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Philip Roth’s Portnoy’s Complaint is framed as a joke, and one centered around the idea of a traditional Yiddish schlemiel-style character recounting their sexual exploits to a psychiatrist in a way that sears and satirizes American society. Dated sexual politics aside (it was 1969, and oh, does it read like it) Roth’s work remains a classic.

It is also telling of how we frame mental illness in our society.

In fairness, Roth’s book is not by any means an accurate account of this, nor does it aspire to be or make any pretension of being so. Of the many, many points of attack in Portnoy’s Complaint, problematic and otherwise, mental health is not prominent among them.

Even so, that method of framing mental health as a joke, or as something that’s as simple as “sitting on the couch with a shrink” paints a picture of mental health that’s cliché, inaccurate, and detrimental to our healthcare.

How We Stigmatized Mental Health

It isn’t just Roth who uses this technique. A few years later, Erica Jong inverted the sexual politics of Roth’s novel with her own taboo-breaking book, Fear of Flying. One of her big targets was the male-centric and especially Freud- and Jung-centric nature of psychology of the time. For Jong, psychology stigmatized women as “irrational” before and more than actually helping them.

And they aren’t alone in that regard.

Early Freudian psychology in particular focused on defining “norms” and those “abnormal” to said norms. That’s a process that goes back at least to the Enlightenment’s focus on reason and the Industrial Revolution’s focus on standardization. However, it overlooks the fact that there are many “norms” in society, especially when it comes to mental states. Moreover, simply labeling someone as “abnormal” does little to help them and merely stigmatizes them.

Destigmatizing Mental Health

Stigmatized groups have long been a target of healthcare discrimination. The more we make metal health about personal “abnormality” and less about actual, tangible medical conditions, the more we take away our ability to effectively treat it. The first and most important step to take in securing better healthcare for those with mental health, therefore, is to work to destigmatize it. We all know someone who suffers from mental health issues in one form or another. It is vital that, rather than visions of people who are a “joke” or “abnormal,” we associate their human face with these conditions.

Until we do that, our societal and healthcare system’s response to mental health will remain a “joke” – and a horribly unfunny one at that.