is oppressive, stifling, and frequently self-fulfilling. The Queer community has long been marginalized by these naming practices, their identities and orientations being referred to as “disordered”. It seems these outdated attitudes are changing, yet, the nomenclature of disorder surrounding mental illness seems indelible. I do not want to misrepresent myself: I am not here to speak on behalf of the Queer community. This essay –that is what I am calling it– only aims to borrow Queer theory, in order to apply it to the naming conventions of the “mentally ill”. To this end I will closely examine one of my favourite fictional people: Martin Ward in Rose Tremain’s Sacred Country. For those who have not read it, it is, primarily, the story of an individual’s (initially Mary Ward) transition from female to male during the sixties in rural England. Using his story and my own (I apologize for eschewing “critical distance”), I would like to explore the ways in which names, especially the names we are given, both emancipate and dominate, particularly in the context of “mental illness”. Given the nature of my and Martin’s stories, my research has primarily examined issues of naming in a clinical, pathologizing context, particularly as it relates to the diagnoses of gender “disorders”. The names given to us by authority figures all too often serve to reify narratives of normalcy and conformity; the names we give ourselves have the potential to free us. Names are dangerous, though it is not always clear to whom.
Our identities are informed, if not defined by the names we are given. When these names come from authority figures – parents, doctors, therapists – they assume a distinct, domineering valence. Diagnoses from therapists have significant power in identity formation as “[c]lients tend to experience therapists as extremely powerful; they view their therapists as having authority and expertise, and they tend to place value on the expertise of the therapist” (Pittman 33). We see this in Martin Ward. When he is first speaking to Dr. Beales, in reference to his potential gender reassignment surgery, he is told he will never be fully male. He asks “what will I be?” (Tremain 179). Martin’s identity exists in a liminal space for which there is no name; it may as well not exist, and thus he appeals to the authority of Dr. Beales. When my therapist told me I was “depressed”, I trusted her, and the name gave my misery form. My depression became tangible, and my suffering somehow more legitimate. My condition, however, worsened. When Martin was in middle school, he began binding his breasts. His father catches him, and calls him “an abomination” (Tremain 102). For Martin this “the worst moment of [his] life” (Tremain 102). In this instance, Martin does not possess a name for what he is, and thus “abomination” unconsciously fills that gap. My father never called me an abomination, but he did call me “disappointing”. I internalized that; I am disappointing. Get to know me, and you’ll see. These are the mechanics of “naming – in this case giving names to people”, and are why it is “a powerful symbolic act in establishing if not defining a person’s identity” (Pauwels, Winter 404. Emphasis added).
We often privilege names which are given to us over the names we give ourselves. I have certainly noticed this in myself. Martin takes great pleasure in others affirming his gender through their language. One day, he is eyeing the pedal boats on a dock. When asked “want to take one out, lad?”, “The word lad stab[s] [him] with pleasure” (Tremain 228). Similarly, although feeling as though “[his] life was always ahead of him, and never in [his] hand” (Tremain 232), he took solace in the fact that “at least people called [him] ‘sir’. . . [he] liked that” (Tremain 232). I crave that external validation too, though with a uniquely self-destructive lilt. I take great pride in being called “useless”, or “miserable”. These sentiments conform to my own conception of who I am. They are the “me” I perform. This performance was, for a long time, inspired by a name that was given to me. “[T]here’s a constant search for that validation to be okay from other people” (Saltzburg, Davis 101. Emphasis added), and in this search we tend to forget to be okay for ourselves. Looking in the mirror, and saying “I’m beautiful”, has never had the same significance for me as someone else telling me I’m beautiful. My thoughts change all the time, and I’m privy to this, but when I hear a thought from someone else, it is a discrete entity, yet to be invalidated by thoughts to the contrary. This might account for why we privilege the external, I don’t know. What I can say is that privileging the external above the internal, creates a schema in which we seek validation from without, and this search, paradoxically, leads us through a skein of invalidating cultural expectations. If we only seek external validation, we are tacitly submitting to patriarchal hegemony; we define our worth in relation to our normativity. Maybe some of us should be easier on ourselves. Take the names you are given, and give them to yourself again. I am useless; I don’t like being used.
