“The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.”

So, “equal” mental health care means health care that is “no more restrictive” than your regular medical health care. You’ll be forgiven for not bouncing up and down for joy at the thought if, like most Americans, “unrestrictive” or even “adequate” are not words you would use to describe your health coverage.

Right now health care reform is being leveraged as an election campaign issue, and it’s a debate that is framed in very narrow terms that are dictated by conservatives. As Democratic and Republican politicians essentially argue about what is best for the insurance business — requiring people to buy insurance, or keeping “big government” out of it and letting the free market decide who gets health care and for how much — the actual health care needs of ordinary Americans (and their mass support for at least a public option, if not universal health care) are completely marginalized. In this context, the Mental Health Parity Law requiring that mental health care be as accessible as medical health care does not come close to ensuring that people receive the care they need, even if they are aware of the law.

The article about the Parity Law says, “More than 26 percent of American adults have a diagnosable mental health disorder, but of those, only 33 percent are receiving care, according to data from the National Institute of Mental Health. And of that number, one-third is receiving treatment that is considered only minimally adequate.” The suggested answer to this problem is to inform more people about the Parity Law so that they know they can get affordable mental health care — but the law only applies to those who already have medical health insurance, and assumes that medical health care under their current plan is affordable for them, which very  often isn’t the case. Plenty of Americans fail to seek necessary medical health care because they don’t have adequate coverage, or can’t afford to see a doctor even with their insurance. The Mental Health Parity Law only ensures that people will have no MORE trouble accessing mental health care than medical health care, and that is a very grim prospect for thousands of people.

From the same article: “More than half of respondents (56 percent) selected cost of care as a reason why they or a family member might give for not seeking treatment. The other commonly selected reasons pointed to a need for improved communications about mental health treatment: not knowing how to find the right professional (42 percent) and not knowing if seeking help is appropriate (40 percent).” It is unsurprising that the cost of care is the number one reason that people don’t seek help in our current devastated economy and high rate of unemployment, which is why we should demand universal health care, including mental health care, as a universal right for all. The insurance business bureaucracy stands as a barrier to people receiving care, since their job is to make money on not providing it, and it also makes the process of attempting to get care unnecessarily complex and paperwork-intensive, which can be prohibitive in itself, especially for someone with mental health problems.

40% of people don’t seek care because they don’t know if it’s necessary, which speaks to a serious need for education about mental health issues — and education would go a long way toward removing the stigma against mental illness that prevents a reported 8% from seeking care. If we take seriously the problem that “[m]ental health disorders are the leading cause of disability in the United States, according to the National Institute of Mental Health, and suicide was the 10th leading cause of death in the country in 2007,” then the demand for free universal health care and quality public education for everyone must be made an urgent priority. We can’t accept that there is always money for war and for bailing out Wall Street and for ensuring that insurance companies remain profitable, and we can’t allow our lives to hang in the balance while politicians dictate the terms of the debate on health care in the most cynical and self-serving way imaginable. We have to actively participate in the “conversation” about health care — and as we’ve seen demonstrated in other parts of the world, from the anti-austerity strikes in the UK and Greece to the revolution in Tunisia, the only way that our demands will be heard is if we go out and make them in the street!

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There is no doubt in my my mind that the shooter, Jared Lee Lougher, is a sick man. And I would be the first to argue that putting more resources into mental health services would reduce crime substantially, both in terms of prevention and rehabilitation. And I wouldn’t argue with the recent spate of articles decrying the stigma against mental illness that prevents the mentally ill from seeking help, and pointing out that adequate mental help is not available to most people in this country anyway. All of those things are true. But in this case, the media rhetoric focusing on the Arizona shooting as an indictment of the mental health system in America serves a hypocritical purpose, and that is to shift the blame away from the unabashed incitements to violence coming from right-wing celebrities like Sarah Palin and Tea Party candidates like Jesse Kelly, who invited his constituents to come and shoot an automatic rifle with him while he was running against Giffords, saying “Help remove Gabrielle Giffords from office. Shoot a fully automatic M16 with Jesse Kelly.” In her insightful article about the politics of hate that created the context for this shooting, Nicole Colson writes: “The shooting in Arizona has demonstrated in the most shocking way how easily the hate-filled rhetoric of supposedly respectable politicians can spill over into violence. Whether it’s the wave of Islamophobia that leads to the stabbing of a New York City cab driver, or a political assault on immigrant rights that turns into actual anti-immigrant violence, or an anti-abortion climate in which doctors can be assassinated as they attend church services, none of these acts occur in a vacuum.” Focusing on Jared Lee Lougher as an individual with specific mental health issues is a way of pretending that this tragedy did happen in a vacuum, allowing the powerful people who build their careers on spreading hate to continue to incite violence without being held accountable.

The sudden concern about access to adequate mental health care is about as genuine as the Swedish prosecutors’ concern for women’s safety when charging Julian Assange with rape. All the sound bytes about how we need to do more to meet the needs of people suffering from mental illness will, unfortunately, be nothing more than a smokescreen – a temporary diversion to protect the right-wing incendiaries, and nothing will actually be done to improve the mental health care system.

Doctors have been rightly concerned that this sensational focus on Jared Lee Lougher will deepen the stigma against the mentally ill. I think that if we want to fight that stigma and not allow mental health issues to be used in bad faith to mask political agendas, we have to speak up and demand a culture free of bigotry. The hateful rhetoric of the right is as toxic to our environment as the pollutants that bring us ever closer to catastrophic climate change. They are creating a climate that is damaging to everyone’s mental health by stirring up unfounded hatred and fear – and ultimately, as the shooting in Arizona proves, what is “merely” poisonous to the mind can eventually become deadly. We all have a right to breathe clean air, drink clean water, and go about our lives without being exposed to hateful fanaticism. We all have varying degrees of sensitivity to what is toxic in our environment, and obviously Jared Lee Lougher was more susceptible to it than most. But it does take its toll on all of us in some measure, and together we can stand against the far right to protect the health and safety of our communities.

