Sunday, 30 June 2013

Mental Health without Mental Illness?

The Sunday Times  boasts two agony aunts: Mrs. Mills and Sally Brampton . Aunt Sally deals with the serious stuff and has a side-bar that recommends books, products and websites she thinks might help readers. In today's issue there's a recommendation for a book: Jonathan Haidt's "The Happiness Hypothesis". This might be a fine book and I may even read it but the wording of  the recommendation itself bothers me. Brampton writes that the book is "part of the positive psychology movement (which emphasises mental health rather than mental illness)".

Which Emphasises Mental Health Rather Than Mental Illness.
This got me thinking; is it possible to emphasise mental health without mental illness? Those who advocate more thinking about mental health, more talking about mental health, more funding of mental health and that we all need to look after our mental health would dispute that they are raising the incidence of mental illness. They claim that the more we look after our mental health, the less likely we are to succumb to mental illness.  I would argue that the opposite is true.

This is because you cannot promote one side of the coin without the other. The definition of mental health espoused by the positive psychologists is broad and its breadth necessitates a corresponding broadening of mental illness. Take this definition of mental health from the, ahem, well-known yoof website
“Mental health is about more than being free of mental illness such as depression, bipolar disorder, schizophrenia etc. It is also about having a positive sense of wellbeing. Positive mental health allows us to enjoy life’s pleasures, believe in our own abilities, cope with the normal stresses of life, work/study productively and enjoy socialising.”
Is this telling a young person that if he or she doubts their own abilities, finds life hard to cope with, find study difficult or look forward to the school disco only to find it the inner circle of Hell, that they have a mental health problem? The problem with this definition of mental health is that it can be summed up in one word: perfection.
Because if you're a young person who enjoys socialising, studies productively, believes in your own abilities, appreciates life's pleasures and has developed adult coping skills while still a teenager, then you're just about perfect.
This is the mental health that we are promoting to young people, that the ads on television urge us to mind, that SPHE and tries to inculcate and that Minister Quinn wants to put at the heart of the new Junior Cert.  Schools are adorned with positive thinking slogans. Motivational speakers are brought in to address Transition Year students, often on the theme of Positive Mental Health.  My local Mental Health Organistion no longer satisfy themselves wth providing support to psychiatric patients and their families. They now run an annual Mental Health Fair, attended by teens from the entire province. Past speakers include Patrick Holford. You can read more about his work here

Promoting Inadequacy
I believe that promoting mental health as not just the absence of mental illness but as a state of psychological perfection is leading to the rise of mental illness. Not actual, real mental illness but rather Mental Illness Lite, or mental health problems as described by another website, this time aimed at a younger audience than SpunOut. This website is

 A mental health problem occurs when someone's thoughts or feelings are troubling them, to the extent of affecting their day to day activities or relationships. They may not necessarily have a mental illness, but could need help to get them through a difficult time. A mental health problem that isn't sorted out could lead to someone developing a mental illness.

A mental illness is a more serious or long-lasting problem, which can be diagnosed by a doctor or mental health professional. It may require medical treatment as well as support. There are many different types, just as there are different forms of physical ill health. Examples include schizophrenia and clinical depression.”

Needing help to get through a crisis does not mean having a mental health problem. It means being human. These campaigns are dangerous not only for the effect they have on unhappy young people who are encouraged to self-diagnose and seek medical help for non-medical problems, but also for the effect they have of lowering compassion and empathy in the population at large. Categorising some-one else's difficulty as a health problem might lead to an increase in sympathy but it also leads to a categorising of the person affected as the Other.  We would be far better off cultivating the idea of Common Humanity, as defined by Dr Kristin Neff
 " Common humanity recognises that suffering and feelings of personal inadequacy are part of the shared human experience - something we all go through rather than something that happens to "me" alone."
Mental health advocates try to get around this by arguing that all of are vulnerable to mental health problems, that we all need to take care of our mental health but this not true. Most of us do not carry genes for disorders like bipolar, the majority of people will never experience psychosis or debilitating depression.

