You Don't Have to Call Yourself a Marxist If You're Not

I’m a Marxist, and my Marxism is integral to my understanding of insanity. I don’t mean that in a biological or medical sense; I’m not a Soviet anti-psychiatrist, insisting that all mental illness is a byproduct of the present mode of production (although surely some of that millennial Anxiety and Depression(TM) is). I believe that my particular illness, and most severe mental illness, is a product of biology and interpersonal circumstance, and that these illnesses have existed across cultures and histories. But mental illness is also a political problem, a problem of healthcare and housing and employment and criminal-justice; the mentally ill are a subset of society with particular abilities and particular needs, and as with all political questions, I believe that a Marxist, materialist outlook is the best way to get at what is going on, and what, if anything, is liable to remedy the situation.

My Marxism is part of what makes me so skeptical of anti-stigma rhetoric. The destigmatizers are classic liberals and idealists in their outlook. They believe that society and politics proceeds from people’s ideas about the world; therefore, if people in general were only more understanding and compassionate toward the mentally ill, then they would treat us better and improve our circumstances. I’m a materialist. I believe stigma, inasmuch as it’s a problem, is an ideological consequence of the material condition of the mentally ill. We are not, in general, particularly productive members of society. We tend to consume more resources than we produce. Worse, the worst of us tend to be disruptive; difficult or criminal, unclean or weird, and so it is no surprise that given how little use we are to really any mode of production, nearly every mode of production has given rise to an ideological rationale for hating and maligning us. If you want to end stigma, then improve the material condition of the lunatics. Ideology and sentiment will change accordingly.

Mental illness is not the only part of our discourse dominated by an idealist theory of politics, of course. A great deal of liberal and even purportedly-left thinking about race, gender, sexual orientation, even class, proceeds from the premise that ideas drive politics and therefore if we educate people—or, as is often demanded, they educate themselves, banishing the metaphysical taint of bigotry from their hearts, presumably in order to please the liberal arts graduates who keep calling them assholes— then, and only then, will material iniquities begin to change. Get rid of all the stigmas and isms, and the coalition of the woke will fix the world, this discourse says. Of course, this discourse is precisely wrong and backward. Basic materialism is right: Correct the hierarchical distribution of material goods, and therefore the hierarchical distribution of power, and only then will all the ideas which have sprung up to justify the current hierarchies begin to wither from lack of usefulness. One doesn’t have to be a communist, or even a full Marxist to believe this. You only have to accept that first premise: the world of ideas reflects the world of things, not the other way around. Goods are distributed and certain way, and politics largely functions to explain why that’s Good, Actually. Base and superstructure. Material and ideology.

What I find particularly frustrating, both in general and in the case of insanity politics, is how many people even on the alleged left, how many people who self-identify as Marxists, are nonetheless fundamentally idealists. This is true in marginalization discourse — they tend to be among the most prominent destigmatizers and wokescolds — but it’s most obviously manifest in their ongoing obsession with individuals as the battlefield of politics.

I expect this has something to do with the huge influx of new and particularly young people into the so-called American left over the past few years. They’ve come over to the “right team” in the sense that they can correctly identify the broad contending classes of a socialist left account of the world, but are still basically liberal in their sense of how that conflict takes place. They still have a Manichean view of morality, where there are Good People and Bad People, and what kind of person you are in some way reflects your individual choices about the state of your soul. They tend to believe bankers and landlords are Bad People, rather than believing wealth itself is the moral bad. They hunt for metaphysical Predators (often, ironically, described with the very mental health vernacular of sociopaths and narcissists they claim to want to disassociate with intrinsic criminality), rather than paying anything more than lip-service to the structural conditions that give rise to predation. They claim to hate the defensive “a few bad apples” theory of racist cops, but they only seem to take issue with the words “a few”, instead believing that the kinds of people who become cops are all bad apples. They claim to believe in class and structure, but they act as if a class is merely a quorum of individually Good or Bad individuals with the Right or the Wrong ideas. They speak—and act, in an incessant effort to destroy particular individuals—as if changing structure simply means eliminating all the wrong kinds of people. It’s in the incessant effort to “keep the left weird”, as if it’s a subculture. But the workers of the world uniting will, by definition, not be a bunch of weirdos.