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I was struck with the idea and inspiration to start this blog when one of my closest friends posted this quote on facebook in early October. It encapsulates the deep contradictions inherent in life under capitalism, and it brought to light for me a deep concern that I had never quite consciously articulated to myself before. I realized that there are two ways to interpret that statement, and my great fear is that the radical leftists who want to see a better society – the most important people in the world to me – might experience suffering ill health as a form of protest. I don’t believe that the debilitating pain of depression, mania, anxiety, schizophrenia, or any other mental illness can be considered a form of resistance to adjusting oneself to this sick society. On the contrary, refusing to care for or prioritize one’s mental health is as counterproductive to changing society as refusing medical attention for a gunshot wound is to a soldier returning to battle (or going home alive). Anecdotally, my experience is that the people I know who show the greatest concern for others’ oppression around the world are also the least concerned about their own mental health. People have a right to be proud when they are able to function well enough to live their lives and devote themselves to causes they believe in while suffering significant disability – but I think we have to be careful not to hang on to misery and wear our suffering like a badge of honor or as a sign of refusal to accept all that is sick in the world. We can be healthy without adjusting our radical perspective, and we’ll be better equipped to fight for a better world if we aren’t swinging with one arm tied behind our backs, struggling within ourselves at the same time we struggle against our oppressors.

When I read the suicide note written by programmer Bill Zeller that was published online by his request when he took his life last week, it was his clear, lucid rationalism that broke my heart. Our society encourages and rewards the ability to be logical, detached, analytical, calculating, and unemotional, and Zeller accomplished this so perfectly that he became a PhD candidate at Princeton University, was a very successful programmer, and could isolate himself as a mere variable that should be eliminated for the greater good. In his letter, he points out that this ability to make coldly detached decisions about whether a person should live or die could as easily result in homicide as suicide – and by extension we can say that the same kind of emotional detachment is a requirement for waging war. Culturally, we are led to believe that emotions are chaotic and irrational, that this is bad, and that “bad behavior,” like suicide or murder is therefore irrational or insane. I think Bill Zeller’s well-composed letter explaining his rationalization for his suicide is one of the most poignant examples I’ve seen making the case that suicide is ultra-rational, and that rationality is not the ultimate good. 

It is difficult for me to write about Zeller’s letter, because unlike anything else I’ve ever seen or read, it made me feel in a strikingly present way exactly what I felt when I made my own suicide attempt. I don’t know if everyone experiences that feeling of calm, detached logic when they’ve decided on suicide – but I imagine it must be fairly common if two people who could not possibly be more different from one another than Zeller and myself had such a similar experience. I was never a victim of abuse, and nobody would ever describe me as being emotionally detached and analytical as Zeller apparently was. If anything, I have always had a difficult time with personal boundaries, unable to disentangle my own emotions within myself or separate others’ feelings from my own. Emotions have always been strong, immediate, and all-consuming for me – but I remember clearly how all of that messiness was cleared away in the bright light of rational calculation when I decided on suicide in 1999. Like Zeller, I efficiently tied up any loose ends – completing the next day’s homework so that nobody could say that I had been shirking my responsibilities. It felt good to be unsentimental for once, and make a decision analytically instead of emotionally, the way you are “supposed to.” The other one – because my self was split in half the way Zeller’s clearly was when he referred to “the darkness” as a “he” in his letter – approved. Prior to my suicide attempt, and again at other times when I became suicidal again, I experienced the other in myself not as an amorphous, haunting darkness like Zeller’s second self, but more like an incessantly annoying twin – someone I couldn’t stand to be in the same room with because she was so irritating and contemptible. In our society, hatred and intolerance of another person is accepted as inevitable and understandable. You aren’t supposed to act on it, but the intolerance itself is normalized rather than resolved.

I think a failure to learn how to accept others and integrate others who are different into our whole idea of what it means to be human in our society is mirrored in the suicidal person’s experience of him or herself as two people, one of whom is intolerable. We marginalize the parts of ourselves that we don’t want to include in our idea of who we are, and then the excluded parts manifest as an outsider who terrorizes us. Zeller was justified in being angry at his family’s religious intolerance, but he himself displayed intolerance and mistrust of others, saying that nobody can ever be counted on to keep a secret, which was his reason for never telling anyone, not even a therapist, about his childhood rape. He dismissed the idea that a psychologist might feel compelled to break doctor/patient confidentiality in the interest of protecting other children from his molester as unimportant. That the secret must be kept and that no person alive is capable of keeping a secret were two rigid constants, absolute certainties, that Zeller was unwilling to ever compromise on. Working within that dogmatic framework, he was able to rationalize his suicide in much the same way that the United States rationalizes its War on Terror. That the US must maintain economic superiority, and that Arabs and Muslims are an inherent threat, are two unchallengeable constants that prefigure courses of action that follow a certain logic that is perfectly rational IF you accept those premises that are phrased as absolutes. If it were true that Zeller could trust no one and that the secret of his molestation must be kept at all costs, then I’m willing to admit that his suicide did follow logically – but I’m not convinced that either of those things were true or that logic necessarily dictates the best course of action.

Hannah Arendt, a renowned political theorist, wrote about forgiveness as an irrational act that does not follow the normal course of logic. For her, vengeance was rational because it was a reasonable reaction to a transgression, and the chain of action and reaction that follows is logical. But compassion has the power to break this death-dealing system of logic.  She writes:

“In contrast to revenge, which is the natural, automatic reaction to transgression and which because of the irreversibility of the action process can be expected and even calculated, the act of forgiving can never be predicted; it is the only reaction that acts in an unexpected way and thus retains, though being a reaction, something of the original character of action. Forgiving, in other words, is the only reaction which does not merely re-act but acts anew and unexpectedly, unconditioned by the act which provoked it and therefore freeing from its consequences both the one who forgives and the one who is forgiven.”

I would expect outrage if I suggested that Zeller should have forgiven his molester. It’s completely irrational to expect a victim of abuse to forgive his abuser. It seems to me that Zeller saw himself as guilty and was unable to forgive himself. Certainly, he freed his molester from any consequences by keeping the secret of that person’s identity, even to his grave. By taking the guilt upon himself and letting his abuser off the hook, he essentially “forgave” the molester without gaining any benefit or freedom for himself. I’m not saying forgiveness for somebody was necessarily required in this situation, but refusing to follow the logical chain of events was necessary. Zeller needed a way to break from chain of reactions that unfolded from his childhood rapes instead of following them to their logical conclusion in his death. He could never come to that break by calculating rationally – it would have required a spontaneous act of compassion for himself in spite of what he’d gone through.

I’m reminded of a conversation that I had with a good friend and comrade of mine shortly before he killed himself three and a half years ago. He was being very hard on himself and basically said that he would give himself a break once he finally got his life together. I said that I knew it seemed counterintuitive, but instead of saving kindness toward himself as a reward for accomplishing all his goals, maybe he should try being nice to himself first, and then everything else might come easier. When I said this, it was the only time he was ever completely unwilling to listen to me. He said absolutely not, it was impossible for him to even consider, and he would not talk to me about it any further. It was a rigid, unshakable truth, like Zeller’s idea that secrets must be kept and people can’t be trusted – my friend believed that going easy on himself could only result in complete catastrophe, and to hold things together he absolutely had to be his own drill sergeant, splitting himself apart so that the cold, calculating overseer would always be judging him.

