Categories
Issue 22

Prolonged Grief: A New Mental Disorder?

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) features a new diagnosis: prolonged grief disorder—used for those who, a year after a loss, still remain incapacitated by it. This addition follows more than a decade of debate. Supporters argued that the addition enables clinicians to provide much-needed help to those afflicted by what one might simply consider a too much of grief, whereas opponents insisted that one mustn’t unduly pathologize grief and reject an increasingly medicalized approach to a condition that they considered part of a normal process of dealing with loss—a process which in some simply takes longer than in others.    

By including a condition in a professional classification system, we collectively recognize it as real. Recognizing hitherto unnamed conditions can help remove certain kinds of disadvantages. Miranda Fricker emphasizes this in her discussion of what she dubs hermeneutic injustice: a specific sort of epistemic injustice that affects persons in their capacity as knowers1. Creating terms like ‘post-natal depression’ and ‘sexual harassment’, Fricker argues, filled lacunae in the collectively available hermeneutic resources that existed where names for distinctive kinds of social experience should have been. The absence of such resources, Fricker holds, put those who suffered from such experiences at an epistemic disadvantage: they lacked the words to talk about them, understand them, and articulate how they were wronged. Simultaneously, such absences prevented wrong-doers from properly understanding and facing the harm they were inflicting—e.g. those who would ridicule or scold mothers of newborns for not being happier or those who would either actively engage in sexual harassment or (knowingly or not) support the societal structures that helped make it seem as if it was something women just had to put up with. 

For Fricker, the hermeneutical disadvantage faced by those who suffer from an as-of-yet ill-understood and largely undiagnosed medical condition is not an epistemic injustice. Those so disadvantaged are not excluded from full participation in hermeneutic practices, or at least not through mechanisms of social coercion that arise due to some structural identity prejudice. They are not, in other words, hermeneutically marginalized, which for Fricker, is an essential characteristic of epistemic injustice. Instead, their situation is simply one of “circumstantial epistemic bad luck”2. Still, Fricker, too, can agree that providing labels for ill-understood conditions is valuable. Naming a condition helps raise awareness of it, makes it discursively available and, thus, a possible object of knowledge and understanding. This, in turn, can enable those afflicted by it to understand their experience and give those who care about them another way of nudging them into seeking help. 

Surely, if adding prolonged grief disorder to the DSM-5 were merely a matter of recognizing the condition and of facilitating assistance, nobody should have any qualms with it. However, the addition also turns intense grief into a mental disorder—something for whose treatment insurance companies can be billed. With this, significant forces of interest enter the scene. The DSM-5, recall, is mainly consulted by psychiatrists. In contrast to talk-therapists like psychotherapists or psychoanalysts, psychiatrists constitute a highly medicalized profession, in which symptoms—clustered together as syndromes or disorders—are frequently taken to require drugs to treat them. Adding prolonged grief disorder thus heralds the advent of research into various drug-based grief therapies. Ellen Barry of the New York Times confirms this: “naltrexone, a drug used to help treat addiction,” she reports, “is currently in clinical trials as a form of grief therapy”, and we are likely to see a “competition for approval of medicines by the Food and Drug Administration.”3

Adding diagnoses to the DSM-5 creates financial incentives for players in the pharmaceutical industry to develop drugs advertised as providing relief to those so diagnosed. Surely, for various conditions, providing drug-induced relief from severe symptoms is useful, even necessary to enable patients to return to normal levels of functioning. But while drugs may help suppress feelings associated with intense grief, they cannot remove the grief. If all mental illnesses were brain diseases, they might be removed by adhering to some drug regimen or other. Note, however, that ‘mental illness’ is a metaphor that carries the implicit suggestion that just like physical illnesses, mental afflictions, too, are curable by providing the right kind of physical treatment. Unsurprisingly, this metaphor is embraced by those who stand to massively benefit from what profits they may reap from selling a plethora of drugs to those diagnosed with any of what seems like an ever-increasing number of mental disorders. But metaphors have limits. Lou Marinoff, a proponent of philosophical counselling, puts the point aptly:

Those who are dysfunctional by reason of physical illness entirely beyond their control—such as manic-depressives—are helped by medication. For handling that kind of problem, make your first stop a psychiatrist’s office. But if your problem is about identity or values or ethics, your worst bet is to let someone reify a mental illness and write a prescription. There is no pill that will make you find yourself, achieve your goals, or do the right thing.

