What if talking about the madness of King Donald actually fights stigma?

September 24, 2017 § Leave a comment

Since the fall of 2015—during the presidential primary scramble, when I first became aware of his violent will to power—I’ve wanted to write about Donald Trump’s mental health, like everyone else. More specifically, I’ve wanted to reflect on all of the agonizing over whether it’s okay to write about Trump’s mental health, and whether that unfairly stigmatizes those with mental health diagnoses, from the standpoint of one with various and sundry diagnoses. I’ve held off because not only because so much ink has already been spilled on this topic (or so many frantic keystrokes, I guess) but also because I have so much to say about what’s already been said that it feels like the task of saying anything, or saying something concisely and coherently, would be exhausting. But here we go.

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12.12.14

December 12, 2014 § Leave a comment

talked to g last night over text, sitting in my car outside the al-anon meeting. he’s not a drinker–anymore–but my therapist said i should go because our problems are similar. me needing him to do certain things to stay healthy and him not doing those things. me trying to control the outcome, me accommodating to stay in the relationship.

i liked the meeting. i felt in good company. some of was a little hokey and…borderline cultish? the almost mechanical chanting of the slogans and something called Council Approved Al-Anon Literature. but the principles crystallized in those slogans are actually helpful and make me feel better. and the stories people shared were raw and authentic. it was good to realize so many people go through the same stuff, that it’s not the end of the world. it’s felt so hard moving through the world feeling like i’m having this experience that is absolutely incomprehensible to others. that feels absolutely impossible to articulate to others, at least others who seem to have their shit together.

but something i’ve been thinking about is how common it is for people not to have their shit together. how common and human to love too much, to accommodate, to get wrapped up in your own internal dramas, to struggle with addiction or trauma or self-injuring impulses. to rage and act out (or act in) because you’re not doing what you need to do to stay well. to create chaos in one’s own life or someone else’s. to deal with situations that are much harder than this one. the normality of crisis. how common, how inevitable, how human, to struggle with hardship and loss and grief. to have to make a way outta what feels like no way.

how otherwise could aimee mann have produced the masterpiece that is The Forgotten Arm?

this morning i was thinking about my two closest friends from grad school. we all ended up marrying (well, i am not married but it’s that kind of arrangement) white dudes with mental illness. i’m the only one of the three who also lives with significant mental illness. but friend 1 just married a recovered heroin addict (dios mio) and friend 2 an alcoholic who still drinks (dios mio!). he’s not supposed to but he does–she finds bottles buried in the trash from time to time–and when he gets really drunk he gets crazy. once broke his neck falling down some stairs. more than once tore up the house, once when she was 9 months pregnant.

the first time it happened i was like, A: you have to leave now. this is abuse. it was easy for me to say, easy for me to shake my head when she decided to stay and work through it. he quit drinking, mostly. they went to counseling. he went to AA. i didn’t understand then how hard you can love someone. but, more importantly, i didn’t understand how, while the other person’s illness is never a choice, a person does actually have a choice in how they manage it. and it can be okay to stay with a person who is taking responsibility for managing their illness.

at the al-anon meeting the first thing they said was that most people first come to meetings for the ill person. they hope that by coming to the meetings the person will get help. it’s another way of trying to control the person’s behaviours, control the outcome. but the meetings are for YOU, the facilitator said. it’s YOUR illness and YOUR program. it works if you work it. i liked the positivity. there is always something we can do, but we have to decide we want to do it.

the meeting was really small. three other women. i didn’t have any particular expectations of who would be there, but i was struck by how unlike san antonio’s overall demographics it was. i’m used to being in all or mostly brown spaces, but the facilitator sounded like she came from brooklyn or jersey and the other two women sounded eastern european and middle eastern. the venue for the meeting was interesting, too. it’s at a place called Club 12–for the 12 steps, i guess–and it had a kind of raucous atmosphere. even before i stepped inside, a guy sucking on a cigarette stopped me at the door with, You AA or Al-Anon? Al-Anon, i whispered, looking down. Yeah, cause if you was AA I was gonna ask if you wanted to sell some tickets for our holiday festival. But most of the Al-Anons, they don’t really want to be around no cork popping! he held the door as i passed through, bewildered, into a common space bouncing with AA guys yukking it up.

