I’m going to put this at the top because, in the off chance that someone does actually attempt to read this, you will probably not make it all the way through, and I don’t blame you for that.
Some people tend to dismiss the notion of treating mental disorders with medications as merely relying on a crutch. These people imply that the use of crutches is a bad thing, and ought to be avoided. These people are wrong. There is no logical reason to believe that crutches are necessarily bad. In fact, there is evidence that crutches are useful and good.
Let’s Talk About Crutches
Here’s a sentiment I hear tossed around every now and then; it usually goes something like, “You know, X is just a crutch.”
I was thinking about crutches a few days ago, about this statement in particular, and wondering just what the fuck it actually means. I want to spend some time examining the statement and the attitude behind it. When people say this, or something like it, what are they actually saying, why are they saying it, and is it a valid thing to say?
To begin with, I think it’s fair to rewrite the statement “X is just a crutch.” Whenever someone says this, it is always with a hint of disapproval. It would, I think, be fair to rewrite it as something like, “You shouldn’t do X, because X is just a crutch.”
There are two important pieces of this new statement.
Crutches are Bad
First, there is an implication that crutches are bad. After all, the only reason not to do a thing is if the thing is bad. Basically, on the good-bad spectrum there are only three options. You’ve got good, neutral, and bad (with differing levels, but that doesn’t really make a difference for this discussion).
If X is good, there is no reason to not do it. If X is neutral, there is no reason either to do it or to not do it. If X is bad, there is reason to not do it. The final option is that X is both good and bad, and then it becomes a matter of degree. The only reason to avoid X is if the bad outweighs the good.
So the first implication is that X, where X is a crutch, is bad.
The second important element of the statement, “You shouldn’t do X because it is just a crutch,” is the word just. “Just” means “only.” The implication is that an alternative to X (called ~X, or not-X) would be something more than just a crutch. Taking these two implications together we can infer that the more of the alternative to a crutch would also be better than a crutch.
So we can rewrite the statement again. Now it looks like this: “Crutches are bad and avoiding crutches is better than relying on crutches, so you should avoid crutches.” This is an argument with three premises. In a bastardized version of formal logic it would look like this:
P1: X = bad
P2: ~X = good
P3: You want what is good.
C: Therefore, you want ~X
(Where X is the use of a crutch, and ~X is avoiding the use of a crutch)
So now that we have transformed the original statement, “You know, X is just a crutch,” into an argument with three supporting premises and a conclusion, the next task is to ask whether this argument is valid and sound. The answer: No, it is not.
Valid and Sound?
To clarify, the argument actually is valid, but it is not sound. Meaning, if all of the premises are true, the conclusion will logically follow. However, the problem is that not all of the premises are true.
I take issue with P1 in particular, the statement that “X is bad” (or, “crutches are bad”).
My reasoning: Crutches are, by definition, a good thing. Crutches help disabled people do things they otherwise would not be able to do, things that they presumably want to do. So X, by its own definition, is good, making the argument unsound.
Now the question becomes: Why do (some) people make this unsound argument?
I have to assume that no one would tell a one-legged man that he should not use a crutch because the crutch is bad for him. No, the people who are anti-crutch are usually targeting specific kinds of metaphorical crutches, rather than literal sticks that people use to support themselves while walking. Medications usually are the targets, things like Ritalin, Adderall, antideps, even things like epidurals.
So why the difference?
Why is one form of a crutch, a literal and physical crutch, seen as being OK, while others, metaphorical crutches, are not? The issue is with that sticky first premise.
With clearly disabled people, P1 is clearly false. With mental issues, P1 is not quite so evidently untrue. It is easy to see that a literal crutch is a good thing for a one-legged man, but not so easy to see that Ritalin is good for a boy with ADHD, or that antideps are good for a depressed housewife. So the next thing that we had better do is to examine P1 in more depth, to find out if it is necessarily untrue in all situations, or if there are some instances where it may be true, making the argument implicit in the statement “X is just a crutch” a sound and valid argument.