But the truth, of course, is that a material world structured around the distribution of wealth and power according to hierarchies will inevitably give rise to people who benefit from those hierarchies. It doesn’t surprise me that the rich exploit the poor and will do anything they can to protect their status. They’re only acting in their class interest. How could they do otherwise? The trouble isn’t with their souls, the trouble is with a world which will always replace any oligarch individually destroyed with a new individual oligarch. I don’t want to shoot the landlords, or punish them for being who they couldn’t really help but be. I just don’t want them to be landlords anymore. And really, it’s the same with these new “Marxists”. I don’t blame them for remaining fundamentally liberal and idealist in their outlook. They can hardly help it. That’s the kind of outlook, and the kind of person, that late capitalism is designed to produce. All I ever really want to say to them is that look, you don’t have to call yourself a Marxist. The word doesn’t grant you any special powers. You’re not a materialist. That’s fine. Do you. Be the hearts-and-minds Manichean warrior for the souls of the Good People that you want to be.

But in case anybody is inclined to listen, or in case you really are a Marxist, or a materialist, but you don’t believe a full revolution is around the corner, and you want to know what you can do to help the millions of insane people on the streets and in our jails, and figure, well, isn’t anti-stigma work a start?, let me suggest this: instead of begging sane people to be nice to us, to give us better doctors and free medicine, and compassion and dignity—always with the implicit threat that we better not fuck it up and perpetuate stigma through our actions—work to change the material world. Sane people won’t be nice to us until that world changes. So work to get us free medicine. Work for universal healthcare. Work for guaranteed employment, and housing, for the insane and for everyone. Quit NAMI and other respectability organizations and help found a radical organization, dedicated to organizing around a demand for the real material needs of the insane. Even easier: vote for Bernie Sanders for President, then get Medicare for All through Congress. Agitate for criminal justice reform, and an expansion of insanity pleas. The largest lunatic asylum in the United States shouldn’t be a prison in Los Angeles. If you want to be kind, and not use words like “crazy” in the meantime, fine. But that’s not going to change anything at all. Only one thing will, and it’s the only thing that ever has: radical politics, focused on structures, not people, and the reconstitution of production and society that comes with them.

Call for Help and They'll Kill You

On August 10th, 2016, Tony Timpa called 911 from a parking lot in Dallas. He told the dispatchers that he wasn’t well. He was schizophrenic, and depressed, but he hadn’t been taking his medication. He didn’t feel right. He had taken some street drugs—cocaine, it turned out—but they weren’t making him feel better. He needed help.

When police arrived, they pinned Timpa to the ground. In body cam footage, he screams for help, repeating “You’re going to kill me! You’re going to kill me!” until he passes out. The police hold him face down and retrained for nearly fifteen minutes, and joke about Timpa not getting back up. “I don’t want to go to school! Five more minutes mom!” one of them shouts. “It’s time for school — wake up!” says another. They push his limp body around but do not check for a pulse. Later, an autopsy discovers that Timpa died as a result of a drug overdose, brought on by the “stress associated with physical restraint.”

It took three years for the body cam footage of the incident to be released. In the meantime, the police lied about what happened, of course. They claimed Timpa was “aggressive” when they found him. They claimed that they pushed his body around to stop him from “rolling into the road”. They claimed that his death had nothing to do with them. They claimed Timpa was dangerous, and unstable, and that anything they might have done was justified, even merciful. But in July of this year, the bodycam footage finally came out. Now we know that Tony Timpa was murdered by the police, who thought all of this was very funny.

The insane are murdered by police at extraordinary rates. A 2015 study from the Treatment Advocacy Center found that despite making up less than 2% of the American population, those of us with severe mental illness make up between 25% and fully 50% of all people fatally shot by the police. The mentally ill are sixteen times more likely than the average person to be killed during an encounter with law enforcement, the worst rate—by far—of any subcategory of the overall population. If you happen to fall into more than one group of people considered subhuman by cops at the same time — say you’re black, schizophrenic, homeless, and male all at once—then the risk is even higher. And if you’re insane, then your chances of falling into one of those other groups—homeless, unclean, unemployed, on drugs—are higher too. There’s a great deal of talk about the violence that the mentally ill inflict on one another, on the street and in hospitals and in life, the ways that so many of us become both instigators and victims of violence, but I feel safer—and the statistics tells me that I should feel safer—with another lunatic than I do with an armed American cop.