the al-anon meeting room was at the back of the building, behind a closed door. it was semi-dark and smelled like old cigarettes from decades past. the walls were covered with posters and murals bearing the Al-Anon principles: one day at a time. progress, not perfection. you didn’t CAUSE it, you can’t CURE it, and you can’t CONTROL it.

during the meeting i felt my phone vibrate in my pocket, but i ignored it, probably because i was telling my story and crying about how i should not have acted so hastily–the brooklyn lady distractedly shuffling the collection baskets around like so what’s new, sweetie?–and anyway you’re not supposed to be on your phones during the meetings. but it’s a good thing i didn’t check or even register the text, because when i got to my car it caught me completely off guard. and because i was in a completely different frame of mind after the meeting, so that i was able to respond with love without abandoning myself. how could you do this to me when i’m sick? his text cried. i hope you never find out what that feels like. 

i want you to come home, i texted back. if we can do the things we need to do to help you/us. 

The Politics of Madness: Claiming Idiopathy, Or the Ordinariness of Mystery

December 25, 2013 § Leave a comment

The final paper for a graduate course in disability studies, which I took back in 2002 during my first quarter in graduate school. The course was the first time I really thought about my own history of psychological weirdness in a critical way–or even as something I “had” that I could think about. I spent most of my early years desperately trying to appear normal by hiding mood states, anxiety levels, and compulsions that from my earliest years I regarded as too bizarre to even speak about. Only later did I realize how normal it was to not be normal, or that what I experienced many other people did too. I had no idea at all.

***

Shame and fear are personal burdens, but if these tales are told, we can demonstrate how the personal is indeed the political.

–Simi Linton, Claiming Disability

Winds, writes Shigehisa Kuriyama, “[can] never be truly known” (2002: 269): and in the disparity between the muscular body of the Veslius and the ample-bodied yogic, we see diverging cultural responses to the similar problem that wind presents. According to Kuriyama, both ancient Greek and ancient Chinese medicine viewed wind as the primary cause of illness and bodily disorder; to both cultures, wind represented the ultimately unknowable, elusive nature of the world, its unsettling mystery and unpredictability—and hence the fragility and mystery of the body as well, simultaneously the object of cosmic whimsy and the agent of its own strange and inexorable logic. Wind, Kuriyama writes,

embodied contingency and chance, the obstinate halo of uncertainty that made all science mere approximation. Because they arose unexpectedly, spontaneously, irregularity, because they made harsh, abrupt shifts, winds became associated especially with the most, dramatic, sudden afflictions—with strokes, epilepsy, madness. (258)

The response of both Chinese and Greek medicine to the problem of uncertainty—easily associated with corporeal existence—was to cultivate an understanding of the body as impervious to the reality of impermanence, mutability, and sudden change: the Greeks through the creation of the muscular body, the body as sinewy instrument of the will; the Chinese through the full and rounded body, the body at harmony with its surroundings and hence untouched by both internal desire and external chaos.

To the ancient mind as well as to our own, the body kept itself secret, and both Chinese and Greek medicine sought to divulge this hidden truth by speaking the language of medicine, the delineating language of order imposed.

***

I begin with Kuriyama because of the shape of my madness: because I recognize myself in the mind of antiquity, with its worries about instability and abrupt change, the ever-potential threat of mutiny and reversal of fortune. The shape of my madness, then, takes the shape of ancient Chinese and Greek science: like ancient medicine, my madness is a desperate attempt to seal myself off from chance and contingency, to impose the silencer of my own will upon the unruly truth of my body. I will return to this idea—the particular shape of my madness—later in the essay, though I will touch upon it throughout.