I have written here mostly about young people, not just because I work with them, but because my own experiences with the mental illness services began when I was sixteen. I was a vulnerable teenager, full of unrecognised anger at those around me, full of  what David Grey calls "the yearning inside to swim with the tide and taste it" but I wasn't as atypical as I feared. And I can see now, looking back, that what would have helped me was compassion and acceptance and reassurance. Instead began a ten year slide that started slowly, with counselling, and developed over time to anti-anxiety drugs, to anti-depressants and anti-psychotics, to self-harm, to failed bids to end my life, to locked wards and social exclusion.

I think now of myself as I sat in the GP's surgery for the first time. I didn't enjoy socialising. I struggled to reach my potential in school. I found it hard to cope with  living at home after all  my siblings had left. I doubted my own abilities. But my mental health? My mental health was fine.


Thursday, 27 June 2013

Is is too late? Today's now is next year's then.

Is it too late? Am I too late? The most maddening questions of all. Since about the age of fifteen, I've felt like the White Rabbit checking my watch and muttering "f**kitty, f**kitty, fuckitty, f**k, f**k", or staring in desperation as the sand flows through the hour glass. I think often of Marguerite Duras' observation that "Very early in my life it was too late."

My over-riding feeling these days is "It wasn't too late then, but it is now". That I wasted years and years bemoaning my lost years. My real lost years numbered around seven; from the time I went in to St. Ann's to the second time I was discharged from St. Patrick's. The latter was more than ten years ago and I've spent most of those ten years recovering from treatment
Now I realise that it wasn't too late. That nineteen is a fine age for your first kiss. I turned up for the first day of the HDip thinking I'd be the granny of the class but soon found out that twenty-nine is a common time to turn to teaching as a career. And I know that thirty-eight is an okay age to have a baby and that if I get pregnant in the next two months, I will indeed a mother by thirty-nine. Which wouldn't be bad for some-one who lived at home until she was thirty-seven.

The logical turn seems to be that today's now is next year's then and, following on the pattern, I am surrounded by opportunities that in year's time, or even a month's time, I'll be kicking myself I didn't exploit. This is the logic, but the reality is subtly different. I might be the same person I was five years ago, and the world might be the same place, but my place in said world has changed. I am no longer a young woman. I woke up and smelled the pheromones only to realise they were coming from the married men who are everywhere. Men who were single when I was busy being crazy. And when it comes to writing I don't have the time now. I can make the time, I can carve it out.
So in one way, it's later. But later doesn't have to mean too late. It might be too late. It's too late now to go back to college and do journalism rather than the HDip, it's too late to go back in time and act less crazy and get back on Campus Radio and launch my broadcasting career. It's too late to go back and photocopy and keep the whole, entire novel that I wrote and can't find. It's too late now to be nicer to the gorgeous man who really liked me but who now lives half-way around the world and is seeing another woman.
But does all this mean that It's Too Late? I don't know.

I've made major changes in my life lately. Following on from joining Gateway Women, an online community for NoMo's(women who are not mothers) I found the work of Brene Brown. Brown's work has transformed my way of thinking. I've thought for many years that my experiences were not down to mental illness but couldn't articulate what they were down to, until I read "The Gifts of Imperfection" and realised the role that shame has played in my life. The book recommends Gretchen Rubin's "The Happiness Project"  and I feel I have found a kindred spirit there. I've printed out the Resolution Sheets and feel finally, what I've always wanted, a tool to help me get a grip on my life.
So the past few days, having seen the fantastic effect my reading and changing has had on my life, I ask "Is it too late?" Will what I've learned help me reach my goals, my mountain, or merely help me come to terms with never getting there?

Today's step is to realise: It doesn't matter. It doesn't matter whether or not it's too late because I won't know it's too late until it has already been too late. I won't know until now is then. And by then it really will be too late. Or it won't have been.

The sand  is still trickling from the bosom to the hips of the hourglass. But the White Rabbit is sitting down and having a nice rest.