Much more could be said about the differences between psychotherapy, psychiatry, and the newcomer in the field: philosophical counselling. Interested readers may benefit from consulting Marinoff’s work. Written in a provocative, sometimes alarmist style, it is both entertaining and—if taken with a substantial grain of salt—frequently insightful. My own view is this: from Fricker’s work, we can extract reasons to side with the proponents of adding prolonged grief disorder to the DSM-5. Creating hermeneutic resources that allow us to help raise awareness, promote understanding, and facilitate assistance is commendable. If the addition achieves that, we should welcome it. And yet, one may indeed worry that practitioners are too eager to move from the recognition of a mental condition to the implementation of therapeutic interventions that are based on the assumption that such afflictions must be understood on the model of physical disease. The issue is not whether certain mental conditions are real—they are. It is how we conceptualize them and what we think treating them requires.

No doubt, grief manifests physically. It is, however, not primarily a physical condition—let alone a brain disease. Grief is a distinctive mental condition. Apart from bouts of sadness, its symptoms typically include the loss of orientation or a sense of meaning. To overcome grief, we must come to terms with who we are or can be without the loved one’s physical presence in our life. We may need to reinvent ourselves, figure out how to be better again and whence to derive a new purpose. What is at stake is our sense of identity, our self-worth, and, ultimately, our happiness. Thinking that such issues are best addressed by popping pills puts us on a dangerous path, leading perhaps towards the kind of dystopian society Aldous Huxley imagined in his 1932 novel Brave New World. It does little to help us understand, let alone address, the moral and broader philosophical issues that trouble the bereaved and that lie at the root not just of prolonged grief but, arguably, of many so-called mental illnesses.

Footnotes:

1 For this and the following, cf. Fricker 2007, chapter 7.

2 Fricker 2007: 152

3 Barry 2022

References:

Barry, E. (2022). “How Long Should It Take to Grieve? Psychiatry Has Come Up With an Answer.” The New York Times, 03/18/2022, URL = https://www.nytimes.com/2022/03/18/health/prolonged-grief-
disorder.html [last access: 04/05/2022])
Fricker, M. (2007). Epistemic Injustice. Power & the Ethics of knowing. Oxford/New York: Oxford University Press.
Huxley, A. (1932). Brave New World. New York: Harper Brothers.
Marinoff, L. (1999). Plato, not Prozac! New York: HarperCollins Publishers.

Professor Raja Rosenhagen is currently serving as Assistant Professor of Philosophy, Head of Department, and Associate Dean of Academic Affairs at Ashoka University. He earned his PhD in Philosophy from the University of Pittsburgh and has a broad range of philosophical interests (see here). He wrote this article a) because he was invited to do so and b) because he is currently nurturing a growing interest in philosophical counselling.

Picture Credits: CBD Oracle

We publish all articles under a Creative Commons Attribution-NoDerivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).

Categories
Issue 22

Racing Ahead: How The Popularity Of F1 Rebounded Globally

2005 was very similar to the way 2021 ended with Lewis Hamilton losing out on the world title for the first time in 4 years. Michael Schumacher had won five driver’s world championships on the bounce and Ferrari had won 6 constructor titles in a row. F1 had become predictable and boring. In 2005 and 2006, the legendary German was dethroned by Fernando Alonso in a fast Renault car and some rule changes designed to stop Ferrari in its tracks. It was an end of an era, but it was a time when F1 should’ve adapted but didn’t.

