In many families, traditions are cherished as the glue that binds generations. They’re passed down like heirlooms: recipes, rituals, phrases, and values—shared touchstones that offer identity and continuity. But not all traditions are benign. Some are invisible threads of control, shame, and conditional love. Some traditions, quietly handed down, teach us not how to live, but how to comply, how to hide, how to endure. How to succeed in an unfair, dysfunctional world.
These inherited dynamics can be hard to see precisely because they’re so normalized. They’re absorbed early, often without question: Don’t talk back. Don’t get too emotional. Don’t bring shame to the family. Mistakes must be punished. Deviance from family values must be corrected. Pain must be kept private. When someone breaks these rules, some families respond with scapegoating, gaslighting, or exclusion. In some, humiliation, manipulation, violence, and threats of violence are considered part of learning a lesson. And in some, even expressions of love can come with strings attached—resources, information, and even genuine affection can be withheld until their loved one “straightens up and flies right.”
What does this have to do with “madness”?
Plenty. Because when we talk about psychiatric diagnoses that are said to “run in families”—like schizophrenia or bipolar—we are still often asked to look at the genes. But the focus on genetics doesn’t tell the whole story. While there may be some genetic component, a growing body of research suggests that epigenetics—the study of how experience can alter gene expression—may provide an even more nuanced understanding of how traditions of distress are inherited.
Epigenetics refers to the way external factors, such as trauma or stress, can alter the expression of genes without changing the genetic code itself. These changes can affect how we respond to stress, regulate emotions, and develop mental health conditions. Rather than just focusing on inherited genes, we need to consider how early experiences, especially those within families, can influence epigenetic changes that impact mental health. For example, trauma or chronic stress can leave epigenetic marks on genes involved in the stress response, emotional regulation, and brain development, predisposing individuals to psychiatric conditions. This suggests that mental health conditions may not only be passed down through genetics but also through the inheritance of trauma and environmental influences embedded in family traditions.
Mental health, like lived experience, doesn’t exist in a vacuum. The familial and societal environments we grow up in profoundly shape how we experience and express mental distress. Consider the old school advice for housebreaking pets: “rub their nose in it: bad dog!” Though now a debunked theory of housebreaking, it’s been metaphorically applied to human correction, too. At its core, it’s about using shame and punishment as a tool for correction.
Though often justified as “tough love” or discipline or training, the real outcome is emotional harm. It sends the message that love and acceptance are conditional—that you’re lovable only when you’re conforming, not when you’re simply being yourself. And maybe it’s unfair to rub someone’s nose in the family’s mess in the first place.
With dogs, most experienced trainers will tell you that rubbing their nose in feces or urine doesn’t help housebreaking. It breaks trust. It causes confusion. It triggers stress and anxiety, and may lead to avoidance or even aggression. It may lead to suppressing natural signals. Most importantly, it fails to teach the behavior you actually want. The lessons being learned are not the lessons being taught. Still, some traditions die hard.
Families pass these patterns down not only through direct actions but through silence, denial, and implicit agreement. The phrase “That’s just how we do things” becomes a shield against reflection. Attempts to question or reject these traditions are often met with resistance or scorn. The one who pushes back may become the black sheep—the “troubled one,” the “problem,” or eventually, the “mentally ill.” Such responses highlight how deeply ingrained these traditions are—and how deeply resistant to change.
Could it be that what psychiatry calls madness is, in some cases, a natural rebellion against being shaped by these harmful traditions? A form of internal protest against the unbearable pressure to conform, to be silent, to carry the emotional load of generations without breaking?
The Impact of Early Relational Trauma
Some researchers have studied how early relational trauma—especially chronic emotional abuse or neglect—shapes brain development. Martin Teicher’s research emphasizes how early emotional and physical neglect can cause long-lasting psychological harm, influencing the development of mental health in adulthood. Similarly, the World Health Organization’s 2025 guidance on mental health reform underscores the importance of addressing the social and structural determinants of mental health, including adverse childhood experiences (ACEs). These experiences, which often occur within the family unit, significantly correlate with increased risks for psychiatric conditions, substance use, and chronic illnesses.
Rather than focusing on individual pathology, it may be useful to consider the intergenerational transmission of trauma. Families often pass down emotional and behavioral patterns that affect not only their immediate relationships but also their children’s capacity to cope with the world. When children grow up in an environment where emotional distress is hidden, conflict is suppressed, and compliance is demanded, they internalize these norms, which may later manifest as depression, anxiety, or other “mental disorders.” The body and mind, in their struggle to survive these oppressive traditions, can rebel in the form of what is clinically labeled as “madness.”
