Book Review: Ethan Watters’ Crazy Like Us

February 13, 2010 at 6:33 am | Posted in Book Reviews, Philosophical Problems | Leave a comment

I resisted Ethan Watters’ Crazy Like Us long before I picked it up. In essence, he argues that mental illness is socially constructed, and for the last 20 years, Big Pharma and mental health professionals have evangelized for a pernicious and peculiarly American flavor of madness. Oh, Lord, I thought, another author earnestly “undermining discourse” by pushing a bastardized version of Foucault and postcolonial theory. Ho-hum. When rigorously supported, arguments based on social construction can be illuminating. However, the ideas behind it have become so pervasive that few authors feel the need to support them — instead, they rely on shared assumptions about causality to make the argument for them.

Since Crazy Like Us does, indeed, take social construction as a given, I’d like to begin with a brief overview the concept. I’m not going to prose on and on (I hope), but understanding what Watters means may head off some of the more obvious objections to his claims. This should help us to predict the book’s strengths and weaknesses alike.

Many people bristle at the phrase “social construction” because it seems like a trendy equivalent of its baggier sibling, nurture. Laypeople assume that socially constructed traits stem from individual neuroses, and that, through psychoanalysis, we can control them to some extent. Or, more absurdly, even sociologists may assume that groups choose how they mold members. (To my disgust, the entry in Wikipedia on social construction engages in just such oversimplification.) However, in its strict sense, “socially constructed” does not equal faked or chosen, whether by the individual or a group.

The concept of social construction offers two powerful theoretical advantages: it offers an alternative to deterministic arguments for genetics and allows thinkers to avoid the American sin of psychologizing, and thus pathologizing, individual expressions of, say, gender. Theoreticians (I’m thinking here of Judith Butler’s early work here) do this by arguing that social construction begins from the cradle and involves attributes that people experience as fixed. In fact, genetics may be more mutable, since all but a few traits that people regard as “biological” or “hard-wired” amount to strong tendencies rather than fate. Twin studies bear this out in the case of mental illness; the greatest concordance I’ve read about for even manic depression and schizophrenia is roughly 60 percent.

Further, the concept of social construction pushes philosophers to consider systemic causes rather than falling back on stigmatizing and scapegoating individuals who deviate from the norm. I’m big on systemic causes, particularly economic ones, so I tend to favor anything that jars us out of our national obsession with the individual.

One important objection to vulgar genetics also applies to social construction. In many people’s hands, the latter seems as deterministic as the former, and determinism raises both practical and philosophical objections. For one thing, some people, myself included, feel that they have molded their gender or sexuality through their actions. If the culture is generally homophobic, it seems unlikely that it would routinely construct lesbians and gay men any more than our genes would lead us in that direction. Finally, for many thinkers social construction becomes an unquestioned premise; whole communities of academic tend to take it as gospel and use it as a handy explanation for every behavior that call out for an explanation.

Oh, Lord. I just spent 30 seconds battling the conviction that “explanation” can’t possibly be a word. This is far from perfect, but I’ll run with it. More later.

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