Rationality and logic are useful tools, but they are not absolute ideals or moral goods. There are a variety of explanations for why our society places such a high value on reason and detachment from emotion – the elitism of early philosophers, the need to justify exploitation for profit, and the cultural association between women and emotion combined with women’s oppression. Different people have different strengths and ways of seeing the world, and our society is more accepting of certain personality types. I know I often feel frustration and despair when I’m in an argument with someone who sees the world differently than I do and they attack me for being utopian or naive or irrational when my solutions for society’s problems are long-term, holistic and compassion-based rather than immediate, analytical, and constructed on constants and variables.

Ultra-rationality is just as debilitating to a person or to a society as a completely chaotic lack of reason and over-emotional entanglement. Mental health is a harmonious synthesis of our rational and emotional capabilities, which means being able to observe the world scientifically while also being able to experience and express a full range of emotions. We should be able to set aside personal rage or disgust in order to determine appropriate methods of punishment for our society’s needs; but we also have to be able to introduce compassion, kindness, and acceptance when the uninterrupted logical conclusion to a chain of events would be destructive.

I fear that too many radicals equate seeking professional mental help with having to conform to the norms of our society. Therapists are not magicians or hypnotists who can change your fundamental beliefs or brainwash you into seeing a sick society as a sane one. I intend to speak in more detail about what one can and should expect from a therapist at another time, but for now I will just say that seeing a therapist is comparable to going to school. Yes, we are told a lot of lies in school and we have to take a lot of meaningless tests that don’t accurately measure anything other than our ability to perform well on exactly those kinds of tests. Yet we still consider public school education to be necessary, important, and even a basic human right. Education that needs to be reformed is still much better than no education.  The same can be said for mental health care. A therapist is there to help you identify your strengths and weaknesses, and help you develop important skills for improving the quality of your own life, which you have complete autonomy over. Skills for managing thoughts and emotions are as essential as learning how to read, but because we are better able to mask deficiency in these skills than we are able to hide an inability to read, most people don’t make their mental health a priority.  Rather than seeing mental health care as a luxury, we need to demand access for everyone, and take full advantage of what is available to us now.

Just as a reminder, there is an Emergency Info section of this blog, and I urge anyone who has thought about suicide or suspects that someone they know may be contemplating suicide to read that section and take appropriate action. There are too few of us champions of compassion and fighters for radical change in this sick society – we can’t afford to lose any more.

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Due to a change in my schedule (work, school, ISO, and volunteering), The Struggle Inside will now be published weekly on Mondays instead of on Fridays.  The first “real” post of the New Year will appear on Monday, January 10th.

Folks have not stopped sending me suggestions for topics that they want to see me address on this blog, which is so exciting for me, and I really appreciate it!  Here are a few reader-suggested issues that you have to look forward to in the next few weeks:

The Agonizing Last Words of Programmer Bill Zeller

Marxism and Disability

Pressures on teachers to cope with their own and their students’ mental health issues

The issue of “Gender Identity Disorder” being included in the DSM-V

The work of Canadian physician and socialist, Susan Rosenthal

Thank you all again for being engaged with this blog and for sharing your ideas — your participation is vital in making this evolve into a productive conversation instead of simply an archive of articles. I’m really looking forward to continuing with this together!

Alana

The most common expressions of the logic that “it has to get worse before it gets better” that I’ve heard are related to war and the economy. In the absence of an antiwar movement, people form the opinion that nobody is motivated to challenge the U.S.’s imperialist ventures because they aren’t personally affected, and there will be no resistance until there’s a draft. In the absence of fighting labor unions that actually represent the interests of workers rather than acting as mediators on behalf of management, people get the impression that working people are still too “comfortable” in their relative prosperity compared to the rest of the world and that greater economic hardship will be necessary to push them into action. In general, it is progressive liberals who hold this notion that most people are too complacent to agitate for real change – mainly because they buy into the mainstream ideology that “we are all middle class,” even if it’s on an unconscious level and they outwardly acknowledge that the middle class is disappearing. I think radicals can sometimes be subject to these same mistaken impressions, especially in academic environments where post-colonial theorists emphasize the ways in which all Americans benefit from exploitation of poorer nations. I would never seek to minimize or dismiss the plight of the so-called “Third World,” but comparing relative miseries and calling one of them a position of privilege because it is comparatively less miserable only allows the truly privileged ruling economic class off the hook and divides those of us who are exploited by them in different ways, but who share a common interest in ending exploitation. 

However, even Marxists who have a developed understanding of class society can still fall prey to the notion that things must get worse before they get better. Rather than coming from mistaken impressions of comfort and privilege, our misconception stems from a too-mechanical understanding of Marx’s theories. Marx wrote the following in The Communist Manifesto:

“Hitherto, every form of society has been based, as we have already seen, on the antagonism of oppressing and oppressed classes. But in order to oppress a class, certain conditions must be assured to it under which it can, at least, continue its slavish existence. The serf, in the period of serfdom, raised himself to membership in the commune, just as the petty bourgeois, under the yoke of the feudal absolutism, managed to develop into a bourgeois. The modern labourer, on the contrary, instead of rising with the process of industry, sinks deeper and deeper below the conditions of existence of his own class. He becomes a pauper, and pauperism develops more rapidly than population and wealth. And here it becomes evident, that the bourgeoisie is unfit any longer to be the ruling class in society, and to impose its conditions of existence upon society as an over-riding law. It is unfit to rule because it is incompetent to assure an existence to its slave within his slavery, because it cannot help letting him sink into such a state, that it has to feed him, instead of being fed by him. Society can no longer live under this bourgeoisie, in other words, its existence is no longer compatible with society.

“The essential conditions for the existence and for the sway of the bourgeois class is the formation and augmentation of capital; the condition for capital is wage-labour. Wage-labour rests exclusively on competition between the labourers. The advance of industry, whose involuntary promoter is the bourgeoisie, replaces the isolation of the labourers, due to competition, by the revolutionary combination, due to association. The development of Modern Industry, therefore, cuts from under its feet the very foundation on which the bourgeoisie produces and appropriates products. What the bourgeoisie therefore produces, above all, are its own grave-diggers. Its fall and the victory of the proletariat are equally inevitable.”

