Sander L. Gilman
Bipolar Expeditions: Mania and Depression in American Cultureby Emily Martin
Manic behavior holds an undeniable fascination in American culture today. It fuels the plots of best-selling novels and the imagery of MTV videos, is acknowledged as the driving force for successful entrepreneurs like Ted Turner, and is celebrated as the source of the creativity of artists like Vincent Van Gogh and movie stars like Robin Williams. Bipolar
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Manic behavior holds an undeniable fascination in American culture today. It fuels the plots of best-selling novels and the imagery of MTV videos, is acknowledged as the driving force for successful entrepreneurs like Ted Turner, and is celebrated as the source of the creativity of artists like Vincent Van Gogh and movie stars like Robin Williams. Bipolar Expeditions seeks to understand mania's appeal and how it weighs on the lives of Americans diagnosed with manic depression.
Anthropologist Emily Martin guides us into the fascinating and sometimes disturbing worlds of mental-health support groups, mood charts, psychiatric rounds, the pharmaceutical industry, and psychotropic drugs. Charting how these worlds intersect with the wider popular culture, she reveals how people living under the description of bipolar disorder are often denied the status of being fully human, even while contemporary America exhibits a powerful affinity for manic behavior. Mania, Martin shows, has come to be regarded as a distant frontier that invites exploration because it seems to offer fame and profits to pioneers, while depression is imagined as something that should be eliminated altogether with the help of drugs.
Bipolar Expeditions argues that mania and depression have a cultural life outside the confines of diagnosis, that the experiences of people living with bipolar disorder belong fully to the human condition, and that even the most so-called rational everyday practices are intertwined with irrational ones. Martin's own experience with bipolar disorder informs her analysis and lends a personal perspective to this complex story.
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Sander L. Gilman
Rif S. El-Mallakh
Roy Richard Grinker
"[Emily Martin's] serious and engaging book...is a much an ethnographical study as it is an autobiographical account. Martin...goes beyond just seeing how medicated bipolar patients deal with their illness: she argues that at least one aspect of bipolar disorder is today seen as a model for a certain type of productive behavior in society. This positive reading of mania comes...to be part of the way that bipolar patients internalize their illness. Martin's book documents our late 20th and early 21st century and its treatment and rehabilitation of bipolar disorder. In examining our world she shows how we have moved from [a] culture of narcissism to a world of mania."Sander L. Gilman, Lancet
"This book is exceptional in that it spans the fields of anthropology, psychology, psychiatry, and sociology. Martin expertly incorporates the literature from these fields with lay perspectives and experiences from support groups and clinical subjects. This book provides new insights and a deeper understanding of the bipolar experience in America."Rif S. El-Mallakh, American Journal of Psychiatry
"Anthropologist Martin continues with her long-standing project of unpacking U.S. values, categories, and, in this case, psychopathology as artifacts of history and society with a focus on their cultural rendering, shifting content, and context....General audiences as well as specialists who have particular interest in the social and cultural life of mental health in the contemporary U.S. will appreciate this book."S. Ferzacca, Choice
"If there is a single thread that runs through this timely, well-researched and wide-ranging book, it is that bipolar disorder is a framework of our time for understanding and even facilitating new conceptions of rationality, irrationality, mood and motivation."Roy Richard Grinker, Project Muse
"This book provides a very welcome development (substantive and theoretical) in the field of anthropology, but economists, politicians, and historians reflecting on the recent depression in the US, and the 'cold' caught by other 'Western' countries, would also do well to read it."Christine McCourt, Journal of the Royal Anthropological Institute
"Emily Martin shatters common sense distinctions of public and private, individual and communal. In the process, she makes sense of what may seem counter-intuitive on the surface: the conscious self-presentation and sociality of people living with the diagnosis of manic depression."Helena Hansen, American Journal of Psychiatry's Residents' Journal
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Bipolar ExpeditionsMania and Depression in American Culture
By Emily Martin
Princeton University PressCopyright © 2007 Princeton University Press
All right reserved.
