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DISCUSSION: Writing Mentally Ill Characters

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5. Be aware that mental illness isn't a fantasy element, it's a host of medical conditions that are as mundane and vexing as physical ailments. Don't treat it like a superpower or a magic curse or whatever.
I would agree with @Snuggle Tier List's general point, certainly.

On the other hand, there's an important distinction between "this character is mentally ill, and therefore has psychic powers" and "this character has psychic powers, and this has caused them to develop a mental illness". The latter is instantly interesting to me. Overwhelming sensory input, involuntary exertion of force over the minds of others, social stigma, pressure, fear, and confusion sound like a recipe for generating anxiety disorders and CPTSD in an affected person. That's very different from "I'm fantasy-schizophrenic and it gives me telepathy".

Also the onus isn't really on authors to write didactic prose fiction that always perfectly expresses the right and true way to think about mental health. I just think it's harmful to write about mental health conditions which are also superpowers without putting some thought into it.
 
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On the other hand, there's an important distinction between "this character is mentally ill, and therefore has psychic powers" and "this character has psychic powers, and this has caused them to develop a mental illness".
This is an important point, which is to get it the right way round. To an extent you cant account for your audience's reaction, and if your audience is determined to get it the wrong way round and the excoriate you for it, there's not a lot you can do other than be aware of it in the first place
 
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Also the onus isn't really on authors to write didactic prose fiction that always perfectly expresses the right and true way to think about mental health.
Something about that statement doesn't sit right with me. Though that's swerving away from mental health and towards epistemology and aesthetics, topics that I like to call "philosophical flame bait". And then someone mentions Death of the Author, and then Uncle Barry racks the slide, and then there's cranberry juice all over my couch again.

Just noting that I personally disagree with this statement, but I recognize your opinion and would like to move on. And maybe discuss it some other time, when I'm not addicted to Review League points.
 
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@Snuggle Tier List — noted and appreciated. It's certainly a longer discussion, and one I've experienced multiple perspectives on.

I've had another thought on the thread topic, which is this: just because you may know someone with a mental illness, or experience poor mental health yourself, doesn't make your handling of these issues beyond reproach. (That might sound like "nobody can do anything right!" but really it's just part of a larger principle that creative works are always going to affect the audience and the audience won't always love what you've made. These are the risks we must take!) I would just say that in the same way that I don't give myself a free pass to skip research on writing characters with PTSD just because I've had anxiety and depression, always be sure to do due diligence when writing about a sensitive topic.
 
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On the other hand, there's an important distinction between "this character is mentally ill, and therefore has psychic powers" and "this character has psychic powers, and this has caused them to develop a mental illness". The latter is instantly interesting to me. Overwhelming sensory input, involuntary exertion of force over the minds of others, social stigma, pressure, fear, and confusion sound like a recipe for generating anxiety disorders and CPTSD in an affected person. That's very different from "I'm fantasy-schizophrenic and it gives me telepathy".
I do have a question under this: How would you deal with it if a character, as a result of a psychic assault by a Pokemon, ended up with psychic powers as a side-effect of that assault leaving a perfect copy of said Pokemon sharing their mind? In this particular case, the psychic powers result from the trauma and resulting mental disorder; if that Pokemon copy were removed, they'd lose the psychic powers.

I ask this because, at this point, I think we've delved too far into realism and generalization to serve as functional guidelines for how to write a story in which things like psychic powers, mechanical teleportation, and actual dragons exist (using just the Pokemon games for this).

To a degree, we need to keep in mind the rules of the setting when dealing with mental illnesses. That doesn't excuse an author from creating rules for the setting that are insulting to mentally-ill people, but at the same time it doesn't mean we should necessarily rule any element out as long as it's presented respectfully and shows a consistency with the established rules of the setting.

But, the key word there: "respectfully."
 
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I do have a question under this: How would you deal with it if a character, as a result of a psychic assault by a Pokemon, ended up with psychic powers as a side-effect of that assault leaving a perfect copy of said Pokemon sharing their mind? In this particular case, the psychic powers result from the trauma and resulting mental disorder; if that Pokemon copy were removed, they'd lose the psychic powers.
This is a good case study for examining framing, which I've mentioned is the key to this topic.