The ordinary line from mainstream mental health advocacy organizations is that police need to be trained in “de-escalation” tactics. They need to learn to recognize the difference between a threat and a person in the midst of a mental health crisis. They need to learn that people suffering from paranoia or delusions will not necessarily respond to instructions or behave predictably or rationally but that they are not doing so out of some criminal disrespect for police orders. You can question whether or not the cops should or even can be trained social workers on top of their training as law enforcement, but, this line of thinking goes, if they were, then there wouldn’t be these kinds of murders.

I have no doubt that widespread mental health crisis training would reduce the number of crazy people shot by cops. But I only think it would reduce it. De-escalation imagines that the typical encounter between the insane and the police involves the insane person acting in a way that isn’t—but which could be interpreted as—erratic or dangerous, and in which the cop in question is acting in good faith. They don’t want to kill a civilian, but sincerely believe in that moment that they’re dealing with a sane but dangerous individual who they have to stop. If only they knew how to recognize the signs of a frightening but non-threatening mental health crisis. If only they had the training to “de-escalate”. But not all—and I suspect not even most—encounters between police and the insane go that way. It is possible, after all, that the mentally ill suspect really is dangerous. Should the police have license to execute them in that case? It is possible too—even likely—that the crazy person isn’t dangerous or behaving dangerously. They’re just weird and loud and disruptive and they get restrained and something happens and—now they’re dead. Finally, it’s possible that the officers aren’t acting in good faith. I don’t think anybody needs much convincing at this point that cops open fire even when their lives, or the lives of others, aren’t in any immediate danger. If they want to shoot, they aren’t doing to de-escalate. If they’re the kind of cop who wants to shoot, that’s what they’re going to do. Remember that the police didn’t find Tony Timpa on their own. Nobody saw him acting strangely and called 911. He called himself. He wasn’t menacing anybody. He wasn’t refusing police orders. He told dispatchers where he was. The police arrived, but they weren’t afraid of him. They laughed about what they were doing. Tony called for help, and they killed him. What’s de-escalation going to do about that?

I’m not terribly afraid of the police being afraid of me. I’m white, and small. I don’t own any weapons and even my worst psychotic episodes have not involved armed threats of violence against officers or anybody else. But I’m afraid of becoming Tony Timpa. I’m afraid that I’ll need help and call the police, or that I’ll need help and somebody else will call the police and I’ll act strangely, or refuse to calm down, or run away, and wind up dead.

I’ve had the police respond to me before. As a teenager and in my early 20s, as my symptoms first began to manifest, I was picked up more than once for disorderly conduct—yelling in the streets, or sleeping on a patch of grass by the sidewalk, or crashing my car. A little over a year ago, I left my apartment convinced that I had to go to California, and I walked 12 miles to the next town over and checked into a hotel under a fake name and waited for the morning bus to come and take me to the airport. My girlfriend and two other friends managed to find me, and when I refused to come with them to the hospital, they called the police. I wasn’t threatening them, or even yelling. I just kept trying to walk or run away. I barely recognized them. I was gone. They did everything right: they explained to the police that I was having a mental health issue. They said I wasn’t armed, and wasn’t dangerous. The police came and confronted me, but it took hours for me to calm down and agree to go to the hospital. I didn’t make a scene—psychosis isn’t like that all the time—but I ran across a freeway onramp in the dark into a ditch in order to escape the officers. I played hide-and-seek with them in a parking structure. When they managed to corner me I just said “I have something important to do, am I breaking the law? I’m just walking. I’m just walking” over and over until they gave up. It worked out in the end, but what if they had been different cops? What if they’d gotten out of their squad car, guns drawn, and I’d made the wrong move? What if they’d cornered me, and I’d tried to push past them, or hit one of them, and they’d shot me? What if, as I ran across the onramp, they’d pursued and tackled me and in the process of restraining me, I’d died on the ground? What if they’d laughed about it? What if they’d thought it was funny to roll me into the road and pretend I was asleep after I said “You’re gonna kill me, you’re gonna kill me”? I am absolutely certain that I will have another encounter with the police some day. I will probably have many. I don’t worry that those police officers won’t be trained in de-escalation. I worry that one of them—and in my whole life it will only ever take one them—just won’t care.