Chapter OnePersonhood and Emotion
1. A living human ... 2. An individual of specified character: a person of importance. 3. The composite of characteristics that make up an individual personality; the self. 4. The living body of a human: searched the prisoner's person. 5. Physique and general appearance. 6. Law A human or organization with legal rights and duties ... 9. A character or role, as in a play; a guise: "Well, in her person, I say I will not have you" (Shakespeare). -American Heritage Dictionary of the English Language, 4th ed., 2000
When one is diagnosed with manic depression, one's status as a rational person is thrown into question. What it means to be rational or irrational depends on what notions of personhood are in play, notions that must be understood in their cultural context. In Western culture since the seventeenth century, a particular kind of person, the "individual," has been the norm. In the writings of John Locke and others, the individual was defined as "essentially the proprietor of his own person or capacities, owing nothing to society for them. The individual was seen neither as a moral whole, nor as part of a larger social whole, but as an owner of himself." He was a being capable of conscious awareness, deliberate choice, and independent volition. His actions were generated from his own desires, desires that grew out of his individual intention to grow, develop, or acquire. In due course, I will make clear what it is about manic depression that seems to challenge this conception of the rational individual person. For the moment, I will say that a manic-depressive person takes these desirable traits to extremes: when depressed the person is profoundly dejected and turned inward, unable to act or love; when manic the person is consumed by his desires and acts on all of them, whether for sex, or money, or power, at once. Freud described the "maniac" just released from the inhibition of depression as someone who runs after his new desires "like a starving man after bread."
Taking things to such extremes seems like being out of control. But is being in control always considered desirable and normal? Historically, the individual "owner of himself" has not always been expected to exert continuous control over his actions. In the United States in the late nineteenth-century, psychic states that might erode the edges of the disciplined and aware self, make its borders permeable to other selves, or allow it to drift into discontiguous psychic spaces were given positive value. In 1889, when William James carried out his "Census of Hallucinations" in the United States, he, his collaborators, and many of the over six thousand Americans interviewed regarded states such as hallucination in a variety of positive ways. However, by the twentieth century, mainstream popular culture in the United States had largely come to denigrate "forms of experience not characterized by self-consciousness." Even experimentation with mind-altering drugs, popular in the 1960s, was generally valued for heightened self-consciousness rather than loss of self.
The ideal that a person should be disciplined and self-aware came about partly through the requirements of work in industrial settings and the growth of a consumer society. The moving assembly line with its dedicated machinery enabled efficient mass production and paved the way for profitable mass marketing based on increased consumption of commodities. Corporate organizations were hierarchically structured bureaucracies whose ideal employee was conformist, passive, stable, consistent, and acquiescent. More broadly, scientific planning was brought to bear on all kinds of human groups, yielding rational social organization and rational thought. People and the groups they formed were devoted to development (in a linear way) through time, toward goals that not all could reach, but which all should desire, because they represented the lofty heights of abstract thought. For the adult person, stability and solidity were at a premium. Early in the century, identity was described as something that was "forged": like wrought iron, a person's identity should be strong. This solid sort of identity was akin to the older concept of "character," which was a more or less given quality of the person manifested by working hard and honoring the dictates of duty. However, at the same time, the locus of a person's stability was changing. The term "personality" came into common usage only in the early twentieth century, bringing with it the potential for more flexible self-presentation. In his classic book The Organization Man, published in 1956, W. H. Whyte gives satirical advice on how to get a high score on personality tests: always choose the most conventional word in word association tests, so that you will be classified as a person who has normal ways of thinking rather than abnormal emotional ways of thinking. But Whyte's advice contains the possibility for other ways of defining the personality. One could now strategize about presenting one's personality in different ways for different purposes.
