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.


Elizabeth said...

Thank you so much for your openness & honesty.

Cat C-B said...

I have never suffered from OCD, though I have had my struggles with anxiety and depression. I can relate to a lot of what you write here, though, and I'm especially moved when you say:

"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."

I think we live in a culture that is primed to discount spiritual insights, and which teaches us to invalidate one another's insights unless we can "prove" ourselves sane. I know that one piece of the many reasons why I left psychotherapy as a profession was that I felt that the practice was encouraging me unduly to think about people as collections of symptoms, and not as whole and spiritual beings. I know that I was yearning to see people in a fuller, more fully-dimensional way. (I'm not saying that traditional mental health is incompatible with such a vision, by the way--just that there came a time when my being a counselor was interfering with my seeing in that way.)

I'm grateful you have been able to pick your way between symptoms and insights, between anxiety and spiritual concern, so well. I know that I have found deep encouragement in knowing you, and in contemplating what I know of your journey--which, before I read this piece, did not include your struggles around emotional health.

In case it is not obvious, reading about the integrity you've brought to those issues only deepens my respect for your spiritual discernment, and makes me more tender and grateful to consider you my friend.

If ever I can be of help to you as a friend, either with your prophetic discernment or finding your way through the storms of anxiety and OCD, I hope Way will Open for us to share that.

And if not, I am just grateful for your strength, your willingness to be vulnerable and honest, and for being a witness to your life and gifts.

It is an honor to know you, Joanna Hoyt.

Joanna Hoyt said...

Thank you, both.

Cat, I keep thinking about how traditional mental health care and whole-person connections could fit together better. I know there's a need for straight-up psychological/psychiatric work. I've been grateful for the psychiatrists who wrote the books that helped my untangle my symptoms and find solutions, and to many of the psychiatrists and counselors who've helped some of my friends as they struggle with mental illness. And I hear from friends and relatives who work in that system about the difficulty of seeing people whole, or the systemic tendency to treat spirituality en bloc as sick...

So far I've been lucky in finding a combined approach that lets me cope fairly well, and in having a wise friend who is also a clinical social worker. But here at the Catholic Worker we often end up offering hospitality to people who know they have major mental health challenges--and others who seem to us to have them but don't admit it-- and wish we knew a better way to work constructively with the people who are qualified to offer professional care.

Thank you for your offer of help. And for your kind words. And for your example.

Stabler said...

This is a fine, brave description.
I am so grateful to you for it.

a soulful life said...

I just wanted to pop in and say hello :) I started following you blog a while back because I really appreciate your honest, articulate posts. Thank you for sharing your story. Wishing you a lovely day!

Anonymous said...

Hi Joanna, thank-you so much for this post. I found it thought-provoking and inspiring.

In my work as a Counsellor (with a Christian charity, but offering a free counselling service to anyone in need) I am constantly praying for discernment, wisdom and humility as I explore (in myself and others) what is, mental, emotional, physical, spiritual dis-ease and well-being? How do they overlap and how can we pursue healing, wholeness and "abundant life" whilst embracing a "theology of suffering". What does that look like for those of us who are Christians, and those whom I work with of no faith??

Whilst studying the work of therapists (old and new) such as Freud, Jung, Rogers, Yalom and others; I draw deeper encouragement from a rich and eclectic range of spiritual writers, philosophers, pastors and poets including: Henri Nouwen, Martin Buber, Richard Rohr, John O'Donohue, Selwyn Hughes, Cloud & Townsend, Phyliss Tickle, Joanna Macy, Thomas Berry, Richard Foster, Barbara Brown Taylor.

Today I'm adding Joanna Hoyt to that list, thank-you.