This brings us back to the familial context in which these patterns develop. For many, these contexts are shaped by family traditions that prioritize control over emotional health, or silence over vulnerability. The unspoken expectation that children should bear the weight of these burdens can set the stage for future psychological struggles.
The Pathologization of Family Systems
Yet, our cultural default is still to pathologize the individual, rather than examining the social and familial systems they emerged from. By focusing solely on individuals’ professional or arm-chair “diagnoses”, we overlook the environmental factors in which individuals are embedded—particularly in the family environment.
In line with the 2025 WHO guidance, we need to adopt a systemic approach to mental health that takes into account the full scope of a person’s life, including the intergenerational dynamics at play. This approach emphasizes the need for multi-sectoral collaboration and the addressing of social and structural determinants, which include family dynamics and traditions. Families, in many cases, are not merely a source of comfort and support but also a breeding ground for dysfunction, unhealed trauma, and emotional neglect.
The socialization that takes place in family settings can foster resilience and healthy emotional development, but when these environments are laden with shame, emotional deprivation, or neglect, they become breeding grounds for the distressing conditions that become diagnosed and treated. To address the root causes, we need to look beyond the individual at the larger systems they are part of—including the family and cultural frameworks that shape one’s sense of self.
Hidden Sources of Distress in the Family Tradition
“Madness” might sometimes be a natural response to unnatural expectations and punishments embedded within family traditions. The very customs we prize as “family values” often developed as survival or success mechanisms within a broader context of societal dysfunction—and rather than protecting us, they can become hidden sources of distress that ultimately fuel what we call madness. For example, when a family’s survival hinges on maintaining a façade of perfection or strength, any deviation from these ideals can be seen as a threat to the family’s identity and cohesion. Consequently, individuals who do not fit this mold—whether due to emotional sensitivity, mental health struggles, or simply non-conformity to dysfunctional societal norms—are often scapegoated and labeled as the “problem.”
For those who suffer under the weight of these contradictions, the deepest wounds come when loved ones—those who should know better—side with the mainstream narrative. And become the face of it. Instead of offering refuge or understanding, they reinforce the very norms that cause harm, becoming instruments of dysfunction in the life of someone they claim to love. This betrayal cuts deeper than societal rejection because it cloaks itself in concern and duty, masking compliance with cruelty.
To speak of this is not to blame families, but to open space for truth. Often, these traditions were born out of survival—out of the desire to adapt to societal pressures or to avoid stigma. Or perhaps out of a drive to be “winners,” in keeping with the family tradition of success. They may have been passed down from previous generations shaped by war, poverty, or societal repression. But if we don’t examine and interrupt them, we risk preserving harm in the name of heritage.
Inherited Roles and Expectations
We inherit more than genes. We inherit stories, roles, expectations, and the means by which love is earned or denied. Reform of mental health systems involves recognizing the intersectionality of various factors, such as family dynamics, cultural practices, and socioeconomic status. Inherited patterns might shape how individuals experience the world and their sense of agency in it. The pressure to conform to family roles or expectations, often learned in childhood, can be a significant source of psychological distress, particularly when those roles are rigid or toxic.
If we’re serious about understanding human distress—and building more humane responses to it—we need to look beyond the individual. We need to consider how so-called family values can sometimes serve as vectors of trauma. These traditions—often rooted in outdated notions of discipline, control, and shame—can prevent individuals from fully embracing their authentic selves, which is essential for mental health and well-being.
Maybe healing begins with a new tradition: listening. By fostering spaces where individuals can share their experiences, unmasking the hidden wounds passed down through generations, we can begin to challenge the conventions that limit our growth. Healing begins with listening, but it also begins with examining the traditions that have long been accepted without question. Are these traditions protecting us, or are they subtly creating the very conditions for distress that we label as madness?
Thanks Dan, great article and a very important topic. Psychiatry has little interest in how dysfunctional and narcissistic family systems play a role in a person’s mental health. They are not interested in any context and would rather pathologize and blame the person coping with familial emotional abuse and scapegoating than put blame where it belongs – on family members or environments that are inflicting scapegoating and emotional abuse.
