Kathryn Cohan Who am I
now?
continued: page 4
For some of us, these elements of surprise and uncertainty are superimposed on a mind
that is already experiencing a state of differentness. Further, the line between what is
experienced and what is real becomes harder to perceive. But the line is solid and
indelible in cultural terms with respect to difference. Having a different mind is
shameful. Being different is shameful. Being different on account of having a different
mind is about as shameful as it gets. This is the breeding ground for stigma.
Stigma. "The Stigma of Mental Illness." A shame so universally understood as
an aspect of having mental illness, we use a word in a special way for it. The stigma that
is described in much of the literature is not the "mark" on the flesh of the
person with the disability, it is more like an invisible stain of shame on the person's
soul. Stigma, or shame, is a cultural construct with extreme consequences for persons with
mental illness. Stigma, too, is an introject. It is the product of discrimination; a
prejudice so universal and so unquestioned that "the stigma of mental illness"
is a socially acceptable, and widely anticipated, by-product of having a psychiatric
label.
Linton describes the second category of the cultural view of disability as
"Economic and Social Liability." In this category, persons with disabilities are
viewed as impairing the economic well- being, vitality and viability of society. Mental
illness, despite the fact that it often has no physical manifestations, is regarded in the
same way as other disabilities in this vein. The cultural message of "useless
eater" contained in this category is the source of discrimination and prejudice that
leads to the acceptance of stigma as an integral part of the experience of mental illness.
The additional facts of the invisibility and, often, able-bodiedness of mental illness
leave us very vulnerable to this message. The internal disequilibrium evoked by extreme
states, coupled with external messages about worthlessness and waste can be devastating to
self esteem.
I was afraid to tell anyone of my discovery; I was equally afraid
of being believed and disbelieved. That phase didn't last long, as a few weeks later I
appeared in my therapists' office for our weekly counseling session wearing hot pants,
lots and lots of make up, and spitting while I spoke disjointedly of many, many things. My
secret was out, and I was started on lithium.
I took the cultural messages about "useless eater" quite to heart, despite
the fact that I was employed, in a relationship, and mother to two children. I did
everything in my power to keep from appearing "mentally ill." I did not deny the
diagnosis, but I worked strenuously to give off the appearance of being different from
what could be expected by the description of the label. I was fighting off stigma that I
felt coming at me from outside of myself, and fighting off a growing sense of futility
about my future based on the course of the illness through my life. I attempted to
structure my life in the face of internal and external disequilibrium.
From an earlier essay:
Over and over again, in the local Manic Depressive and Depressive
Association support group, I hear people talk about how guilty and how bad they feel that
they are not cleaning house, doing laundry, getting a job, eating properly, attending to
chores, and other basic activities of daily living. The things we feel guilty about are
highly individualized: some folks just don't get out of bed, and some folks have an
extremely sophisticated project at work on which they repeatedly fail to make progress. I
suspect that people with mood swings develop or intensify low self-esteem due to repeated
failures to do the most "simple" things that are expected of
us. Week after week I sit in group and listen to others - and I have heard myself do the same
thing - describing themselves in the most disparaging of terms. I have come to believe
that this is intimately connected to the way we come to look at ourselves after months -
if not years - of having mood swings and acting accordingly. Our mood swings affect our
functioning, and after not functioning well for a while we begin to believe that that is
who we really are. Every negative message we've ever received confirms this, every
critical old tape plays over and over, and it is very challenging to believe anything
different. We come to look at ourselves as terminally worthless, when, in fact, the
opposite is closer to the truth. What we need to do to combat this insidious misconception is to work hard at loving
ourselves. Some effort is required, but the first step is simply recognizing that just
because we don't feel good doesn't mean that we are not good. We have to find ways to
honor our goodness, to give ourselves credit for the things that we are doing, even as we
sometimes appear to be doing nothing at all. It is so easy - and so dangerous - to sell
ourselves short, to do violence to our self-esteem, by focusing on what we should be doing
and ignoring the things that we already do. For a person who is in early recovery from a
mood swing, the basic acts of eating, bathing, receiving a phone call, absorbing the
sights and sounds of the TV, collecting the mail, and taking out the trash are quite
heroic. They affirm that we are alive, and even though it may not be the life we want or
the life we are used to, it is our life for that time. As we struggle with the ebb and
flow of energy, feelings, thoughts, and actions affected by the our moods, it is crucial
to keep one thing front and center in our consciousness. That one thing is a question, and
it is a question we need to answer for ourselves over and over again: Given the energy I have available at this moment, how can I show myself that I love myself
? I have found a few things helpful in accomplishing this. The following list is a
chronological recounting of the various events of my life that converged during my most
recent recovery. They are the things that gradually worked for me over an eight month
period. Taken as a whole, the list is overwhelming. These events emerged serially, and if
you wish to make use of my experience, I'd suggest a linear approach.
- Do not accept that the psychiatric treatment you are receiving is the right treatment if
it is not working.
- Delegate the essential things you can't do.
- Pay attention to what makes you feel better.
- Find ways to remind yourself that you live in a body.
- Do not cut yourself off from people.
- Cut yourself some slack.
- Keep a daily activity list.
- Use the list to love yourself.
- Make a master list of priorities.
- Believe that things will change.
top || continued
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[Who am
I now?] [Strategies for Self-Determination] [Talking
Points]
[Inner
Science] [The
Hard Questions] [Provider
Psychopathologies]
[Inviting
In The Wolf] [Recovering
Self Esteem] [The ECT
Suite]
[Consumer
Satisfaction Surveys] [The
Therapeutic Value of Cyberspace]
[The
Self-Help Lens] [The
Language Barrier] [Waves
of Change]
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