Challenging ideas in mental health
Challenging ideas in mental health

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Challenging ideas in mental health

1.2 Boundaries of exclusion

The first idea to come under critical consideration is that of boundaries. Boundaries can be helpful and, indeed, we use them here as a means of exploring different, and competing, explanations of mental health and distress. However, they can also be limiting and excluding, emphasising the differences between people, some of which run very deep. At their simplest, boundaries put limits on tasks so that they appear manageable. They help to mark out personal space in a shared office, or indicate the extent of someone's home and garden. Boundaries are often physical, represented by partitions or walls or fences, to show who is allowed in and who is not (and under what terms).

The sorts of boundaries we consider here are more social than physical. They also define ‘who's in and who's out’, as Shakespeare's King Lear explains:

So we'll live,

And pray, and sing, and tell old tales, and laugh

At gilded butterflies, and hear poor rogues

Talk of court news; and we'll talk with them too –

Who loses and who wins; who's in, who's out –

And take upon's the mystery of things …

(King Lear, Act V, Scene iii, lines 11–16)

The king at this point was excluded from the royal court and was more at one with the ‘poor rogues’ on the outside. This was because he had crossed a social divide – into madness. He was on the other side of a crucial social boundary that determines ‘who's out’ on account of their mental distress. In many ways, social boundaries are the most pervasive. They serve to exclude people who look or behave differently, and they are much harder to shift than a garden fence.


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