European Journal of Communication, v.26:3, September 2011
Madness, Power and the Media: Class, Gender and Race in Popular Representations
of Mental Distress, by Stephen Harper, London: Palgrave McMillan, 2009, 240 pages,
ISBN: 0230218806/978-0230218802
In 1997, the World Health Organization warned of a pandemic of mental illness, and
mass scale epidemiological studies backed up the warning. Approximately 1 in 4
people suffer mental illness during their lifetime, and it is likely that these figures will
increase. Between 1990 and 2000, diagnoses of mental illness in Western countries
more than doubled, and WHO predicted that, by 2020, mental illnesses will be the
most significant Western health problem after heart disease, and will be the primary
cause of disability. Based on the premise that intervention in the cultural sphere will
positively affect mental health, lobby groups, health agencies, service users and
groups such as Mental Health Media repeatedly call for legislation to ensure ethical
media representations and anti-discrimination policies.
The media is the public’s main source of information about mental health and
disability, yet the majority of media images of mental health play on negative
stereotypes. Groundbreaking research in the 1990s by the Glasgow Media Group
established that representations of mental distress have tangible and powerful social
effects (See: Philo, 1996). Concurrently, research by the American Psychiatric
Association confirmed that film and television are the primary modes of
dissemination of information about mental health to the Western public (See: Wahl,
1997; Heaton and Wilson, 1995). Images of mental distress on film and television can
and do affect the construction of, and actual experience of, mental distress:
sensational, stereotypical, and derogatory images reinforce discrimination and
misinform, whereas empathic, realistic, and positive images challenge stigma and
educate.
As diagnoses of mental ill health increase, representations of mental distress have
proliferated and the cultural face of mental distress in the west has undergone
profound shifts. Nonetheless, the literature on mental health and the media stems
mostly from the 1980s and 1990s before the full impact of ‘care in the community’
polices, new pharmaceutical products such as SSRIs (Prozac etc.) and Ritilin,
cognitive behavioural therapies and self-help industries transformed the discourse of
mental distress in the west. These discourses have come to structure the organization
of mental wellbeing in late capitalism. Stephen Harper’s Madness, Power and the
Media is an urgently needed book in that it offers a new way of thinking about media
images of mental distress and updates important but outdated literature on the topic; it
is tasked with covering a vast array of contemporary images, theories and critical
analyses in this fascinating and significant field.
Images of mental distress appear throughout history in media texts from the Bible to
Big Brother, Shakespearean tragedy to TV drama, art cinema to talk TV. The
contemporary critic has to survey this array of representations and to map out
tendencies, as well as account for paradigm shifts - such as the recent trend for
ostensibly ‘positive’ images of mental distress. It is the work of the contemporary
cultural and media critic to analyze why images of mental distress hold such
fascination for media-makers and their audiences, and what function images of mental
distress have in structural discourses of white western capitalism, democracy and
patriarchy.
Historically, ‘madness’ described actions, beliefs, and experiences that deviated from
shifting definitions of normal, right and good. The concept of ‘mental distress’,
however, places emphasis on personal suffering and not on the expression of that
suffering. Taking into account the complex inter-relatedness between psychological,
biological and social models of mental health, Harper’s Marxist analysis of media and
mental distress asserts: “madness is best understood in relation to its social, political
and economic contexts rather than the medical model of ‘mental illness’” (1). His
book emphasizes the importance of paying very close attention to the social and
media contexts through which popular images of mental distress are produced. It
outlines many of the habitual uses of mental distress in popular culture, arguing that
‘classic’ media forms such as newspapers, magazines and cinema function alongside
new genres such as reality television and the internet. Harper’s extremely thorough
grounding in not only existing literature on mental heath but in critical and media
theories affords the book a substance often lacking in straightforwardly anti-stigma
studies, or those that adopt the ‘hypodermic syringe’ model of the cultural
dissemination of discourse.
