Depathologizing Rebellion
Medicalizing Behavior
Before we can look at how rebellion is pathologized in American society (and elsewhere), we need to recognize an astonishing fact: the mental health establishment routinely medicalizes behavior. If, according to the highly subjective judgment of a professional, a person exhibits a certain cluster of behaviors, they may be said to be diseased in some way. This practice is central to our mental health system.
We have accepted this paradigm as a society to the degree that we don’t even see how significant it is: we determine whether people have mental illnesses based on totally subjective criteria that can’t be reliably diagnosed.
These behaviors arise in a context and often serve a purpose in that context. What this approach does is it takes people’s experience and decontextualizes it. This makes them powerless to actually deal with the truth of their situation and become whole.
If we’re medicalizing aspects of the human experience, we could, in theory, do so for anything we want. We could say that being Canadian is a psychiatric illness if we wanted to. The American Psychiatric Association considered homosexuality a disorder until the 1970s. Today, grief can be diagnosed as a disorder. Being transgender is also considered a mental illness. It doesn’t seem to me that it is actual science determining what is and isn’t a disorder. It seems to be more about politics, culture, and the opinions of people on committees.
While this practice of medicalizing behavior is taken for granted by much of our society today, it wasn’t always this way. In the introduction to One Flew Over the Cuckoo’s Nest (2002 Viking Penguin edition), Robert Faggen writes that by the 1960s, prominent voices “looked at psychiatry and mental illness as instruments of social purification masquerading as science with little diagnostic or therapeutic value. Therapy meant learning to internalize the moral codes of a particular society, not treatment of an illness.” Since then, the establishment mental health field has consolidated its influence in Western society, to the degree that it is virtually invisible to most of us. (There are still dissenting voices in this area including the online magazine Mad In America, dissident psychologists like Bruce Levine, and spiritual leaders like Gabor Mate and Marrianne Williamson.)
Pathologizing Rebellion
There are countless such behaviors that are medicalized and decontextualized (the DSM lists hundreds of so-called disorders) rather than seen as parts of the human experience. One of these behaviors is rebellion. Rebellion can be pathologized directly with diagnoses like so-called Oppositional Defiance Disorder and Conduct Disorder and can be pathologized indirectly with diagnoses like ADHD, Generalized Anxiety Disorder, and Major Depressive Disorder.
This pathologizing essentially denies the possibility that rebellion may serve a purpose in its context. In general, if you are trapped in a painful, destructive situation, rebellion might help to preserve your connection to your true self. Maybe your authentic needs aren’t being met in some way and/or the context is trying to break you to conform to it.
There are countless possible scenarios in which rebellion is perfectly sane, even healthy behavior. We don’t look at the Revolutionary War as a symptom of Oppositional Defiance Disorder or Gandhi’s civil disobedience as Conduct Disorder. That’s because we see that there are reasons behind these efforts. You could even disagree with these efforts and still see them as not a disease. Of course, I’m not saying that a misbehaving child is the next Gandhi. However, it might be wise to consider the actual reasons behind the behavior, particularly if we care about the people involved. But when we don’t want to look at the reasons or don’t think they are valid, pathologizing is an easy answer that absolves us of responsibility.
If you suffer high opportunity costs for conforming to an environment that isn’t serving you well, you might rebel in order to preserve some of that value. This could be the case in a school system in which intrinsic motivation, creativity, and curiosity are destroyed every day. It could also be the case in an authoritarian family system, where you have to go along with the dysfunction and be quiet about the massive costs incurred.
Probably most people have had an experience where they have to abandon who they are to fit into a context that doesn’t serve them well. And this is why I think it’s important to expand our understanding of rebellion. So far, I have been mostly talking about outward rebellion. But I would argue there is such a thing as inward rebellion. When we are trapped and squelched, inward rebellion might come in the form of ADHD symptoms, addiction, depression, PTSD, so-called behavioral problems, etc. This is what happens when people don’t have an outlet to express what is true for them and make decisions based on their authentic selves.
