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Mental Health
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Don't try and cope on your own

The company of those who care helps when handling traumas.
a man in a wheelchair sits in a subway station holding a sign reading 'seeking human kindness'.
Michael, Boston, 2018.
Matt Collamer on Unsplash.

I did a horrible piece of training at the weekend. You have to do a lot of continual learning if you’re a counsellor, and some of it is hard going. This particular session (with Cruse, a national bereavement charity) was about self-harm, and it contained sheets and slides and lists of the ways in which people hurt, damage and punish themselves. Usually as a way of expressing another kind of pain or because it’s the only thing they can control in a chaotic world. Six hours of it, on Zoom. 

All of us have topics that we struggle with – areas that we find difficult to contemplate – and self-harm is one of mine. It is so far from my own experience of reality that it makes me feel square and naïve and overprotected, and every part of me revolts against it in some way. How terrible that people who are already suffering can only find relief by inflicting further harm on themselves! And some of the injuries are so grievous. Mortifyingly, my main reaction on this occasion was an urge to put my fingers in my ears and tell everyone to STOP IT... not just the trainer, but the poor souls involved in hurting themselves too. Training can be humbling, in the way it reveals the limits of your own compassion to you.  

Clearly though, telling people to ‘stop it’ is not an option, however you might feel! So what to do? 

Christianity, usefully, offers quite a lot of different options for coping with difficult life stuff, so I started considering some of these as I attended to the trainer. The peaceful, thoughtful series of Lent reflections I’ve been listening to recently, for instance… might they help? Um no, not suitable really. Too meditative. You can’t ‘gather the scattered pieces of your consciousness and centre them on God’ when someone is talking about teenagers cutting themselves in ‘risky places, or too deep’ I found. Tranquillity of mind is too passive a response.  

So then I thought about people talking sometimes of being able to hand over their troubles to Christ. He ‘takest away the sins of the world’, as the communion service puts it... his arms are open and he is God, so he can bear the weight. But that didn’t work either. Too mystical. It felt as if action was required, not meek handing over of sorrows because I couldn’t bear to contemplate them. I don’t think we’re meant to dodge responsibility and simply go, ‘Ugh, you have these ones Lord because I don’t want them’.  

So, I sat there writhing inwardly and feeling sweaty and miserable and wishing I was somewhere else. 

This kind, accepting, unshocked conversation was immensely comforting and reassuring, I found. There was safety in it, and daylight, and hope. 

But then I started wondering how everyone else at Cruse copes with such things. I began looking at the other faces on my screen… the 21 of my colleagues who were also attending the training, almost all of them volunteers.  

There was the strong, calm face of Manju, an Indian doctor lady, and Suki, a smiley gappy-toothed African lady, who both work on the triaging team, assessing callers as they come in and assigning them to helpers. There was Richard the First and Richard the Second, both white, one younger than me, one older, both friendly and knowledgeable and kind. There was Naga, a retired nursing sister who looked Scandewegian, and Christina, ditto – except she’d been a teacher. And Nick, not much more than a teenager by the look of him, and Sat, a big Brummie taxi driver in a turban. William looked as if he might be an academic, with his leather elbow patches, and Keith had his sound off due to the presence of a large cat on his desk, which leaned over periodically to miaow into his mike. Lots of others too. 

And suddenly I realised that there was my answer: all those good people, giving up their Saturday because they cared. Listening to stories of suffering because they wanted to understand better, in order to be able to help – to do something for the broken and the sad among us. 

That’s the presence of God, surely: that an army of people turn out, day in, day out, to do things simply because they are good. There is no payment, no special recognition. They have to listen to some very difficult things and contemplate darkness that they wouldn’t necessarily in their own lives. But there they all were that morning, one small group among thousands of others all over the country no doubt – ready to serve, and cheerful and friendly and attentive. 

They talked matter-of-factly about cases they’d encountered and situations which can lead people to injure themselves, and about self-harm as a phenomenon in certain social groups. About how it can be treated, about how it can heal and disappear with the right care and compassion. About how sometimes it can even be preferable to other alternatives. It is much easier, for example, to stop self-harming than it is to recover from an eating disorder. 

This kind, accepting, unshocked conversation was immensely comforting and reassuring, I found. There was safety in it, and daylight, and hope. A feeling that even if someone is suffering, there are others who are able to meet them there, to keep them warm and hold them up. That people do act as the hands and feet of God actually sometimes, regardless of creed or faith or fallenness. 