Schumacher was by far the biggest brand in F1. He drove for the most famous and loved team in the history of the sport – Ferrari. F1 was a machine in the mid-2000s and its popularity was spiking when in late 2006 Schumacher decided to retire. A decade and a half later Lewis Hamilton would statistically overtake his feats but F1’s popularity through his career has been in decline. The emergence of a Netflix documentary series, a young prodigy in Max Verstappen who many believed would put an end to the Englishman’s dominance has changed things.

In 2007 — F1 was treated to one of the greatest championship battles of all time. There were not 2 but 3 drivers in the mix for the crown. The battle went down to the wire to the last race of the season . It was the year Lewis Hamilton announced his arrival when he took on the world champion Alonso. But in the end, Kimi Raikkonen and Ferrari prevailed. Raikkonen had replaced Schumacher took an unlikely win by a point. 2008 there was another titanic fight — this time it was Massa’s Ferrari and Hamilton in the McLaren. They went down to the wire, but Hamilton fortuitously prevailed. This year F1 had 600 million unique viewers, a number that has since not been achieved. F1 never embraced social media as its CEO Bernie Ecclestone was against it and would remain so till he was in charge till 2016. 

2009 was when the tide started turning against the sport. Ferrari and McLaren, the two icons of the sport, were nowhere in the mix. Alonso was struggling in the Renault. Brawn GP came from the ashes of Honda’s F1 project to propel Jensen Button to a world title. This team by 2010 would become the very same Mercedes team with whom Hamilton would become a world-beater. There was the rise of another power — Red Bull which had an Schumacher acolyte in a young Sebastian Vettel who made Button sweat for his only world title in 2009, but in 2010, he trounced the entire grid 4 years in a row. In this period F1’s growth of unique viewers dropped from 527 million to 450 million uniques between 2010-2013. But the overall viewership figures were growing still, even in India. 

In 2010 the eponymous Senna documentary was released by Asif Kapadia in 2010. It chronicled the story of Aryton Senna who had passed away during a crash in May 1994 at Imola. He is still considered the greatest F1 driver of all time and F1’s star was given another fillip. 

That year — Alonso who was now at Ferrari heartbreakingly lost out to Vettel in a cliffhanger. By 2011 the race in India was getting off the ground at the Buddh International Circuit in Greater Noida. Things were looking good, but people didn’t show much love to the brash dominance of Vettel and the Red Bull team. People were still rooting for Ferrari and Alonso who pulled miracles in a slow car till 2013 coming P2 three times in a 5-year tenure at Maranello.

Come 2014, Mercedes had nailed the new turbo hybrid V6 engine and its advantage was immense. Mercedes and its driver line-up of Lewis Hamilton and Nico Rosberg were different gravy. The 2014 season was a battle between the two — and Hamilton won out. Vettel had also joined Ferrari as a 4-time world champion. But in his 5-year tenure, especially in 2017 and 2018 when he had a car to match Hamilton and Mercedes, he faltered. In 2015, Red Bull fast-tracked a racing prodigy called Max Verstappen to its junior team Toro Rosso and then in 2016 elevated him to the main team where he won his first race becoming the youngest Grand Prix winner in history.

By 2017, F1 was also now under the control of Liberty Media which acquired the commercial rights from Ecclestone. It opened up social media for the sport. Before Liberty Media, drivers were not allowed to post on social media any content from the races and generally F1 till 2016 as a sport had no digital presence. Under Liberty Media, F1 even closed a deal with Netflix for a series called Drive to Survive (DTS). The first season debuted in 2019 chronicling the 2018 season but it didn’t feature Ferrari and Mercedes as the teams opted out of it only to change their mind for the next seasons.

DTS has been the single biggest catalyst for the rise of F1 in the US which had hit a stinging blow in 2005 thanks to a fascicle USGP at the legendary Indianapolis track. Even the return of the US GP at in Austin didn’t do much to improve things as F1 was mostly a one-man, one team show — Hamilton and Mercedes. Under Liberty Media in 2023, the US will have three races.