Marx later revises his overly optimistic view that victory is inevitable, but he maintains his position that oppression causes resistance to it. This is the dialectical nature of class politics – that conditions of exploitation under capitalism are such that the exploited class has both the power and the interest in putting an end to their exploitation, which can only be done by eliminating social classes altogether. It’s not that this theory is mistaken, but that it is sometimes interpreted in such a way that there is assumed to be a one-to-one ratio between oppression and resistance. The logical extreme of that interpretation results in the assumption that the most severe oppression produces the strongest and most confident resistance, but history shows this conclusion to be false. There is a threshold at which oppression becomes so debilitating that resistance is curtailed – either by physical incapacity, extreme demoralization, or both.

This is true not just socially, but personally as well. Depression can also be thought of as a threshold condition. If we feel a little down, frustrated, sad, or irritated, it is possible for a spontaneous gesture or change in circumstances to cheer us up. Past a certain emotional threshold, where depression is severe enough to be considered clinical, we will not spontaneously bounce back. A more concentrated and serious intervention is required to return to an emotional range that allows for normal ups and downs in mood to occur. Likewise, in the realm of class consciousness and struggle, there is a bottoming-out point where we can no longer expect spontaneous resistance – a more conscious and serious political intervention (like rebuilding the eradicated Left in the United States) is necessary.

We might fantasize that it would be easier to start again from scratch than to work with the political and personal baggage of our history. But the concept of creating a “clean slate” is a ruling-class ideological nightmare that has been used to justify razing whole economies and torturing individuals, as Naomi Klein reveals in devastating detail in her book The Shock Doctrine, which compares economic “shock therapy” and psychological experiments in electro-shock therapy which both have the ideal of a tabula rasa, or blank slate, at the core of their destructive operations.

In short, the reasons not to accept any conventional wisdom that states, “It must get worse before it gets better,” are as follows:

1. It does not take into account a threshold at which oppression becomes deep enough to make resistance impossible.
2. It minimizes how bad things actually are now, and the urgency of preventing a point of no return.
3. It relies on a concept of class struggle as inevitable and spontaneous, when we have reached a historical point where more concentrated and conscious political intervention is absolutely necessary.
4. It propagates two different ruling class ideas that do not benefit us: that most Americans are privileged and content members of the middle class, and that change requires complete annihilation so that we can start rebuilding from a blank slate.

As socialists, we fight for reforms that make life better for working class and poor people in the here and now while also laying the political groundwork for revolutionary class struggle. We don’t stand to gain anything by having things get worse than they are. People fight back against oppression when they have confidence and can build on smaller victories, not when they have lost everything and have succumbed to desperation and despair. Too often in our personal lives when we face depression, too, we think that one big revolutionary change will have to happen for us to get better once and for all, when in reality there are small victories that need to happen along the way first. Fighting both oppression and depression takes dedication, strategic planning, hard work, and patience – and we shouldn’t hamstring ourselves with the false belief that reforms which make life slightly better in the short term undercut our long-term objectives of personal satisfaction and a classless society.

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Instead of running down statistics on how bad things really are right now, or going through a cultural and historical critique of winter holidays from their pagan roots to today, I’m going to try something a little different. I want to discuss some concrete ways of coping emotionally with these holiday pressures and contradictions. This is something a bit more personal, drawing from my experiences with therapy, but is still very much informed by my politics. I’ve been getting feedback and suggestions from readers, which I deeply appreciate and I do take to heart (even if it does take me a while to process what you’re saying and find a way to address it), and this is an attempt to respond. Please don’t hesitate to let me know if this kind of post is helpful and whether you want to see more like it sometimes; or whether you would rather have seen a more explicitly political, economic, social, or historical analysis along the lines of previous posts. You have my sincere thanks!

* * *

It is widely acknowledged in the mainstream that the holiday season induces extreme anxiety and depression in many people, and a quick search online will bring up plenty of ‘tips’ on how to deal with holiday stress – but they have always rung rather hollow to me. Leaving aside those that want to sell you stress-reducing products and focusing on those that are more earnest, even these lists can leave you feeling pretty hopeless.

Commercials at this time of year are always reminding you how little time there is left to do your shopping, as though all you have to be concerned about spending is your TIME. Many of these coping tips have to do with time management – for example, saying ‘no’ to some of those party invitations to leave more time for yourself. If you’re unemployed or underemployed, these commercials are laughable because you have more “free” time than you’d like, but you certainly won’t be spending it on shopping with no money to spend. Even if you’re working 40-60+ hours per week, there’s no guarantee that you have money for gifts when so many people are supporting families on low-wage jobs and are burdened with medical bills that aren’t covered by insurance, the fallout from the mortgage crisis, or astronomical student loan payments. Tips on coping with financial difficulty are stated simply: “Don’t spend more than you can afford to.” Meanwhile, the vast resources of capitalist culture are bombarding you with exactly the opposite message, and if you fail to join in the gift-giving and merry-making, you’ll be seen as someone who is stingy and isolating yourself as a killjoy scrooge. 

If you don’t have money for gifts, you’re encouraged to “get creative” and make gifts for everyone – as though what you don’t have in cash you must possess abundantly in time, energy, and inspiration (not to mention materials for making things). If the commercialization of the holidays are getting you down, you’re always urged to volunteer at homeless shelters and soup kitchens, or give to charity. Again, if what you lack is “holiday spirit,” then you must have plenty of time and/or money to give. There is no acknowledgement of the fact that the working poor have the least amount of money to spend AND the least amount of free time – and that these factors leave workers feeling overburdened financially, physically and emotionally drained, often times hungry and cold, and desperate. These are not conditions that lend themselves easily to developing a spirit of generosity, goodwill, and celebration, yet we have this nostalgic mythos in our culture surrounding the poor family who makes up for all that they lack with their stouthearted resilience, unwavering optimism, great moral character, and profound capacity for self-sacrifice and finding joy in simple things. Self-sacrifice is the overwhelming imperative, as is continuously recapitulated in the multitudinous retellings of O. Henry’s “Gift of the Magi” tale. The message is that no matter how little you have, there is always something you can give up in order to properly demonstrate the requisite selflessness of the season. While displays of luxury and gift-giving within their own inner circles stand in as signifiers of “generosity” for the upper and middle classes who don’t actually have to make meaningful sacrifices, working people are expected to compensate for their inability to emulate these mere representations of magnanimity with quaint, wholesome, genuine “holiday spirit.”

