Why 'Bad' Does Not Equal 'Mad'
The recent mass-killing at Marjory Stoneman Douglas High School in Florida has opened up an age-old debate regarding the conceptual distinction between ‘bad’ and ‘mad’. This is something I have been examining for many years, in my role as lead researcher on a national project investigating media coverage of mental illness.
In times past, perpetrators of mass-killings were typically considered ‘bad’ people, and were often described using moral terms such as ‘wicked’, ‘evil’ or ‘depraved’. In this line of thought, mental illness has nothing to do with mass-killings. Instead, perpetrators are considered to lack a moral compass, possess an extreme ideology and/or harbor strong social resentments. In other words, they are considered ‘bad’, not ‘mad’.
More recently, there is a growing tendency to explain mass killings by speculating upon the suspected perpetrator’s mental state. In this line of thought, the perpetrator is ‘mad’, not ‘bad’, and their actions are attributed to symptoms of an unknown mental illness. This argument frequently manifests itself in media coverage of mass killings, which sometimes defaults to the language of psychiatry when describing such tragedies.
Sadly, this is often done in the absence of any evidence that mental illness was involved.
For example, Anders Breivik murdered 77 people in a mass-killing in July 2011. Some media coverage at the time imputed his actions to mental illness, specifically psychosis. However psychiatric evaluation in the cold light of day indicated that he was not suffering from psychosis, but was instead driven solely by extreme ideology and bitter resentment. Breivik was ‘bad’, not ‘mad’.
Other examples abound, especially if a broad definition of mass-killings is used. Stalin and Hitler could be considered the two biggest mass-killers of the twentieth century. Both were consumed by hatred, resentment and extreme ideology. It was this, rather than mental illness, that led them to initiate heinous crimes against humanity, including mass killings of Jews, Kulaks and others.
Language has consequences. The continuous (and erroneous) conflation of ‘bad’ with ‘mad’ can contribute to already high-levels of stigma associated with mental illness. It can result in unwarranted fear, mistrust and suspicion about people with mental illness. Reducing such stigma is thus a high priority for mental health advocates.
Here in Canada, researchers and activists have been working pro-actively with journalists for many years to help improve their mental health reporting. As part of these endeavors, best-practice reporting guidelines have been produced and widely disseminated, containing a strong emphasis on fact-checking and avoiding speculation. Recent research suggests that Canadian journalists have been adhering to these guidelines, which is very welcome news.
Similarly, researchers have been working with people with mental illness to produce short educational videos that have been shown at journalism schools and other outreach events to reduce stigma. One of these short stories insightfully turns the ‘mad’/‘bad’ conflation on its head with delicious irony (see video below).
We in psychiatry and psychology have been at the forefront of efforts to shift the language that is commonly used to describe human behaviours. In times past, the behavioural symptoms of mental illnesses were commonly considered to be the consequence of moral failings, or even demon possession. Clinical research has helped disabuse the public of such faulty notions.
Indeed, former President of the American Psychological Association O. Hobart Mowrer wrote a famous paper where he argued that one of psychology’s ‘epoch-making’ contributions to society was reducing the widespread use of moral terminology such as ‘sin’, and replacing it with clinical terminology such as ‘sick’.
However, an unintended consequence of such a shift in dominant language means that the concepts and terminology of psychiatry and psychology have become the ‘go-to’ explanations for all human behaviour, including incomprehensible acts of violence such as mass killings.
This linguistic bracket creep (or ‘medicalization’ to use the correct social science terminology) means many people are quick to impute mass killings to ‘mental illness’ rather than a complex web of causation which may include moral turpitude, extreme ideology and social resentments. Indeed, mass killings are events where moral and sociological explanatory language may be more accurate and appropriate than the explanatory language of psychiatry or psychology.
In short, the notion that ‘bad’ equals ‘mad’ is a pernicious stereotype that arises from various sources. It is an inaccurate rendering of social complexities that contributes to damaging stigma about mental illness. Many key stakeholders including the media, clinicians, researchers, policy- makers and advocacy organizations have a role to play in undeceiving the public of such notions.
Recent research with the Canadian media indicates we may be making headway in this regard.
Let’s hope this continues.