We were at a BBQ out on a friend’s farm, sitting on the porch surrounded by half-empty Miller Lite tall boys in the early night. I offered a new acquaintance some of my kratom. They declined with a slight frown, saying, “No thank you, I have an addictive personality.”

I’ve heard that phrase many times in my life, always someone self identifying with it. Once said, it comes heavy laden with assumptions. Images of long nights in years gone by, struggling to free oneself from the clutches of this or that bad habit. Alcohol, cigarettes, pornography, cocaine, binge-watching Netflix, coffee enemas, Candy Crush, whatever it might be — this person has seen inside themselves as through a glass darkly. And after one (or many) dark night(s) of the soul, they emerged with a hard earned truth of themselves that they carry as a sword and shield against temptation.

“I have an addictive personality.”

What that means, whenever you hear someone say it, is rather up to the speaker. It is a medicalized term, borrowed no doubt from someone else equally unqualified to diagnose as the speaker is. Are some people more likely to become addicted? Maybe. Does becoming addicted make you more susceptible to become addicted to another substance? Maybe. Is there even a coherent enough shared understanding of what addiction is to go around labeling behaviors as addictive according to a checklist? Maybe.

But in each case, of course, maybe not.

Diagnosing the Problem

So I’ve turned to analyze myself, not to see whether I have an addictive personality but to suss out why I hate the phrase itself. I am not angry so much at self diagnosis per se. After all, any trip through the Diagnostic and Statistical Manual of Mental Disorders or to a psychiatrist’s office teaches even the most obtuse observer that diagnosing mental illness is not an incredibly certain sphere. As long as the appearance of symptoms are generally maladaptive (i.e. they get in the way of living a full and productive life, whatever that could mean — maybe just living your best life or simply doing you) and you check enough boxes under an illness heading, you have that mental illness. 

There is no brain scan to determine if you either: A) tend to be a homebody during the winter, or B) are afflicted with seasonal affective disorder. There isn’t even a clear idea of how such a scan could possibly function. [1] Scarier still, some mental illnesses could plausibly be diagnosed in two people who share few if any symptoms. This leads to the sensitive-guy wisdom that “No two depressions look the same,” which is dispensed with knowing empathy and yet should create a shuddering chill. If two depressions can be so different, why would we consider them the same thing?

Dogged defenders of the DSM will point out that a multi-form mental illness like depression has specifiers to classify and subclassify, to whittle down to a much more specific diagnosis.

Others will point to experiences in their life with people suffering mental illness and recall how you can clearly tell that something is off. And that is true with some mental illnesses that express themselves with extreme behaviors that are more or less the same across the entire diagnosed population.

So I highlight those countering points for two reasons. For one, they happen to be true and point to the fact that the medicalized approach to mental illness is reaching at something — there is a there there. For two, if I don’t bring them up, I can’t neatly clip those points out of the discussion for my own intellectual convenience. I’m not here to complain about any and all medicalization of mental illness as if all psychiatry is a scam diverting us from going clear and reaching full OT. What I want to highlight is that the medicalisation of mental health has trickled into the general population and lends scientific wording to a potentially poisonous way of being. Not only that, but the trust people give to scientific claims passes over the bridge of this borrowed wording and nestles inside concepts that lead people to trap themselves in self delusions.

Deep breath.

To put the problem simply: when we borrow wording from science to describe our self-conception without the rigor of good science, we can end up trusting these self-conceptions with the same trust we place in good science. To put the stakes simply: our self-conceptions are often damaging, and it is difficult to overcome a self-conception (even a clearly damaging one) when we believe it to be rooted in hard, scientific Truth™. [2]

The Symptoms

When someone thinks about themselves as an addict, they typically think in terms of the “alcoholic” inside Alcoholics Anonymous jargon. Namely: once an addict, always an addict. If it keeps someone from ever smoking another cigarette and falling back into a pack-a-day habit after years of abstinence, fine. But it happens to not always be true. Much, much more importantly, this attribution of a fixed diagnosis to a not-necessarily-fixed psychological tendency is paradigmatic of the lay discussion on mental illness. The equation (where a scientific sounding label equals an inescapable truth of who a person is and could ever be because science says so) at some point leaked out into the self-conception of so many of our psychological experiences.

How many people in your life have self diagnosed social anxiety? Why is that so bad? Because once someone “has” social anxiety, it is a feature of how they function and an inescapable one at that. 

There is a parallel line of thinking in our culture where we are expected (rightly, in most cases) to be understanding and considerate of neuro-divergence. While well intentioned, the introduction of this belief stirred into the medicalisation of our own self-conceptions creates the real witches brew. A self diagnosis is not only a way to set proper expectations of yourself but also a claim for special consideration on behalf of the community. The social group is now responsible for managing any personality trait or habit that you have self diagnosed as mental illness — regardless of the validity of your self diagnosis.

It’s time to compare two examples. 

Someone notices that they have trouble making new friends after college. In the years after school, their reduced socializing led to nervousness when interacting with new people. This person might then decide to do something about this, to solve their problem because it is their problem. They swallow hard and step into the line of fire and withstand the anxiety of social interaction with new people until they learn how to make friends as an adult. 

But if someone in the same situation decides that they have developed social anxiety disorder, then the issue of dealing with these feelings transforms from a personal responsibility to a social one. “You have to put up with my social anxiety and create spaces where I can interact and/or benefit at the same level as those without it,” says so much of the contemporary discourse. The person with social anxiety disorder can not be expected to easily and openly interact with new people, nor are they expected to change this feature of themselves.