Why Our Society Pathologizes Rebellion
Maintenance of the status quo fundamentally requires suppression of rebellion. There are a variety of ways to suppress rebellion, and pathologizing is just one of them. Throughout history, ruling power structures have attempted to suppress what they perceive to be disruptive forces by using more directly violent means, as well as more “compassionate” means. But the goals are the same - suppression of change and maintenance of the status quo. Earlier in American history, the more conservative approach to dealing with Native Americans was direct, violent suppression. The more “compassionate” approach was to send them, against their will, to residential boarding schools, where they were stripped of their identity and abused. Similarly, one approach to dealing with women who resisted male domination was physical violence. The more “compassionate” approach was to label them with “hysteria” and treat them psychiatrically to blunt any strong emotional responses to the situation.
And in children today, I think we see a similar pattern. More conservative approaches to rebellious, disobedient children involve corporal punishment. While more “compassionate” approaches involve pathologizing: drugging, labeling, behavioral modification, etc. But both approaches are authoritarian and the goals are fundamentally the same: obedience, conformity, and submission. (I can’t decide if I’d rather be beaten or labeled as feeble-minded.) Most importantly, we’re not even attempting to understand what’s really going on for the individual - what they’re thinking, feeling, and experiencing.
As a means of repression, pathologizing has distinct advantages. When suppression happens through direct force, it often just increases the anger of the oppressed and creates greater risk for those in charge. It also generates sympathy for the oppressed. Pathologizing, on the other hand, does something very different. It tells the victim that (a.) there is something wrong with them and (b.) that they, therefore, need the help that the authorities are providing. The advantage in this approach is that it radically distorts reality. It then heavily frames any response. Any response, other than submission, is interpreted as a symptom of one’s pathology. The pseudo-compassion inherent in this approach obfuscates the ruthless authoritarianism driving it.
Most importantly, any truthful or authentic response to this situation is pathologized and punished. This coerces you into becoming something you are not. All of the following responses may be filtered through the lens of pathology: refusal, commitment to one’s own integrity, further rebellion, and strong emotional reactions like anger, fear, etc. It’s a radically dehumanizing approach that manages to distort reality for those involved and anyone that might be observing. To be clear, I don’t believe people do this because they are evil. They do it because it’s what they know to do and are in denial of the true nature of their actions.
And here we arrive at a key problem: A person, especially a kid, that experiences a mental health professional labeling them and denying their real experience, could have a number of negative reactions to this situation. Because this situation is harmful, they might get upset, they might be reactive, their core emotional wounds might get triggered, and/or they might rebel against the situation. A mental health professional that would ever approach a situation this way is also one that would misunderstand these very sane reactions to the situation. Again, they continue to filter it through the lens of pathology. Even if the patient mounts an intelligent argument as to why this is wrong, the professional can defer to their credentials and licenses, which effectively says, “society gives me this power, so you have to submit.” The professional, again, doesn’t see this situation as inherently authoritarian and dehumanizing, but sees it as “helping the patient.”
As we can see, pathologizing rebellion confuses and gaslights the victim in a very extreme way. This is exacerbated if the victim doesn’t have people around to help them understand the truth of what is happening, which would be helpful in maintaining their sense of reality. (In fact, this is part of why I’m creating these resources here - to validate these experiences and help people heal. Most of us have been alone in these experiences, and we should never forget that isolation is a key tactic for breaking people.)
Conclusion
Depathologizing rebellion isn’t strictly about legitimizing opposition and disobedience. It is about recognizing the opportunity costs that come with drowning out people’s inner compass, authenticity, etc. It’s about recognizing when behavior is a natural response to environments that are out of touch with human needs, emotions, and instincts. And in that context, rebellion serves a purpose. It’s an attempt to preserve one’s potential, authenticity, creativity, uniqueness, or integrity.
Allowing for deviation from the status quo helps to facilitate positive change, virtually by definition. This is true whether we are talking about innovators and creative people, old souls rebelling against dysfunctional family systems, kids that don’t want their inner authority drowned out by an authoritarian school system, or anything else.