Naming “the other”, when carried out by dominant cultural forces, is an oppressive act which seeks to marginalize those who do not conform to prescriptive modes of behaviour or feeling. This phenomenon is evident in, for example, the clinical nomenclature used to describe transgender and intersex individuals. Gender Identity Disorder is used to classify transgender individuals, while Disordered Sex Development is used to describe intersex individuals. Unsurprisingly both terms are controversial; they pathologize the individual and reinforce normative, binary constructions of gender. These problematic names were introduced in order to correct a perceived gap in our language, yet this gap still remains. Even the terms transgender and intersex are inadequate and frustrating for some. “Naming can evolve into the invalidation of one’s identity and experience and the perpetuation of domination and control” (Pitman 33), and in these case studies, this is exactly what is happening. There is an insidious predilection toward normalcy in people’s professed dislike of the term intersex, as well as in referring to these forms of identity as “disorders”. This “sociocultural intolerance for gender nonconformity among children” (Sennott 95) is demonstrated in how “[s]ome parents . . . [are] uncomfortable with the intersex label for their affected children. To them, intersex mean[s] a third gender, something in-between male and female. They wanted to see their newborn babies as girls or boys, not as intersex” (Reis 537). This privileging of the “normal” is ingrained in our culture; “[p]arents of affected children do not want them to be considered “abnormal,” or intersexed. They want “normal” girls and boys. For their part, doctors want to provide the best care possible, and, ironically, in their world labeling something a “disorder” normalizes it. Doctors (and insurance companies) understand disorders” (Reis 540).
This rhetoric of normality and disorder reinforces the patriarchal assumption that sex and gender are binaries. Liminal spaces cannot exist because of the threat they pose to the status quo. Thus anyone who finds themselves within one is, through naming, alienated, and existentially invalidated. It is our culture that is disordered, not the individual. This is why “gender ambiguity is ‘corrected,’ not because it is threatening to the infant’s life, but because it is threatening to the infant’s culture” (Reis 539). This is why diagnosis, “[t]he most common and institutionally sanctioned example of naming within the field of psychology” is so often used to “locate the ‘‘disorder’’ within the individual rather than within culture” (Pauwels, Winter 24). The word “disorder” “impl[ies] that something is seriously wrong and needs to be corrected” (Reis 538), and thus establishes the normal, or “ordered”, as preferable. This is precisely why naming is so dangerous, as “[it] often reflects and reinforces the moral framework of society” (Pitman 23). Pathologization is one of the most perfidious forms of social control; “psychologists are actually containing the threat to the dominant power structure through the imposition of control” (Pitman 25), and they are doing so through the process of naming. This diagnostic nomenclature is necessarily stigmatizing because “[w]hen a person is stigmatized in a society, that person becomes discreditable” (Sennot 96), and thus no longer poses a threat. Naming is a method of controlling and marginalizing dangerous peoples.
Why then, do we not think this marginalization extends to those named “mentally ill”; what happens when we apply these same modes to the nomenclature of “mental illness”? Sennott claims that “to categorically pathologize gender difference but not gender conformity is to socially and politically police and stigmatize a person’s mental status as well as their gender expressions, roles, and behaviors, in a way that diagnosing depression . . . does not” (Sennott 99). Why do we make this assumption? I would argue that pathologizing and naming depression functions in a similar manner. I appreciate the distinction; I am often disappointing, but not stupid. The ostensible argument is that depression, and mental illness writ large, is intrinsically unpleasant, while being transgender or intersex is only so because of cultural stigma. I understand that; it is miserable, but couldn’t it be less so if it weren’t the “wrong” kind of misery? If we might suffer on our own terms? Why is it that certain kinds of suffering are privileged over others?