To a certain degree, of course we should make efforts to craft social spaces that are welcoming to all people. We should aspire to make all people feel comfortable and to take them as they come, and we can change the way things are done to be more inclusive of the neuro-atypical whenever we can. That being said, we are all of us variants from the “typical”, lacking in certain life skills. In some, these variations are in the extreme. And it is hard to see how we can optimize social spaces for all people without reducing the benefit of the spaces for the vast majority.  

If we want to take part in the social realm (not just for socializing but also participating in public life) then we have to, as much as we can, adjust ourselves to fit the social. The nature of the social realm is that it is not personalized. Demanding a personalized experience of the social is not possible for all people because the social has to take into account so many different human needs, many of them contradicting across individuals. And so, while the social realm should make an effort to be inclusive, likewise individuals should make an effort to fit into the social realm. That the fits are not always perfect is sub-optimal but unavoidable.

Environmental Factors

It is not the responsibility of the social realm to be a good fit for any single individual, but by framing certain unpleasant features of your inner life in a pseudo-scientific medical diagnosis, then demands for special treatment can be made on the wildly prevalent grounds of identity politics around neuro-divergence. So micro-group visibility and acceptance and access is then weaponized around personality traits that are, in many cases, fixable through personal action.

When such a critique is given, many will protest that it is easy for people without mental illness X to dismiss the experiences of people with mental illness X. Almost anyone can see their point. If you don’t struggle with something everyday, then you probably have difficulty understanding the scope of its impact and the contours of dealing with it. And the phrase “It’s all in your head,” is cold comfort and inappropriate. But this argument, while obviously true so far as it goes, is pushed against any unevenness whatsoever based on self-reported symptoms. This puts the entirety of the burden on the social realm rather than on the individual. In some cases this is justified, but how do we determine which self diagnoses are legitimate and which are traits that could be fixed by taking personal responsibility over resolving them? The current discourse protects both cases.

That renders the responsibility a deeply personal one because you are the only one with access to the experiences of your own mental health (in most cases). So the culture must insist: the individual has responsibility to fit into the social realm. The burden to integrate and participate in the social realm is on the individual in the last instance. [3]

Treatment Protocol, or: Circling Back

“I have an addictive personality,” is not, in my experience, as undermining of social life as its self diagnosing cousins, but it does share a root system. If thinking of your personality as “addictive” helps steer you clear of destructive behavior, it is probably best to stick with the phrase, no matter who it irks at the BBQ — even if it irks the guy who is going to go home and write an essay about how this kind of thinking is destroying the fabric of collective human enterprise and the possibility of world-historic transformation of society.

In that sense, the negative reaction I feel when I hear that phrase is really just a symptom of my own pathological pretentiousness. But that kind of makes you think. Though this is not accepted in the DSM (yet), it is a form of neuro-divergence and should be respected. It is all too easy to wave away my symptoms if you don’t experience pathological pretentiousness — must be nice. If you find yourself at a social gathering with someone who suffers from pathological pretentiousness (especially of the contrarian subtype) it is very inconsiderate to go around saying things like “I have an addictive personality,” based solely on the fact that you can’t go a single morning without your cup of coffee and you played too many video games in freshman year to the detriment of your GPA.

I digress.

The solution to this problem is fundamentally too personal to find a clear path. On the one hand, neuro-divergence should be respected and handled with empathy and a great deal of listening, and social spaces should be as welcoming as possible. On the other, this creates a moral hazard where people can self diagnose their way into special treatment that hollows out the collective element of social life and puts undue pressure on the social realm to cater to individual needs at the expense of group needs. How do we insist on the importance of one side of the scale without neglecting the other?

I suppose we can borrow the rule of thumb used in the diagnosis of mental illness: are the symptoms maladaptive?

Notes

[1] The reader will shout at the screen that the difference is: how do the symptoms affect your life. But feeling like staying at home can affect your life negatively without being some inescapable disorder with no solution. This thread of treatability is picked up later on in the essay.

[2] We will set aside for now the incredibly interesting tangent of why and how we place our trust in science, as this is a topic already well-tread in critical theory. Needless to say, I’m making no value claim on trusting science as a discourse one way or the other but simply noting that we do, as a culture, place trust in science — or at least sciencey sounding claims.

[3] Now that liberal activists and left-liberal activists have so thoroughly taken up identity politics as the primary vector of social action, the entire purpose of changing the social realm to meet the specific needs of a micro-group becomes centered as the entire struggle itself. The social realm must integrate and eliminate all unevenness of entry for a particular micro-group so that said group can participate in… eliminating unevenness of entry for itself. We now have a snake making dinner of its tail — which is probably a self diagnosable disorder.

In the absence of a class revolution as the primary goal, the majority of US leftists (who long ago replaced class with identity as the revolutionary subject) serve only this ouroboros. Centering class as the primary political battle line is derided by identity politics as class reductionism. The thinking goes that if you are talking about class, you aren’t talking about sex — which makes you sexist. You are not talking about race — which makes you racist. And so on. 

Identity politics thereby makes class the only lens through which politics are not able to be defined. By this fancy alchemy, class conflict is impossible, because no forward movement is allowed until every single person, no exceptions, is in on the game. No identitarian struggles are to be left unstruggled before any steps may be taken toward broad, collective interests (i.e. class interests).