Eye of the Beholder
Labels are both helpful and harmful. While labels help to define things, they also overly generalize and categorize people. They become constructs of how we compartmentalize information. But labels only mean something to the specific society that defines them. Perception is fact in the eye of the beholder. What matters here is not the label but the perception that comes with it.
The Twilight Zone
On November 11th, 1960, CBS aired episode 42 of The Twilight Zone titled “Eye of the Beholder.” In this episode, a young lady undergoes multiple surgeries seeking to conform to society’s version of conforming beauty. As the camera pulls out, we see that the surgery has failed, and the woman is still hideous to her society. The twist is that she looks like a completely normal human woman, and the rest of her society is revealed to have misshapen faces. The episode closing includes the lines “You want an answer? The answer is it doesn’t make any difference, because the old saying happens to be true: beauty is in the eye of the beholder…”
Rod Serling used this theme a few times in his productions. It was to challenge the definition of normal. What is normal aside from what the society determines it is? If we look around the world, there are multitudes of different unique concepts of beauty, of social norms, of codes of conduct, of national law, customs, and more. Serling used the visual concept of beauty to sell his concept of perception, but his principle applies to almost anything.
What is normal? Just like on the front page of this site, there is a social definition of Stigma, there must be a social definition of normal. I would couch it in the same terms: “the general population endorses stereotypes of human appearance, actions, and interaction.” Normal varies by social strata, cultural background, gender norms, and more. What is normal is constantly shifting. The mental health page on this site discusses the AIDS epidemic and how the definitions changed, which served to change what was normal, which served to changed what was socially acceptable.
Disorder in our context is defined as: “a disruption of normal physical or mental functions; a disease or abnormal condition.” Anyone else catch the term normal in there twice? I have been diagnosed with a few disorders, but I feel normal to myself. Am I normal? Do I have normal physical or mental functions? What is so abnormal about my condition? Is it truly a disorder if one in five Americans have it? Or if one in seven will develop it?
For someone to experience flashbacks and crippling anxiety after a traumatic event, is that a disorder? Or is it the brain’s normal response to an event which overloaded its ability to process? What about major depression from the loss of a loved one when that loss upends your entire existence? Or is that the brain’s normal response to the loss of daily dopamine levels the relationship caused? Are these disorders or are they normal?
The rub here is that the medical community and the insurance industry work on labels. The ICD 10 is used to bill specific payments for specific diagnoses. A monetary value is attributed to each ICD 10 label. This is also how we get federal funding for mental health and substance use programs. So these labels are as important as they are destructive. The problem is when those narrow definitions are used to bin humans into a diagnosed code. When our nation’s leaders throw around the term “mental illness” they forget that they are surrounded by those who have said illnesses. Stigmas can be conscious or unconscious. But they exist nonetheless.
For myself, I prefer the term “issue” as I can take issue with many things. It’s an issue to address. It’s an issue to discuss. It’s an issue to celebrate. And so on. So for the most part, I try to use the terms mental health issue and substance use – unless citing a specific term defined by a specific organization.
I accept my diagnoses. And if my labels help you understand me, then so be it. I am just not defined by my diagnoses.