Video description: Live with your strength, not with your weaknesses. "Bizarre how fast your life can change," that’s how Clarissa started her talk. She worked as a caregiver when she got mentally ill.
Video description: Live with your strength, not with your weaknesses. "Bizarre how fast your life can change," that’s how Clarissa started her talk. She worked as a caregiver when she got mentally ill.
My mother was a woman hollowed out like a tree struck by lightning. I wanted to know why.
Ever since her first suicide attempt, in 1978, when I was 22, I had been trying to fill in gaps. She was gone much of the time in my early childhood, and when she returned nobody spoke about the absence.
I learned much later that she had suffered acute depression after my younger sister’s birth in 1957. She was in hospitals and sanitariums being shot full of insulin — a treatment then in vogue for severe mental disorder — and electricity. The resulting spasms, seizures, convulsions and comas were supposed to jar her from her “puerperal psychosis,” the term then used in England for postpartum depression.
In 1958, my mother was admitted to the Holloway Sanatorium, the sprawling Victorian Gothic fantasy of a 19th-century tycoon, Thomas Holloway, who amassed a fortune through the sale of dubious medicinal concoctions. The sanitarium, opened in 1885, was a great heap of gabled redbrick buildings, topped by a tower rising 145 feet into the damp air of Surrey.
Run initially as a private institution, the Holloway Sanatorium became a mental hospital within Britain’s National Health Service after World War II. It was not closed until 1981. Many of its records and casebooks were burned. The gutted building became a setting for horror movies. Directors could not believe their luck. It is now a gated community of luxury homes.
Some records were preserved at the Surrey History Center. In the faint hope that a trace remained of my mother, I wrote to inquire. My parents had never spoken in any detail of her first depression. A letter came back a few weeks later. References to June Bernice Cohen had been located in the admissions register and in ward reports from July 1958.
These showed that “she was patient number 9413, was admitted on 25th July 1958 and discharged on 12th September 1958.” The ward reports for most of August and September had vanished. I applied under Britain’s Freedom of Information Act to see the records.
My re-encounter with my mother involved painstaking negotiation with an archivist. At last I was presented with the weighty register for female patients. Entries are written with fountain pen in cursive script. In columns across the page my mother is identified. “Name: June Bernice COHEN. Ref Number: 9413. Age: 29. Marital Status: Married. Religion: JEW.”
I stared at her age — so young — and at the capitalized entry under religion: “JEW.” The noun form has a weight the adjective, Jewish, lacks. It seems loaded with a monosyllabic distaste, which was redoubled by the strange use of the uppercase. June was not religious. She is the youngest on the page. She is also the only non-Christian.
The first ward notes on my mother read, “History of depression in varying degrees since birth of second child, now fourteen months old. Husband is engaged in medical research. Patient has some private psychotherapy and also modified insulin treatment at St. Mary’s last month, being discharged July 8th. On admission she was depressed, tearful and withdrawn.”
The doctor examining my mother was struck by how “her tension increased remarkably on mention of latest child.” I ran my fingers over the page and paused at “JEW.” I wanted to take a soothing poultice to her face.
On July 28, 1958, my mother was visited by a Dr. Storey. He “confirms diagnosis of post-puerperal depression and advises Electro-Convulsive Therapy (ECT), which patient and husband are now willing to accept.”
She first underwent electroshock treatment on July 30, 1958. I see my slight young mother with metal plates on either side of her head, flattening her dark curls, her heart racing as her skull is enclosed in a high-voltage carapace. I can almost taste the material wedged in her over-salivating mouth for her to bite on as the current passes.
The treatment was repeated a second time, on Aug. 1, 1958. That was one day before my third birthday. So, at last, that is where she was.
I now have some facts to anchor memory, fragments to fill absence. My mother, who recovered sufficiently to be stable, if fragile, for about 15 years through my childhood and adolescence, would suffer from manic depression, or bipolar disorder, through the latter third of her life. She died in 1999 at the age of 69. The ravages of this condition I observed; the onset of her mental instability I only felt.
The hidden hurts most. Mental illness is still too clouded in taboo. It took me a long time to find where my mother disappeared to. Knowledge in itself resolves nothing, but it helps.
Acceptance — it comes down to that. This is how I came to this point, and to this place, by this looping road, from such anguish, and I am still alive and full of hope.
Loser! You messed this up again! You should have known better!
It’s that know-it-all, bullying, mean-spirited committee in your head. Don’t you wish they would just shut up already?
