Mental Illness and ‘The Economy of Esteem’

I went to a philosophy workshop the other week, and I sat next to a philosopher I hadn’t met before, named Geoff Brennan. During the lunch break we had an interesting chat. We were discussing the talk we had both just heard, and our discussion moved to self-esteem. Another man was sitting close by and he interjected saying, “Geoff has written a book on the economy of esteem”. I looked at Geoff and said, “Sorry, I haven’t read any of your work”. But I went home and looked up his book, which is fascinating. I haven’t finished reading it, but as I read it I had some responses. And that is what this piece is about.

I begin by outlining some ideas from the book, which he wrote with another philosopher named Philip Pettit. The authors are economic and political philosophers, and they aim to show how esteem works like a commodity in our society. I respond to their ideas by asking how they apply in the case of mental illness where there is a lot of stigma. I then suggest that we should seek to esteem people based on their potential, rather than their performance. And that esteem should be an attitude we seek to cultivate and extend to everyone.

But, firstly, what is esteem? Esteem and disesteem are attitudes that one person has towards another. They are evaluative attitudes. This means we rate a person in respect to something. Often, we compare how a person rates to others on a scale. For example, we rate people for virtuous dispositions, or virtuoso achievements – such as great skill in an area. So, we esteem individuals when we assume they have some control over their performance. This means they could put more effort in to get a better rating.

Esteem has practical benefits. It helps us have self-esteem and our interactions with others are helped if they esteem us. We supply as well as receive esteem. We offer esteem to others by giving them our attention, or speaking well of them, or simply hanging out with them.

Now, this is the interesting part. We can’t choose to esteem someone. Because it is evaluative, we evaluate individuals in the context of a domain. And this means, you must earn esteem. Because we rate people in comparison to each other, esteem is scarce. It takes effort to attain, and as a result people compete for it. It is in this sense that it is like a commodity.

As I was reading these ideas my main worry was that there are individuals, and groups of individuals, in our society who are left out of this esteem economy. There are people who, through no fault of their own, cannot compete in an economy of esteem.

A way to highlight this is to look at those with mental illnesses. Mental illness often goes hand in hand with stigma. Stigma can be understood as disesteem. I suggest it’s an irrational form of disesteem. It is based on the incorrect, implicit, assumption that people are responsible for their illness, or that the illness itself represents a deficiency of character. Stigma is the result of others believing that the stigmatised person does not have qualities worthy of esteem. And this results in stigmatised people being excluded from the esteem economy.

This has devastating effects on self-esteem. Arguably, one of the greatest challenges facing stigmatised individuals is the lack of esteem they receive from family, the community and professionals. This leads to a lack of self-esteem and resulting self-stigma. Self-stigma can prohibit individuals from achieving goals and can have detrimental effects on health outcomes.

While the authors state that everyone can pursue esteem, this doesn’t seem applicable for individuals who are unable to meet society’s benchmarks in terms of performance. Clearly, there needs to be other criteria by which individuals are ‘judged’ for performance, such as courage. But, often this is not the case. If a person is esteemed because it is believed that they have earned positive appraisal, then stigma automatically sidelines mental health consumers. And this is wrong.

Here are some ideas about how an economy of esteem should operate in society. My basic idea is that it is important to esteem everyone, to see their potential and to respond to that potential, rather than responding to their achievements.

We need to look closely at a person’s circumstances, including any disadvantage. Society is not a meritocracy. Some individuals are more privileged, and more able to compete in an economy of esteem, than others. If we don’t understand the circumstances of others, we’re not making rational judgements when we esteem or disesteem them. We are acting from our conditioning. What we have been implicitly taught to value. These implicit commitments need to be questioned.

My belief is that we perform better when we are given esteem upfront. We need others to believe in us if we are to believe in ourselves.

And this has direct ramifications in terms of mental health treatment. Good treatment involves professionals supplying esteem. But they can only do this if they actually esteem a person. For treatment to work professionals, family and the community need to see beyond stigma to the inherent worth of the individual.

I have discussed some ideas from the book “The economy of Esteem” and related these to mental illness. I have then suggested some ideas about esteem in our society. It’s important to note that this book is a positive account of esteem. This means, it is an account of how esteem actually works in our society. It is not a normative account, that is, an account of how esteem should work in society. In contrast, my ideas are normative.

We all need to feel valued and to have our worth reflected to us by others. This is particularly necessary when we are lacking in self-esteem. It is our role to respect everyone for their intrinsic value. When we esteem others, we offer them the opportunity to develop courage and strength and self-esteem. This allows individuals to set goals that are in line with their potential.

Rather than being a rare commodity available to few, we have it in our power to give generously to others. Once we accept that we cannot know the full circumstances of an individual, their challenges and adversities, we can choose to see the potential in those around us. In return, we hope that others see our own potential. In this way, we create a society of mutual support and a climate of growth and self-acceptance.