Two Saner Views Of Mental Illness

The Hearing Forest and the Seeing Field by Hieronymus Bosch

I’ve written here before about how easily the person can become obscured by psychiatry’s fixation on the symptom or a collection of symptoms (syndrome). This is a grave problem with our current conception of mental health, which views psychological symptoms as analogous to symtoms of a physical disorder. While the ‘disease model’ can be a comfort to people who finally have a label for their inexplicable behaviours, hallucinations or delusions, labels tell us little about how to effectively treat such disorders. They too often lead to a life of chronic medication, with the goal of ‘managing’ a ‘disorder’, rather than making sense of the suffering of a person. I’m not suggesting for a moment that psychiatric medication is without its uses, especially in relation to acute states of psychosis or the profound depths of depression. What I will say however, is that (when not a symptom of disease or degenerative processes, or the result of a neurological insult like a stroke or head injury), the symptoms we associate with mental illness – delusions, hallucinations, compulsive behaviours and so on – are meaningful. They relate to processes at work in the individual, and are frequently hysterical in the old Freudian sense.  They serve to express unacceptable emotional suffering, desire, aspects of the hidden and disowned authentic self.

Risk is an amazing podcast, established by The State writer / performer and sex positive campaigner Kevin Allison. I came across the show when Kevin was interviewed by the ever penetrative Marc Maron. Risk is a show where people tell stories. So far, so much like the Moth, or This American Life, or any number of other podcasts leading the storytelling revival. But Risk is different. These stories are confessional, lewd, challenging, often unheard before in public. Allison coaxes his guests to confess secrets, to normalise life events – whether sexual, violent or merely outre, that once brought them shame. In doing so he promotes the self acceptance that Carl Rogers, founder of the Person Centred approach to psychotherapy argued was essential to emotional wellbeing. Risk’s participants are helping to heal the toxic shame that we all carry, to greater or lesser extents, having internalised insult, humiliation and derogation. There are lots of blogs and podcasts that give lip service to self acceptance, complete with motivational poems and posters and wretched screeds against an uncaring world. Risk is different – it’s sexy, funny and performative, it’s joyous. This was brought home to me listening to an episode called ‘Transcendent‘, in which a young woman discusses her experiences with psychotic violence. Without spoiling the story, Becca’s experience of mental illness did not spring forth out of some hidden well of biological disfunction. Our brains can certainly make us more vulnerable to mental illness, genetic studies of the heritability of schizophrenia demonstrate that. But those same stories also demonstrate that mental illness is multifactorial – it is caused by many things, including abuse, poverty, social and familial dislocation. In Becca’s case those things included the loss of her father at an early age, and living up to an enormously demanding false self. A self that demanded success, perfection, to fit in. Her story is one of recovery, and finally coming to accept her experience as heroic, as meaningful.


Another inspiring story is that of Eleanor Longden, who as a student was diagnosed with schizophrenia because of her persecutory voices. In recent years online collaboration has encouraged communities to coalesce around people who share the same experience. These experiences can be benign, as in the case of Synesthesia, where reading a number might conjure a sound or colour.  They can even be delightful, as with the strange (and still hardly understood) Autonomous Sensory Meridian Response (ASMR). The can be terrifying and destructive, as is often the case with persecutory aural hallucinations. Eleanor and others with similar symptoms have banded together to form organisations like the Intervoice Network the Hearing Voices Network, that give a voice to those who hear them. Eleanor, now a clinical psychologist, formed a relationship with her voices – which she ultimately came to accept as disowned parts of herself. Examples like hers demonstrate that making meaning from the experience of suffering is one of the most profound ways to transcend it. As psychotherapist and holocaust survivor Victor Frankl wrote, “In some ways suffering ceases to be suffering at the moment it finds a meaning”. Through self acceptance, and with it self revelation and gradual self efficacy, we can find a voice for our suffering, and let it empower us rather than constrain us.