I want to begin, however, by prefacing such discussion with a few preliminary remarks about what I aim to do in this essay. In addressing what I have learned this term as a scholar of disability, I find that I cannot do so without speaking about the difference that I have always both recognized within me and tried strenuously to disavow. It was, in fact, the knowledge of my own long-unspoken strangeness that originally drew me to the subject of disability studies, with its prospect of a liberatory politics of the weird, a revolution of the physically and mentally variant: the “gangly, pudgy, lumpy, and bumpy” (1998: 3)—as Linton puts it—but also the crazy, unstable, unable, and unfit. My secret identification with this project drew me in, and it has been my referent throughout the term, my continual point of comparison and contact (to borrow from Susan Crutchfield and Marcy Epstein). I cannot talk about disability studies, then, without talking about this strangeness, this difference. « Read the rest of this entry »

Foucault’s Madness and Civilization, as Read by a Crazy Person

December 25, 2013 § Leave a comment

This is a synopsis–what did they call them in grad school? A precis?–of Michel Foucault’s Madness and Civilization, which I read as part of my disability studies grad class. It struck me as profoundly weird, like seeing yourself in the mirror for the first time. 

Michel Foucault’s classic Madness and Civilization: A History of Insanity in the Age of Reason might be just as aptly subtitled The Extermination of Madness at the End of the 19th Century. For Foucault’s main argument–which does not come until the tail end of the book, a la Henri-Jacques Stiker–is that “what we call psychiatric practice is a certain moral tactic contemporary with the end of the 18th century, preserved in the rites of asylum life, and overlaid by the myths of positivism” (276). Foucault argues that this modern-day sleight-of-hand is the result of a centuries-long process of “scission” (x) between the language of Reason and the language of madness; his task in Madness and Civilization is then to trace the development of this gradual split through an analysis of European history during the Middle Ages, Renaissance, and Enlightenment Age. Through numerous case studies and extensive quotes from prominent figures of the era, Foucault examines how shifts in the role of institutional structures such as the leprosarium, the house of confinement, the hopital, and the asylum paralleled shifts in European society’s understanding of madness. From the 15th century’s conception of madness as indistinguishable from indigence and criminality to the 18th and 19th centuries’ liberation of a differentiated madness unto a normative and condemning bourgeois moral order, Foucault documents the process by which institutional structures and practices have inscribed themselves upon the bodies and minds of those considered mad: excommunication, physical abuse, regulation, and judgment have given way, in more recent times, to the creation of that “serene world of mental illness” in which “modern man no longer communicates with the madman” (x).

Curiously, Foucault leaves off his historical analysis here, at the doorstep of the 20th century. Unlike Stiker–who makes similar claims and uses similar methodology to support them–Foucault refers to contemporary society only obliquely. We can only surmise that his silence regarding his own century echoes the great silence of an Unreason stilled by the totalizing discourse of medicine; after all, he warns us in the preface that “I have not tried to write the history of [psychiatric] language, but rather the archaeology of that silence [which results from such a language]” (xi).

Confronting this strategic silence, I cannot help but wonder what a more cultural criticism-focused scholar like Rosemarie Garland Thomson would make of this obstinate absence of the present. Would she not say that in critically addressing the history of madness–that is, in addressing the history of madness with an eye to power, to the domination of certain bodies and minds–we must also discuss this contemporary psychiatric language, given that it continues and has real force in the lives of modern subjects (especially those defined or who self-define as disabled)? The language of unreason may indeed be the unreachable abyss beyond which no Western discourse can venture–but what of the ways, immediate and concrete, in which contemporary society treats and represents those considered mad, insane, crazy, mentally ill? Certainly, for me one of the most surprising aspects of Foucault’s text was this subjective disjunct between his history and my experience–two things which, objectively speaking, should be seamless. As a teenager, I was hospitalized for a time in a psychiatric institution, the primary effect of which was to scare me straight, basically: an experience that echoes Foucault’s description of the asylum as “an instrument of moral uniformity and of social denunciation” (259) which merely masquerades as modern medicine. Yet reading Foucault, I am left with the sensation that the history he details so painstakingly in no way bears upon the now: it seems a disembodied account of madness, a history discontinuous with present times and present practices–an impression strangely belied by the realization that what I am reading is somehow “our” history, “our” legacy. Not until I have finished the book does it hit me, and then only oddly, in the space of his silence: these things continue, and I have lived them. 