In American Cool, the historian Peter Stearns argues that Americans experienced a major change in emotional style in the 1920s. In the late nineteenth century, influenced by Victorian values, Americans placed great importance on the intense emotions attached to romantic love and to the passions necessary for great deeds. After the 1920s, the emotional climate shifted to restrained coolness: management was the key across the board-"no emotion should gain control over one's thought processes." Since my argument develops from a recent resurgence of interest in strong emotion-like states, Stearns's argument has particular salience. How exactly might Americans have gotten from the restrained cool that was the ideal in the beginning decades of mass production society to the unrestrained heat that ignites our cultural heroes today?
One explanation lies in an understanding of recent political and economic changes that have begun to make themselves felt in the United States, as elsewhere, changes with important implications for understanding contemporary concepts of the person. The differential internationalization of labor and markets, the growth of the information and service economies, and the abrupt decline of redistributive state services (among other things) have meant that access to the world's wealth has become much more difficult for most people. In the United States, concentration of wealth and income at the top of the social order is more extreme than at any time since the Depression, and poverty has grown correspondingly deeper, despite the persistent myth of social mobility toward the American dream. Successive waves of downsizing have picked off, in addition to the disadvantaged, significant numbers of people from occupations and classes not accustomed to a dramatic fall in their prospects and standard of living. The imperative to become the kind of flexible worker who can succeed in extremely competitive circumstances has intensified, and the stakes for failing have greatly increased. In one sign of the unforgiving nature of increased competition, references to the "survival of the fittest" have increased exponentially in the popular media since the early 1980s.
Everyday experiences of time and space themselves may be shifting, too. Activities that were once localized-education, work, and family life-are now increasingly being spread over space, changing the spatial and social dimensions of human interaction. "Close" and "distant" once applied both to relationships and spatial distance, and usually were coincident. No longer. Space seems to loom larger as it intrudes into relationships (a couple, of necessity, holding two or three jobs, parents and children following available jobs away from their extended family, grown siblings scattering to the four corners of the globe). Simultaneously, space disappears through electronic technologies (cell phones, the Internet) that make time speed up and communication happen instantaneously. The stable time-space grid described in many earlier accounts of the disciplinary control characteristic of factories, prisons, military barracks, mental asylums, or schools since the onset of modernity has altered beyond recognition.
The factory, which has often served as both a laboratory and a conceptual guide for understandings of human behavior, is also changing. The hierarchical factory of the mass production era, with its worker drones and foremen, is being replaced (at least in the elite sectors of the global economy) with new forms: machines that process information and communicate with "self-managed" workers, who are in turn invested with greater decision-making powers. Corporations are flattening hierarchies, downsizing bureaucracies, and enhancing their corporate "culture," becoming nimble and agile in hopes of surviving in rapidly changing markets. Relentlessly, corporations are also sending manufacturing divisions to cheaper labor markets overseas (where most laborers do not have the resources to follow them). To enable these activities, corporations seek organization in the form of fluid networks of alliances, a highly decoupled and dynamic form with great organizational flexibility.
Six million manufacturing jobs have been shed in the United States over the last thirty years, and many workers who lost their jobs have skidded down the socioeconomic hierarchy. As my previous work has shown, workers and managers are expected to meet this threat by "evolving" with the aid of self-study, training courses, and an insistence on self-management when they are lucky enough to be employed inside a corporation, and then aggressive entrepreneurialism during the frequent periods they now expect to spend outside it. Although from the beginnings of capitalism, firms and individuals have had to innovate and improve or decline and perish at the hands of competitors, competition in the present climate has become extremely fierce. Because of policies guided by "neoliberal" ideas, the individual must now creatively pursue his or her own development with the aid of fewer supports than ever before. The role of the state, according to the theory of political economic practices that fosters this climate, is to establish strong private property rights, free markets, and free trade. The state should ensure the free functioning of markets, and expand or extend markets to areas such as education, the environment, or social security. But the state should not provide social safety nets that would protect individuals whom markets exclude or defeat. Corporations, too, are increasing the risks employees must bear, not only by cutting jobs but also by stopping their contributions to the pension plans of the workers who remain.
