Sunday, August 18, 2013

Mental illness, healing, and the life of the Spirit, part 2: discernment and accompaniment

Our mental health discussion at  Quaker Spring often returned to how we discern the nature of experiences which don't fit into our culture's norms.  Some Friends spoke with gratitude of faith communities which acknowledged that seeing visions of Jesus or hearing God's voice could be a gift, an experience of spiritual communion rather than alienation, a quickened perception of truth rather than a delusion.  Others spoke of the difficulty of discernment: How can we distinguish depression from the dark night of the soul or from the 'gift of tears' that springs from compassion? How can we tell the difference between the painful but salutary promptings of a tendered conscience and the crippling guilt that can accompany OCD? Others spoke of experiences of sickness and despair which they found dispiriting and barren, which they perceived as wounds and not as gifts.  At different times in my life I have experienced my mental differences in all these ways.  I still struggle with discernment, but in all cases I have been grateful for the accompaniment of people willing to sit with me as I went through the discomfort that can equally accompany spiritual experience, rightly guided concern and mental illness--people who helped me to deal with the pain of the wound and to recognize the gift.
When I was a child some people told my mother that I seemed to be disturbed and should get psychiatric help.  I had conversations with trees and with a young friend who had died.  I often had a strong sense of the presence of God, sometimes also of the presence of evil. My mother listened to me, checked that my talks with my friend weren't making me careless or suicidal, gave me helpful suggestions for dealing with the fear of evil, and consulted a wise (non-Quaker) friend.  The friend said that she thought I could cope so long as my mother could cope with listening to me.  She did that.  I'm grateful.  Looking back, I don't think those experiences were false or destructive; I think they were glimpses of truth filtered through a child's limited understanding and active imagination.  On the whole they tended to deepen my sense of connection, courage, joy and meaning rather than weakening it.
Even such benign experiences need to be appropriately contained. Later, in my early teens, I encountered some people who considered such experiences 'special' and an indication of potentially useful psychic power.  In my immature eagerness to be special I spoke pridefully and loosely of experiences that should be put into words with caution and humility or not at all. I encountered personality conflicts and misunderstandings and spent a while being confused and ashamed. I was and am grateful to my mother and others who continued to speak of the experience of Spirit as neither sick nor special but simply part of being human, who saw it as a gift to be received attentively and gratefully when it came rather than a delusion to be denied or a power to be sought and used. 
Also as a child I tended to react strongly to the hurt I saw in the people around me and in the wider world.  I was eight or nine during Operation Desert Storm; I felt implicated in what my country was doing, so I tried to watch the news, but I ended up in tears and with psychosomatic pains.  When my very part-time school schedule had me in the cafeteria for lunch I often couldn't eat because I felt overwhelmed by the noise and the upsets around me. This tendency to empathize sometimes made me kinder and more forbearing with the people around me; it shaped my commitment to pacifism; it helped me to listen better, and to write better stories. But I needed help learning to deal with it constructively; otherwise I ended up needy, out of balance and completely unhelpful.  At first my mother helped me to find a balance (write to the President if you want to; pray for the people who are being hurt; follow the news in the paper if you can do that and cope; don't try to watch the video footage since it seems to make you sick…) Eventually I learned to do that for myself.  
As I grew up my sense of ethics sometimes didn't fit well with the surrounding culture.  I experienced this disjuncture as both wound and gift. I've written elsewhere about the time in my teens when I learned about how the workers who grew my food and made my clothes were treated, and realized that this didn't square well with the commandment to love my neighbor as myself (or even the more limited commandment in Leviticus 19:16b, "Do not profit by the blood of your fellow").  I was quite sure that I was called by God--and also required by decency and common sense--to do something about this gap: to change my life so that it did less harm, to work toward creating a system that was fairer. I didn't know how. My mother listened and asked clarifying questions.  Other adults at my church told me it was abnormal and developmentally inappropriate to worry about such things at my age and urged me to shop, date, drink and stop worrying.  I stopped churchgoing and began a lonely and sometimes scary time of worshiping alone, confronting my own personal and economic shadow side, and wondering if there was a community somewhere that would find my questions sane and worth asking.  I found the Quakers, and they did, and my distress settled down into something clearer and more detached and finally manifested as a clear leading.  
