Making Friends With Our Mental Illness
It's common for people to ask therapists, “Are they mentally ill? Is it a mental illness?”
This question is often from parents asking for their child, who is struggling. If the answer is “Yes,” and if a diagnosis is provided with some root causes added, the parent often feels some relief and is more apt to respond with empathy rather than frustration or anger. I hear this same question raised when people are talking about a public figure like a celebrity, politician or mass shooter. In these cases, the therapist does not have the ability or license to formally diagnose the person but may talk about behaviors consistent with a specific diagnosis. With the diagnostic manual and our training, our license allows us to weigh-in on a diagnosis after personal observation or testing. There are clear lines drawn that delineate if symptoms reach the clinical level qualifying the individual as “mentally ill.” Yet, rather than thinking of mentally healthy and mentally ill in a binary way—mental health goes in one pile and mental illness goes in the other pile—I have found it helpful to think of the mental health-mental illness distinction as a continuum and one that we are all on. In this way of thinking, we all have some mental health and some mental illness. This takes some courage and we must walk past the shame and stigma which would have us externalize any of the bad we see in us, dismissing or at least minimizing it. I heard one person describe it this way—mental illness is anything less than ideal in the way we process, respond to, or treat another person.
Recently, I was talking with my therapist about the work we are doing with professionals at Evoke’s Intensives, and she said this to me: “I think the thing we are all trying to do is make friends with our mental illness.” The Buddhist teacher Thich Nhat Hanh explained the idea this way,
“If you feel irritation or depression or despair, recognize their presence and practice this mantra: ‘Dear one, I am here for you.’ You should talk to your depression or your anger just as you would to a child. You embrace it tenderly with the energy of mindfulness and say, ‘Dear one, I know you are there, and I am going to take care of you,’ just as you would with your crying baby.”
Many might flinch at the idea of labeling themselves as mentally ill—it is a bit jarring. However, understanding that we all have wounds and we all have symptoms and behaviors that don’t suit us, is liberating. Many people will strive to be seen by others as “good” and seek out friends and therapists who will affirm this idea. I find it more liberating to regard oneself as human, imperfect, flawed, and still okay. This is what it means to be a self. This idea is akin to the concept I write about in my book, The Journey of the Heroic Parent, where I ask parents to own their own idiocy. When setting a boundary with a child, parents who struggle with being human often try to convince the child they are right or that the said boundary is justified according to some standard—a therapist, a book or the magical “everyone thinks this way.” But when we allow ourselves to just be okay, to be a self, rather than right, we disarm the Other. We simply assert our needs. We say “This thing I am asserting, this boundary I am setting is what I need to feel okay. I might be wrong or old fashioned or neurotic, but I am me and that is enough.” We have a hard time operating in this way because as children we grew up in a context where being right was the thing. We didn’t grow up in a context where being us, being a self, was enough.
During a recent family intensive, it came to me with a new focus. This particular family was a family of 4, with a mother, father, son (15) and daughter (17). The daughter was the identified patient. She graduated from our Wilderness Program 16 months ago and was finishing her stay at a residential program in Utah. In preparation for the intensive, I spoke with the parents letting them know they would be in the hot-seat too. They agreed, yet as they arrived at the retreat, I could feel their urgings. They were there to problem solve. They wanted to find tools that would ensure or at least encourage a different response from their daughter and their son. We settled into the 4-day experience. On the third day, each of the family members were to create a psychodrama depicting what it felt like to grow up in their family. The parents would go first since their stories preceded their child’s and we imagine a virtual flow chart through each generation tracking the trauma and its impact on the next. In this exercise, the parents’ work is independent of the child which also helps the children, especially the identified patient, to see that they are not the only ones with issues to work on. Courageous parents embrace this process while still biding their time, waiting for the portion of the work where we focus on how to fix the child. Most participants are surprised by the power and energy of this exercise. The participant leading each exercise is called the protagonist and is supported and guided by a director. They assign others as role players for each member of their family-of-origin, in various positions around the room, to illustrate dynamics, unspoken rules and roles, as well as the emotional climate for the child. Participants are then invited to talk to each of their family members, represented by other participants and staff enrolled as stand-ins. These role-play dialogues reveal an unexpected amount of emotional energy. We all witness and feel what it felt like to grow up in the “soup” of the protagonist’s life. The protagonist reverses roles to providing role players with a script of responses.