DTS showed the inner struggles and rivalries of the drivers. The audience saw the human side of the sport for the first time as mostly it was regarded as something highly technical and boring to watch. By the end of 2020, the cumulative average was 87.1 million viewers per race and overall the figure was at 1.5 billion ( not unique ) across a 17 race season which had 4 fewer races thanks to the pandemic. The overall figures of 1.9 billion in 2019 were higher though but it was social media that had 99% growth impressively. In India alone, F1 had 31.1 million viewers. That year the Italian GP had 112 million viewers — it was the race in which Charles Leclerc for Ferrari beat out Hamilton to win at its home — outlining how important its success is to F1 globally.

From a peak of 600 million uniques in 2008, the year Hamilton won his maiden title, these numbers had plunged to 352.3 million in 2017 when Hamilton won his fourth title in 2017 which was the first year of Liberty’s takeover of F1.

Aside from Drive To Survive and opening up social media, Liberty Media put in several measures to improve the reach of F1 which resulted in that number catapulting to 490.2 million uniques in 2018. These numbers have stayed relatively steady since — at 471 million uniques in 2019, 433 uniques in 2020 and 445 million last year. A big part of the digital push was the development of the F1.com website, the F1 app and also a series of podcasts like Beyond the Grid, F1 Nation which propelled the digital growth of F1 further. Now, there is a focus towards E-sports as well thanks to the pandemic.

This growth continued with 1.55 billion viewers at the end of the 2021 season, but this was a year Ferrari wasn’t in play for the world title hence the TV numbers of the audience were lower than in 2019 despite having one more race. The season finale at Abu Dhabi where Verstappen beat Hamilton to the world had only 108 million viewers was still lower than when Leclerc won for Ferrari in 2019 at Monza.

ESPN reported that the first race of the 2022 season that was won by Leclerc and featured Ferrari’s first 1-2 since the 2019 Singapore GP was the highest viewed F1 race since 1995 in the US. And with Ferrari having a competitive car, the rise of young Max Verstappen and the popularity of drivers like Carlos Sainz Jr, Lewis Hamilton, Charles Leclerc and George Russell, F1 is set to have its best year ever — both globally and in India.

Sahil Mohan Gupta is a technology and automotive journalist with more than a decade of experience specializing in the field of artificial intelligence, consumer electronics and semiconductors. Currently, he works with a multitude of publications across domains. He is consulting technology editor at carandbike.com and also leads F1 coverage for the website. Alongside, he is the India editor of TechAdvisor UK and contributing tech editor for CNBCTV18.com and GQ India. 

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Categories
Issue 22

The Bold Type

The Bold Type is a story about three young and ambitious women working at a magazine and taking New York City by storm. Across its five seasons, the show follows Jane, Kat, and Sutton navigate their 20-something lives, struggle with their identities, attempt to find love, and manage their friendship. The show brilliantly subverts tropes to create storylines full of substance. Each character faces serious character development, and the show ensures to avoid categorising these three friends into stereotypical roles such as the “smart one” or the “pretty one”. All three of them have their eyes on working up the corporate ladder, and while they may occasionally get involved in romantic relationships, their love lives are just a part of their lives and not the end-all.

While the show is hardly based in reality and has received criticism for oversimplifying working in the media, its beauty lies in the world the creators have constructed, one that we want to be real. With a female-led cast and its focus on meaningful friendships and growing together, something that is vital for survival in adulthood, the show manages to find the perfect balance between heartwarming stories and hard-hitting, taboo subjects. Overall, the show is a fresh take on workplace dramas and is a great comfort watch.

Reya Daya is a third-year student studying psychology and media studies at Ashoka University. Her other interests include writing, photography and music.

Picture credits: UNO Gateway

We publish all articles under a Creative Commons Attribution-NoDerivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).

Categories
Issue 22

Super Sixer: Analysing the Success of Sports Cinema in India

In the closing minutes of Shah Rukh Khan’s 2007 blockbuster, Chak De India, the national women’s hockey team makes a triumphant return to India post bagging the coveted title at the world championship. As the team returns to India with gold medals hanging around their necks, one cannot help but feel a powerful sense of pride in being an Indian. Be it Lagaan’s (2001) underdog cricket team from rural India, or a female boxer from the farm regions of Manipur as played by Priyanka Chopra in Mary Kom (2014), sports films invoke a sense of national pride in audiences that is unmatched. 