In the example given, Ereshkigal states that the character obtains psychic powers as a result of trauma and mental illness, and that they'd lose their powers if the pokémon consciousness sharing their mind were removed.

Firstly, one could frame the powers as being a result of mental illness, but only if one chose to frame having a psychic presence in your head as a mental illness, and the powers as being those of the host and not those of the entity. In fact, one can even do exactly that without pushing the "mental illness is cool but dangerous" angle, provided the narration itself handles it deftly.

Secondly, the incident leading to this was surely traumatic, but it seems to me that such a trauma would be comorbid with the mindsharing issue, not a cause of the powers per se. This person had their mind coopted by a psychic entity, and they also were traumatised. Indeed, I'm sure that having a separate person inside your brain for some time couple with psychic abilities that aren't your own might subsequently cause compounded complex trauma. By presenting the situation in this way, the messy trope of "schizophrenics are magic" is not unduly perpetuated.

As for how I would deal with it — I'm hesitant to answer that in full considering that there's context I'm not aware of, and I wouldn't write such a plot myself in any case.
 
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This is a good case study for examining framing, which I've mentioned is the key to this topic.

In the example given, Ereshkigal states that the character obtains psychic powers as a result of trauma and mental illness, and that they'd lose their powers if the pokémon consciousness sharing their mind were removed.

Firstly, one could frame the powers as being a result of mental illness, but only if one chose to frame having a psychic presence in your head as a mental illness, and the powers as being those of the host and not those of the entity. In fact, one can even do exactly that without pushing the "mental illness is cool but dangerous" angle, provided the narration itself handles it deftly.

Secondly, the incident leading to this was surely traumatic, but it seems to me that such a trauma would be comorbid with the mindsharing issue, not a cause of the powers per se. This person had their mind coopted by a psychic entity, and they also were traumatised. Indeed, I'm sure that having a separate person inside your brain for some time couple with psychic abilities that aren't your own might subsequently cause compounded complex trauma. By presenting the situation in this way, the messy trope of "schizophrenics are magic" is not unduly perpetuated.

As for how I would deal with it — I'm hesitant to answer that in full considering that there's context I'm not aware of, and I wouldn't write such a plot myself in any case.
An important item I think you didn't take into consideration with suggesting it's not a mental illness is that dissociative identity disorder exists. Having another being inhabit your head would be an externally-induced, potentially-temporary version of that. Being, in effect, possessed would still meet all of the diagnostic criteria for dissociative identity disorder and all of the criteria for a mental illness, and it would be far from the first time a mental illness has been induced in a person rather than naturally-occurring.

I chose my framing in this case under the question of "how would this specific instance be diagnosed," with a question of if they would create a new diagnosis or use an existing one with a more complex diagnosis to indicate it has a slightly different cause than normal. In general, psychiatry tends to rely on the more complex diagnosis when it can rather than simply creating new categories.

So, I did not frame it improperly. I framed it realistically, as has been generally advocated so far in how to treat mental illness.

Note, also, that this is a relatively-common problem characters suffer in science fiction and fantasy, in that they end up both possessed and with powers they do not have once the external personality is removed.

For extra problematic fun, read the DSM-5's description of its first criteria for DID. "Feeling possessed" is apparently a symptom of that specific disorder. This is what I meant by us getting both too realistic and too generalized in guidelines; some of the DSM-5 mental illness criteria would mandate some extremely problematic depictions of mental illness in many Pokemon stories in order to depict the diagnosis of mental illness realistically.
 
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Well, at that point you really need to ask yourself whether you can actually consider what you're doing offensive from any of the relevant perspectives.

Possession is a concept that's existed basically as long as the belief in spirits has, and that's a damn long time. It's a well known trope, and while at some point in time it may have been used to explain multiple personalities due to lack of information and/or superstition, today's popular culture understands the two aren't the same. The key difference is that, in possession, the audience knows this entity is truly external (and usually can be removed by magic and so), but dissociative identity disorder is known to be caused by internal reasons (and either takes years of psychiatric treatment or can't be cured at all). There are exceptions, such as cases where it's impossible to tell whether the entity is external as claimed or only a belief of the person afflicted, but that's not relevant at the current moment.