I had to deal with a shocking ordeal of this type while I was in cancer treatment, very physically ill, bald, underweight and dealing with adverse effects from chemo drugs, including vertigo, tinnitus, profuse daily nosebleeds, chemo/steroidal induced insomnia and a head injury after falling due to weakness and lying unconscious bleeding from a head wound requiring stitches and CT scan.
I recently found the work of Rebecca C. Mandeville, LMFT, CCTP who has coined the term Family Scapegoat Abuse (FSA) to describe this type of mental and emotional abuse. She is on YouTube and also Substack at Uncovering Transgenerational Grief, Loss, and Trauma. Her work has been very helpful and validating in trying to heal from the burden of family scapegoating and as you stated to unmask “the hidden wounds passed down through generations”.
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I recall a study done in recent years where volunteers went in to interview kids in residential treatment centers. Over 80% of the kids identified traumatic experiences as a major factor in their lives (willing to reveal this information to total strangers), but something like only 20% had such events recorded in their notes or files!!! So either 60% of the kids knew they’d been traumatized and none of the staff ever bothered to asked them about it, or else 60% of the time, the staff didn’t regard these facts as relevant to the child’s treatment!
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Steve, wow that is shocking and such ignorance goes to show just how little attention is given to context and root causes.
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You’d think it would be the first thing you ask them, right? And of course, most of the 20% that didn’t share probably had traumatic experiences as well, either not wanting to share it or not realizing it was traumatic based on it being what they were used to. I’ve found traumatic exposure to be almost universal in the foster youth that tend to occupy these homes. How can we ignore that fact?
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Nice. When the question is, “What’s wrong with that person” (here, a treatment center resident), the answer invited by the question involves explaining what fault (or “illness”) the person has or what “poor choices” the person has made.
A better answer would question the question. It’s poorly framed. What’s wrong might be the expectation that the person should always be “normal” and behave “normally”—like everyone else—after being shaped by biological realities and (uncommon) abusive lived experiences beyond their control as their “normal” introduction to life.
When they try to tell their truth, it’s so easily dismissed as manipulation, exaggeration, “playing the victim card” by those focused upon and empowered to answer the question about what’s wrong with the person.
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The questions asked reflect the intentions of the questioner. If one really wanted to help, asking about what happened would be the natural first step. A semi-enlightened 8 year old child knows this. The adults should know better. They do know better, but their intention is not to help but to control.
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What about those who know much of what happened (having witnessed it or participated in it), but join everyone else (or even lead the charge) in wondering what ever could be the problem?
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Unfortunately, psychiatry plays right into this dynamic. I saw it many times working with foster youth. The kid is blamed for acting out when clearly s/he is reacting to horrible parenting or abandonment. They are told they have a “chemical imbalance” because they are upset or depressed or anxious about their clearly unstable and unsafe situations! And the psychiatrists generally play right along.
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Or, if the person starts smoking regularly or using other drugs—as people with high ACE scores are KNOWN to do at significantly higher rates—their troubles are then blamed on the drugs. The focus shifts to addiction. Or (as you say) untreated “mental illness” awaiting proper “diagnosis and treatment.” Anything to avoid recognizing deeper responsibility, while ignoring the stigma they affix with every story told, all while remaining in a blissful state of denial.
“It must be the drugs! It couldn’t possibly be the abusive upbringing, the unconditional tough love, or all the oh-so-responsible, diligent efforts to ‘help.’ We tried everything—we even recruited everyone who would listen to our narratives to join in our effort to ‘help’. So obviously, it must be the druuugs!”
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Additionally, antipsychotics lead to increased smoking, as they reduce dopamine and cigarettes increase dopamine slightly and so tends to reduce side effects.
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Or, 60% of the time, the staff didn’t see the experiences as traumatic. I work in substance use recovery and many’s a times, the staff’s ‘normal’ is just as traumatic as the client’s ‘normal.’ Staff may tend to minimize to avoid their own ACE’s.
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60% though? Seems like a lot of “normalizing” going on there. Hard to believe it’s all a matter of unconscious bias. I think it mostly has to do with intent. If you don’t want to deal with trauma, or don’t know how to, you try really hard not to see it.
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Intent reveals motivation. Intent reveals character. It runs through everything.
Bias it ain’t.
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OXYMORON DETECTED: “tough love”
REAL love can never be “tough”.