The mentally ill are dangerous sometimes, of course. Sometimes they even push cops, or hit them, or make threats. And cops will tell you that there’s no way to tell the difference between somebody who is actually going to hurt or kill an officer, and somebody who won’t, until they do it. So they’ve gotta protect themselves. They’ve gotta be safe. But I’ve always wondered—when following these cases, or the cases of murdered black civilians, or anybody else gunned down by law enforcement—how safe do police have to be? If there’s a 50% chance that the person in front of them is a real threat, and a 50% chance they’re just crazy, or confused, or didn’t hear the officers’ instructions, why is it that the civilian is always the victim of the cop erring on the side of caution? Police officers chose to be police officers. I’d rather 10 cops hold their fire in error and get killed than one innocent civilian get murdered in error by a nervous cop. The police agreed to take these risks. I didn’t. “If you make an officer nervous, an abundance of caution dictates that you must be shot” wasn’t on any doctor’s paperwork I ever signed. But the truth is, of course, that most of the time, it isn’t that somebody is going to die. Most of the time, it’s that somebody needs help. Maybe they even called for help themselves, desperate and confused in a parking lot somewhere. But instead of getting helped, they got murdered, and their killers laughed and laughed and lied about it for years.

Sometimes They're Crazy, Sometimes They Aren't

I’ve spent this week and weekend driving across the country again; as it happens, I drove through El Paso two days before the recent shooting there. As of this writing, the mass-murderer managed to kill twenty people on the scene, and wound nearly thirty more, but I expect that some of those thirty-odd will die, or will have died already by the time that you may be reading this. I haven’t looked up an absolute ranking in terms of fatalities and injuries and terror, but this is a massacre which, even in a country largely numb toward these events, was terrible enough that it provoked no fewer than four people to get in touch with me because they remembered that I was in Texas somewhere.

I was in Big Bend National Park during the shooting itself, and so didn’t watch it unfold in the news. I’ve been driving since — I’m in Oklahoma now — and so I haven’t followed too closely since. But I have seen that, as is always the case after a shooting like this, a series of dull takes and counter-takes about what role (if any) “our mental health crisis” played, and how urgently, if at all urgently, we need to “fix mental health care in this country”. Who happens to be fixated on mental health after any given shooting tend to depend on the circumstances of the shooting itself. In this case, it is reactionaries (including the President) who have stressed the mental health angle because the shooter was himself a reactionary. They’ve also raised violent video games, and, I imagine, rap music as possible culprits, which feel a bit like a throw-back affectation, given that “mental illness” was the extrinsic non-firearms-related-factor which largely replaced the Grand-Theft-Auto-and-Eminem explanation over the past decade in virtue of sounding significantly less ridiculous if you needed to avoid talking about NRA money and neo-nazi websites.

Of course, liberals have also trumpeted the “mental health crisis” alarm after certain shootings, which is to say, after shootings where the ideology of the shooter is less transparently attributable to the right. Liberal invocations of the "mental health issue” are less transparently cynical than their ring-wing counterparts, but it doesn’t feel entirely beyond cynicism. Worrying over mental health as a cause of mass shootings can, after all, lend a kind of sensitivity and sophistication to your post-shooting Facebook update that just going on about the NRA for the hundredth thousandth time can’t manage on its own.

Regardless of who is blaming mental illness after a given shooting, they are inevitably met with the woke retort: it’s stigmatizing to be talking about mental illness here at all. These shooters are evil not ill, and in fact, it hurts mentally ill people who are actually did you know like, more likely to be the victim of a violent crime than the perpetrator? to act like a symptom of insanity is buying an assault rifle and shooting up a school. They point out, correctly, than the vast majority of gun homicides are not committed by people with a serious mental illness. But this point is about as valuable as the point that the National Alliance for Mental Illness is making when it points out that actually, the majority of violent crimes aren’t committed by schizophrenics. Which is true. Schizophrenics make up less than 2% of the population. They are not committing 51% of the violent crimes.