In this particular case, it's external, unless there's some kind of twist where the human always had latent powers and they're active only with the trauma-induced persona of what the mon was perceived as, which doesn't look like is the case. Therefore people will understand these concepts are separate and will likely hold onto that perception unless you make some really heavy-handed similarities (without refuting them in-universe). Similarities with the symptoms don't necessarily matter - false equivalencies do exist.

For another angle, consider the 2016 movie Split by the man, the meme, M. Night Shyamalan. While from what I understand, the character in that with DID has one or multiple personas with superhuman powers, it's clearly marketed as "yo this guy has split personality and it's super spooky". It's pretty exploitative of that mental illness and looking at it, it's pretty easy to see how people would consider it a harmful portrayal. Also reading the Wikipedia page I noticed they also have "The Beast" in that movie and if someone's gonna claim I ripped it off with Hunter, Haunted I'm gonna be pissed.

Anyway, the lesson in the end is to use common sense. Human culture is extremely complicated and there's no one catch-all set of rules that wouldn't have gray area or exceptions. Rules are good for checking something you may have overlooked, but if a rule says something should be offensive and you genuinely can't see it there and/or you're confident enough in your skill to portray things in a respectful way, you shouldn't let it stop you. And, well, if it does end up being offensive, you'll likely hear about it, and the right thing to do then is to try to fix it and do better in the future.
 
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I tend to prefer "Would this be offensive under reasonable circumstances?" with "reasonable circumstances" meaning "offensive to a group of those affected." The reasoning is twofold:

  1. With the variability of mental illness, you're going to misrepresent someone no matter how you present it. It's just what happens when you have a population of over seven billion.
  2. I observed that people when encouraged to ask if a representation of mental illness would be offensive from a relevant perspective, they tended to simply avoid depicting mental illness at all.
The issue I have with the "it's external" argument for the cause while still trying to be as realistic as advised in this thread is that it could easily have an "induced" or similar term tossed in front and left with essentially the same diagnosis, especially since the DSM-5 does not agree with the popular understanding of possession and in fact cites possession as an example in the entry for dissociative identity disorder. So in this particular case, possession is not understood as being different. I could go with "possession is different," but the moment I do so I am leaving a realistic presentation of dissociative identity disorder behind.

Now, I'm fine with leaving some realism behind to serve the purposes of the setting. But, then, I'm the one arguing that we need to step back from realism a bit and accept that there has to be some unrealistic representation in order to serve the purposes of a story taking place in a world that deals with challenges which simply do not exist in real life.
 
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So hold on, do you want to make it representative of DID or not? I'm confused about your intentions here, and intentions are pretty important to consider. If you intend to take a mental illness and make it fantastical, you better have a great grasp on what the disorder is like and say something meaningful and beneficial (or at least neutral, as long as it's not harmful) about it. If you just want to make a possession story and it can be interpreted as DID as much as any other possession story, people will judge it as a possession story.

In the end, if you're really serious about this, the best source for opinions is actual DID afflicted people. No one in this thread seems to have DID, so we're only gonna get so far with speculation. We can't ultimately speak on their behalf. If you actually want to make a story about DID, you'll have to research DID anyway, so conversations with people afflicted will be beneficial in multiple ways.

You can make all kinds of arguments for different things being offensive to different groups - say, claiming werewolf fiction is exploitative of people with hypertrichosis, for example. But you can't actually know if it is offensive or not if you don't ask the people affected.
 
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The funny thing is, what we're arguing about is the legitimacy of the example I provided as a mental disorder, when what I've been saying all along is that there's a certain amount of fantasy that has to be considered for mental disorders and that we shouldn't entirely rule out some presentations because of that.

I'm not arguing that possession is representative of DID; the DSM-5 pretty much outright says it is. And, yes, I do have some issue with this and a few other portions of the book; this strikes me as a case of the book being released prematurely due to the "didn't think this through" wordings that remain in it. The DID entry is just one of them. I'm saying a fanfic would probably have to rely on a fantastic definition of DID in order to separate out possession as a different issue without being disrespectful, and that it's not necessarily the only case where that is true.
 
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Passive listening and active questioning are also two separate things, as conclusions can often times only be drawn from speculation in the latter's case. And if one is too unsure about the validity of the speculation to continue, they should move on to active questioning or give up.

