April Fool’s 2020 - The Folly of Mental Health

            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 1^st…. 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:

1. I’m a fool to think I have power over my own mental health.
2. I’m a fool to think that mental health is worth pursuing in this world.
3. 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:

1. 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:

1. 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.