Schizo-surveillance: the politics of sanity
Psychiatry has been scrutinized more as a mechanism of control than recognized as a tool for healing. Why is this? Are psychiatrists trying to heal those mentally unwell? Many of them (almost all of them even), yes. But psychiatry, as a symbol, has been weaponized into a blunt instrument of ideological enforcement. Let me explain.
"Sluggish schizophrenia"—a phrase coined by the Soviet Union—was their preferred phrasing instead of the more commonly understood "paranoid schizophrenia." This was a diagnosis used by the Soviets as a mechanism of control, one that masqueraded as care. Those who could not contort their identities into the state-prescribed reality were no longer simply wrong…they were considered schizophrenic. The disorder was fabricated to brand political opposition as pathological. No delusions, no hallucinations—just an unfiltered dose of independent thought. Some of these patients may have demonstrated schizo tendencies, but schizophrenia is a spectrum, one that we all operate on. Those who lean towards neurosis might not be so crazy but instead…hyper-aware of an enforced and prescribed narrative.
The relationship between psychiatry and power never disappeared…it has merely adapted. It became more integrated. Instead of overt political repression, its influence now seeps into corporate rhetoric, media narratives, and online discourse. So, it became more integrated, more efficient.
Here’s an example…
Jordan Peterson and others have lumped postmodernism and Marxism into a vague, amorphous category that serves as a catch-all diagnosis for anything they find politically dangerous. In more mainstream right wing circles, ‘DEI’ functions in a similar vein…implying that these ideas are symptoms of a larger mass psychosis, a collective irrationality that must be exposed and eradicated. Terms like “woke mind virus” echo psychiatric language, framing belief in these ideas as akin to a contagious mental disorder.
By positioning those that are vaguely distributed into these categories (woke, postmodern neo-Marxist) as inherently detached from reality, the right effectively renders it unworthy of rational debate, because for them, you don’t debate someone who is psychotic, deranged, or delusional…you manage them, neutralize them, and dismiss them.
Yes, I’m aware the left does this too. I decided to check out what was happening on Fox News and couldn’t help but feel like the entire place is an endless schizo rant—where everyone speaks in some strange, self-referential meme language. There’s analysis to be done on that front as well. There is a power structure embedded in their language—one that is weaponized for nefarious purposes by constantly invoking symbols of legitimacy to maintain control (also, it’s this part that the left uses like a bunch of superficial and performative idiots).
Anyway, let me explain how I’m using schizophrenia. A study on schizophrenia in China revealed just how deeply cultural frameworks shape both stigma and social control. In the Western psychiatric model, there is a strong emphasis on the biomedical—framing schizophrenia as a discrete brain disorder. But consider the Chinese concept of xiang tai duo (“thinking too much”), which treats it as an extreme form of ordinary cognition—rumination taken to pathological excess. An explosion of neurosis that, unchecked, can escalate into psychosis.
Do you see the connection? The paradox, even?
On one level, this reframing makes schizophrenia more legible by integrating it into familiar patterns of thought. The afflicted are no longer seen as incomprehensible anomalies but as individuals who have simply lost their sense of mental balance. They are, in a sense, not centrist enough! Perhaps we should just introduce them to the "enlightened centrist"—the one too scared to take a stand on anything, preferring instead to pontificate endlessly about how much they love discourse...
(Sidetracked.)
The point is: moral standing is a big deal in China…and their framing helps preserve the afflicted individual's moral legitimacy. Rather than being perceived as something foreign, defective, or alien, the patient is reframed as someone whose mind is operating in excess. Their neurotic cognition is simply unable to find a state of contentment because…at least in the context of this essay…they do not wish to conform to a prescribed reality.
This is the example I want you to keep in mind, because this is how these structures become weaponized.
Now, consider the flip side: by linking schizophrenia to overthinking (xiang tai duo), this subtly implies that the sufferer bears some responsibility for their condition. It also means the behavior can be learned. This does not mean the diagnostic framework is wrong—that’s not my point—but it does create space for conformity to be demanded at a political level.
"Oh, they simply don’t fit in because they’re thinking too hard—seeing conspiracy where none exists!"
Or… perhaps we should be coming to terms with the reality that much of our cognition is based on learned behavior…which inevitably requires a powerful enforcer.
We see it and hear it all the time: "The government has been overtaken by radical extremists!"…"The postmodern neo-Marxists have infiltrated academia!"