Monday, 24 June 2013

Instruments of Navigation; Why Rihanna is Wrong

The theme of this blog is choices and how to make the right choices so as to reach the mountain by the least circuitous path. So I was a bit stumped today because it was, as I saw it, a day devoid of choices.
A few months ago I made the decision to once more act as an advisor for the State Exams Commission. I didn't even make the decision; the form came, I signed it and sent it back. I figured I need the money and I like having people in my regular job know that I'm an advisor. The money point is fair enough but the second point is based on my feelings of not being enough. It's still a valid point though, and should in theory do me no harm.
All things come at a price however, and last week was when I started paying. The work involves three trips up the country. The last of these was today. I set the alarm for 6 o'clock, got up and drove, knowing how I'd spend the day and knowing I'd have to drive back in the evening. No choice. No backing out at this stage beyond pulling a sickie.
I decided the only choice I could make today was to try to be happy. I would try to have a happy day. And I did, and I had a happy enough day because I remembered at the neutral bits, the standing around bits, to point towards happiness, towards the mountain. Even the existence of neutral bits was new to me.
Am I any nearer the mountain than yesterday? I don't know. I have decided though, that one of my navigational tools will be to move towards happiness. They say that that's how cats and pigeons navigate. Once they have lived in area long enough, they know the angle of the sun. Put them in a strange place and they move in one direction, find the angle worse and try another and another until the angle improves. That's how they make their way home. So in my choices I will aim to do things that make me feel happy in the short-term.
That awful song "Diamonds" has been running through my head. I find "I choose to be happy" the most irritating lyrics ever as they imply that happy people are that way because they choose to be and ergo, unhappy people are unhappy because somewhere along the line they decided to be unhappy. We had a speaker in work one day who said the same thing. A motivational speaker who told us life was all about choices and people who are depressed are that way because they're making the choice to be that way. I was outraged then, and still am. How can anyone make the choice to move towards happiness in a world so lacking in compassion? No-one chooses to be depressed, or chooses to be unhappy. I didn't choose to be a psychiatric patient. I did what I thought was best. I did what I thought would appease those who held the power and authority in my life. I didn't think I had a choice as I'd been in situation and situation where it was explained to me that I didn't have  a choice.
-You have to stay here until the doctor says you can go.
-You have to take this pill.
-You have to stay away from the person who is complaining about you.
-You have to accept that you're not wanted here/there.
And I did have to stay there until they let me go, and I did have to take the pill. I didn't realise how I could have behaved to make them let me go. I thought I did, and I tried but the more I tried the more determined they became to keep me prisoner.
Happiness was an impossibility for me. Not a theoretical impossibility, but impossible given my lack of knowledge, my situation and my lack of support. I gave up. I lost the map.
Today I had a happy day. Not a good day- I spent it a prisoner of my sense of lack- but a day in which all my choices were based on what would bring me the greater happiness. Rihanna was wrong; we can't choose to be happy. We can only choose to move towards happiness.

Sunday, 23 June 2013

First, Locate Your Mountain

The title of this blog come from Neil Gaiman's commencement speech at the University of the Arts in 2012. It's at the bottom of the page and I highly recommend it. I came across the speech on and it's been on the back of my mind for a while.

It's a simple concept and hopefully on that works. My life so far has taken me far from the mountain, or I have taken myself far from the mountain. Maybe so far I'll never reach it in this lifetime.

I have to start the journey though, as it's the only one worth taking. I'm seeing the world now like one of those maps at the start of fantasy fiction novels. There's the Mountain, and where I am now, and beyond that the Swamps of Despair and the Saline Sea of Infertility and the Forest of Confusion. Beyond them again, around the perimeter of my imaginary world, lies the Desert of Oblivion. It's a small world; life is short and I don't like travel.

Before I can take any steps I have to define my mountain. What is it like, beyond high and imposing? I came up with three things this morning to define my mountain; motherhood, publication and a full-time contract in my current job. I just threw the last one in because it feels more attainable than the others. Up to now these have been three separate locations on my cognitive map but I have put them all together because it's my map in my head and I can do that.

So my mountain is personal to me. Your mountain may be different. No, it'll definitely be different. So far today I've taken these steps towards my mountain:
-decided to taken Gaiman's advice.
-decided I want to happy along the way and that this will form part of the journey to the mountain.
-started the blog.

This is a test post. The work begins tomorrow.