Alcoholic fathers, neglectful mothers, abusive siblings, nurturing grandmothers’ all make their appearance. The dialogues that are created reveal to everyone the parts of ourselves that we carry with us through life. These parts may show-up now, every day, in our lives, our relationships, and in our parenting. The energy that comes from a demanding mother or a perfectionistic father rear themselves in current-conversations with our children, our spouses our co-workers. If left unexplored these forces will often take over when triggered or under stress and our responses create a mismatch to current situations. In Al-anon, they say “If it is hysterical, it is historical.” In the intensive described above, the two ideas of making friends with our own mental illness and psychodrama came together for me. We visit with our mothers, fathers, siblings, and others from our childhood to know them better. We sit with them and feel them, so we recognized when they show up in our life. And when they show up (those parts of us—those old wounds and our way of navigating them) we gently say to them, “I know you are here. I know the pain you feel and know how easy it would be for the old coping to take over. But you are okay. We are okay. We can let this pass through us.”
Making friends with our mental illness is integration. It is enlightenment. Plato concluded that there would only be one law in a Utopian society: “Everybody would be themselves.” Making friends is leaning into and looking at our wounds and the things we do to protect ourselves from it happening again. Often, we look at a symptom or a maladaptive way of coping with shame and derision. If the shame and derision are intense enough, we deny we have the trait. We do this because that is how others responded to us in the past—we think this derision of our shameful traits will make it go away, but I have learned this is not how it works. We must follow the undesirable trait and see what it has to tell us. Write about it, talk to a therapist about it, discover where it came from. As a therapist, I have learned that every behavior, no matter how irrational or seemingly self-destructive, makes sense in some context. As I have learned from my therapist, if a client were to tell me they are in love with a chicken, it is best if I try to remain curious and try to understand them. Trying to fix, responding with anxiety, or even simple problem solving can communicate their response is unacceptable to me. So, we honor the defense. This new way of reacting to them differs from earlier responses and contexts. It creates a safe place for them to explore themselves. If I respond with disgust, they will be apt to hide, avoid or deny things. Alice Miller explained how our responses come from an earlier time, “We then realize that all our lives we have feared and struggled to ward off something that really cannot happen any longer; it has already happened, at the very beginning of our lives while we were completely dependent.” We avoid conflict because we were overwhelmed with it as a child or because our parent’s divorced. We protect our children from things that happened to us. We worry our children will abandon us because we were left alone or not seen as a child. Yet, if we do our work, visit our wounded self, these old stories lose their power over us. And this takes a lifetime.
The best time to go to therapy to start befriending your mental illness is 5 years ago. But, if you haven’t gone yet, today is the next best day to start. Once, I shared this thought on social media: “The fact that you think you don’t need therapy is the biggest sign you need therapy.” A colleague responded, “So if I know I need therapy, does that mean I don’t need it?” I replied, “No. you still need it. Just not as badly.” I have been surprised in my career to learn that many therapists don't go to therapy. They justify this the same way our clients or our clients’ parents justify it. In Addictive Thinking, Abraham Twerski explains why addicts or alcoholics (identified patients) resist treatment: “I am not like those people; I don't have a problem; I can handle it on my own; I wouldn't want to be seen by someone I know.” Further, he states, “The same kind of self-deception occurs in codependency [or simply for the family members].” We resist embracing our own issues. While they may be under control and not severe enough to qualify for a “mental illness” diagnosis according to the criteria of the manual, we can be sure there is work to do. At the conclusion of an intensive some time ago, a father remarked, “For years I have heard therapists say I need to do my work, but I never knew what my work was. Now, after visiting my childhood and the energies, messages, wounds, and feelings there, I am leaving this retreat with a mountain of work. I know what my work is, what the project is, and this knowledge gives me hope.”
After some discussion at a parent meeting years ago in New York, a father asked, “So. What you are saying is that the problems in our parenting stem from some childhood issues or experiences?” The honesty and simplicity of his question were profound. In the first sentence of what I believe to be one of, if not the most important books on child development ever written, The Drama of the Gifted Child, Miller states it perfectly, “Experience has taught us that we have only one enduring weapon in our struggle against mental illness: the emotional discovery of the truth about the unique history of our childhood.” It is critical that we do this work. It is critical for our children that we do this work. And when we have a child who needs treatment, it is imperative for us to join them, model for them, and lead them into the process of coming face-to-face with our wounds and learn to say, “Dear one, I am here for you.”
As a therapist and father, I know this because I also walk this path. It is a heroic journey to look inward and learn how to make friends with our mental illness.