Good
afternoon and welcome to my 15th annual April Fool’s observance. My talk today
is on “The Folly of Mental Health.”
Would
you believe that my observance of this holiday started with a mental
health episode? In spring of 2005 I was in my last semester of college, and
learning a lot of Hegel and Heidegger, and the paradoxes of human life were
really blowing my mind. Then on April 1st…. I felt like I could see,
I could understand, I could truly appreciate how life was made up of tensions
that we must hold rather than solve, how each individual life exists as both
complete and incomplete, how we must be both bold and humble, how we were
mortal and our possibilities were endless. It was very exciting!
It
was too exciting. I, um, tend to get too excited. For the next 4 days I felt
little need to sleep or eat, while I did feel the need to tell everyone
what I’d learned. It was really great-- until it was exhausting. That episode
ended with a brief visit to the psychiatric ER at St. Luke’s, where I was
deemed too safe for myself or others to be kept there, given something to help
me sleep, and that was that. Ok so I’m leaving out all sorts of distressing
details, but that’s a nice clean version of the story, so let’s enjoy it for
that.
Now
here we are 15 years later, and I’m just emerging, hopefully, from another
mental health episode. Why, yes, it was precipitated by the global pandemic,
what a good guess!
Now
then, for anyone who needs a refresher, here’s how the speech works. First I
will spend some time attacking mental health, pointing out its stupid and
tragic contradictions, and mocking anyone who pursues it. Then I will close by
defending and promoting it. I hope that you will be convinced, and then
convinced again, and you’ll feel foolish, and you’ll think of me as foolish.
Here
are my three main points:
- I’m a fool to think I have power over my own mental
health.
- I’m a fool to think that mental health is worth
pursuing in this world.
- I’m a fool to think I can help others with their
mental health.
Uplifting, right? Let’s do it!
First,
I’ll need a working definition of mental health. For today’s talk, I’ve decided
to use one that’s probably glib and self-serving, and hopefully just reasonable
enough that you’ll let me use it for now. How about this: Mental health is a
state of internal coordination that makes possible the desire and ability to
live in the world.
Now then, the follies of mental health:
- I’m a fool to think I have power over my own mental
health.
If
mental health is a state of internal coordination, how much power do I have
over that coordination? I generally think of myself as a kind, patient,
positive, upbeat person, but if I’m hungry enough, or tired enough, or
congested enough, or stressed enough, those traits can disappear. I think of
myself as a stable person, and then some unstable times come along, and that’s
that. Mess with my body, trouble my future, shake up my worldview, and I can
crumble. It turns out that I am only as stable as my surroundings, only as
stable as my security.
In
short, mental health appears to be highly dependent on physical and
environmental health. As a therapist and someone who works on themselves a lot,
in the last month I pulled out every coping tool I had, and developed
some new ones, and none of them were as effective in calming me down as
medication, security, and love. While I certainly had to take my own steps to
get those things, my ability to get them was largely based on access, which is
to say, privilege. If I didn’t have access to them, I can’t imagine where I’d
be right now.
So,
it feels very difficult to claim confidently that I have power over my own
mental health.
2. I’m a fool to think that
mental health is worth pursuing in this world.
Mental
health makes possible the desire and ability to live in the world, but who says
this world is worth living in? Here’s the voice of Folly, in Erasmus’ “The
Praise of Folly,”:
“...how
many disasters human life is exposed to, how miserable and messy childbirth is,
how toilsome it is to bring children up, how defenseless they are against
injuries, how young men must make their way by the sweat of their brow, how
burdensome old age is, how death comes cruel and inescapable… how man is
besieged by a whole army of diseases, threatened by accidents, assailed by
misfortunes, how everything everywhere is tinged with bitterness-- to say
nothing of the evils men inflict on each other, such as poverty, prison,
disgrace, shame, torture, entrapment, betrayal, insults, quarrels, deception….
…
in fact, who have been the most likely to commit suicide out of weariness with
life? Isn’t it those who have come closest to wisdom?”
Sorry
for this dark passage. These are dark times. Remember, I do promise I’ll end by
affirming mental health.
But,
for now, let’s talk about how this world is crazy-making. Camus and other
existentialists would probably use the word “absurd,” but in this context I
think “crazy-making” really gets my point across, doesn’t it? I’m thinking of
the classic bumper sticker: “If you’re not outraged, you’re not paying
attention.” This world will drive you nuts and break your heart. Here’s another
cliche quotation: “In a mad world, only the mad are sane.” (Kurosawa) I know
I’m not really building a case here-- I’m just leaning on a general and
increasingly common sentiment that the world is either disordered or corrupt or
both, and so why should I bother getting myself in order? Why bother trying to
keep it all together, when it all seems set up to fall apart?
So,
it feels very difficult to even desire mental health in this world.
3. I’m a fool to think I
can help others with their mental health.
If
I can’t control my own mental health, and this world is crazy-making, then how
could I think I can help anyone else with their mental health? This is the most
damning folly, the one that’s kept me out of work for the last few weeks. I can
hide away in my apartment and feel ok, but exposure to the suffering, and
putting myself in a helping role these days-- it’s been overwhelming, and
depressing, and anxiety-provoking, and appetite-stealing, and just seems dumb.