We all have voices inside our heads commenting on our moment-to-moment experiences, the quality of our past decisions, mistakes we could have avoided, and what we should have done differently. For some people, these voices are really mean and make a bad situation infinitely worse. Rather than empathize with our suffering, they criticize, disparage and beat us down even more. The voices are often very salient, have a familiar ring to them and convey an emotional urgency that demands our attention. These voices are automatic, fear-based “rules for living” that act like inner bullies, keeping us stuck in the same old cycles and hampering our spontaneous enjoyment of life and our ability to live and love freely.
Some psychologists believe these are residues of childhood experiences—automatic patterns of neural firing stored in our brains that are dissociated from the memory of the events they are trying to protect us from. While having fear-based self-protective and self-disciplining rules probably made sense and helped us to survive when we were helpless kids at the mercy of our parents’ moods, whims and psychological conflicts, they may no longer be appropriate to our lives as adults. As adults, we have more ability to walk away from unhealthy situations and make conscious choices about our lives and relationships based on our own feelings, needs and interests. Yet, in many cases, we’re so used to living by these rules we don’t even notice or question them. We unconsciously distort our view of things so they seem to be necessary and true. Like prisoners with Stockholm Syndrome, we have bonded with our captors.
If left unchecked, the committees in our heads will take charge of our lives and keep us stuck in mental and behavioral prisons of our own making. Like typical abusers, they scare us into believing that the outside world is dangerous and that we need to obey their rules for living in order to survive and avoid pain. By following (or rigidly disobeying) these rules, we don’t allow ourselves to adapt our responses to experiences as they unfold. Our behavior and emotional responses become more a reflection of yesterday’s reality than what is happening today. And we never seem to escape our dysfunctional childhoods.
The Schema Therapy Approach
Psychologist Jeffrey Young and his colleagues call these rigid rules of living and views of the world made by the committee in our heads “schemas.” Based on our earliest experiences with caregivers, schemas contain information about our own abilities to survive independently, how others will treat us, what outcomes we deserve in life, and how safe or dangerous the world is. They are also responsible for derailing intimate relationships.
Young suggests that schemas limit our lives and relationships in several ways:
A woman we will call Diana has a schema of “Abandonment.” When she was five years old, her father ran off with his secretary and disappeared from her life, not returning until she was a teenager. The pain of being abandoned was so devastating for young Diana that some part of her brain determined she would live her life in such a way as to never again feel this amount of pain. Also, as many children do, she felt deep down that she was to blame: she wasn’t lovable enough, or else her father would have stuck around; a type of “Defectiveness” schema.
Once Diana developed this schema, she became very sensitive to rejection, seeing the normal ups and downs of children’s friendships and teenage dating as further proof that she was unlovable and her destiny was to be abandoned. She also tried desperately to cover up for her perceived inadequacies by focusing on pleasing her romantic partners and making them need her so much that they would never leave her. She felt a special chemistry for distant, commitment-phobic men. When she attracted a partner who was open and authentic, she became so controlling, insecure and needy that, tired of not being believed or trusted, he eventually gave up on the relationship.
Diana’s unspoken rule was that it was not safe to trust intimate partners and let relationships naturally unfold; she believed that if she relaxed her vigilance for a moment, her partner would leave. In an effort to rebel against her schema, she also acted in ways that were opposite to how she felt; encouraging her partner to stay after work to hang out with his friends, in an attempt to convince herself (and him) that she was ultra-independent. This led to chronic anger and dissatisfaction with her partner.
Diana did not understand her own role in this cycle. Diana (and her partner) needed to understand how her schemas resulted in ways of relating to herself and others that are repetitive, automatic, rigid, and dysfunctional. By acknowledging and connecting with her unresolved fears and unmet needs, Diana could become more flexible and allow her partner more freedom without feeling so threatened.
The schema concept helps us understand how early childhood events continue to influence adult relationships and mental health issues, that we need to recognize their influence and (with professional help, if necessary), begin to free ourselves.
Six Things You Can Do Right Now
The tools and tips below will help you begin to identify your core schemas and take some corrective actions.
2. In close relationships, think about your partner’s background, beliefs and behaviors to see whether they fit into one of the schema patterns identified here. Think about the times when your communication gets derailed and you both get angry or defensive. What schemas may each of you be bringing to the table and how may they be setting each other off. For example, a partner who has an Entitlement schema may act in needy and demanding ways that trigger the partner with an Emotional Deprivation schema to feel uncared for.
3. Pay attention to when you or your partner are getting triggered. You may notice feelings of anger or helplessness, thoughts that contain the words “always” or “never,” and feelings of tension or discomfort in your body. You may feel reactive and tempted to withdraw or say something impulsively.