In this environment, the individual is responsible for his or her own success or failure in a high-stakes and ever-changing set of arenas. The person now seems to be made up of a collection of assets, as if she were the proprietor of herself as a stock portfolio. In the 1990s, there was an increase in "home-based work," based on telecommuting or the "You, Inc." phenomenon. "People need to invest in their development as if they were a corporation," said Anthony Carnevale, chairman of the National Commission for Employment Policy at the Department of Labor. Individuals, like mini-corporations, were supposed to "shapeshift" in their changing environments, accumulating and investing information and resources. There is a sense in which, as the U.S. government withdraws from provisioning individuals, the individual moves from being a citizen, oriented to the interests of the nation, to being a mini-corporation, oriented primarily to its own interests in global flows of capital. In preparation for this endeavor, as I will describe in coming chapters, American children, teenagers, and adults are doing many things to develop their mental capacities in specific ways, taking on self-management practices with or without the help of mind-enhancing drugs.
In one popular formulation of the state of things, Virginia Postrel's The Future and Its Enemies, "stasists" will be left behind by "dynamists" who celebrate "emergent, complex messiness ... an order that is unpredictable, spontaneous and ever shifting, a pattern created by millions of uncoordinated, independent decisions ... these actions shape a future no one can see, a future that is dynamic and inherently unstable." In the radically atomized world Postrel imagines, there is an imperative for people who are always adapting, scanning the environment, continuously changing in creative and innovative ways, flying from one thing to another, pushing the limits of everything, and doing it all with an intense level of energy devoted to anticipating and investing in the future. High school and college-age children in the United States and globally appear already to be entering this future.
Given this procession of dramatic changes on many social, cultural, affective, economic, and political fronts, what concepts of the person are enabled by and enable these conditions? As the mechanical regularity demanded of the assembly line worker gives way to the ideal of a flexible and constantly changing worker, what will happen to the value previously placed on stability and conformity? A new attitude toward change is emerging: continuous retraining for workers at all levels is becoming normal. Today it is not just that individuals circulate among different jobs or careers, nor just that the conditions of their work change over time. In addition, the individual comes to consist of potentials to be realized and capacities to be fulfilled: self-maximization and self-optimization are the watchwords. Since these potentials and capacities take their shape in relation to the requirements of a continuously changing environment, their content, and even the terms in which they are understood, are also in constant change.
What competent and successful persons are expected to do has changed over time. These changing expectations might even stretch to include the emotions: could the value of emotional coolness characteristic of the early twentieth century be giving way, under conditions of greatly increased capitalist competition, to a focus on emotional lability? Coolness is by definition flat and restrained, and might be seen as suited to ordered and stable environments and institutions. Lability in emotional life means movement on the scale of feelings, and might be seen as suited to the ferment and turmoil of entrepreneurial activity. This possibility brings us directly into view of the changeable emotions thought to be characteristic of manic depression and hints at why fascination with manic depression may be increasing. This hint, however, raises more questions than it answers. In psychiatric terms, manic depression is a "mood disorder." Rather than taking this at face value, we need to ask: Are moods actually a form of emotions? Does manic depression only involve a disorder of moods or does it more centrally involve a diminution or exaggeration of motivation? How exactly could an entrepreneurial climate call forth a revaluation of manic depression, whether it involves moods, motivations, or both? To pursue these questions, I begin with the basics: the changing definitions of emotions, moods, and motivations in their cultural contexts.
Excerpted from Bipolar Expeditions by Emily Martin Copyright © 2007 by Princeton University Press. Excerpted by permission.
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What People are Saying About This
Lorna A. Rhodes, University of Washington
Charles Rosenberg, Harvard University
Louis A. Sass, author of "Madness and Modernism"
Tanya Luhrmann, author of "Of Two Minds: An Anthropologist Looks at American Psychiatry"
Meet the Author
Emily Martin is professor of anthropology at New York University. Her books include "Flexible Bodies: Tracking Immunity in American Culture from the Days of Polio to the Age of AIDS" and "The Woman in the Body: A Cultural Analysis of Reproduction".
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