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Just to add the link to the website of Rebecca C. Mandeville if anyone is interested in more information on FSA.
https://www.scapegoatrecovery.com
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Thanks Rosalee, and for your earlier comment, too
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About scapegoating, I can offer this:
In families with a scapegoat, it may often be the case that at least one member learns how to subtly provoke or manipulate while maintaining plausible deniability. This person might “poke the bear” by undermining, gaslighting, or baiting the scapegoat, then feign innocence when conflict erupts.
Because the scapegoat is already perceived as “the problem,” their emotional reactions reinforce the narrative, while the instigator is protected by their composed or sympathetic or even “protective” façade.
This dynamic lends itself naturally to sibling sabotage—especially in families where image management, hierarchy, or favoritism are part of the unspoken rules. The “golden child” or “innocent” siblings might weaponize trust or social perception, knowing the family (and often outsiders) will side with them. It’s a survival strategy within a dysfunctional system: “if someone must be cast out, better them than me.”
This behavior pattern mirrors larger social dynamics too—how people in groups sometimes isolate one individual through subtle provocation followed by group reinforcement, all while claiming to just be “reacting” to that person’s behavior responsibly.
“Don’t encourage, enable, or even react,” urges the conventional wisdom—leaving the one(s) self-empowered by dispensing this wisdom the ones being reacted to (and encouraged and enabled).
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This is spot on Dan. Re: provoking and gaslighting – my eldest sisters did a lot of that and even when I was in cancer treatment. They didn’t want to be helpful or supportive and I had no problem with that as we were mostly estranged due to their scapegoating behavior. However they chose to provoke instead telling me “oh just quit the chemo and prepare to die” (as the best way to resolve the adverse effects I was having from chemo) and then stating to me when I did decide to quit chemo “well, you better find a way to finish chemo or you are going to die a slow, and VERY painful death from cancer”.
Some scapegoating with a little sadism thrown in for good measure.
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The true masters of manipulation can recruit others to agreeably or unwittingly corroborate their manipulation; it’s especially effective if done under the guise of “helping” or “protecting”.
The masters are good, too, at projecting their own manipulative intentions onto another, while convincing others to overlook their own manipulations and to focus on viewing the scapegoat as a manipulator.
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Being a scapegoat and being the target of gossip, judgment, and blame all go hand in hand. I’ve noticed that the popular label “narcissist” often gets thrown around to pathologize whoever stops playing along with the family (or societal) script—particularly a scapegoat.
Here’s a recent example that speaks volumes.
Some context: I have limited contact with my mother and no contact with my siblings. For years, sharing the details of my struggles has been a family pastime—an armchair psychiatry group project disguised as concern. They tell just enough of each story to make sure I’m seen as the full author of my misfortunes. My life, though I wish it were private, has become public property—used to bond over arm-chair diagnoses, judgments, and homegrown interventions. (Professional help? Tried that. Now even my refusal is another symptom.)
So when I do speak to my mom—the only point of contact left—I’m careful. Guarded. Because I know whatever I say can and will be shared freely with the family tribunal (and beyond).
But today, she gave me “family news”: my sister has lost hearing in one ear. She also mentioned that her own hearing isn’t great. I paused. I wanted to be polite, but I also didn’t want to violate my own sense of fairness. If I press for details about someone who would gleefully spread mine, am I not reinforcing the very dynamic I resent?
So I chuckled—awkwardly—and said, “I don’t know what to say.”
That was it. My mom grew cold. “I don’t want to talk anymore,” she said, and hung up.
I called back and tried to explain: “It’s not that I don’t care. It’s not that I’m a narcissist. If I press for details about her troubles, I feel I’m inviting or entitling her to press for mine. And I’ve learned the hard way what that leads to. It’s that I don’t want to violate fairness. I went no-contact with her for a reason and pressing for details about her seems wonky. It seems dishonest somehow to press for details about someone else when I know that I don’t want them pressing for mine.”
But she cut me off. “Well, I thought you could show some interest in your siblings,” and hung up again. Her mind was made up, she’s been programmed very effectively to view my every action and response as “bad”. It’s a great example of how her programming prevents her from hearing me.
I called once more—just to leave a message—but she blocked it.
This is dishonest harmony in action. I’m expected to perform interest, empathy, connection—while my own feelings, pain, or even reasoning are dismissed as symptoms. My discomfort is rebranded as narcissism. My silence is taken as indifference. All I ask not to be talked about but that’s of course the one thing that can’t be done.