In my early 20s I attended a large Quaker gathering where few youth and young adults participated in wider activities; several older adults told me that the young folks mostly kept to themselves and experimented with sex, drugs and alcohol.  I found this troubling. The older adults said that experimentation was developmentally appropriate; one identified himself as a psychologist and told me that the failure to engage in such experimentation was generally an indication of neurosis.  I thought that wasn't my case.  I wasn't ashamed of my body or my desires (though sometimes embarrassed by the latter), and I'd spent a fair bit of time reading books on sexual ethics from widely different perspectives and working out my own, and I'd decided that the consumer model of sex felt unwhole to me and that I was looking for something more covenantal. As for drugs, I found reality quite fascinating and frightening enough without artificial enhancement.  I told him this, and believed it, and still believe it, but his remark stuck in my mind and resurfaced when I found myself caught in what I recognized as actual neurosis. 
In my mid-twenties my mother began telling me that I was becoming difficult to communicate with, that I got upset very easily, seemed frequently agitated and exhausted, and didn't seem to be making sense.  I argued, but at some level I knew that I felt anxious, guilty and desperate much of the time, not always for adequate reasons.  I tried ignoring those feelings and trying to project--and, when possible, feel--more positive emotions.  That didn't work.  Finally my anxiety crystallized into clear symptoms.  I worried constantly about whether I had washed my hands adequately or whether I was passing on deadly germs as I picked and processed food to share.  I got out of bed over and over to make sure I had shut doors and turned off burners. I got to the end of a street, realized I'd been driving on autopilot, and retraced my route in case I had hit someone and driven away without noticing. 
I'd known other people with OCD.  I knew what I had.  I hated to admit it.  A lot of that was garden-variety vanity.  But I also feared that if I admitted that I was stuck in obsessive-compulsive thoughts that would show that I was neurotic, which in turn would show that my choices about sex and economics and pacifism and my experiences of God were really just signs of neurosis, which would mean that I had wasted my life.  Once I had stopped pretending to be fine and had more energy free for dealing with the truth I realized that fear was based on a false assumption.  I knew plenty of other people who had mental health struggles and also had valid insights and deep spiritual lives.  When I dealt with them I realized that it wasn't an all-or-nothing matter.  I began to see that for myself as well, and I started to work on discerning what was sickness and what was rightly led concern.
I started dealing with the sickness as a straightforward neurological problem.  I read Jeffery Schwartz's fine book Brain Lock, got a handle on the mental feedback loops that kept my anxiety going and learned to recognize and interrupt them. (Any sequence ending with "And they'll die, and it will be my fault" is probably OC thinking...I am not having a problem with dirty hands right now, I am having a problem with fear...Here's what I can do about that...Here's a more realistic thought...) Then, with my mother's encouragement and listening, I began to look at larger patterns. I began to see even my symptoms as a kind of gift, because they revealed a deep-seated falsehood by which I had been living. My obviously neurotic thought patterns and some more subtle ones that I'd carried for a long time had a common underlying story: If I don't do things just right, people I care about will be harmed.  This story has an implied converse: If I do things just right, people I care about will not be harmed.  Or, more crudely, I have the power to wreck people's lives or to protect them; I am God. This story has some obvious tempting features.  But it isn't true, and in the end it produces unreason and despair.  It is true that I am part of God, and that I have some responsibility for what happens to my neighbors.  But when I put myself in the center of the story the story becomes false.  
This should have been painfully obvious. I grew up steeped in a religion that taught grace, humility, and the fact that I am not the center of the universe.  But I seem to need friends to remind me of the truths I already think I know until I actually let those truths shape my life. I need this in times of prophetic witness and in times of mental or spiritual sickness.  I seek people who will not automatically dismiss me whenever I see a truth that looks different from theirs or that would require something of them. I seek people who will not automatically reassure me that whatever I do or think must be just fine.  I seek people who are actively listening to God and who are also sometimes willing to really listen to me.  I strive to listen in this way, to offer this kind of support and accountability to other people.   I've heard this process of accompaniment described in part in Sandra Cronk's Dark Night Journey and Jennifer Elam's Dancing WIth God Through The Storm, both of which stress the importance of a community which can help people to contain and process spiritual experience, spiritual struggles and psychological pain.  I am still learning to actually practice it. I'd be glad to hear about any resources or practices that have helped any of you who have made it to the end of this very long post.