I’ve been pontificated to about depression so many times, regarding how “it’s not just feeling sad! It’s a chemical imbalance in your brain”. So then, suffering isn’t valid unless it is quantifiable, unless some authority figure has deemed your brain chemistry deviant. This is the danger of disorder rhetoric. This is the danger of names. Names are rigid. We are only allowed to suffer within the rigid structure of diagnosis. There is no room for ambiguity. This is an unabashed attempt to normalize and marginalize suffering as a whole. In calling something a disorder, the sufferer is implicitly blamed for it, and its antithesis, the “ordered” individual, is established as preferable. Society is absolved of any responsibility in this context. We must call into question this prelation of contentment, as a content individual is tacitly content with society, and as so presents no threat to that power structure. Yet still we are bombarded with the outmoded “bootstraps rhetoric”, that we cannot blame society for our problems. Certainly, we should not entirely absolve ourselves of responsibility, but is it now our responsibility to constantly criticize and check the dominant power structure? This is the difficulty with the “chemical imbalance” mode of justification: the disorder, as before, is located firmly within the individual, and acts to diffuse any sense of agency, through the violent and insidious sensitivity that tells us it is not our “fault”. Fault however, is not the issue; in absolving us of our responsibility, we are also relieved of our autonomy; the idea that it is not our “fault” means in reality, we have no control over our own condition. This is what the nomenclature of mental illness does: it depoliticizes, and dehumanizes. Forms of suffering, when named, become prescriptive and standardized, and thus so too does their treatment; those that remain unnamed are obscured, invalidated, and ideologically mystified. We must be wary of the names given to us, lest we be disempowered by them. Instead, we need to find and construct names which enable and empower us.
The names we receive, and more importantly, the names we give ourselves have the potential to emancipate us. Certainly there are names that fall into our laps which may broaden our identities. When Martin first hears the word “transsexual”, he seems excited at the prospect that he’s “not alone” (Tremain 176) anymore. However, it is Mary’s creation of the name Martin which truly informs his identity. “[Names] attract, as well as resist, regulatory procedures” (Pauwels, Winter 404), and if we choose those names ourselves, we decide if they will attract, or resist, those procedures. Mary’s unflinching desire to become Martin is an unflinching act of resistance. While “there is a sense of liberation that comes with being able to tell others about [one’s] ways of knowing gender” (Saltzburg, Davis 99), it is important to recognize that gender identity, and I would argue identity as a whole, is “more about internal sensibilities than external presentation” (96). The dominant discourse constructs differences as medical pathology. In order to free ourselves we must create our own discourse. Freedom for Mary, was renaming himself Martin. For the non-conforming youth in Saltzburg and Davis’ article, it was a matter of renaming their sex and gender identities. I’m still searching. I have a lot of names. White, male, cisgendered, privileged, fuck up. I have one foot firmly in the patriarchal public sphere, and one in the asylum. When we enter this world, we are given a name. The rest is trying to make it ours, without being flayed alive by brands and paper cuts, difference and disorder. Names are dangerous. This is not the question. The question is: dangerous for whom?
Two years ago I tried to kill myself. I failed, but then, everyone’s first time is awkward. I wanted to divorce myself from my name. Because I was “a danger to myself” I spent the next two months in a hospital, my rights rescinded, being given yet more names. I’m still not healthy. I may never be. This is fine. I’m no Zarathustra, but I do have an imagination. Like Martin, I’ve had to create new names for myself; the names I was given didn’t fit. Mary became Martin. For me, “disordered” became “dangerous”, and more importantly, that danger isn’t for me anymore. If names shape our identities, the ones we choose do so on our behalf. At the end of Sacred Country, Martin’s mother Estelle is hospitalized for her “mental illness”. I was able to escape the hospital by imagining new names for myself. For Estelle, “a woman with no imagination” (Tremain 320), her prospects are surely less optimistic. I like to imagine though, that one day Estelle realizes just how dangerous she is.
Pauwels, Anne, and Joanne Winter. “The Politics of Naming Reform in the Gendered Spheres of Home and Work.” , Current Issues in Language Planning. 8.3 (2009): n. page. Web. 29 Nov. 2013.
Pitmanq, Gayle E. “The Politics of Naming and the Development of Morality.” Women & Therapy. 22.2 (1999): n. page. Web. 29 Nov. 2013.
Reis, Elizabeth. “Divergence or Disorder? The Politics of Naming Intersex.” Perspectives in Biology and Medicine. 50.4 (2007): n. page. Print.
Saltzburg, Susan, and Tamara S. Davis. “Co-Authoring Gender-Queer Youth Identities: Discursive Tellings and Retellings.” Journal of Ethnic and Cultural Diversity in Social Work. 19.87 (2010): n. page. Print.
Sennott, Shannon L. “Gender Disorder as Gender Oppression: A Transfeminist Approach to Rethinking the Pathologization of Gender Non-Conformity.” Women & Therapy. 34.1-2 (2010): n. page. Web. 29 Nov. 2013.
Tremain, Rose. Sacred country : a novel. New York: Washington Square Press, 1995. Print.