I don't understand the point you are trying to make. Are you saying all media containing possession is representative of DID unless the work specifically mentions DID having different criteria? How would that work in a setting based on a time where DID isn't even known yet? What is it that you'd ultimately want authors to do?
 
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But people who have mental disorders are not monolithic on their opinions of fictional depictions of their mental disorders. Some love being spoken for and represented; some hate it with a passion. Some prefer serious depictions of their mental disorders because those help others understand what they are going through, and some hate those depictions because those depictions remind them of the very problems they are trying to escape. This is what I learned from active listening and asking questions of a variety of sufferers of various mental illnesses.

I can explain my point again, but without the context in which the point is being made it cannot be understood properly. Look at it in the context of how it relates to what I said in post 65 and what I was replying to in that post. It makes sense then.

Just bringing this in line with the mod edits above,
 
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*Mod hat on

I've noticed that the discussion here has been getting tense. It's been largely civil so far, which is good. However I'm going to take this opportunity to make a general reminder to discuss in good faith, and be prepared to agree to disagree.

Feel free to carry on, or, if you have nothing more to add, move in to a different topic
 
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I apologize if I seemed tense. My last post was written on my phone. There are limits imposed by time and technological familiarity.

My last item in my previous post is also because we have moved far enough away from the initial start of this digression that I realized it has become disconnected from that initial disagreement, and thus what I am saying is becoming incomprehensible. I meant only that what I am saying is comprehensible when connected to that initial point.
 
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Diagnostic criteria for mental illnesses have been raised here recently. I'd just like to say that the diagnostic criteria of the DSM-5, among other standards, are certainly not perfect laws. That specific document is in its fifth edition, it's not in international use, it's the target of a great deal of criticism, and it was written in the real world, where fantasy concepts are unaccounted for. If a person can be literally possessed, for example, which I've seen in pokémon canon and fanfic more than once, then I would expect the mental health professionals of the setting to have a diagnosis specific to that.

Ultimately, I still believe more or less what I did when I wrote my earlier posts in this thread. I would suggest that if you're writing about something fantastical, that you don't equate it to conditions people actually experience, but either frame it as not a mental health issue, or make it clearly distinct from the experiences of real people.
 
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Just my two cents.

First thing first, this very concept of "mental health" in the Real-World, together with all the fancy acronymic disease and disorder names, only has its history of approximately a century or so. This is also true for Psychology (or more correctly speaking, Psychiatry) being treated as observable science with experimentalized condition and quantifiable numbers, implemented it into a branch of medical science and treated as part of the healthcare system, did not happened until the late 1800s.

So one should understand, this concern of "mental health", at least our nowadays understanding of Psychiatry (not the same as Psychology) which leaning more toward the medical field, did not exist in the past until the recent century. Therefore, all theses fancy names of "PTSD", "MDD", "DID", "ADHD", "PDD-NOS".... whatsoever etc., was not available in the past (Just a side note, why the medical academians love acronyms so much!? I could hardly remember any of these. I prefer if one say out the full name even it is long. So no "MDD", but call it major depressive disorder, please). Before that, Psychology was not part of the Medical Science, but treated more as a branch in the Humanities and Philosophy.

So here is the question: Before Psychology implemented into Medical Science hence becomes Psychiatry we know nowadays, what happened to the mentally ill patients in the past? Or, what defines a "mentally ill patient", before the time where scientific knowledge of Psychiatry arose?

History tells you, such people were never ill from the beginning. Or more correctly speaking, they were never seen as "ill" like how we would deem them to be according to nowadays APA's definition. Those "patients" are simply just normal people with eccentric behavioral patterns, or with a bit of social problems in human relationship, or with abnormal mindset or thinking pattern. Mentally ill patient in the past are at best called weirdo or freaks, but just never ill nor sick nor at an unhealthy state. That is not the same because it is equivalent to the perspective question of are you seeing a naked women as a naked women, or a sexual object?

As far as the concern of writing mentally ill character in a fanfic world differ from ours, the first thing that must be clarified before we even write a mentally ill character, is the answer to the question: What is the definition of being "mentally ill"?
If the APA definition is the one one would like to follow, then there you have it. But when the Pokemon World (or, any fictional world) does not have APA nor medical institution similar to it, will it follows a different definition? Or, does such definition even existed? All of these will affect how the world treat your "mentally ill" character, and how one will depict such character.

