Late last year, in a graduate writing seminar on biography and biographical portraiture, I was talking to my classmates about an ethical dilemma I’d encountered while beginning to plan my final project. I was writing about a man with paranoid schizophrenia whose been incarcerated for over forty years in California for the murders of over a dozen people, and I wanted to quote at length from some of the letters we’d exchanged over the past several months. But this man (who I am still in touch with) has never accepted medication; while his condition has stabilized some from old age and the routine imposed by prison life, his letters were semi-incoherent. I worried that paraphrasing or “translating” them might be patronizing, but that if I simply “let him speak for himself”, without proper context, he’d come off as a raving lunatic, or a joke, exploited by an opportunistic writer. I was asking the class for any ideas they might have about how I could avoid both of these traps while maintaining the integrity of the piece.
A lot of my peers had good suggestions, but one of them was more concerned with my project in general. I hope you’re writing the man and not the disease, she said, because there’s a lot of stigma around mentally ill people. I don’t know if you know this but actually people with schizophrenia can lead perfectly normal lives, and they’re more likely to be murdered than to murder someone else. While she was talking, the room became suddenly quiet and uncomfortable. There were about twenty people there, and it was more or less evenly split between those who knew about my illness and those who didn’t. Of course, the student who raised the concern about stigma was in the dark about me—she thought she was offering some useful caution to a sane, but potentially insensitive writer—and I don’t doubt that her intentions were good. When she was done, I didn’t say much. More or less thanks, and yeah, I know that, but still, his illness is relevant here. Class ended a few minutes later.
In the days that followed I found myself returning to the exchange in my head and sometimes becoming unfairly annoyed about it. I fantasized about saying, Yeah, I agree there’s a lot of stigma out there. For example, there are all these woke liberal graduate students who think we should be more sensitive to the pitiable maligned schizophrenics, who are so maligned, and some pitiable, that they could never, for example, get on medication, and get therapy, and then wind up your now-basically-functional peer in graduate school. I’m glad I didn’t say that. It would have been petty and needlessly humiliated somebody who was trying to be helpful. But what she was doing—or rather, the assumptions which undergirded the conversation she believed that she was in—are part of tension in liberal attitudes toward “difficult” conditions which require “compassion and understanding.” It goes more or less like this: there are members of society — the mentally unstable, the drug-addicted, the frankly weird—who are unfairly maligned for the consequences of conditions which they can’t entirely control. And we ought to be sensitive and merciful and understanding toward them. But that sensitivity and mercy and understanding are really only ever exercised when their objects exist at a sufficient distance; when they are an abstract “social concern”, not people with whom you might actually share an office or a classroom or a friend group. It’s tolerance, so long as it’s somebody else’s job to do the tolerating. It’s patience, so long as people with social work degrees are the ones who need to actually endure tests of their patience, preferably in a clinic of some kind. It’s what I’ve started calling NIMBY Compassionate.
It isn’t surprising that people are more willing to urge kindness and understanding toward the theoretical schizophrenic or drug addict than they are to practice kindness or understanding toward actually mentally ill or addicted people in their lives. As I’ve written here before, the negative consequences associated with illness and addiction are not all just some big, stigmatizing misunderstanding. With the ordinary caveats that this is not true in literally every case, people with serious problems are a drain on those around them. They tend to hurt and betray people who try to help. Even if we leave out extreme cases of escalation to felonious violence, drug addicts steal money from loved ones, they lie about getting clean, they use again and again and again, even when it hurts them and hurts their friends and families. Even if we leave of extreme cases of escalation to full-blown psychosis and violence, people who are paranoid or delusional or suffering from a severe mood episode will be aloof and then lash out. They will accuse those around them of every kind of malicious conspiracy. They’ll ramble and yell about nonsense and make a scene in private or public, say wildly inappropriate things and make wildly inappropriate decisions. They’ll act, sometimes, like frightened animals: terrified and cornered and dangerous. They will be unfair and impulsive and irresponsible; if they didn’t, then these illnesses wouldn’t be half as devastating as they are. It is incredibly hard to love somebody with one of these problems, not because they are unworthy of love, or even because they do any particular one thing which destroys their relationships, but because it is just harder, day in and day out, to deal with the steady grind of uncertainty and struggle and perpetual small harms so often inflicted by people who are unable to help themselves. I don’t want to fall into the tendency I’m criticizing and speak only in the abstract here. During the years between the onset of my symptoms and my eventual diagnosis and medication, the super preponderance of my regrets involve the endless tiny ways in which I drove away people who tried to love me. It wasn’t by hurting them on purpose, by beating them up or stealing their cars or through the exercise of big, distinct, deliberate malice. It was by being weird and unpredictable and unpleasant and erratic and inconsiderate and mean and untrustworthy and suspicious and hostile and rude in tiny ways, day in and day, out until for many people it wasn’t worth the pain and trouble of trying to deal with me anymore. Compassion is difficult. It doesn’t surprise me that it is difficult to be compassionate when the person you are trying to love is eroding your patience a little bit at a time, all the time. It’s much easier to see a homeless man on the streets, clearly insane, clearly high, shouting obscenities and menacing strangers, and think God, people are so judgmental—that man clearly needs help! That man is not going to turn up at the party that you’re headed to. He’s not going to be at work tomorrow. He is not, for the purposes of your life, a person, so much as he’s an example of a political concern.