The underlying implication of these critiques? That those who hold them are delusional, gripped by fantastical thinking, and mentally unwell.
This is the reality: governments, corporations, and media outlets subtly (or explicitly) frame dissenters as mentally unstable—reducing radical thought to a symptom rather than an argument.
And this isn’t just a tool of authoritarian regimes. Consider the United States, where psychiatric labeling has long been used to neutralize political threats. In The Protest Psychosis: How Schizophrenia Became a Black Disease, psychiatrist and historian Jonathan Metzl examines how schizophrenia diagnoses in the U.S. were manipulated in the 1960s to criminalize Black resistance.
At Ionia State Hospital in Michigan—once a psychiatric institution, now a prison—Black men involved in the civil rights movement were disproportionately labeled schizophrenic, their political rage reframed as psychiatric pathology. Why? Because in 1968, the DSM-II redefined schizophrenia, adding “hostility” and “aggression” as symptoms. Suddenly, the same traits that made a person revolutionary could now make them insane.
Now, I know the DSM has evolved since then—but that’s not the core of my point. This is about power—about how those who pull the levers of control weaponize psychiatric and cultural narratives to dismiss and ostracize their dissidents.
What does this tell us about the category of mental illness itself? Do we fully consider how various positions of power weaponize this language at different levels? Further options in a toolset of control.
If schizophrenia—or the schizo spectrum, in this case—can be understood as thinking too much, what does that mean for the person who questions too much? The one who refuses to accept the prevailing order? If rational thought is defined by how closely it aligns with dominant narratives, then paranoia, skepticism, or hyper-analysis become liabilities. And the more someone diverges, the more easily they are slotted into the framework of mental illness—an individual problem to be medicated rather than a social condition to be interrogated.
I’m still developing my thoughts on this... but even within frameworks that seem to offer compassion, the logic of control persists. While xiang tai duo may grant schizophrenia a kind of moral acceptability, it still functions as a disciplinary mechanism. It still tells the sufferer: “You are wrong because you have gone too far.” And in that reasoning, we see the broader function of psychiatry under power—not just to heal, but to define the limits of the thinkable.
So where does pathology end and political convenience begin? How do we distinguish genuine illness from constructed deviance? And in an era where paranoia (schizo) is both encouraged (rabbit-hole conspiracies, hyper-analyzed digital discourse) and pathologized (fringe groups dismissed as delusional), how does the internet reshape this dynamic?
If psychiatry is a mirror to society, then perhaps our concept of sanity is less about truth than it is about obedience. And if that’s the case—who gets to decide what thoughts are excessive? Who gets to decide who needs to be cured?
Stay curious.
Excellent piece. You focus on schizophrenia as an example but it has me thinking about more popular diagnoses in the modern culture—adhd, depression, anxiety, autism, etc.
Many of these seem to me to be partially political—taking somewhat normal reactions to a broken modern society, or at least a normal reaction for a sizable chunk of people—and reframing it as a personal neuro-emotional problem.
The interesting aspect about how this manifests in modern society is that the people themselves play a huge role in perpetuating it. This likely happened in many other contexts, probably including china, but it differs from the more authority-enforced way it occurred in the 60s black rights movement.
Much to think about.
I had the thought a little while ago that the design of the major social media platforms not only encourage schizophrenic symptoms in individual users, particularly through features like algorithms showing one more content like that which they have already seen or engaged with, but through the very shape of the platforms being that which resembles the neurobiology of the schizophrenic brainstate.
In the neurochemical model, at least, schizophrenia is characterized by an excess of dopamine that exists because the brain fails to eliminate it after its normal deployments in neuron signaling. Normally, the brain uses dopamine for reinforcing a stimulus, and once that's over with the dopamine goes away. But in the schizophrenic condition, this dopamine hangs around for far longer, having a likewise effect of constantly reinforcing stimuli beyond their original sensory inputs, hence the common symptoms of hallucinations and apophenia.
And on something like Facebook or Youtube, content is always fed endlessly, without clear ends to bookend experiences (also why one can waste hours there and remember nothing), and is homogenous to what one already engages with, reinforcing its own themes, worldviews, etc. On the social level, groups and social circles similarly curdle together to feed reinforcing stimuli into themselves, something beyond just the infamous 20th century cults. QAnon and the Zizians could not exist at the formalistic level without the internet.