Emetophor: Notes Toward an Abandoned Video Project

December 25, 2013 § Leave a comment

These are notes on a video project I once imagined releasing on YouTube, about my lifelong experience with emetophobia (phobia of vomiting and seeing others vomit). I still may complete the project one day, although emetophobia has lessened its grip over my day-to-day life to the degree that I’ve learned about and treated the underlying–and also lifelong–anxiety disorder of which it is simply an expression. That being said, I still feel like the video would be helpful for others, from fellow emetophobes to scholars of embodiment to therapists. 

***

video installments:

–introduction (purpose of videos. inspired by series on anorexia. why this format – anonymous, but also simultaneously public and intimate. who i am – academic, emetophobe – and how that informs my approach/goals.)

–what is emetophobia (clinical understanding, statistics, what kind of research has been done, gaps in research, most helpful information comes from largely online community. It is not just a fear of vomit or vomiting, but a complex condition characterized primarily by shame, anxiety, and panic at the prospect of violating social proscriptions against “losing control” of one’s body, especially in public settings)

–my story (prob several parts, draw on essay i wrote for kudlick’s class)

–emetophobia as metaphor: the western excretory imaginary and where vomit fits in (relation to my project on excreta…the negativity of the body, the desire for social acceptability through bodily control, the status of vomit relative to other kinds of excreta, vomit as irredeemably abject.)

–story of my treatment attempts: what i did, what worked, what didn’t (talk therapy as a means of exploring personal metaphoricity of emetophobia, necessary approach but ultimately not sufficient for me.)

–the anxiety and phobia workbook and how it changed my thinking about the phobia (led me to realize that altho technically a specific phobia, involves significant dimensions of other anxiety disorders, i.e. social phobia, agoraphobia, panic disorder. “cure” came from getting away from specific content of phobia and dealing with its symptoms as I might agoraphobia, social anxiety, panic attacks, etc)

–emetophobia and eating disorders (personal history of anorexia, how emetophobia complicates this history, overlaps/differences between anorexia and emetophobia. Example of Intervention episode with Nicole – diagnosed as eating disorder, but primarily panic disorder or PTSD as a result of sexual assault that manifests as struggles around eating/swallowing. As in this case, emetophobia is primarily an anxiety disorder that gets expressed physically in ways that can resemble anorexia. That being said, my body doesn’t know the difference between intentional starvation and not eating because I’m anxious about throwing up, and the ramifications for my physical health have been enormous. I have been underweight pretty much all of my adult life, and in my 20s I have had to deal with a diagnosis of borderline osteoporosis and dental problems stemming I think from loss of bone density—thinning enamel. This is damage I can’t remedy easily, if at all, and it’s taken me 5 years to work through my grief over this damage enough that I can be proactive about doing what I can do preserve my health. Only now can I face the reality that there are life and death stakes in learning how to better deal with my anxieties about embodiment without this reality overwhelming and paralyzing me. And so I make a conscious effort to eat even if I’m anxious about eating, and I do weight bearing exercise regularly, and I floss daily and brush with an electric toothbrush and get regular cleanings.)

–for the therapeutic community: 5 misconceptions about emetophobia, 5 suggestions for improving treatment

