This week has seen Theresa May shouting her mouth off about “Mental Health” – Apparently, the problem is stigma, and we all need to talk about our mental health and all will be well with the world (That’s a trap by the way)
I could write for a long time about how utterly offensive I find it for the leader of this government, and this particular party to dare to isolate “mental health” as an individual, personal problem that many of us just happen to have, that occurs in isolation from the socio-political context for which they are directly responsible. I won’t do that – not too much anyway. I’m actually getting quite bored of reviews, and IAPT, and “parity of esteem” and however many shades of “doing nothing while making it look like we’re doing something so that we can shut up those who criticise us and make the rest of society look the other way” they can come up with. Enough already. I’d like my focus here to be a little different.
I’ve read a couple of good things this week too though, which have made me think.
One of those things is this – “The Problem with Resilience” (Written by Linda Gask)
I liked this piece, it made me think. So here, I want to add to the points it raises by sharing my own thoughts and perspective (as a physically disabled autistic woman with “psychiatric co-morbidity”). So then –
I’m glad people are challenging the use of the word “resilience” (as in the article above), because to be honest, this word (and its synonyms) feel like a stick that has been used to beat me with for most of my life. The labels that have followed me around – “over-sensitive”, “anxious”, “depressed”, “ill”, “emotionally labile”, “autistic” “psychiatric co-morbidity” (for goodness’ sake), – or, as I’d often describe myself, “off my fucking head”, are all often taken to mean someone who is not “resilient”. Someone who, according to the standards of the world, spends periods of time “not coping”. The consequences of this are advice along the lines of “look on the bright side”, “put it out of your mind”, “toughen up”, “think of others worse off than you”, or … the worst, the dreaded recommendation of “mindfulness” and “therapy”.
And according to any objective standards of the world, that’s all quite accurate. Objectively, I’m physically fine most of the time. I’m not in a war zone, I’m not starving, I’m not experiencing domestic violence, I have a fairly regular income, a great family and am in a particularly loving relationship. Objectively I’m safe. Objectively things are good. Objectively I should be able to cope, and my frequent failures to do so must indicate lack of resilience (and a lot of other bad things and moral failings too). But this objectivity is not the sum total of my truth.
My reality is often a racing mind of tumbling confusion that goes so fast I can’t hold onto it. That just won’t keep still. It’s spiralling screaming of internal monologue telling me everything that’s dreadful and wrong and horrid. It’s (really, actually, truly, and quite distressingly) not being able to go near the oven in case I accidentally cook the cat. It’s really believing I might have cooked the cat. It’s repeatedly checking I haven’t cooked the cat. It’s getting other people to check I haven’t cooked the cat… It’s not daring to move because I might hurt someone. It’s being doubled up on my bed unable to move because anxiety can be literally crippling. It’s trying to hold a coherent conversation while blocking out the disgusting, violent images that accompany my intrusive thoughts (in my case I mostly know these aren’t real – I know some people don’t, but they seem real, and they’re distressing, and trying to ignore them and concentrate takes work). It’s wanting to be alone because people hurt, but being terrified of being alone because I don’t trust my own thoughts. It’s knowing that my loved ones are about to die horribly. It’s screaming and hitting myself because there are just no words anymore. I can’t escape my own mind, even when it’s the enemy.
My reality is walking down a street, or sitting talking to someone while my body is telling me (my reality) that I’m about to be hit by a train. It’s permanent fight or flight. It’s stomach churning sickness. It’s being expected to “just email someone” or “just phone someone” when actually that “just” involves putting my head in the jaws of a lion. It’s being totally terrified and out of control because a train is delayed, and then being exposed and vulnerable because “being totally terrified” makes me do odd things like moan, rock and hit myself. It’s being asked if I’m “alright”, and just not having the words because the person asking is just nowhere near my reality, and probably doesn’t want to be.
It’s feeling a bit better. Feeling like the sun’s come out. But knowing it won’t last. It never has lasted.
I don’t deny that these are problems. They are. It’s not fun. They’re part of who I am – for whatever reason – clinical genetics, neurological abnormalities, “environmental factors “ – whatever. They’re part of who I am. But I have to say – managing them makes me feel pretty damn resilient. I’m still here, and I achieve (sometimes not everything I’m supposed to achieve by objective standards – sometimes not everything I want to achieve) But I manage.
The thing that angers me though, is the political context of my personal experiences (back to Theresa May. Well, not totally.) Before the things I’ve described above acquired their clinical labels, and gave me the words for my “psycho-social disabilities”, my diagnoses related to physical disabilities. This meant that the advocacy and campaigning that was fought on my behalf was for equipment and adjustments for me to be able to access my physical (educational) environment on the same basis as my peers. My disability politics were framed around the Social Model (with various adjustments as I’ve gone along) – but the idea that the environment was disabling, and that adjustments to enable participation were my right felt like it was established, even if it was ignored by many, and made me doubt for myself whether I was truly deserving of such adjustments and accommodations.
The trouble is though, that I just don’t experience much of that for my “psychiatric co-morbidity”/psycho-social disability (elements of which I’ve described above). For these, I’m offered medication (can be useful, but still carries the expectation that I’ll fix myself and become socially acceptable – and stop causing others problems by talking about my weirdness), or therapy (which translates as “fix yourself” – or “allow a professional to fix you”, and results in self-blame when it fails to work).
I’ve been trying all that stuff for years though, and I’m still not “fixed”.
And I wonder how long a wheelchair user would be expected to persevere with physiotherapy and rehabilitation before they were allowed a ramp to enter their workplace?
The problem is, that as I think about it, the equivalent of a ramp – the situation that would feel like true equality (or “parity of esteem”), that would honour my resilience and respect the “work” that becoming and staying well can sometimes take, and that would represent a true challenge of ableist oppression and the pursuit of a truly just world, would involve acknowledgement of the fact that for some of us, at some times (often and repeatedly and as a core, ongoing part of our lives), “resilience” might look like getting out of bed and having a shower. It might look like making a cheese sandwich, or summoning every ounce of strength and courage that you have and walking 100 meters to the post box. It might involve getting from one end of the day to the next, and managing to find the ability to sleep in the midst of the screaming and hopeless crying. It might involve still being alive.
I hate wanting to feel good for having “managed through a bad day” and wanting to celebrate what, to me, feel like huge victories (I cooked dinner, I made the phone call, I looked at the mail, I checked my bank account, I ate in front of strangers), but rather than feeling good, beating myself up because of all the “proper” things I haven’t done because I was busy directing all my efforts at coping with what was in my head.
Shall we think though about what this “true equality” might mean for our society? This society tells us that we’re the problem, because to suggest otherwise would involve contemplating social change and a fundamental challenge to “how things are” (according to neoliberal, capitalist orthodoxies). So unless Theresa May is taking on such a challenge and working to address it (I don’t think she is), then she accepts that people like me (and people who experience this injustice far more extremely than I do) are collateral damage. She accepts that society makes us into personal failures and lets us live on a knife-edge.
Okay – but can we please stop dressing it up as concern for “mental health” or as “challenging stigma”? It’s not. It’s protecting the status quo and keeping things comfortable for those who aren’t falling apart, while causing more and more of us to fall apart, and then blaming us when we do – Conservative Capitalism’s Cannon Fodder.
It’s brutal, oppressive and unjust. Let’s not pretend otherwise.