They act shocked by my guardedness, but it’s not rooted in arrogance or narcissism—it’s self-preservation. It’s not that I don’t care or feel. It’s a habit born of self-preservation, not disinterest. My family has demonstrated time and again that they’re quick to share with whoever will listen any evidence that I’m crazy and need to be continually monitored and controlled. (Gee, what could go wrong?) So I don’t press for details because I don’t want them pressing for my details. It’s that I’ve learned what happens when I let them in–it can cause some very serious mental distress.
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Dan, that certainly is difficult to deal with, to be put in a “damned if you do, damned if you don’t” situation. That seems to be another tactic of families who scapegoat. I can relate to not wanting to share any information with my older sisters as to health issues or misfortunes etc. Scapegoating families like to twist any problem or misfortune into something to use against you. Best to keep them out of the loop.
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The United States and other countries abd throughout human civilization has always made a show of supporting children but in essence no not at all. And the same for families. Every time there is a bolt of concern about children and some gains then backsliding. So the work of Florence Kelly is forgotten and there is the horrors imposed on the indigenous and enslaved families and children. Women and children seen as chattel or pawns to be used. If one reads the lives of female aristocrats they were basically pawn in a multi monarchy game of chess.
This is good to discuss and to see. We really need several visual and graphic timelines to see who , what, when, where, and how this all played out in global history.
We still are living in the echoes and shadows of old times depending what our family roots are.I still think Selma Fraiberg’s essay Ghosts in the Nursery is seminal and seeing the parents who hurt and harm are coming from a life where they were hurt and harmed as well.
And if support systems are weakened or taken away that makes a hard situation even worse.
We need a system and systems of support that highlights TLC in the best way abd understanding possible.
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Agreed, Elsewhere, thanks for the comment
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never ever ever seen a “schizophrenic” who wasn’t clearly abused and continued to be preyed on by the most extreme disgusting narcissistic family dynamics. The imprints of this family dysfunction can be seen in the other “healthy” siblings as well far far away from any context having to do with the identified patient, isn’t this just a little too much corroboration of the dysfunctional family narrative? I’ll certainly spend a good proportion of my life’s efforts trying to bring back the concept of the schizophrenogenic mother. Was it unfair and sexist to focus so much on the mother? Yes, only in that the norms of older time periods normalized the neglect and abuse of the equally damaging schizophrenogenic father, while giving disproportionate caregiver responsibility to mothers.
The extent of the abuse is so clearly proportional to the resulting later pathology, but this is not something that can be easily quantified by survey scientists who dismiss anecdote, but call the anecdote distilled into numbers by a quack “scientist” data. This proportionality can only be seen basically, by basic honesty. Of course, honesty is the one true enemy of the abusive family, and pathological lying and gaslighting certainly one of the defining pillar characteristics.
Although I can appreciate the diplomatic nature of “To speak of this is not to blame families”, from what I’ve seen, families are almost always nothing short of to blame, and continue to be extremely abusive and scapegoating. I’m reminded of Bertram Karon who similarly said the parents are not to blame and are victims themselves. Only a few pages before or after was it that he detailed the mother who put her 5 or 6 year old sons hand on a hot stove as discipline, or the father who anally raped his own son. Again, I can understand this euphemistic speak when dealing with such a charged and taboo topic as mommy and daddy driving their child insane, but forgive me for not being nearly so generous about what can only be described as pure evil.
I do believe mommy and daddy are victims too and narcissism itself is a part of the cycle of narcissistic family abuse obviously. But when faced with either the millionaire engineers and their bully budding narcissist engineer son living in cushy suburbs vs the quasi homeless scapegoat who attracts hate and bullying from all sides, I’m tempted to level the favorite nonsense refrain of our extremely ableist society “mental illness may explain but does not excuse behavior” towards the powerful party, not the scapegoated insane. I’m far from a no excuses kind of person, but I do think that the sadism and intentional abuse of the narcissistic parent is vastly downplayed as a subconscious reaction in turn to the narcissists own trauma. Many children of narcissists have noticed the duper’s delight subtle smirk and drastically different public face of this type of bewildering parent. On the other hand, I do truly think many schizophrenics find themselves in a place of truly losing their reasoning and finding a state of diminished responsibility, a fact that is ignored not by the “logical morals” of the sane majority, but because of course the ableist society would nickel and dime the untouchables for responsibility and blame points. Also, this responsibilism is typically leveled not for violence, but for extremely petty reasons and to justify social exclusion (“I just treat him like anyone else, and he’s being weird”). Essentially, for violating the thou shall not act insane clause of polite society. I’d go as far as to say there have even been murders where I don’t really blame the insane for what happened. Not that the violence wasn’t extremely tragic regardless.
