It was World Mental Health Day this week — and it drove me mad. I don’t have ‘mental illness’. I have bipolar disorder, and I feel as possessive about my diagnosis as Gollum did his precious ring. One term. One label. To lump the manifold terrors of the mind together under the monolithic ‘mental illness’ is an offence against the person. Failing to differentiate shifts the stigma like a bubble under a carpet.
So I was horrified to discover, in my latest stint in a psychiatric hospital, that others experience exactly the same as me. Others use the same ‘maladapted coping mechanisms’. They are also their own worst critic; they replay their mistakes; they are wracked by ‘meta-worries’: being worried about being worried.
To complement the pharmacology, a large part of my treatment in the hospital is Cognitive Behavioural Therapy (CBT). I didn’t know much about it on arrival and was sceptical. But the young woman who teaches the seminar, Dr Akita, is drop-dead dreamy, so now I’ve decided it’s scientific.
She explains that it is a method for tackling anxiety by teaching you to stand back from your emotions and appraise them. The idea is to catch the thought underlying the feeling. For example, I become livid with the driver who’s just cut me up. How quickly can I ‘read myself’ and figure out I’m really irritated about a put-down I’ve experienced at work? With the relevant information, another person could deduce that; CBT gives you the tools to do it yourself. It sounds banal. But Dr Akita’s ruthless application of common sense is appealing. If you can take an observational stance and become your own therapist, you won’t have to rely on someone else to talk you out of your terrors.
She asks us to list our ‘triggers’ on a white-board: ‘being alone’, ‘making comparisons’, ‘family’, ‘relationships’, ‘work situations’, ‘finances’, ‘new situations’, ‘expectations from others’, ‘dreams’, ‘things not going to plan’, ‘people judging you’, ‘indebtedness’, ‘rejection’, ‘thoughts about the past’.
‘What’s it like to see it wasn’t just you who came up with all these things, but the group?’ she asks. ‘Belittling,’ I think. ‘Reassuring,’ they say. Even more of an affront to my ego is the idea of group therapy. I came into hospital pumped up by my sister--in-law’s motivational speech that I need to take the therapy as well as the pills. So I committed to the sessions, despite assuming I would get nothing out of them.
It’s not promising at first. There are anxious faces in the hot little room; one man sits with shoulders slumped, head drooping, arms dropped. Some people bounce on their chairs. One lets out a shout of frustration. The floor is covered with mutilated stress toys. People stretch like cats, yawn like hyenas, watch the clock and offer Too Much Information. They turn anyone else’s testimony back to their own problems. They exchange platitudes and clichés.
Yet though my colleagues are not well-mannered, they are well-meaning, and to my horror my progress comes to depend on their goodness of heart.
When it’s my turn to share, I assume I know how it will go. I’ll say I feel guilty that during bipolar episodes over the past year I have not been a good parent. I crash during the hours I’m most needed: supper, bath-time, story time; I am irritable; I can’t relieve my wife of our youngest even for a morning. I’ll get teary and the group will tell me it’s not my fault, it’s the illness, and I’ll thank them and go away still feeling guilty.
But that isn’t how it goes. They pitch in with questions. They try out theories. They offer counsel. ‘Is that the only problem, though?’ ‘Why are you afraid of those parental duties?’ And this is the amazing thing: presumptuous though they are, their questions provoke ideas I wouldn’t have entertained before. What is the ideal I am operating with? If your father is your hero, and the embodiment of the steadiness you’re trying to emulate in your parenting, then of course that might lead to a paralysing fear of making mistakes.
It’s hard enough to accept that you do in fact have something in common with other mentally ill people. But even worse, now I’m learning about myself through them. I need them. This isn’t just similarity confronting me; it’s the awful truth of solidarity.
The early Christians talked about the wisdom of pagans. Here is the wisdom of weirdos. There are things on the periphery of your vision, says the therapist, which people in your situation can see: what you’re like, what you’re not like, what you’re doing, what you’re not doing. What Shakespeare says of self-awareness is just as true for those who are mentally unwell: ‘Speculation turns not to itself, Till it hath travell’d and is mirror’d in another person’s eye, Where it may see itself.’