I’m on the road and don’t want to dig, at great length, into parsing what we mean by “mental illness” and what we mean by violence. Are we talking about all mental illness, regardless of severity? Or do we mean only “severe” mental illnesses, like bipolar disorder? Only do we mean what most people probably imagine when we talk about “mental illness” after mass shootings, i.e. largely psychotic illnesses which involve elaborate delusions, hallucinations, and bizarre behavior? Are we talking about all violence? Are we talking about all violence plus the non-violent acts rhetorically refigured as “violence” by humanities graduate students? Or do we mean only serious violent crimes? Or only homicides? Or only gun homicides? Or only this particular genre of American massacre: the mass shooting?

(And when we gather these statistics, are they based on patient reports? Police reports? Are we only including those crimes for which charges were filed? Or only those crimes where a conviction was obtained? If a schizophrenic proffers a defense of not guilty by reason of insanity, and this plea is rejected, not because the defendant is a malingerer, but because their illness doesn’t satisfy the strict legal boundaries of “insane” at the time of a crime, do they count as a mentally ill criminal, or is there crime added to the pile of those committed by people without mental illness? What if their illness is only diagnosed after they enter the prison system, and are, for the first time, able to see a psychiatrist at all? Are the statistics updated? Are we sure they ought to be updated? After all, it may have been the extreme stress prison which brought on the first episode, as is often the case, meaning that the illness was not present at the time of the crime.)

You could combine any set of answers to these questions and get a wildly different account of the relationship between mental illness and violence, and I don’t propose to get into all of the permutations right now. Suffice it to say, according to the best meta-studies, people with severe mental illness commit violent crimes at a slightly higher rate than the general population, although these are usually more impulsive acts of violence. Mass shootings, which tend to involve quite a bit of planning, are not the ordinary domain of manic depressives and schizophrenics.

But that doesn’t mean that the mentally ill never commit mass shootings. James Holmes, the Aurora theater shooter, appears to be a clear case of clinical insanity. John Hinkley Jr., who shot Ronald Reagan, was schizophrenic as well, and while his crime wasn’t a “mass shooting” in the traditional sense, it did involve a good deal of preparation and planning. (Indeed, Hinkley was remanded to a psychiatric hospital after the assassination attempt, and back then it was Republicans insisting that mental illness is an ‘excuse’ we ought not to fall for, rather than liberals). The woke scolds are right that handwringing over a “mental health crisis” is a cheap way of avoiding the fact that the vast majority of these crimes are committed by the perfectly sane. But the woke scolds are wrong to pretend that insanity is never the cause of large-scale violence. It is. Every time a shooting like this occurs, it feels as if one gets to choose between believing that “mental illness” is a significant sufficient cause of the American gun nightmare, or believing that mental illness has nothing to do with it at all. But that’s a bad choice. Sometimes they are crazy. Sometimes they aren’t.

There are of course a good number of people who believe that in order to murder dozens of strangers, you must, in some sense, be insane. It’s the same reasoning that gets all serial killers called “crazy.” Very few of them have an actual biological mental illness — for the most part, serial killers are just sadists with a cluster of other undesirable personality traits — but how sane can you be if you chop up co-eds in your cabin? No matter what the doctors say, how sane can you be if you decide to walk into a high school, or a Walmart, or a movie theater, and open fire?

You might think of it like this: all mass shooters are insane. Only a few of them are Insane. The capital-I Insane ones are mentally ill; their trouble is that they are not accurately perceiving reality. They might start firing into a crowd because they’re convinced that everybody in that crowd is an alien, or out to get them, or is already not alive at all. The crime they commit is a tragedy because innocent people are killed, but the Insane murderer does not really know that. If the delusion were true — that is, if it were actually the case that everybody in the room was a dangerous alien on the verge of attack — then opening fire might be the right move. The Insane shooter is reacting appropriately to imaginary circumstances.

The insane shooter, meanwhile, is reacting inappropriately to real circumstances. Their insanity is not found in any confusion in their senses, but in the fact that they correctly apprehend a real fact — let’s say the fact that the United States is home to a great number of Latino immigrants — and conclude that this is a terrible thing that can and should be corrected by the random execution of two dozen people. This does not require mental illness. It only requires exposure to the dominant political climate of the United States and easy access to firearms. The El Paso murderer is, of course, insane. But he isn’t Insane. Maybe the next one will be. Probably not. But sometimes they are.