Of course even in this (what I consider more realistic than the biogenetic, yet unsubstantiated psychiatrized nonsense) psychosocial narrative of etiology, there is the complication that the schizophrenic does somewhat frequently become the schizophrenogenic parent. I guess my sympathies typically lie with the disabled in an impossible Jim Crowe world that truly hates the disabled. However, of course when there is scant good rehabilitation for the insane available, some of them will repeat the cycle with their own children. I would never tell a child who’s parent was acutely psychotic for much of their early development to simply forgive in an uncomplicated way.
And of course, this isn’t to say people should be trigger happy with blaming parents either. There are other ways to become extremely traumatized, and every family and every individual is obviously different. But the ignoring of blatant and severe trauma, while allowing the diagnosis and accompanying biogenetic lore to cover up this trauma is ridiculous. This disclaimer aside, from what I’ve seen and read about, along with personal knowledge of how insidious and covert these dynamics can be while simultaneously being 10/10 abusive, I’d be willing to bet that 95% of schizophrenics had at least one extremely narcissistic caregiver. And that’s a conservative estimate. On my riskier days I wouldn’t even feel all that risky putting out a number like 99 instead of 95.
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Parents can also traumatize their children unintentionally, either through unavoidable events like early hospitalization, or simply unconscious personality traits that lead to feelings of abandonment or insignificance on the part of the child. My mom was a perfectly nice person but did not attach well to her babies due to her personality. Nothing mean going on, she just wasn’t able to be there and it affected me very significantly. I could say “it’s not her fault” but it still messed me up pretty badly!
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Thanks, Jakob, nice comment. I appreciate your appreciation for my diplomacy and I don’t disagree with what you said there. It’s just that blame is a hard one. It can’t rest solely upon a family because the family members’ beliefs are shaped by forces outside of the family tradition—to some degree by the community the family is part of.
But it can’t rest solely with the community, either, because the beliefs common in a community are shaped by the broader political, economic, social, and religious institutions and systems upon which community beliefs are predicated (or to which individuals’ beliefs within the community have been commonly indoctrinated via state/national/international programming).
Personally, I think it’s these broader (dysfunctional, loveless) systems of governance that are ultimately to blame for much of human suffering.
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Great blog, Dan. Here’s what hit home for me:
“With dogs, most experienced trainers will tell you that rubbing their nose in feces or urine doesn’t help housebreaking. It breaks trust. It causes confusion. It triggers stress and anxiety, and may lead to avoidance or even aggression. It may lead to suppressing natural signals. Most importantly, it fails to teach the behavior you actually want. The lessons being learned are not the lessons being taught. Still some traditions die hard.”
Yessireebob! And makes me think of this: patients are the dogs, psychiatrists are the dog catchers, and their labels and “medications” are nothing more than urine and feces!!!
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Thanks, Birdsong. Glad you liked!
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You’re most welcome, Dan. I’m always happy to read your stuff! 🙂
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Dan, I had given the link to your article above to a fellow on Substack as I felt he would find it helpful. Just wanted you to know he certainly did, and calls you a “modern day shaman”.
He posted this regarding your article…..
“thanks so much to Rosalee for passing me this deeply insightful article. more and more in the last 13 years ive felt this to be the case but i dont have the vocabularly this pioneer has. ,,(id call him a modern day shaman who are sorely lacking even in psychotherpaist and psychiatric circles regretfully where they are needed more than ever)”
Thanks again Dan and I hope you keep writing!
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Wow! Thanks! Glad it resonated and thanks for letting me know
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Very true. My family on both sides has generations of horrific trauma. I think I got a “watered down” version of it but it still did long lasting damage to me. I feel like I can’t escape it, and part of it is my fault. I’m a believer in determinism (to an extent). I know I can choose to take certain actions, but I know that absolute free will is impossible. We can’t will ourselves to grow wings, after all. I think that personal worldview has me locked into the notion that because I grew up abused, I will always be “wrong” in some way no matter how much I try and change. I never had the opportunities mentally healthy children had, and since my foundation was corrupted from the beginning there’s no way I can build it up solid. Our poor dog is afraid of certain types of people now because one person decided it was a good idea to use “tough love” and now he’ll neve be ok with them. What are we but animals too intelligent for our own good?