P1 as it relates to Mental Health
Here’s another argument, one that seems evident to me. X is good if a person has a disorder that prevents normal (or desirable) functioning, and X helps them to function at normal (desirable) levels. Now, there are a few things that might seem to be exceptions, and they are:
a) You don’t believe in mental disorders. In this case X (the crutch) is only needless, not inherently bad. And it’s hard to hold this position; the evidence is overwhelmingly against you.
b) You don’t believe that X provides a benefit. Again, needless rather than bad. Also a hard position to defend.
c) If the negatives of X outweigh the positives. When this is the case, it is fair to say that X = bad. But this only means that one particular X (crutch) is bad for one particular scenario. It doesn’t follow that all X are bad all the time. (If I try to use a raw salmon as a literal crutch, the negatives will more than likely outweigh the positives)
So the first two exceptions are not really exceptions, but the third one seems to be. It seems true that some X are bad some times, and some X are good some times. So here is the new argument:
P1: X = either good OR bad
P2: If X = bad, then ~X = good
P3: You want what is good.
C: You want either X or ~X
Conclusion: X is not necessarily bad. You may want X, you may not want it. It does seem to be more likely that you will want it.
An important note to consider is that if X is bad (the bad qualities outweigh the good), you want to avoid it because it is bad, not because it is a crutch. So it is not fair to say “you should avoid crutches because they are bad.” Crutches, as we have just seen, are not necessarily, inherently, bad. It is more fair to say “when crutches are bad, they should be avoided.”
There is another possibility for P1 of the original argument being true. When I’ve heard discussion about the idea of “crutches,” one concept that usually hovers around the edges, but is never quite explicitly annunciated, is that anything a person accomplishes with the help of a crutch is meaningless, or less meaningful, because they had to use a crutch.
Here’s why this is a bullshit idea: Is it meaningless for a one-legged man to walk down a hallway because he has to use a literal crutch to do it? Is it meaningless for someone to continue to live because a pace-maker (a metaphorical crutch) is keeping their heartbeat regular?
Now, this is a complex idea, and I think it needs some unpacking. So here we go.
I used to agree with the sentiment that things you accomplish with the help of crutches are in some way less meaningful than they otherwise would have been. When I thought such silly and foolish things, the reasoning was along these lines:
– Mind or mood altering drugs make you a different person. Ritalin-Jim is not the same as Regular-Jim.
– The things that Ritalin-Jim does do not count for Regular-Jim.
I no longer agree with this reasoning for two reasons. First of all, I do not believe that the use of mind or mood altering drugs like stimulants, anti-anxiety, or anti-depressant medications, makes you a “different person.” This is just as likely as the idea that the use of a wheelchair, or a walker, or a literal crutch, would make you a different person.
Now, the difference is that a literal crutch only alters your physical being, whereas a metaphoric crutch like Ritalin alters your personality to some extent. So let’s accept, for the sake of argument, that it does make you a different person in some way. Does it follow that your achievements are meaningless? I think not.
Clearly Regular-Jim is deficient, not up to the task. Jim doesn’t want to be Regular-Jim, he would rather be Ritalin-Jim, because Ritalin-Jim is the one who can get shit done. In the same way, I would rather be Wheelchair-Matt than Drags-himself-down-the-hall-with-bleeding-fingers-Matt.
The implication is that Jim ought to want his achievements to count for Regular-Jim rather than Ritalin-Jim, because Jim ought to want to be Regular-Jim rather than Ritalin-Jim. Why so? Nature is descriptive, not normative. It didn’t make Jim the way he is because that is how he ought to be, it’s just the luck of the draw. If Jim can augment himself, or make himself into a new and better person, there is no reason not to.
I have a good friend who is very driven to achieve. He is motivated, energetic, and charismatic, and he has had a remarkable amount of success in his life so far. Basically, exactly the opposite of me. If I could permanently change myself to be more like him, I would do so in a heartbeat, because I judge his state to be better than my own.
Conclusion; or, What Does This Mean for Me?
Crutches are not inherently bad. The use of crutches is not a bad thing; it is actually a good thing. Don’t handicap people for no reason. Don’t trivialize the accomplishments of people who use crutches.
If your child would benefit from medication, there is no rational reason to deny that child the opportunity. If you would benefit, there is no reason to handicap yourself, just like there is no reason to handicap a one-legged man by denying him a literal crutch.
Stop the madness!
The one valid worry, as far as medications go, is that the harm may outweigh the benefits. It this is a concern, do your research! Don’t assume. Don’t take advice from people who are not professionals.