Fear-less . . . that’s just crazy talk

I have for some time, and mostly on the back-burner, tried to understand the 1960s-70s conversation about the social context of mental illness in light of contemporary experience.  The basic tension being whether the determinant role in mental illness can be fixed primarily on biological factors or social factors.  High school was my first encounter with mental illness when a good friend was diagnosed with depression.  I can still remember him talking about ‘chemical imbalances’ and as I recall this was also presented to us in a class.  The basic point of focusing on biology was so that individuals would not equate their experience with their identity or ability.  They could no more ‘create’ or ‘identify’ with their condition as could someone with a cold or flu.  This sort of conversation also placed hope in science as the messianic figure for those in bondage.

I find it unfortunate that the conversation continues to be reduced to the need for a bio-medical cure and that other forms of response are basically the bandage which keeps the individual from completely being bled out.  Now I want to be clear that I am not opposed to medications that respond to mental illness (though I remain supremely frustrated in how they get distributed and the ‘results’ they offer).  What I want to consider is simple.  Regardless of an illness’ origin and manifestation how would a person respond to their symptoms (apathy, melancholy, hallucinations, paranoia, etc.) if they lived in an environment that actively and rigorously rooted out expressions of fear or the factors which most commonly lead people to be afraid.

I don’t really care at the moment about whether or not this possible.  I just want to consider what it would be like for someone to experience symptoms of mental illness (assuming they are somehow of independent origin) without being afraid of them.  What if there was no fear of hearing voices only a need to process what they said.  What if there was no fear of apathy but a space to rest and act without the spectre of productivity.  These ‘services’ are already offered but they stand distinctly under the banner of ‘sick’ (dysfunctional, abnormal, absurd, etc.).  There is a lot of talk about dealing with the ‘stigma’ of mental illness but until we consider that the power to make it an ‘illness’ is held directly within the stigma I don’t see it being taken seriously.  The typical response of dismantling stigma is to handle a person with ‘kid-gloves’ that still perpetuates diminished status.  How then can we nourish lives that can withstand the fearful realities of life or must we ‘flee Babylon’ and created spaces (perhaps like L’Arche or La Borde) where another manner of life is possible?  And what of the church in all this?  I don’t see those addressing a mental illness flocking to my congregation.  And yet there are so many individuals and families struggling under this burden.


10 thoughts on “Fear-less . . . that’s just crazy talk

  1. Herman Dueck, long time Mennonite pastor, theologian, and now chaplain in Winnipeg gave a series of evening seminars at my church last month on his struggle with depression and his relation to the church and the church’s relation to him throughout. It really was excellent. I realize I’m not actually telling you anything helpful but advertising something you missed but it might be possible to get in touch with him. He’s definitely given the best theological account of mental illness and the church I’ve ever encountered. I can give you more info if you want as he’s an acquaintance of mine.


  2. I don’t think the problem with mental illness is that people are simply afraid of the symptoms, but it’s that the symptoms are extremely distressing. People don’t have auditory hallucinations that say “You’re number one or world’s greatest boss”. No. Rather the voice often say quite upsetting things like “Eat shit and die”. When someone is hallucinating it’s not simply that they fear going crazy, they often have what we call “annihilation anxiety”. They literally fear killing themselves or being murdered. I can understand your point regarding depression and anxiety but more severe mental illness is more complicated (not to mention more organic in its etiology).


  3. Could you clarify what you mean by ‘organic in its etiology’? Is that a reference to the chemical component? I definitely agree things are more complicated then what I have reduced it to here. Auditory hallucinations are an interesting component. My experience with people hearing voices is that they connect the voice directly to an individual (seriously unsure as to whether or not that person said it . . . yet also rarely mistaking something that was said). So there is fear/distress about your inability to understand the world. Fear/distress about the content of voices. Fear/distress about what people will think. I suppose my reflection was on the extent to which all those fears could be addressed and received in another context, that is, one which does not pretend to have control of all the above mentioned fears (while persecuting those who cannot control them). After talking with someone extensively who hears voices I began to realize a milder form of experience in my own life that I was able to control. My voices do not even come as a whisper but more as a feeling. One difference seems to be my ability to control and categorize.
    I am very sensitive to the fact that I may come off as minimizing the experience of those who have gone through psychosis and it seems as though medication can help people stabilize in helpful ways but I can’t foresee them being an end in themselves.


  4. Not only the chemical but also the genetic component.

    Auditory hallucinations can be individualized, but they can also be persecutory and anonymous. You mentioned the voices that come as a feeling or perhaps the negative self-talk we also engage in. The difference is in auditory hallucinations is that the person would swear up and down that the voices are coming from elsewhere (I’ve always heard the idea that imagine you’re at a cocktail party and you hear someone in conversation across the room mention your name).

    It’s interesting to think about the different context in which these voices are heard. However, the brain of someone who is having active hallucinations is literally on fire. They need to stop because the neural damage is quite damaging.

    I don’t think medication is the only thing that we have to use when battling difficulties like schizophrenia. Individual therapy can also be of some value. However, medication is mandatory.


  5. I’m not sure why I am so unsure about medication. I suppose I need to be more realistic about it. The experiences I come across are so uninspiring (and some downright frightening) that I think there must be a better way or at least that being off meds can hardly be worse. But I know this is simply not the case. I know that while medication is not the solution it can minimize the possibility of some severe circumstances both for the patient and those around him or her. I probably should not make the issue as polarized as it is my head.


  6. I’m not denying there are some overmedicated people out there (especially w/ lesser forms of pathology like depression and anxiety). Also the side effects can be really awful for some meds as well. Quite frankly, my experience has led to me to believe that people reap much more benefit from adhering to medication. Also, we’re not in 60s anymore. I think some of these concerns were more appropriate back then before we understood, you know, the brain.


  7. Of course poor use of medication is simply poor use of medication (and this is where I have been astonished at the wind range in which doctors will prescribe medication). And I am almost entirely ignorant of neuroscience. What I catch wind of has not given me confidence that we indeed ‘understand’ the brain . . . but again that is not saying much.
    Auditory hallucinations are still fascinating on this level. I don’t suspect that a neuroscientist would argue that chemicals ‘create’ words, would they? Does this move into conversations about ‘real presence’? Is syntax embedded in biology? Otherwise the question remains ultimately social and relational with regards to the voices themselves as I don’t think ‘eat shit and die’ is an ontologically baseline phrase. Just rambling here. And again to be clear I am not trying to set this up as an argument against meds.


  8. You’re right they wouldn’t argue that chemicals create words. However, there’s a remarkable similarity in the content of auditory hallucinations amongst many various clients (same goes w/ delusions). I won’t deny that there is some sort of social-relational reality that contributes to the content of what the voices say, but nonsense is nonsense.

    So I’m less inclined to think that the delusion or hallucinations are idiosyncratic and revealing of someone’s inner world, but rather the commonalities amongst these symptoms across different culture indicate they are just a byproduct of schizophrenia.


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