If my ideas and coping tools weren’t enough to help me, how can I help you? If
I can’t get you safety or security or medication, what good am I? If this world
is crazy-making, why do I insist on being this gatekeeper, in defending and
promoting an absurd life?
Let
me put this another way: AHHHHHHHHHHHH! Yeah, that’s about right.
Well
then! Time to try to argue the reverse eh? Let’s see if I can redeem mental
health as a personal and professional ambition:
- Regarding my power over my own mental health:
It’s
true that I don’t have as much power as I’d like, that my peace of mind is
greatly impacted by physical, relational, and environmental factors. This fact
has really humbled me in the last month.
And
yet, I’ve continued to work on my own coping skills and my own thought
patterns. I’ve continued to try to face my issues, to figure them out, rather
than relying solely on my securities and comforts and external treatments. If I
really think mental health is out of my control, why do I keep trying?
I’d
like to think that I am both fragile and resilient. I crumbled but I continued.
I’m starting to recognize how resilient people are, how they have hidden
reserves of resilience, sometimes unknown even to themselves. People have
survived and thrived (or as Faulkner says “endured and prevailed”) throughout
history, despite the repeated collapse of, or persistent lack of access to, structures
that meet our basic needs. If people keep getting by and keep wanting to get
by, I guess they must have some power over mental health.
We have so little power
to determine our fate, but we still do what we can. I have so little power over
my own mental health, but I’ll do what I can. I’m pushed around and battered by
enormous waves, but I’ll still try to swim. Which brings me to my next
response...
2. Regarding pursuing
mental health in this world:
Why
bother trying to swim in a turbulent abyss? And how? Oy-- the best I can do
here, and this strikes me as both true and important and insufficient, is to
say this-- the world is not only a turbulent abyss. It can be! And it
will be. But it’s not always awful. How’s that for a ringing endorsement, eh? “Life:
It’s not always awful!”
A
slogan I’ve been playing around with is “Stare into the abyss, but then find
something else to do for awhile.” I’m not confident that such a slogan could
effectively turn my head from the abyss, but the idea is right-- The world will
continue to throw shit at us, but it’s essential to keep perspective and
remember, to see, to witness, to sing out our praises, that the world is more
than just the shit it throws at us.
My
favorite passage in the Talmud is in Tractate Eruvin 13b, in which we’re told
that the schools of Hillel and Shammai debated for 2.5 years about whether or
not it would have been better for man to have been created or not. Well, the
word isn’t “better”-- it should be translated as “easier.” Would it have been easier
for man to have been created or not? And after all that time, they take a
vote and conclude that, no, it would have been easier not to have been
created. But, they add, now that man has been created he should examine his
actions.
What
a debate, right? And what a conclusion! I find this passage almost perfect in
their understanding of the hardship of life coupled with their resolve to
live well anyhow. I find it even more validating that they really don’t endorse
life, and certainly not new life-- they just say, well, now that we’re here,
let’s do our best. The world sucks, but we should still aim for excellence.
It’s a dark and beautiful sentiment, appropriate for these times.
3. Regarding helping others
with their mental health:
Talking about aiming for
excellence, let’s turn to my final folly, working as a mental health counselor.
How do I help anyone?
So, first, the obvious
contradiction, one that’s plagued me for most of my absence from work: as
little as I can help the clients, not being there for them is certainly
less helpful. That’s the point that started bringing me back, and the one my
therapist keeps making-- being present, being a listener, caring, is important
and helpful, even in the absence of any saving action.
In preparing to face my
clients these days, I face so many unknowns-- what will happen next, how I can
help, how they can help themselves, what keeps them going. There’s so much I
can’t imagine, and those blank spaces in my imagination terrify me. I have more
questions than answers, and thus have so few answers for the client, and yeah
it’s terrifying.
What do I do, then, with
my own lack of imagination, about why and how to move forward? I think I have
to humble myself in a few ways:
First, by recognizing
that the failure of my imagination is simply that-- my own inability to
see ahead. I can’t mistake my darkness for the absence of a path
forward. Second, by honoring the client’s
resilience, acknowledging that they always stand on their own strength, not
mine, and that my inability to imagine how they do it is just one more sign of
their strength and my limitation.
Third,
by being process-oriented but not process-obsessed. I don’t know what we do
next, but I’ll be with them while we talk it out. I don’t need to be the
master; I can’t be the master. Here’s a slogan I’ve been playing with recently
that I’ve found liberating and encouraging:
“It's
not my job to justify this life or this world. The client is coming to struggle
honestly, and I'm
there to accompany.”
It’s
not much, and it’s a lot-- to promise to be with you while you struggle. To sit
with you, and use my own struggle to help you with yours, without getting
overwhelmed by mine or yours. To join you in your struggle, and yet not take on
yours as my own.
These
are hard times, and I’m having a hard time, and the world is crazy-making.
Mental health is damn hard, seemingly impossible sometimes. We are fragile--
and resilient. It would be easier not to have been created-- but let’s examine
our actions. And I can’t save anyone from all of this, but I can sit with them,
be with them, struggle alongside, so that we’re together in this.
Thank
you.