For example just a little cultural trivia. Japan's social understanding of the concept of "mental health" did not arise until the recent decade. So just about 20 years ago, lot of places such as schools/workplaces/sport clubs, still educate/train/teach people through very harsh method which often accompanies strong words that is literally just verbal violence. If anyone developed into depression or major depressive disorder due to such verbal violence, they were never deemed as ill, but they were simply deemed as weaklings and cowards because they can't endure the hardships. Only when in the recent decade the concept of "mental health" became widespread, there finally put an embargo on such harsh teaching/training with verbal attack. Nonetheless, common Japanese still had no habits of seeking mental help from psychiatrist nor general practitioner nor even social workers, most not even had an understanding of what does it mean of "being mentally ill". That's why suicidal rate in Japan remains high.

How does your fanfic world sees "mentally ill" people? Or rather, does your fanfic world has such a comprehensive healthcare system as thorough (yet controversial) as the American one? Some of these questions should be consider before further discussing the portrayal of mentally ill character.
 
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Prior to psychiatry existing, extreme mental illness had different solutions than today. One, in more "enlightened" nations, was simply to lock the mentally-ill person away and, effectively, erase them from existing.

In less enlightened... Well, have you ever heard of demonic possession? Or changelings?

The former, in symptoms, sounds a lot like multiple personality disorder and schizophrenia combined into a singular affliction (though nymphomania was sometimes included as well); this was usually "cured" by an exorcism, which was often lethal. Both psychiatry and modern medicine are heavily embraced by the Catholic Church in large part because they massively improved the survival rate of people being exorcised, through both providing a non-supernatural explanation that prevents most exorcisms and through providing medical care to prevent the person being exorcised from dying. But even today, dying while being exorcised is not unheard of. Exorcism is a last resort because it is so dangerous.

The signs for identifying a changeling sound a lot like combining Down Syndrome, autism, and certain types of brain damage into a singular identification. The "cure" for this was often to just abandon the child in the woods to die and accept your "real child" is likely gone forever. Note that if old enough the child will survive, and a lot of the stories about the fey sound like badly-socialized humans who grew up in the woods.

So, before psychiatry, if you were mentally ill and lucky, no one noticed you were mentally ill. If they did notice, the best you could usually hope for was to spend your entire life in isolation.
 
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For example just a little cultural trivia. Japan's social understanding of the concept of "mental health" did not arise until the recent decade. So just about 20 years ago, lot of places such as schools/workplaces/sport clubs, still educate/train/teach people through very harsh method which often accompanies strong words that is literally just verbal violence. If anyone developed into depression or major depressive disorder due to such verbal violence, they were never deemed as ill, but they were simply deemed as weaklings and cowards because they can't endure the hardships. Only when in the recent decade the concept of "mental health" became widespread, there finally put an embargo on such harsh teaching/training with verbal attack. Nonetheless, common Japanese still had no habits of seeking mental help from psychiatrist nor general practitioner nor even social workers, most not even had an understanding of what does it mean of "being mentally ill". That's why suicidal rate in Japan remains high.
Yeah, the Japanese still have a backwards view of mental illness. Some even claim those who have genuine problems are not only not mentally ill, but all of their problems are caused by character flaws, personality issues, are dismissed as simply being assholes, or that everything is all their own fault for not meeting everyone's standards or not fitting in. I found an article that goes into this in better detail. Plus, some anime and manga also perpetuate this ideology, unfortunately. In one manga I've read called A Silent Voice, a deaf girl is frequently bullied by other kids, but most of the bullies' actions are not refuted, and one bully states that the deaf girl brought all of it on herself for merely existing or not fitting in, even daring to claim that she's faking the whole thing not only for pity, but because she got the attention of a boy the bully liked. When she's stopped from committing suicide, the bully in question beats her up and victim blames her for the whole thing and doesn't even get punished for it. Not once is the deaf main character ever told that the whole thing isn't her fault. Yeah, that really turned me off from the manga entirely, and the movie isn't much better. So the stigma against both the mentally ill and the physically disabled is still present in Japan.
 
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