With a welcome reception of the early ’80s and 90’s sports films such as Hip Hip Hurray (1984), Boxer (1984), and Jo Jeeta Wohi Sikander (1992), the trajectory of the portrayal of sports in Indian cinema adopted an upward trend, with actors and actresses increasingly starring in biopics portraying inspiring sportspeople on-screen and winning the hearts of India’s sports-worshipping audience. While such sports cinema covered a wide range of sports in the Indian context, ranging from cricket to hockey to wrestling, a similar diversity was absent in terms of plot imagination. A large portion of such sports films illustrates utopian narratives, an idea of the world as an idealistic paradise where hard work, fair play, and perseverance are the sole ingredients behind success in sports. 

Interestingly, these very banal ingredients are the strands that contribute to the popularity of such sports films. Uncomplicated storytelling that reinforces our belief in the world as an easy place where hard work is the key to success, contributes to the triumph of sports films in India. Despite being largely inspired by real-life sports players, the dramatisation of their lives, the intense rivalry between competing nations and players, and depictions of a separated lover who tends to players’ wounds between training sessions are components that enhance the relatability and our love for these films. Everyone loves watching a wholesome success story, and sports films always deliver just that. 

An important question that then must be addressed, is whether such straightforward narratives lacking complex socio-cultural or political layers can still be portrayed in the same way at a time when cinema emerges as a popular tool to express various social issues. Historically, while sports films have often adopted some complex additions to their plotlines, be it a Muslim hockey player with an anti-nationalist agenda or a female wrestler competing against prevailing social stigmas, their portrayal has been sidelined and almost simplified as a backstory. While this may be another tactic employed by the government to use cinema as a way to advance a soft image of India, it keeps intact the feel-good characteristic of sports films and ensures their commercial success. 

Even while talking about the mass appeal of sports films, what unites audiences and the on-screen players is emotion. A shared bond strengthened by love for the country, a familiar struggle to reach the top, and hero-worship of Bollywood actors. This sense of hero-worship is amplified when a popular actor takes on the role of a popular player, as was the case in 2016’s M.S Dhoni: The Untold Story. Interestingly, one may even observe a blurring of lines between a film’s emotional quotient, and the accurate portrayal of actual sports playing. Films like the worldwide phenomenon Lagaan, are very little about the art of playing a refined sport like cricket as compared to the sentimental value of playing against a colonial regime, patriotism, and national unity. Whether the film traces the history of cricket in rural India, or any other factor related to cricket is irrelevant. What ensured the victory of the film, was the emotions it made the audience feel. This however leads one to contemplate whether films in this category can even be classified as sports films or just heart-rendering movies about sports figures. 

While sports films highlight a sporting infrastructure easily available to the masses in every corner of the country, the reality on the ground might be a little different. For instance, while the government recently announced its plan to upgrade sports facilities in eight cities including Mizoram, Karnataka, and Kerala, a recent impact evaluation found that government sports facilities in Karnataka lack gender parity, with no separate hostels for men and women, lack of representation from minority communities, and lack of proper equipment. Thus, while some sports films highlight such structural issues, the overpowering emotion in these films may be glorifying sports in India and preventing stakeholders from evaluating the actual condition on the ground. 

Therefore, balancing realism, while maintaining the feel-good aspirational significance of sports films seems to be the next step for directors and movie stars. It will be interesting to see how audiences relate to such balanced films, and whether sports movies will continue to simply be our dose of ambition, or a conversation starter about the condition of sports in India. 

Jaidev Pant is a student of Psychology and Media Studies at Ashoka University. He is interested in popular culture and its intersections with politics, gender, and behavior. 

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We publish all articles under a Creative Commons Attribution-NoDerivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).