I came across an interesting essay on Asperger’s syndrome. It investigated how the new disease category was established and the effects the diagnosis had on the self-understanding of the people diagnosed. On the broader spectrum, it touched on how categorization works to define who we are.
When it comes to Asperger’s, there is a lot of disagreement on what defines the syndrome, which leaves the diagnostic criteria rather vague. The introduction of a subclinical variant led to that people who exhibited Asperger’s-like behavior could be categorized, and clinicians became attentive to behavior that up until that point had not been relevant within psychiatry. It allowed for normal and deviant behavior to be interpreted in a new way. By establishing the category, a large group of people who had previously been defined as normal could suddenly be classified as ill.
A glorious history was also attached to the disease. Successful historical figures like Ludvig Wittgenstein were described as Asperger’s personalities which contributed to a form of self-understanding that made the syndrome easier to live with.
The philosopher Ian Hacking has taken an interest in the categorizations of people, both in how they affect those categorized and further how the effects on people, in turn, change the categorization. As people change within a category, they are no longer the same people as before – something Hacking refers to as a “looping effect.” The sciences sometimes create kinds of people that didn’t exist before, thus they’re “making up people.” This often happens in fields like psychology and psychiatry.
The classification of people can be described as nominalistic, which means that the general ideas are mere names without a corresponding reality. Hacking mentions Nietzsche as a potential first dynamic nominalist. In The Gay Science, he wrote that “There is something that causes me the greatest difficulty, and continues to do so without relief: unspeakably more depends on what things are called than on what they are.” The aphorism ends by stating that “creating new names and assessments and apparent truths is enough to create new things.” It also applies to the making up of people that Hacking describes.
All this made me think about what categorizing myself as schizophrenic has done to my self-understanding and how I perceive myself because of it. While schizophrenia comes with a social stigma, there’s just like with Asperger’s the romantic notion of the mad genius. Experience tells me though, that few successful creative ventures come out of psychosis as the mind is too disorganized to function. The most important thing I’ve taken away from my diagnosis is that the condition can be managed. Through group therapy, I learned that my experience is not unique. By being categorized, I no longer navigate the straits of madness alone. Still, I guess I remain, in a sense, a made-up person that exists in a new way.