4. Practice the STOP technique when you are triggered during a conversation with your partner. This is a practice from the Mindfulness-Based Stress Reduction course developed by John Kabat-Zinn. STOP what you are doing, TAKE a breath, OBSERVE what you are doing, thinking, feeling and what your partner is doing, thinking, feeling. Think about whether your schema is calling the shots and if you would like to change tracks. Then PROCEED with a more mindful response.
5. At a time when you are both calm, sit down with your partner and try to figure out the cycle that happens when both you and your partner get reactive to your schemas. Decide how to communicate that this is happening in the moment and call a break.
6. Train yourself in the skill of cognitive flexibility. Deliberately think about other ways to interpret your partner’s behavior that are not consistent with your schema? Perhaps he is withdrawn because he had a hard day at work. Are you personalizing things too much?
Schemas are more likely to be triggered when your emotional needs are not being met. Take some time alone to reflect on what these needs might be. Then practice some healthy ways of taking care of your own needs for love, security, comfort and so on. Harness your inner “Healthy Adult” to proactively take care of yourself so you’re less likely to feel deprived and reactive.
Is it melancholy to think that a world that Robin Williams can’t live in must be broken? To tie this sad event to the overarching misery of our times?
– Russell Brand, comedian/actor
Like millions, I am sitting with the fact that one of the funniest people to grace the planet has died by his own hand. Robin Williams’ death has hit people of my generation, Generation X, especially hard. After all, his face flashed often across our childhood screens. Mork and Mindy episodes were a source of solace for me as a little girl, as I bounced around between foster homes and family members’ homes, while my single mother cycled in and out of the state mental hospital, fighting to survive. I could laugh and say “nanu, nanu – shazbot” and “KO” and do the silly hand sign and forget for just a little while about living a life I didn’t ask for.
“You’re only given one little spark of madness. You mustn’t lose it,” may become one of Robin Williams’ most famous quotes. I was always struck by how he moved so seamlessly between wacky comedy and the most intense dramas. He was so magnificently able to capture the human experience in all its extremes. He threw all that intensity right into our faces, undeniable, raw, frenetic. He showed us our own naked vulnerability and sparks of madness and gave us permission to laugh in the face of all that is wrong in this world.
In the wake of his death, many people are understandably jumping to identify causes. Depending on who you talk to, Robin Williams’ suicide was caused by depression, it was caused by bipolar disorder, it was caused by the drugs, prescription or otherwise. We just don’t know.
As a suicide attempt survivor myself, I can attest that it’s not that easy to find any single cause for the urge to die. It’s true that along with street drugs, SSRI antidepressants and other psych drugs can certainly increase suicide risk in some people. A decade ago, I was one of many who fought and won to get to the FDA to put a black box warning on SSRIs to warn the public of these very real risks. While a drug, legal or illegal, may give us the impetus we wouldn’t otherwise have had to act on suicidal thoughts, for some of us it’s more complex than that.
Our reasons for wanting to die are as varied as our reasons for wanting to live. That, I believe, is the great mystery of suicide.
But I invite us all not to fear the mystery; not to be struck hopeless by it. We can save each other’s lives; better yet, we can find and share reasons to keep on living. If we have 20 seconds, we can share information about a hotline or a warmline. But if we want to really see this horrific epidemic end, we all have to get more involved.
As someone who has looked into the void and longed for it more than once, I can attest that anyone who reaches out in those darkest of times is truly remarkable. It is, tragically, when I am most distressed and most in need of love and acceptance, that I have the hardest time reaching out. This is not an absolution of personal responsibility, because we all must accept some measure of that; rather a recognition that we shouldn’t put the full onus on a suicidal person to “reach out” and “ask for help.” We need to reach out and help. I have written about the problems with the master narrative of suicide prevention, and how punitive and dehumanizing much of the “help” out there currently is. This blog isn’t about that. I’m talking about help that heals.
My point is that we must change the way we relate to ourselves and one another. In revolutionary ways. We must wake up to the fact that we have been socialized since birth to hide the fullness of who we really are. Robin Williams got to act it all out and the world loved him for it. He expressed the madness, the wildness, that we have been conditioned to hide. We are generally chastised for laughing too hard or crying too loud or being too sensitive. We have been trained to put on a proper face and act like all is well. If for some reason we can’t naturally do that (and most of us can’t), we devise ways to cope with the awful unbearableness of it all. They may be fairly innocuous, like binge watching Orange is the New Black in bed all weekend long. Or we may seek to stop the pain in innumerable ways that we know will kill us in the end — from binge eating to chain smoking to staring down a bottle of whiskey or pills.
