What one child’s authenticity taught me about getting help for mental health.
I came out of the bathroom stall at school to find an older girl washing her hands. Janelle eyed my backpack and jacket, and as it was mid-day, mid-class in fact, she asked, “Where are you going?”
“Doctor’s appointment,” I replied.
“Which doctor?” she wanted to know.
I knew what she meant: Dentist? Optometry? Orthodontics? Medical? (Was I sick?) Dodging the question, I replied simply, “Dr. Boon.”
“Oh, I know Dr. Boon!” Janelle replied, much to my dismay. My evasive answer had failed to protect my secrecy. “I saw him for a while after my parents divorced.” She cocked her head to the side. “Are your parents getting divorced?”
“No,” I said, rubbing my hands furiously beneath the heated dryer. I grabbed my bag and coat and hurried out the door.
I was eight years old and it was the 80’s. I was seeing the child psychologist because of my meltdowns which had begun when my parents purchased a used car, bright orange with a black interior. I had panic attacks, crying and refusing to go inside the vehicle. I began dissociatively drawing dark, black pictures. I awoke with vivid nightmares night after night, waking the household as I huddled crying in the hallway outside my parent’s room. Repressed trauma had resurfaced – but all I knew was there was something wrong with me.
It was the 1980s, and we didn’t talk about mental health. At least, not openly, not supportively, not without shame or judgment. We spoke about the relative with schizophrenia, about whether someone mentally ill like that could go to Heaven. We prayed that God would cast the demons out of those suffering from depression. But mostly, we didn’t talk about it. I was old enough to know that while honesty was a virtue, openness was to be avoided.
And yet Janelle’s frankness stuck with me, opening a little something inside me. She was so matter-of-fact, identifying with me without shame or hesitation. At nine years old, she instinctively joined with me and normalized my experience with curiosity and acceptance. A small lump of shame melted away in the bathroom that day, continuing to thaw as I turned the interaction over in my mind in the days and years to come.
May is Mental Health Awareness month in Canada and the USA1, and this is what it is about.
The shame and stigma associated with mental illness blocks many from seeking help. How do you ask for a referral if to admit something is unwell feels like a character deficit or moral failure?
Psychology has evolved significantly over its short history as a science. From the 1950s to the 1980s, mental illness was framed in light of the predominant theory of Behaviorism (think Pavlov’s dog, punishments, reinforcement, and extinction of behaviors). This approach grew from experiments in artificially controlled environments using animals such as dogs and rats as test subjects. When aberrant behavior is conceptualized as a problem of discipline, shame is a direct and natural outcome.
As psychiatric medications were discovered, psychology moved to a medical model. The simplistic narrative of “faulty wiring” and “chemical imbalances” reduced complex psychological realities to mere biology with quick fixes, and a slightly gentler narrative that still laid the problem in the individual or his genes.
The cognitive revolution progressed us to an understanding that the way we think about our experiences alters our neurochemistry and our psychiatric symptoms, and recognized human patients as more complex than the dogs and rats of early behavioral experiments. Still, it failed to account for why people are stuck in painful thought loops or react strongly to stimuli, with emotions rising faster than thoughts can tame them. This led us, gradually, to an understanding of the significant role of trauma as a foundation for mental suffering.
Trauma and PTSD (post-traumatic stress disorder) is the focus of my clinical practice. It is within the trauma framework that I find the most distance from patient-blaming narratives. When we recognize the origins of mental illness in the painful events that precede it, we humanize mental health.
We are all born with different vulnerabilities, both genetically and in our environments. We are not fleshy computers, nor simple animals. We are formed by genes but also by family, by community, by the ripple effects of political nuance, by privilege or discrimination, nurtured or deprived by environment. In short, we become who we are through organic and opportunistic means; through nature and through nurture.
And the same is true for building our best mental health in the present. Mental wellness is built and maintained through cultivating an optimal environment and through caring for the physical organism that is our body, of which the brain is an inseparable part. We do this by:
- Building and remaining intentionally in community with others, cultivating meaningful friendships and spending time with our loved ones
- Orienting ourselves in nature, whether as a lifestyle or as a regular re-set through weekend trips to mountains, forests, lakes, or the ocean
- Building meaning and purpose through giving time to organizations that share our values, whether through work or volunteering, through advocating for and building together a more just world
- Caring for our bodies through daily movement, exercise, or joyful expression
- Eating foods that nourish our gut microbiomes and our brains
- Dedicating regular and sufficient time for restorative sleep
- Training the mind through a daily gratitude practice, meditation, and / or prayer
- Reprocessing traumatic memories with the support of an attuned and experienced caring individual
Not all of these building blocks are in reach for every individual. Mental health must be a community objective, as we both protect and nourish our own and work to create opportunity for collective wellness. My mental health can never be built upon your subjugation, nor yours on mine. Systems of justice and equality are essential to protect against traumatic injustices that rob individuals and communities of wellness.
And within these systems we must start with destigmatization. With understanding and then acknowledging that struggles with mental health are common, are natural, and are morally neutral. With this acknowledgment may we find compassion for one another and, essentially, for ourselves. Because in compassion and openness we find freedom.
Freedom to reckon.
Freedom to heal.
Freedom to be.
- The UK also celebrates Mental Health Awareness week in May; this year it is being observed May 12-18. ↩︎