Sunday, August 11, 2013

Mental illness, healing, and the life of the Spirit: part 1

One evening at Quaker Spring I invited Friends to join me for supper if they wanted to discuss mental illness, healing and the spiritual journey.  I was nervous about offering the invitation; I caught myself thinking (repeatedly) "Probably there aren't many other people here who have mental health problems, and the ones who do probably don't want to sit and talk about it, and if there are some here who are in distress and do want to talk you don't have any brilliant way to help them, and if nobody comes and people see you sitting alone at dinner they'll think they have to come over and try to fix you when they really want to catch up with their old friends who are coping."   
I still felt a need to offer a space for the discussion of mental illness and Spirit, partly because it's a struggle I have in my own life.  We were talking about being broken open by God and called further into faithfulness. For me part of the breaking open has come through my struggles with obsessive-compulsive thoughts and behaviors.  We were talking about making Spirit-centered community more true and deep.  For me part of the true-community thing is owning the parts of myself that shame me. 
I also wanted to have that conversation because I live in a community where we often host and try to be present to people dealing with mental illness.  I'm still learning to do that in a way that is centered and appropriate.  I think that both Catholic Worker communities and Friends Meetings attract many people who don't quite fit into the wider culture, and that both open up a space in which people are fairly likely to speak openly about their wounds.  I see these things as gifts and strengths, but they require us to have some idea of how to deal rightly with others' mental, emotional and spiritual struggles.
Plenty of Friends came for the dinner discussion, more than filling the small space I'd chosen.  Many of us had mental illnesses; some of us were responsible for loved ones with such illnesses; some were therapists. We talked intensely until it was time for the evening plenary to begin.  Some of us--and some who hadn't attended the first session--met again the next afternoon and  talked until another group needed the space.  I found the conversation challenging, healing and opening.  My sense was that some other Friends shared this experience, that this is a conversation that we need to have.  I don't have permission to tell the stories of other Friends or to present any authoritative conclusions that our group reached, but I wanted to raise some themes and questions that have stayed fresh in my mind since our conversation, and to invite you to share any questions or insights that you've had in this area.  
The recurring themes I remember seem to come in paradoxes.  I'm dealing with one of them here, and others in later posts.
The need to be honest and open, and to be seen, accepted, and confronted
Many of us felt it important to be able to own our mental struggles in our faith communities.  When I first admitted to myself that I was not just fine, that I had a problem and that I knew its name, I stopped being so afraid and my energy was freed up to research coping strategies instead of denying facts.  When I told the people I loved what I was dealing with and found that they were willing to remain in relationship with me I stopped being so ashamed, and my attention was freed up to really hear and connect with them instead of trying to maintain an image.  Henri Nouwen has written about prayer as the opposite of illusion.  This makes sense to me, and I think it underscores the need for openness and honesty among people who come together to pray and to open themselves before God.
It's easier to be open in this way if we believe we won't be condemned, dismissed or simplistically 'fixed' once people know what we're dealing with.  Several group participants named this. One described the QS gathering as "a place where I felt I could be my broken, imperfect self and that people would love me for that -- not try to reassure me or help me."  I think this is very important.  Perhaps especially so in this society where mental illness is so often feared and stigmatized, and where the willingness to sit attentively with hard things before trying to fix them seems increasingly rare.
I also think that sometimes acceptance is not enough.  We didn't talk as much about this.  I don't know if or when I would have admitted and dealt with my mental illness if the folks who loved me hadn't told me repeatedly, caringly, firmly, sometimes gently and sometimes in exasperation, that they could tell something was wrong and that I really needed to figure out what it was.  I am grateful for this now.  I wasn't grateful then.  I was angry, resentful, apologetic, desperate; I didn't want to know and I didn't think I could deal with knowing; I hissed, cried, sulked.  Finally I listened.  After I'd recognized what was going on and started taking steps--research, judicious resting, self-directed CBT, reexamining foundational beliefs--I still had to be confronted sometimes. "You seemed to be doing better for a while, but you're really weepy again; do you know what's wrong? What do you need to do about it?"  
It's hard to do this loving confronting appropriately.  Sometimes when guests seem to be struggling with some kind of irrational thinking or upsets but don't speak of having any mental difficulty I talk to them about my own experience; some seem to find this helpful, others get hostile or pull away.  Sometimes I try asking what is wrong.  If they insist that nothing is, but their behavior suggests otherwise, I don't know where to go next. 
I know that confrontation had better come from love and from a Spirit-centered place that allows me to care for the other person and at the same time to be a bit detached from their response.  If I am annoyed with them for complicating my life, if I am trying to prove how different I am from them, or if I am desperate for them to like me, need me or be helped by me, I am more likely to do harm than good.
I would rather have people confront me and remain in relationship than withdraw discreetly.  I have been helped and healed by the simple fact that people were willing to keep working and worshiping with me even though I was struggling to think clearly and not emote inappropriately.  I've sometimes been able to help welcome people with similar struggles into my community.  But sometimes we have had to set a boundary and acknowledge that there are problems we can't deal with.  We've learned through difficult experience that it doesn't work to have people with serious mental illness staying with us if there is not some professional backup and/or some safe place where they go if they find themselves unable to cope.  It's hard for me to say No to people in this situation, knowing my own fear of being rejected because of mental illness.  I also believe that it can be harmful for the prospective guests as well as for us if they come without a safety system and then find they can't cope. I try, when we have to say No, to offer what I can--distance listening, suggestions for possible reading or local support groups, prayers. 
I have written of mental illness so far as though it were clearly identifiable.  Sometimes I think it is.  Sometimes I find it confusingly entangled with mystical experience or with spiritual blockage.  More about that in part 2, which will appear sometime in the next week when work allows.  

Link to part 2