Harper’s chapters on cinema and television show how, alongside the dramatic rise in
mental illness diagnoses and in consumer-capitalist drugs, products and therapies,
there is a contemporary shift in emphasis in the media from mentally disturbed
antagonists that are constructed as wholly Other to protagonists with whom the
audience is able and encouraged to empathize. Contemporary representations of
mental distress are increasingly focused on awareness raising, first person narratives
and anti-stigma campaign. One of Harper’s most intriguing arguments is that there is
a strong case to be made that these ‘new’ images of mental distress are no more
helpful or realistic than those of previous decades. Daytime talk shows like Oprah
Winfrey use psychotherapy and psychology to talk openly about personal problems.
They then appear to rapidly resolve those problems in a pseudo-therapeutic formula in
which public exposure is a key to recovery. Biopics, usually of artists, habitually
structure the narrative and character arcs around a significant crisis or creative illness
as part of the individual’s psychopathology. In films such as Shine, psychological
collapse propels the subject’s talent, reinforcing the cliché that mental illness is a
precondition of creative genius and stardom. This shift toward the positive is also
observable in the news media, such as the public outcry in 2003 when The Sun
reported the boxer Frank Bruno’s mental breakdown in the headline “Bonkers Bruno
Locked Up”. Public and health agency reactions were so swift and unexpectedly
vociferous that the newspaper hurriedly changed the headline to “Sad Bruno in
Mental Home” just in time for the evening edition.
Rather than adopt straightforwardly good/bad analyses, Harper’s critical work
involves an un-cynically skeptical stance towards “positive” images of mental distress
in that they can reproduce unhelpful and stereotypical ideas about mental distress,
reinforce the biological and individual model of mental processes. These images
endorse the ‘disease industry’ promoted by drug companies and health agencies, as
well as ‘eudemonics’ - the ‘positive psychology’ or happiness industries that place
responsibility for mental wellbeing and productivity squarely at the feet of the
individual subject of capitalism, rather than the socio-political and discursive
structures in which that subject is formulated and exists. His book, then, seeks to
understand how public images of mental distress and recovery are mediated via
ideological discourses of race, gender and social class; “positive” representations of
mental distress and recovery can be vehicles for consumer capitalist ideologies that
emphasize personal, but not social, disorders.
While we should not dismiss the consolatory role that media figures such as
celebrities can play in stigma reduction, Madness, Power and the Media also explores
the ways in which ‘real life’ scandals about celebrities’ mental distress reproduce
patriarchal gender roles. Narratives of celebrity confession portray male stars as
reconstructing their own sanity in courageously therapeutic acts of agency. Madness
is a culturally acceptable expression of “essential” masculinity as well as of the
rhetoric of artistic genius. In contrast, female celebrities’ revelations of mental
distress are narratives of failure that undermine their creative agency and diminish
their cultural power.
As Harper’s book demonstrates, the work of being a mentally healthy and productive
“self” is intrinsic to the class, race and gender structures of western consumer
capitalism. Contemporary consumer culture is increasingly moving towards
medication, as well as compulsory self-articulation and expression. Harper earnestly
notes that ‘madness’ as unreason has been, and continues to be, a neatly dismissive
and dangerously oppressive accusation leveled at political radicals in order to
pathologize dissent. Functioning to preserve capitalism and structural inequality, the
mainstream media associates the ‘loony left’ with the mentally distressed, positioning
both as threats to democracy and to the very fabric of social order. The paradoxes that
underlie contemporary images of mental distress and the social organization of
psychic experience is linked intrinsically to the complex web of individual, economic,
social and political discourses of late capitalism. Anyone interested in representations
of mental distress in western media must address the criticisms and arguments in this
important and urgently topical book.
References:
Heaton, Jeanne Albronda, and Wilson, Nona Leigh. Tuning in Trouble: Talk TV’s
Destructive Impact on Mental Health. San Francisco, C.A.: Jossey-Bass inc., 1995
Philo, Greg (Ed.) Media and Mental Distress (Glasgow Media Group), London:
Longman, 1996
Wahl, Otto, Media Madness: Public Images of Mental Illness. New Jersey: Rutgers
University Press, 1997
Dr Emma Bell, University of Brighton
e.j.bell@brighton.ac.uk