The examples that I grew up with will show my age, but I think the under-30 crowd will still be able to identify, as these tropes are carried through into newer incarnations. I remember how the Little House on the Prairie books, which first started being published in 1932, almost always included a Christmas beset by tough times — but with hard work and self-sacrifice, the adults were always able to make the day special for the children and provide them with at least one luxury – an orange, some candy, or a warm scarf. They always worried that they wouldn’t be able to have a “real” Christmas, but an act of ingenuity always translated into something that magically disguised their poverty and allowed Christmas to come after all. It’s no wonder that these books appealed to people in the midst of the Great Depression, or that a TV series based on the novels was launched during the recession of 1974.

Little House on the Prairie

I was also very influenced by another television show from the late 70s and early 80s that also featured a poor, rural family and was actually set during the Depression, called The Waltons. The pilot episode, which became a recurring Christmas special, was called “The Homecoming: A Christmas Story,” and instead of focusing on the miraculous appearance of small luxuries, the magic of Christmas relied on the miraculous appearance of the father coming home. In the absence of lavish gifts (even relatively speaking, as in the Little House series), holiday spirit centers on the blissful harmony and abundant love of family togetherness, with the father’s presence as the linchpin of the entire family structure. For a family with little money, the notion that “at least we’re all together,” can be a comforting one, even if relations between family members aren’t as idealistic as they appeared on The Waltons. But what about families that don’t even have this “least” to celebrate? Economic hardship is one of the most dominant factors in breaking up families (and conversely, single parents and divorced partners are much more likely to have financial struggles). So the idea that the poorest of the poor can compensate for their material hardship with an overabundance of warm familial feeling is something of a cruel joke. The ideal nuclear family has always been an impossible standard that serves ruling class interests by imposing the costs of reproducing the workforce onto the workers themselves and by maintaining a “moral order” that ensures wealth will stay concentrated within particular paternal bloodlines. Workers have to live with the contradiction that the ruling class idea of family benefits their exploiters, while also offering them some sense of security and protection in an oppressive society.

The Waltons

The holidays compound the problems of economic hardship and tense family relations with cultural expectations of celebrating abundance and joy where for many, none exists. This year I’m reminded much more of The Hunger Games (an absolutely brilliant series, by the way) than I am of Laura Ingalls’ or The Waltons’ observances of Christmas. Suzanne Collins’s descriptions of the mandatory festivities surrounding the horrific annual sacrifice of working-class children in the world of her Hunger Games series evokes the strain of corporate pressure to observe the holidays by making personal sacrifices to the profit system through overspending during times of economic hardship. As the protagonist says in the second book, Catching Fire, “Not only are we in the districts forced to remember the iron grip of the Capitol’s power each year, we are forced to celebrate it.”

I imagine that even those who have decently healthy family lives and a relatively comfortable financial situation must still be overwhelmed by the frenzied inculcations to be joyful and giving, robbing both givers and receivers of any genuine feelings of generosity or gratefulness by making gift-giving obligatory. At the same time, our regular lives can be such a long march of drudgery that a festive atmosphere can feel like something we do want to get caught up in so that we can forget hardship for a short time and chase away the darkening cold days by celebrating with the people we love. When it’s in the interest of the ruling class that we put on a display of jollity, it’s easy to want to do the opposite and abstain from any enjoyment of the holidays, ruminating instead on the bitter truth of its hypocrisy. But even if we may save some money that way, we’re not doing ourselves any favors mentally or emotionally. So, as radicals, how do we cope?

Unfortunately, I don’t have an alternative list of simple tips to replace the unhelpful ones that I mentioned above. I would love it if people offered suggestions or shared the ways that they cope with the holidays. The one thing I do want to share is something that my therapist talked with me about on a few different occasions, which in retrospect actually bears some similarities to the way we as activists approach political events. I hope it might be something that others can generalize from and make good use of.

I would run into a lot of trouble at times when I had a lot of different, mixed emotions that left me with a very general, negative feeling of being overwhelmed. My therapist would try to get me to sort out the separate emotions, to identify and name them, and this was extremely difficult for me. As someone who had always done extraordinarily well in school, particularly in verbal skills, it was a very new experience for me to not know the answer or know the right words that I was being asked to provide. It was frustrating and humiliating for me when I would try to give an answer, and I had to be told that the words I was using weren’t emotion words. My therapist had to give me examples of words that I could choose from (happy, sad, angry, afraid, etc.), and even then I had difficulty. My undifferentiated mass of feelings usually amounted to some nonspecific dread, which I supposed was most closely related to fear. Once the emotion was identified – fear – we were able to get even more specific, which was profoundly uncomfortable for me. I tend to think of things in broad, generalized terms in a big-picture kind of way, not in details, so I had an especially hard time breaking things down like this. But, I have to admit that it helped a lot. Once we determined that the main emotion I felt in looking forward to a particular event was fear, she asked me questions like “What are you afraid will happen, specifically?” “What’s the worst thing that could realistically happen?” and “What could you do if that does happen?” The conversation that I had with my therapist wasn’t about the holidays, but it easily might have been. The point is that when there are so many contradictory factors pulling you in all different emotional directions, as there understandably are around the holidays, it is easy to generalize everything into a mass of looming negativity that carries with it a feeling of inevitable, unavoidable doom. I knew that the event that I was dreading was going to be terrible, but I had avoided thinking about it any more specifically than that, and I certainly hadn’t made a plan about what I was going to do if my fears came true. Generalizing bad feelings can make it seem like there are ten times more of them than there really are. Being forced to be specific about what I was worried about made me realize that it wasn’t the entire event that was stressing me out – it was really just the anticipation of one person’s criticism of me. When I focused in on just that one thing, it seemed a lot smaller and more manageable than a whole big giant amorphous cloud of dread. Asking “What is the worst that could happen?” made it seem even more trivial. And asking “What will you do if that person does criticize you?” made me think specifically about the choices that I had: I could respond to the criticism and defend myself, I could decide it’s not worth the argument and ignore it, I could tell the person how much it affects me when they criticize me and ask them not to do it, and so on.

