Mental wellbeing

 

I'm lucky to be in a book club, a fabulous small bunch of blokes who read interesting books and get together once a month in our local pub (and later at the Italian restaurant for affogato and dessert). I'm a newby. This month was my turn to offer a book. Dangerously, I submitted a title I hadn't read, but one from a writer I know and trust, Alain de Botton.

His latest book, A Therapeutic Journey, offers insight into the minds and lives of those of us struggling to stay well mentally. It was heavy going for some of us. A bit close to home and a bit heavy, but deeply appreciated by others.

The strength of the book from my reading, was the normalising of mental sickness. We know that mental illness has become a common, almost ubiquitous phenomena, draining so much life from families, communities and workplaces, let alone the quality of life for those who suffer. De Botton offers an invitation to understand and therefore empathise with those who's internal demons have too much sway. In this post I will copy one little section that I found particularly useful from very early in the book. (What follows is a direct quote from page 8 onwards, not my words.)

***

A mind in a healthy state is, in the background, continually performing a near miraculous set of manoeuvres that underpin our moods of clear-sightedness and purpose. To appreciate what mental health involves- and therefore what makes up its opposite- we should take a moment to consider some of what will be happening in the folds of an optimally functioning mind: 

• First and foremost, a healthy mind is an editing mind, an organ that manages to sieve, from thousands of stray, dramatic, disconcerting or horrifying thoughts, those particular ideas and sensations that actively need to be entertained in order for us to direct our lives effectively. 
• Partly this means keeping at bay punitive and critical judgments that might want to tell us repeatedly how disgraceful and appalling we are-long after harshness has ceased to serve any useful purpose. When we are interviewing for a new job or taking someone on a date, a healthy mind doesn't force us to listen to inner voices that insist on our unworthiness. It allows us to talk to ourselves as we would to a friend. 
• At the same time a healthy mind resists the pull of unfair comparisons. It doesn't constantly allow the achievements and successes of others to throw us off course and reduce us to a state of bitter inadequacy. It doesn't torture us by continually comparing our condition to that of people who have, in reality, had very different upbringings and trajectories through life. A well-functioning mind recognises the futility and cruelty of constantly finding fault with its own nature.
• Along the way, a healthy mind keeps a judicious grip on the drip, drip, drip of fear. It knows that, in theory, there is an endless number of things that we could worry about: a blood vessel might fail, a scandal might erupt, the plane’s engines could sheer from its wings... But it has a good sense of the distinction between what could conceivably happen and what is in fact likely to happen, and so it is able to leave us in peace as regards the wilder eventualities of fate, confident that awful things will either not unfold or could be dealt with ably enough if they ever did so.
• A healthy mind avoids catastrophic imaginings: it knows that there are broad and stable stone steps, not a steep and slippery incline, between itself and disaster. A healthy mind has compartments with heavy doors that shut securely. It can compartmentalise where it needs to. Not all thoughts belong at all moments. While talking to a grandmother, the mind prevents the emergence of images of last night's erotic fantasies; while looking after a child, it can repress its more cynical and misanthropic analyses. Aberrant thoughts about jumping on a train line or harming oneself with a sharp knife can remain brief peculiar flashes rather than repetitive fixations. A healthy mind has mastered the techniques of censorship.
• A healthy mind can quieten its own buzzing preoccupations in order, at times, to focus on the world beyond itself. It can be present and engaged with what and who is immediately around. Not everything it could feel has to be felt at every moment.
• A healthy mind combines an appropriate suspicion of certain people with a fundamental trust in humanity. It can take an intelligent risk with a stranger. It doesn't extrapolate from life's worst moments in order to destroy the possibility of connection.
• A healthy mind knows how to hope; It identifies and then hangs on tenaciously to a few reasons to keep going. Grounds for despair, anger and sadness are, of course, all around. But the healthy mind knows how to bracket negativity in the name of endurance. It clings to evidence of what is still good and kind. It remembers to appreciate; it can- despite everything- still look forward to a hot bath, some dried fruit or dark chocolate, a chat with a friend or a satisfying day of work. It refuses to let itself be silenced by all the many sensible arguments in favour of rage and despondency.

Outlining some of the features of a healthy mind helps us to identify what can go awry when we fall ill. At the heart of mental illness is a loss of control over our own better thoughts and feelings. An unwell mind can't apply a filter to the information that reaches our awareness; It can no longer order or sequence its content. And from this, any number of painful scenarios ensure:

• Ideas keep coming to the fore that serve no purpose, unkind voices echo ceaselessly. Worrying possibilities press on us all at once, with doubt any bearing on the probability of their occurrence. Fear runs riot.
• Simultaneously, regrets drown out any capacity to make our peace with who we are. Every bad thing we have ever said or done reverberates and cripples our self-esteem. We are unable to assign correct proportions to anything: a drawer that doesn't open feels like a conclusive sign that we are doomed; a slightly unfriendly remark by an acquaintance becomes proof that we shouldn't exist. We can't grade our worries and focus in on the few that might truly deserve concern.
• We can't temper our sadness. We can't overcome the idea that we have not been loved properly, that we have made a mess of the whole of our working lives, that we have disappointed everyone whoever had a shred of faith in us.
• Every compartment of the mind is blown open. The strangest, most extreme thoughts run unchecked across consciousness. We begin to fear that we might shout obscenities in public or do harm with the kitchen knives.
• In the worst cases, we lose the power to distinguish outer reality from our inner world. We can't tell what is outside us and what inside, where we end and others begin; we speak to people as if they were actors in our own dreams.
• At night, such is the maelstrom and the ensuing exhaustion that we become defenceless before our worst apprehensions. By 3:00 AM, after hours of rumination, doing away with ourselves no longer feels like such a remote or unwelcome notion.

However dreadful this sounds, it is a paradox that, for the most part, mental illness doesn't tend to look from the outside as dramatic as we think it should. The majority of us, when we are mentally unwell, will not be foaming at the mouth or insisting that we are in Napoleon. We won't be making speeches about alien invasions or declaring that we control space and time. Our suffering will be quieter, more inward, more concealed and more contiguous with societal norms; we’ll sob mutely into the pillow or dig our nails silently into our palm's. Others may not even realise for a very long time, if ever, that we are in difficulty. We ourselves may not quite accept the scale of our sickness.