If we only realized just how many people walked around carrying heavy burdens that are invisible to the world, and were doing every fucking thing possible to keep from cracking under the weight, we would stop feeling so alone and isolated carrying our own. We could put down our burdens and rest, in the all-encompassing field of our human vulnerability and strength.
“Be kind, for everyone you know is fighting a hard battle,” said theologian Ian MacLaren. I am struck by the imperative need for us all to take up the challenge to be kinder to ourselves and others. There is so much suffering in the world. How often do we ask ourselves, in the midst of responding to Facebook posts, Tweets, and emails: how can I relieve suffering? At the very least, how do I not add to it?
No one person can fix this mess we have gotten ourselves into as a species, but we can each be a part of bringing more compassion and acceptance into the world. First, we have to learn to practice it with ourselves. We can be the antidote to the fear and sorrow that exists within us, in other people, and in the world “out there.” Kindness is dismissed as bullshit in a world that values power over others. But as mindfulness teacher Sharon Salzberg reminds us, kindness is a “force.” If unleashed in vast quantities, it could literally reverse the cycle of misery on this planet.
When will we stop walking around in these miraculous, vulnerable human bodies seeing ourselves as separate? What will it take for us to realize our interconnectedness; to act from a deep understanding that suicidal people are not to be feared and judged, but to be embraced and held in the light of understanding and true empathy? Empathy sees that we are all connected, and thus demands well-being for all.
I think of the people who report walking to the bridge and said to themselves, “if one person smiles at me or talks to me, I won’t jump.” Lately I try to go out of my way to smile at people, to talk to people, even if they look at me funny because they aren’t used to random strangers smiling at them or talking to them. Come to think of it, I think talking to strangers is definitely a symptom of some severe mental disorder in the DSM-V.
But seriously, folks. It strikes me that breaking down our collective walls of isolation, of chiseling away our carefully constructed masks, of taking care of ourselves and each other, of judging less and loving more, may be among the most important things we can do with our lives. We can simply value people, not for what they do or what they achieve in the world, but because they are alive on this planet with us, right now, sharing these troubled, turbulent and painfully beautiful times.
In the end, we are stunningly diverse, yet there are basic human needs that we all have in common. The ancient practice of lovingkindness exhorts us to wish for ourselves and all beings to be safe, to be healthy, to be free, to live with ease. How can we create a world where these universal human needs are met? I think this is one of the primary questions we should all be asking ourselves right now, and figuring out the answers together.
I don’t claim that smiling at the person who makes your coffee or talking to a stranger on the metro will save the planet. What I do believe is that if we all made human connection, safety, and a sense of shared belonging among our top priorities, if we all tried in ways large and small to end our collective isolation and suffering, this world would be a safer place to be human. And a lot of people might not be eager to leave so soon.
Nanu, nanu, Robin Williams. Rest in peace.
Even though schizophrenia is one of the most severe forms of mental illness, nearly 40 percent of people with the disorder say they’re happy, new research contends.
Researchers at the University of California, San Diego, surveyed 72 schizophrenia patients, ranging in age from 23 to 70, living in the San Diego area, and found that 37 percent said they were happy all or most of the time.
Their happiness wasn’t related to the length or severity of their mental illness, to their mental or physical status, or to factors such as age and education. Instead, their happiness was associated with positive mental and social characteristics such as optimism, resilience and lower stress levels, the researchers said.
The findings are valuable because these positive traits can be taught to many people, said the authors of the study, which was published online Aug. 18 in the journal Schizophrenia Research.
"People tend to think that happiness in schizophrenia is an oxymoron," senior author Dr. Dilip Jeste, a professor of psychiatry and neurosciences, said in a university news release.
"Without discounting the suffering this disease inflicts on people, our study shows that happiness is an attainable goal for at least some schizophrenia patients. This means we can help make these individuals’ lives happier," Jeste added.
By way of comparison, about 83 percent of people without schizophrenia said they were happy most or all of the time. And none of the people without schizophrenia said they were never or rarely happy, compared with about 15 percent of those with the mental disorder.
"People with schizophrenia are clearly less happy than those in the general population at large, but this is not surprising," study lead author Barton Palmer, a professor in the university’s department of psychiatry, said in the news release.
"What is impressive is that almost 40 percent of these patients are reporting happiness and that their happiness is associated with positive psychosocial attributes that can be potentially enhanced," Palmer added.
The study was funded, in part, by the U.S. National Institute of Mental Health (NIMH).