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Thanks for the comment. Nice. Maybe we’re animals who’ve grown too big for our systemic britches—imprisoned by a tradition of honoring dysfunctional systems that deny natural freedoms and relationships in favor of conformity to a false collective identity?
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Thanks for writing this. Personally I think a huge part of my madness was caused my repressing of emotions, which I learned in my traumatic childhood.
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You’re very welcome. A traumatic childhood can certainly set a person up with a hard row to hoe in life. I’m glad if any of my words help. Thanks for commenting
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Dear Dan,
The current scientific literature lacks empirical support for the biological existence of any so-called ‘mental disorder’ (CEPUK, 2025), and the notion of ‘mental health’ has been critiqued as a construct lacking concrete validity (Szasz, 1961). However, you propose that “Mental health, like lived experience, doesn’t exist in a vacuum,” implying that categories such as ‘mental health’ and ‘mental illness’ are legitimate constructs. Could you clarify the theoretical framework or evidence underpinning your assertion?
Kind regards,
Cat
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Hi Cat, I appreciate your point and I have no defense or clarification to offer. I guess I use the phrase to communicate, even with those who might also know it’s an “off” term but “know what I mean”–especially those in the “mental health” industry. If I had used the term mental wellness or mental comfort or general well being, would those be preferable? Rather than “mental disorder” (and the theory-laden baggage that comes with it), I often use the term “mental distress”. When talking to people who refer to the phenomena Szasz might call “problems with living” instead as “mental disorders,” I sometimes might use their language just to (roughly) communicate while fighting other battles. Does that help? How would Szasz convey the concept of someone who isn’t experiencing “problems with living?”
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“Problems OF living,” not “problems WITH living.” –Having misquoted Szasz (of whom I am no expert by any stretch although I have a lot of respect for much of his thinking).
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Dear Dan,
Thank you for your response. It is essential that we refrain from using the terminology associated with oppressive systems as we continue our efforts against psychiatry. I propose we adopt the term “social distress,” which I believe is more fitting for our discourse. This terminology avoids the pathologisation and re-victimisation that are reinforced by our current detrimental framework. Moreover, it effectively shifts the focus of accountability onto societal structures, identifying them as the fundamental sources of individual suffering.
Kind regards,
Cat
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“How would Szasz convey the concept of someone who isn’t experiencing “problems in living”?
Good question. How about this: mentally unburdened?
And why not replace the overused – and often misused – term “narcissist” with intentionally manipulative and/or antagonistic?
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Apparently I still didn’t have the preposition correct: “problems IN living”. That seems better, thanks.
“Mentally unburdened” sounds good–would that include anyone who is blissfully well-adjusted to a dysfunctional world (and capable of not letting it burden them)?
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Good question… I don’t know enough about Szaaz’s way of thinking to know whether or not he would consider being “mentally unburdened” as including being “blissfully well-adjusted to a dysfunctional world”, although I tend to think he would most likely consider such a disposition as on the dissociative side of things…especially if someone is capable of NOT letting the world’s dyfunction burden them…
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Dear Birdsong,
Thomas Szasz argued that the concept of ‘mental illness’ is fundamentally an illusion. In his work, he further suggested that the idea of ‘mental health’ is equally fictional. He described problems in living as arising from biological, economic, political, or sociopsychological factors. Consequently, I believe it is unlikely that he would have classified anyone as “dissociative,” as he deemed such categories to be “scientifically worthless and socially harmful” (1961).
Kind regards,
Cat
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Thank you, Cat. I agree with Thomas Szasz that the idea of ‘mental illness’ is fundamentally an illusion.
And I like your term ‘social distress’. Much better to stay grounded in reality than indulge in psychiatry’s pathologized rhetoric.
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I love the title “Family Traditions and the Inheritance of “Madness” because I also believe family is the place where most psychological wounds and personality “dysfunction” begins.
Families can serve as a breeding ground for unhealthy power dynamics, which can include parental neglect, usually spawning subtly adversarial relationships between family members, where taking a reasonable stand against mistreatment can result in being labeled “the problem child”, or, worse yet, the much uglier “diagnostic” label of “narcissist”.
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Clarification: I believe that family is often the place where many—but not all—psychological wounds and so-called “personality dysfunction” begins.
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