It strikes me now that I easily approach political events in this way, since I’m part of an organization that makes a point of talking through and assessing events before and after we attend them. We don’t just have a general idea that an event is going to be awesome or terrible – we prepare ourselves politically by being specific about our perspectives and what we know about the positions of those who are organizing the event and who will be there. We set our expectations accordingly, and make a plan for how we’re going to engage with the event. It would be ridiculous if we went to every protest or town hall meeting having a vague sense that it’ll be awful and there will be nobody there worth talking to (which can easily become a self-fulfilling prophecy), and it would be equally ridiculous if we went with the general expectation that it was going to be a perfect storm of political radicals ready to fight together and we’ll actually achieve all our demands. In the same way, it’s absurd to expect the holidays to be a perfect celebration of family togetherness, material comfort, generosity, peace, and joy – but it’s also unhelpful to dread it as worthless and vile. We all have our own individual issues to deal with when it comes to the holiday season, but taking a step back and breaking down exactly how we feel, what we expect, and how we’re going to respond in the same way that we do for political events can help to reduce that general feeling of being overwhelmed.

Of course, another key element that makes the assessment of political situations and events easier is solidarity – the fact that we don’t just make our assessments in isolation, but have full discussions and debates with our comrades and allies. I think in our personal lives, too, resisting the temptation to isolate ourselves and figure things out on our own is crucial. Sometimes we assume we’re the only ones dealing with a particular issue – and especially around the holidays we feel like it would be exasperating to burden someone else with our troubles. Usually, though, people feel relief when they know someone else is going through the same thing and shares their perspective. And truly, at a time of year when the satisfaction of giving is undercut by the obligation of filling a predetermined wish list, the opportunity to give in earnest – even if all you’re giving is solidarity – can be a very welcome gift in itself. I know I appreciate every chance I have to express my natural impulse toward generosity, particularly when my financial situation doesn’t allow me to express it materially. I’m sure I’m not the only person who feels this way, so instead of isolating yourself for fear that you’ll put a damper on someone’s holiday cheer, don’t be afraid to ask for what you need – someone may very well consider it a gift to be able to give it to you. And if someone asks for more than you can give, whether it is more money, time, or emotional energy than you can afford, don’t feel obligated to make the sacrifice. Anyone worth caring about won’t want you to hurt yourself on their behalf, and they’ll appreciate your honesty in saying that you can’t rather than giving what they’ve asked for while silently resenting it. In political organizing, we are honest with ourselves and each other about what resources we have and we are open about discussing how best to make use of them, and there is no reason not to be equally forthright within our personal lives.

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– Alana

These appalling numbers clearly correlate to a miserable economy, which is no surprise given the peak number of suicides during the Great Depression of the 1930s. But if our image is one of old white fat cats jumping from their office buildings following the stock market crash of 1929, it is only because those deaths were the most publicized. A New York Magazine article last year, Are Wall Street Suicide Epidemics Real?, stated that “Bankers don’t appear to be any more prone to preexisting psychiatric problems than other groups… The rise and fall of the Dow isn’t the key factor here; the health of the overall economy is.” While it is true that most recorded suicides from The Depression era were of older white males, the picture today is very different, although still tied to the economy. With Wall Street getting bailed out by the Federal Government, it is the unemployed poor of this country who make up the overwhelming number of casualties in the current class war.

As the SAMHSA press release states:

“The survey provides other insights into the nature and scope of mental illness, including information on those segments of the population who may be at greater risk of experiencing mental illness. For example, the survey shows that mental illness is more likely among adults who were unemployed than among adults who were employed full time (27.7 percent versus 17.1 percent).

There is a marked difference in the percentages with mental illness between men and women as well, with 23.8 percent of women experiencing some form of mental illness, as opposed to 15.6 percent of men. In terms of age, young adults (ages 18 to 25) had the highest level of mental illness (30 percent), while those aged 50 and older had the lowest (13.7 percent).”

The press release doesn’t mention race, but the statistics given in the report show that among adults over 18, 15.5 percent of Asians, 16.7 percent of Native Hawaiian/Pacific Islanders, 17.8 percent of Hispanics, 17.9 percent of African Americans, 20.7 percent of whites, 21.6 percent of American Indian or Alaska Natives, and 32.7 percent of those reporting two or more races suffered from any kind of mental illness last year. This might lead one to assume that depression is still a “white” problem, but these percentages include a variety of mental disturbances, not just depression. The numbers reported for serious thoughts of suicide show the rate as being almost the same between Hispanics, (3.3 percent), African Americans (3.5 percent), and whites (3.9 percent). 

I have to say that I don’t know how this data is collected, and whether it relies on people having access to mental health services to make the diagnosis. It would seem to me that some populations would be under-represented in these percentages if they are unable to seek help and be counted as having a mental health problem. It’s something that I want to investigate further.  But at least from these statistics, we can see that suicide is primarily a class issue.

There is also a serious age discrepancy, with young people at the highest risk. From the SAMHSA report: “Having serious thoughts ofsuicide was highest among young adults aged 18 to 25 (6.0 percent), followed by adults aged 26 to 49 (4.3 percent), then by adults aged 50 or older (2.3 percent).” The common-sense explanation for this is that young people are more impulsive and make rash, emotional decisions. But if young people are essentially more impulsive, then why were middle-aged men more prone to suicide than young people in the 1930′s? Unemployment is a more consistent correlative. For 2009, 14.7 percent of the workforce between ages 20 and 24 were unemployed compared with 7.9 percent of those aged 35 to 44, and 7.2 percent aged 45 to 54. For ages 16 to 19, unemployment was at 24.3 percent.

As social services are being cut, there is more pressure on young people — especially in low-income families — to provide both for their parents and their children at the same time, yet they are also experiencing the highest unemployment rates. A severe flaw in the study that SAMHSA released yesterday was that it was a study of adults over the age of 18. As we have seen with the outbreak of gay teenage suicides this year, suicide is a problem well before the age of 18. Given the correlation between unemployment and severe depression, and given the high unemployment rate of people aged 16 to 19, a study of that age group’s mental health seems like it should be a pressing concern. I would also speculate that the racial makeup of people experiencing depression and suicide at a younger age might be quite different from the adult picture. The National Organization for People of Color Against Suicide (NOPCAS) says on their web site that “The rate of black suicide for teens 15-19 more than doubled from 3.6 per 100,000 to 8.1 per 100,000 from 1980-1995. The latest statistics show that roughly 5.7 per 100,000 African American deaths are certified as suicide-a rate of 5 each day.”

We know that poverty and unemployment correlate to depression and suicide, that being Black in America means you are more likely to be unemployed, in prison, and/or living under the poverty line, that young adults are at the highest risk of suicide, and that discrimination also correlates to depression. But it is nearly impossible to find good data linking these factors. We need a comprehensive study of youth mental health, paying close attention to both race and class, to have a truer understanding of the real mental health crisis in America and to wipe out the false image of suicide as a white upper class phenomenon. This is especially true if we care at all about preventing suicide. It’s absurd to say that depression and suicide affect more older white males in a country where a young Black man is more likely to be murdered or imprisoned before anyone even bothers to ask him whether he’s been experiencing symptoms of depression.