Looking at them all I felt so much better… and that if they could do it, I could. We only need to work in company together and our collective strength will keep us all afloat, rescuers and rescued alike. ‘Be not afraid’ the Bible says over and over again. It is very much easier not to be, when you’re not trying to be brave by yourself. 

  

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Mental Health
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We need to weep over the wreckage of mental illness

While its now OK to talk about mental illnesses, we need to weep over the harm caused and how we’ve tried to treat them, writes Rachael Newham.

Rachael is an author and theology of mental health specialist. 

 

 

A grey and white wall graffited with a tag a image of a person crumpled and crying.

Today, February 1st, is Time to Talk Day. It's part of a long-running campaign encouraging people to have open and honest conversations about mental health. It's aim is to break down the barriers of stigma and misunderstanding. It has been a staggering success - what was a fringe issue talked by those only affected by mental illness a decade ago is now part of common parlance. Mental health training is widely available, and the charity’s work has been seen to have a significant positive impact on the mental health conversation 

However, as our familiarity with the language of mental health has grown so too has the way we use it. People might talk about having PTSD after a bad date, or their friend being ‘so OCD’ about the way they organise. Unwittingly, as psychotherapist and author Julia Samuels points out, “[we have] awareness without real understanding.” 

However, awareness without understanding means we actually don’t reach those most impacted by mental illness. We know about mental health in the way we know about our physical health - but we are no more aware about the serious, sometimes lifelong mental illnesses which rob people of hope, joy and vitality - sometimes leaving them with lifelong disability.  

If you ask most people about mental illness they may tell you about depression and anxiety; the two most common mental illnesses which have become the acceptable face of mental illness. It’s reflected in the way funding is channeled to interventions that get people with mental illnesses back to work, or to NHS ‘Talking Therapies’ which offers short term psychological therapies (both of which are important initiatives) but have cut the number of inpatient beds from over 50,000 in 2001 to under 25,000 in 2022[3] which means those at the more severe end of the spectrum of mental health to mental illness are left to travel 300 miles for the care they need. 

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma. 

Whilst it’s right that we have raised awareness about the most common conditions, we can’t ignore the illnesses which are termed ‘severe and enduring mental illnesses’ which include those such as bipolar disorder, major depression, schizophrenia and complex post-traumatic stress disorder.  

For people living with these conditions, the general mental health advice that we give; for example getting enough sleep and time outdoors may not be enough to keep the symptoms at bay. Just as general physical health advice like getting your five a day will not cure or prevent all severe physical illnesses. Medication, hospitalisation, and at times even restrictions of freedom like being detained under the mental health act might be necessary to save lives.  

These are stories that we need to hear. The debilitating side effects of life saving medications that can raise blood pressure, cause speech impediments. The injustices to confront (such as the fact that black people are five times more likely to be detained under the mental health act than their white counterparts) and the adjustments to life that those with disabilities are required to make to their lives.  

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma. We have to listen to the perhaps devastating, perhaps uncomfortable stories of those who live with severe and enduring mental illness. The mental health npatient units miles from home, the lack of freedom, the searing - unending grief.  

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them. 

By hearing these stories, we are accepting them as a part of reality. For those of us in churches it might be that the healing didn’t come in the way we expected, it might be also be all of us accepting that the systems designed to care for those with mental illness have in fact, caused more harm. It’s seeing the injustices and understanding that we, our systems and professionals need to change our attitudes.  

Understanding and acceptance of the injustice are the way forward- that’s the only way change can come.  

It might look like standing in the rubble, it might feel too huge and all but hopeless.  

And yet in scripture and in life that is so often the only way we can begin to rebuild. 

In the book of Nehemiah, one of the Old Testament prophets who had lived in exile far away from home for his whole life, we see that upon hearing about the state of the walls of Jerusalem, before he did any of the things we expect heroes and innovators to do- he wept. In fact, it’s estimated that for four months he wept over the state of the place that had once been the envy of the ancient world.  

Perhaps we too need hear the stories and then weep. 

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them and then slowly, we can begin the work of rebuilding.  

It isn’t a work that can be done alone by a single agency much less a single person - it requires society to hear stories of the more than just ‘palatable’ mental illnesses with neat and tidy endings to the messy and sometimes traumatic stories that are there if we just care to listen to them. It might be reflected in the petitions we sign, the way we vote, the stories we choose to read. 

So ,this Time to Talk Day - I’m saying let’s continue the amazing work of talking about mental health - we need to keep talking about anxiety and depression. But let us also make conversations wider, so that they encompass the whole continuum of mental health and illness. 

 We’ve seen the difference Time to Talk can make - now it’s time to talk about severe and enduring mental illnesses, too.