We live in the age of a hyper-focus on our mental health. Recently, I read a post that suggested that by mid-life, one in two individuals will have had a mental health struggle. This bothered me, for the same reasons that the ever-expanding diagnostic manual in Psychiatry, which tries to include and name almost every stressful life process, does. At what point do we acknowledge our shared anxiety and struggle as not abnormal, but normal; on a certain level, I feel it does nothing good to separate and identify ways that we respond to the world as problems. I want to strongly emphasize that I am not suggesting there aren’t legitimate and helpful reasons for bringing to light debilitating struggles that people face to cope with life’s demands, and in this sense, the field of psychology has come a long way, but I fear the scales have tilted to pathologizing everyday life and this can then lead to having the opposite effect.
So what then is normal? How do we define it? What does it look like?
An unlikely source inspired me recently in the answer to this question. Samah Jabr, chair of the mental health unit at the Palestinian Ministry of Health and one of just 32 psychiatrists in the Palestinian territories, published a book called Derrière les fronts (“Behind the Frontlines”). She challenged Western notions of diagnosis, particularly Post Traumatic Stress Disorder (PTSD), being applied to a population that is in the middle of experiencing constant threat; there is nothing “post” about it, she argues. Rather, when she is assessing the wellbeing of her patients, she looks for the basic criteria “To be able to have critical thinking, to maintain [one’s] capacity to empathize.” In an environment where high levels of fear, vigilance, rage and horrible symptoms like nightmares and startle reflexes, are all too common, she is not assessing these as abnormal, but rather focusing on the capacity to be reflective and to maintain space for the other.
This is not a political essay. The plight of those living under constant duress is unfortunately all too present in our world, and I fear given what we know from history and our fallibility as humans, is here to stay. Rather, I was touched by Jabr’s need to zero in on what constitutes for her a measure of good enough mental functioning, and I have to agree that what she settled on is at the core of what we should all aim for in our lives when it comes to how we face the world. Putting aside the particularly difficult conditions that she is working in, what she focuses on is the flexibility of thought and the capacity to reflect. In my work with people from around the world coming from all walks of life and with vastly different value systems, I too am looking at the same fundamental relationship to one’s circumstances.
In my interview this week with Dr Gabor Maté, he highlights trauma as the main source of what causes us to tighten up, become defensive and ultimately lose empathy. He describes a lesser-known genocide in the Congo in the late 19th century when it was ruled by the Belgians. He goes into the traumatic pasts of such prominent politicians as Hilary Clinton and Donald Trump. At the end of the interview, he makes remarks about Canada’s colonial past and the irreparable damage it caused to the Indigenous population brought to light and the recent gruesome discovery of children’s graves. Gabor eventually tries to synthesize and simplify what he thinks is needed, and he settles on kindness and understanding towards children as the bedrock of our society and healthy development. But I found myself wondering during and after the interview, how do we work through either the inheritance of such incredible traumas as the one in the Congo or the ongoing violence in the Middle East amongst so many other failures in our world?
I made the point in the interview with him that I believe it is an ongoing process. He also remarked that there is no panacea. When I have spoken to and gotten to know the giants in the field of psychology, such as Gabor Maté or Sue Johnson or Donald Kalsched, one thing has been abundantly clear to me, they are human and still face human struggles. The art of being curious and taking seriously one’s past, ancestry, life experience and inherited dilemmas is not a wild goose chase towards some ideal of stability. It is to be able to cultivate an appreciation for life’s disappointments and to maintain the capacity as Jabr says for empathy, most notably towards oneself!
That is the undercurrent of this essay, that the notion of being broken and different can all too easily get perpetuated by focusing on what we lack, on the particular ways that we face the world, and when we diagnose our difference, it becomes like a monkey on our back. The more we can remain flexible with the specifics of our inherited circumstances and situations, the more that allows us to tolerate what it is that we need to accomplish in our lives, even if we are stuck in particularly difficult circumstances. This is not meant to suggest that those that need our help to be lifted out of poverty, war, or oppression can just magically become ok with things, rather, it is meant to address what are often intractable life circumstances and to wonder together how to cope with and remain healthy enough psychologically to affect change without further demonizing ourselves in the process.
I guess Gabor is right when he talks about kindness and understanding, and as I predicted in my mind before speaking with him, I knew that ultimately that comes back to trying to maintain that within ourselves, whatever it takes so that we might be in a position to possibly help others. We are no good to anyone if we lose our own empathy and ability to reflect, so I guess we always need to start there and see what happens.