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The idea of informed decision-making is especially relevant to women’s health, because culturally we are expected to simply endure particular symptoms as a matter of course because they are part of what it means to be a woman. A certain amount of misery just goes with the territory. Even doctors will tell us that a degree of pain, both physical and emotional, is normal and expected. Rather than having a scientific explanation for premenstrual or menopausal symptoms that would allow us to move away from a fatalistic view of suffering, we curse our ill fortune at having been born female. 

In my last post, I made reference to a book that I found personally very useful called Why Am I Still Depressed?, written by practicing clinician Jim Phelps, M.D. I can’t help but notice that the books I’ve found to be most helpful have not been written by academics writing in the field of psychology, but by clinicians who actually see patients. Another book that was life-changing for me to read was also written by a pair of women practitioners and is currently out of print, but not too difficult to find used. Women’s Moods: What Every Woman Must Know About Hormones, The Brain, and Emotional Health by Deborah Sichel, M.D. And Jeanne Watson Driscoll, M.S., R.N., C.S. is exceptional in its unsentimental, scientific approach to women’s mental health.

The simple idea that actually understanding how brain chemistry and hormones affect your mood and thought patterns can help decrease anxiety about mood swings and mitigate against their severity is one that has stuck with me over the years and has been remarkably effective. Most months for three or four days I may still get extremely irritable or dread the worst-case scenario or take everything everyone says the wrong way or become tearful at the slightest provocation – but taking a moment to register the biochemical explanation for it helps to keep me from harsh self-admonishment for “being a bitch” or wild confusion about why everything is suddenly falling apart. I can calmly and rationally observe that it’s not a good time to draw final conclusions or make big life decisions for a couple of days, because my judgment is impaired through no fault of my own. A scientific understanding removes self-blame and anxiety which are the worst culprits in exacerbating the hormone-induced symptoms. As a Marxist, I appreciate this materialist perspective, which gets at the tangible roots of a problem and suggests that there is a real way to change it instead of simply wishing things were different.

The book discusses ways of caring for your brain as a physical organ along with the rest of your body as one necessary element in maintaining mental health. Much of it is written like a biology textbook, but that is what I found refreshing about it. Case histories of real women’s stories are interspersed throughout the book for people who need to relate to others’ experiences; personally I found the scientific sections more reassuring.

The authors of Women’s Moods and Why Am I Still Depressed? emphasize in their books the importance of educating patients rather than leaving it to the “experts” to hold this knowledge and asking people to blindly follow their advice. I think this is a political position for them to take, because it gives patients a say in their own treatment and equalizes the power dynamic between doctor and patient. My own experience has been that I have received much more effective treatment with more lasting results when I have had enough knowledge to contribute to the decision-making process, as opposed to when I simply accepted diagnoses and treatment without knowing why they were chosen. Education is inherently democratizing, and I wish more people – men and women and every sex/gender combination in between – would learn more about biochemistry, hormones, brain function, and their relationship to mental health, the way it is explained in this book.

I started out talking about how democracy requires an informed public. The media is supposed to serve that function, but as we all know – not all information is good information. What happens when disinformation, or selectively skewed information, is used for political ends?

Brenda Major, a professor of psychology at the University of California at Santa Barbara and a fellow at the Center for Advanced Study in the Behavioral Sciences at Stanford University published a brilliant article in the Washington Post this week about how women are bullied into changing their minds about getting an abortion under the guise of simply providing scientific information to help them make an informed decision. In the article, The big lie about abortion and mental health, she discusses the hypocritical “right to know” legislation that some states have passed, mandating that women be informed of the mental health risks of abortion. She writes:

“Such warnings might sound like a good idea. The decision to terminate a pregnancy can be difficult, and some women end up regretting it. It’s commendable to help women make an informed choice. But an informed choice requires accurate information. And these laws mandate that women be misled.

Rigorous U.S. scientific studies have not substantiated the claim that abortion, compared with its alternatives, causes an increased incidence of mental health problems. The same conclusion was reached in 2008 by an American Psychological Association task force, which I chaired, as well as by an independent team of scholars at Johns Hopkins University. As recently as September, Oregon State University researchers announced the results of a national study showing that teenagers who have an abortion are no more likely to become depressed or to have low self-esteem one year or five years later, compared with their peers who deliver.

Even so, the claim that abortion harms women’s mental health persists. According to research by the Guttmacher Institute, counseling on the negative psychological effects of abortion is mandatory in Mississippi, Nebraska, South Carolina, South Dakota, Texas, Utah and West Virginia. Promoting this claim is part of a political strategy aimed at dissuading women from terminating a pregnancy and at making abortions difficult, if not impossible, to obtain. It is a strategy that distorts scientific principles, even as it uses the umbrella of scientific research to advance its aims.”

When it comes to “right to know” legislation, the goal is not educating women to make informed choices, but to scare them away from exercising the right to make her own choices about her body. It’s not that some women who have abortions don’t become depressed. Knowing the link between hormonal fluctuations and women’s mental health, I might even grant that for some women, the abortion process itself (and not just the stigma surrounding abortion) may indeed contribute to her depression. However, as Major points out in the article, the exact same thing can be said of giving birth. Many women experience postpartum depression, yet nobody suggests that we should legislate that women have “the right to know” about the potentially permanent damage to their mental health that could occur if they have a child. She says, “The law ignores the fact that the very characteristics that predispose women to emotional or mental health problems following an abortion also predispose them to postpartum depression if they deliver or to mental health problems in general, even if they do not become pregnant.” Postpartum depression and psychosis are also discussed at length in Women’s Moods, and if I had ever thought I wanted to have children I definitely would have reconsidered after reading that section. The choice to “educate” women on the mental health risks of abortion is a political move that dis-empowers women rather than helping them to make informed choices. If “the right to know” was really about protecting women’s mental health, then the emotional risks of abortion wouldn’t be overblown while the risks of giving birth are muted. If we are to take women’s mental health seriously, we have to address the root causes that predispose women to depression regardless of whether or not they choose to have children. This would ultimately mean relieving women of the burden of a disproportionate poverty rate, unpaid and unrecognized labor in the form of child-rearing and housework, domestic abuse and rape, and a culture of sexism with impossible and contradictory standards of beauty, sex appeal, chastity, motherhood, submissiveness, and self-sufficiency. Women do need to be educated about their physical and mental health in a way that expands their choices, not limits them – but to uproot the problem of women’s mental health (which touches everyone, men included), and to do more than just treat symptoms on a case-by-case basis, what we desperately need is a renewed and serious struggle for women’s equality.