–emetophobia and pregnancy/parenthood: how i coped/how I am coping

  • did not have morning sickness very bad. However, when I did it wasn’t very bad, and for me was mixed up with hunger. Somehow nausea I felt in pregnancy was less scary than other nausea, bc it meant something different, because it was mixed up with joy I felt at being fertile and pregnant.
  • So if you’re emetophobic and wanting to get pregnant but feeling scared, remember that being PG doesn’t necessarily mean you’ll feel sick or get sick
  • toward the end of my pregnancy, I was terrified not of feeling pain, but that I would feel sick and vomit during labor (my midwives said about a third of women did). When I actually went into labor, my stomach was totally unaffected. The process felt like it was happening somewhere else in my body and didn’t reach my stomach. Afterwards I recognized that even if I had, I might not have cared—labor is that intense; it puts you outside your normal mental and physical frame of reference.
  • One major way I personally handled anxiety about the unknown physicality of labor was to give birth at home with midwives. I realize this is not necessarily desirable for everyone. but for me, so much of emetophobia is about fear of losing control of my body, esp in a social setting where I’m surrounded by people I don’t know. I knew that giving birth in a hospital would intensify my anxieties, so I chose a setting where I knew I’d feel most relaxed, uninhibited and unconcerned about being judged and evaluated. Others might conversely feel safer and less anxious in a hospital. The point is that thinking about birth setting and what will make you most comfortable is important, and can help with anxieties around the labor process.
  • that being said, I really really worked hard while I was pregnant to anticipate what underlay my deepest anxieties about labor and how I would cope if the worst happened. This exercise turned out not to be necessary during labor, but it is the basis of the practical strategies I recommend in other video
  • Something my therapist said that helped a lot when I was dealing with anxiety about flying (related to emetophobia—scared of being trapped and feeling sick, being unable to leave, scared the plane would make me feel sick): think of the end goal and focus all energy on that. yes, the getting there is uncomfortable, but in the end it will be worth it. Keep yr eye on the prize. And the more I did it, the less scared I became of flying. Today I’m not scared at all.
  • This is also helpful when thinking about the bigger challenge of having kids who inevitably get sick. when my daughter has been sick, it has been hard for me. I get really stressed out and anxious. But I HANDLE IT. And one of the ways I’ve been able to handle it is to keep reminding myself that the uncomfortable situation of dealing with throwing up and worrying about throwing up myself is worth the end goal, which is to make sure my daughter feels cared for and loved when she feels bad. That is more important to me than the getting there, as hard as the getting there is—just like arriving and seeing my family is worth the discomfort of the plane ride.
  • I also reframe these situations mentally in a similar way to how they teach you to reframe childbirth. Instead of thinking of it as suffering, painful, horrible etc, think of it as intense, challenging—something that you will get through, and that will make you stronger.

–for emetophobes: general strategies that have helped me

  • Anxiety and Phobia Workbook, esp breathing exercises
  • Recognizing that the problem is not vomiting, it’s anxiety. Realizing that feeling of anxiety/panic (about whatever) is 1000 times worse than actually feeling sick
  • So, learning to distinguish fear of vomiting from feeling sick. being able to redirect fear chatter to more meta-level statements: from “what’s my stomach doing, what if, I feel scared!” to “I’m feeling a lot of anxiety right now” which puts me in a more practical frame of mind, i.e. I’ve identified a problem, which leads me to come up with potential solutions.
  • Shifting ultimate goal from “getting rid” of anxiety/phobia to learning how to live with it, meaning how to compensate for it. Anticipating that living with realistically includes a certain amount of setbacks, where anxiety takes over and affects my eating habits. Thus, not beating myself up over setbacks, but learning how to get back on the wagon and continue to make progress (for me, exercise and eating to gain weight).
  • Exercise and eating right refocuses attention on body but in a positive way. I have found that when I avoid eating because I’m anxious about my body, my anxiety gets worse. I now try to take an empirical approach: I’ll try eating a little something and see how I feel. If I really don’t feel like eating, I can stop. But 9 times out of 10, I find that eating makes me feel better—physically, but also psychologically in that I’ve confronted my fear and moved through it.
  • Writing exercises I did in preparation for childbirth useful for anyone

–phobia in a disability studies context – invisible disability and the importance of resisting shame and stigma (paradox of its being 5th most common phobia yet surrounded by shame and silence) and the necessity of talking about it (to “come out”, to draw attention to need for more research, to draw attention to how it’s been framed in unhelpful ways). Personal, psychological, political importance of destigmatizing the body itself, of refusing a social refusal of its excretory functionality.

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