I don’t want to suggest that those who have a hard time remaining patient and compassionate toward people who are making their lives worse is some catastrophic moral failure. I don’t believe that NIMBY compassion is evil, or reflective of poor character, or even irrational. There are limits to patience and understanding, and often it isn’t worth the cost of caring for somebody who hurts you, whether they mean to or not, particularly if that person isn’t even willing to accept treatment or help (that a refusal to accept that you’re ill and thus a resistance to treatment is a hallmark symptom of mental illness makes this more difficult, and more tragic, but still). But what I am troubled by is a tendency, particularly among the allegedly compassionate and liberal minded, to not just refuse infinite patience and understanding, but to refuse it almost entirely, and to recharacterize this refusal as an affirmative political gesture. We live in a time in which a great deal of moral obligation is being recast as a trap; when a duty to help others, particularly when offering that help does not benefit us and is not reciprocated by its beneficiary, is seen not just as a difficulty but as a kind of exploitation or abuse. We live, perhaps for good reason, in fear of being conned or taken advantage of, and the gut check, more and more, on whether or not a situation or a dynamic is “toxic” is whether or not it requires unreciprocated sacrifice of any kind. This isn’t so troubling if you’re on the right: you conceive all human relationships as contractual, and the goal of human life is to maximize your relative advantage through mutually lucrative contractual relationships with others. But this tendency isn’t exclusive to the right. A great deal of liberal and even left-minded people have come to conceive of social and moral obligations as a kind of trick. They recognize, like the NIMBY-compassionate, that we have some abstract duty to the downtrodden and marginalized and sick. But in their own lives, these kinds of genuinely inconvenient and difficult demands toward care are recast as a scam to be dodged. Sometimes this kind of rationalized selfishness gets referred to as “self-care.” But self-care, in its original and moral form, is a way of consciously attending to your own needs so that you’re better able to serve the needs of others. In the new sense, the second half of that sentence is deleted. It’s a way of transforming exclusive concern with one’s own needs into some kind of radical refusal of all those difficult and sick people who are really just Toxic and Bad and should be Dropped for your own good. We don’t just see this when it comes to the personally taxing, to the drug addicted or the mentally ill. It’s the basis of the endless joke that, for a certain kind of socialist, an abstract commitment to solidarity with workers everywhere inevitably runs into some trouble when they actually meet the workers. It’s the reason that I can attend mass every Sunday, where a hundred parishioners absorb peans to forgiveness and charity and saintliness, and really feel their desire to be Christlike in their hearts, and then go out and be as spiteful and petty and selfish as they were before. It feels good to desire goodness. It’s even easy to wish for it in an abstract way. But it is very, very difficult to practice compassion in the immediate stress and frustration of the moments when its most demanded. There’s a reason it is so difficult to be saint.
I suspect that all of this is an outgrowth of precarity and scarcity and the unbearable pressure of declining capitalism in the west. There are so many unfair demands on our times and so many ways they we are really being exploited and taken advantage of — by elected officials and landlords and bosses — that a degree of sensitivity and paranoia about any situation where we might have to give more than we get back begins to make a certain kind of sense. It begins to make sense, when so much of your time must be devoted to performing labor and enduring difficulty and one-sided relationships just to have enough to eat and somewhere to sleep and medicine when you’re sick, that very few people, even well-intentioned people, have much patience or compassion or willingness to sacrifice left when it comes to those who need their help, but don’t have the power to demand it. When faced with troubling consumer choices, people on the left sometimes joke that there’s no ethical living under capitalism. That’s true, but it’s not just true when we’re forced to buy products we can afford because they were produced under exploitative conditions. It’s true when we’re so drained by the demands of capital that we’re unable to act ethically toward the most vulnerable people in our own lives. Much easier to feel sympathy for the madman on the corner, and say fuck you to the madman and the drug addict and the weirdo in your own life, who has come to feel like just one more taxing hardship in a life already full of them. NIMBY compassion is a consequence of a world built on hierarchies, and if we want to overcome it—if we want, in short, to be as merciful and patient and compassionate and self-sacrificing in our own lives as many of us aspire to be in our hearts—then we’ll need to build the better world, where our energy and our labor can go to those who need it, and not to those who have the power and resources to demand we spend all our willingness to work on making them, and their lives, richer.