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It has become quite common to conceptualize many different things on a spectrum, rather than in discrete categories, and I think this is a positive development. Especially in the arena of mental health, it makes much more sense to identify a person’s position on a scale or variety of scales, rather than placing them in one category or another based on relatively arbitrary criteria. The advantages of a spectrum model in mental health is explained simply and clearly by practicing clinician Jim Phelps, M.D. in his incredibly useful book, Why Am I Still Depressed?:

To understand the importance of a spectrum way of thinking about psychiatric diagnosis, it is important to understand the current, somewhat opposite system of the DSM (Diagnostic and Statistical Manual of Mental Disorders). The spectrum system sees conditions on a continuum… The DSM sees conditions as defined by the presence or absence of specific findings… For example, according to the DSM criteria for bipolar disorder, a manic episode must last at least seven days. Well, what should be done if someone’s manic episode lasts six and half days? Is this not bipolar?… In the DSM mode of thinking, making an accurate diagnosis requires determining whether the patient with depression symptoms is unipolar or bipolar, whereas in the Mood Spectrum approach, we clinicians don’t ask what might be the most accurate label for you. Instead, we ask where might your symptoms lie on the Mood Spectrum. The Bipolar Clinic at Harvard’s teaching hospital recently began using a system like this, which they call the Bipolarity Index. Instead of saying ‘yes’ or ‘no’ as to whether you might have a bipolar disorder, they try to determine how much bipolarity you have.

That is not to say that the DSM is totally useless, of course, and Dr. Phelps talks about the value in having a source of common language and definitions, but applying those touchstones to a spectrum rather than discrete categories is a more helpful way of understanding something as complex as a person’s mental state. The same can be said of a person’s politics. Many people who take politics seriously will discuss where they fall on a spectrum from conservative to liberal, or further, to radical. They may even discuss multiple spectrums, perhaps describing themselves as “economically conservative, but socially liberal.” These descriptions tend to relay a much more nuanced communication of their values than simply stating “I’m a Democrat,” or “I’m a Libertarian.”

However, there is an arbitrary element to spectrum-creation as well, in that one must decide how to categorize the beginning and end poles of the spectrum. Culturally, we tend to like spectrums that have two extremes on either end, with a middle ground between the two in the center. Conventional wisdom says that some compromise between two poles is generally a wise position to take. But this model of two opposite extremes with a reasonable middle ground in the center is not appropriate in every circumstance.

For example, let’s think about physical health. One far end of the spectrum for physical health we can easily identify as near-death or death – it’s a complete lack of health. But we wouldn’t say that the other end of the spectrum is “too much” health. We don’t have a concept for being “too healthy” because health is defined as being in an optimal physical state. If the other end of the physical health spectrum is great health, then we certainly would not say that the halfway point between degeneration to the point of death and great health is optimal. We would want to be as close to great health as we possibly can be, and while we may fall short of it, we know that it’s better to strive for the “extreme” end of good health than to shoot for being somewhat sickly, in the middle of the spectrum.

The problem with Jon Stewart’s “Rally to Restore Sanity” was that it attempted to overlay the Right-Left political spectrum with a “sanity” spectrum that assumes the center is optimal. Most people that I know who have loved Jon Stewart and the Daily Show have always been attracted to a position that is definitively to the Left of moderate liberalism on the political spectrum. The demands of the Left, such as money for jobs and education, and end to imperialist wars and occupations, taking measures to prevent racism, sexism and homophobia, and having health care available to everyone, are all considered by a majority of people to be steps toward greater health, not indicators of extremism. So, equating “sanity” with political moderation is really quite out of step with most people’s definition of what would constitute a sane society. Political moderation, centrism, bipartisanship – however you want to phrase it – is the equivalent of accepting sickliness that lies halfway between good health and death. It’s also the equivalent of accepting feeling flat, emotionless and neutral as optimal mental health, rather than having a concept of health that aims for the capacity to feel deeply and experience appropriate emotional responses instead of being debilitated by emotions. I think a lot of radicals fail to seek much-needed mental health care because they are afraid the goal of a mental health practitioner will be to neutralize their passionate feelings in favor of a middle-of-the-road, emotional mediocrity or to brainwash them into accepting a moderate’s view of society. In fact, mental health care can and should be taken advantage of in the same way that physical health care is – with an eye toward enjoying full functionality.

In politics, too, we must stop accepting that the sickly middle ground is a decent compromise and is the best we can hope to accomplish. I’m not saying that taking a hard line and being uncompromising are admirable traits, but when you assume you’ll have to compromise and start out from an already compromised position by planting yourself in the center, then when you do compromise you fall somewhere to the Right of center – and we’ve seen Obama and the Democrats do this over and over and over again. If we start out fighting for the things we really want, which fall far to the Left of what we have now, and then we end up compromising then at least we might land slightly to the Left of center or at the center instead of to the Right. I felt incredibly betrayed when Jon Stewart spat the word “Marxists” at his rally, using the word to indicate a funhouse mirror distortion of good liberals. I realized then that his definition of sanity is completely different from mine. I’m not willing to accept as sane a halfway point between the 43.6 million Americans who were counted as living in poverty last year, and a society where everyone has enough to eat. I’m not willing to accept as sane a middle-of-the-road compromise between the 46.3 million Americans who had no health insurance last year, and a society where health care is a basic human right. I’m not willing to accept as sane a midway point between hurtling ever closer to a catastrophic 2°C average rise in global temperature within my lifetime and reducing the CO₂ concentration back down from 400ppm at least to the 350ppm necessary in order to avoid reaching this critical threshold. There are plenty of personal situations where meeting in the middle and compromising makes good sense – usually when both options are equally viable and taking some part of each will make both parties happy. This strategy does not even remotely apply to a crisis where one end of the spectrum ensures destruction and misery for millions and the other secures food, housing, physical and mental health, civil rights, and a habitable planet for all. That’s why I won’t use my indoor voice, take it down a notch, or reach across the aisle to meet bigots, racists, homophobes, creationists, and capitalists halfway – I’m going to keep fighting for the healthy, fully functioning body, mind, society and planet that we all deserve.

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