Depression or a Broken Heart?: On the 'Illness' of Emotions

How many of you (us) who work in social work identify with having 'mental illness'? How many of you (us) have experienced some form of trauma in y(our) history that drove you into a field where compassion is central to working with folks who have also experienced trauma? I wager the answer is very different for these two questions, largely due to the framing of mental health 'issues.' What exactly are we talking about when we speak of mental health? Why have we succumbed to a medicalization of our spirits... the auspices of our hearts?

Despite the assumptions you might make about social workers or counsellors, many of us enter this work based in some experience of suffering. Some of us don’t subscribe to hierarchical ideals of ‘professionalism’ and come from our own histories and understandings of trauma which drive us to provide safe space for others to explore their experiences. Some of us (have) experience(ed) first hand what it means to be 'ill.' I put the word 'ill' in quotations because I do believe that the medical system has appropriated the experience of human suffering; sought to classify, contain, and treat it as individual disease as opposed to natural reactions to oppressive and traumatizing situations.

Some folks may differ in their consciousness of the impact of their trauma history on their desire to either work alongside, or to "save" others. Some folks believe they do not have a trauma history, and seek to consume the stories and suffering of others to placate a desire for meaning that is often facilitated by experiencing suffering. For folks entering into any activity that is aimed at being supportive or providing care to others, it is crucial to bring an awareness of one's own history and coping into full consciousness. Sometimes, we may seek to avoid the difficult work of reconciling our pasts, the emotional leftovers, and the unconscious desire to heal ourselves through working out our traumas on people who are already traumatized. This may happen in any realm of community, family, or social life, and is particularly loaded when entering into social justice work.

It is ironic that traumatic experiences - those which impact our hearts and souls - those which evoke strong emotional reactions in vivo, that may be carried with us as a blueprint for self protection for the rest of our lives, have been stripped of that very emotional content and processed into the systematic classification of psychiatric 'disorders.' It is striking, the degree to which simple human experiences and natural responses have become inconvenient and problematic, in the face of dehumanizing capitalist systems that alienate us from the possibility of self connection, and connection with others. Societal notions of competency and functioning are epitomized in the dehumanization of individuals who do not fit into a capitalist system. When folks are derailed in early childhood due to trauma, and are torn from the possibility of safe, nurturing relationships with direct caregivers, or anyone at all, survival can become contingent upon the numbing of pain. Witnessing mainstream society's disdain, degradation, and dehumanization of those visibly suffering with substance misuse and mental health issues becomes emblematic of the distance we have been conditioned to accept from our own hearts. We have become desensitized to the notion that we do have feelings. In order to function in large urban centers driven by capitalism, production, hours worked, goods bought, stress, and a lack of emotional space at all - it becomes necessary to distance ourselves from actual suffering, and instead, contain suffering as a 'disordered' experience in need of medical repair.

A Bit About My Story

I was driven to try to make sense of people, behaviour, communication, and why we do what we do from a very young age. That was my survival strategy. Growing up, I watched my small, isolated, working class immigrant family struggle to support my brother with scarce resources and funding. Doctor's error had resulted in my brother's breech position being complicated by an hour and a half of being stuck in my mother's birth canal with no intervention. The resulting suffocation of the umbilical chord led to my brother being born with profound disabilities. In our small town B.C. rural context in the seventies and eighties, social services were glaringly absent. There were no such things as careshifting, respite support, community rallies, automated doors, wheelchair stalls, chair lifts, ramps, motorized chairs (or even padded chairs), or sidewalk dips, for example. My mother recently recalled a story that exemplified her and my brother's struggle. They would go for a stroll regularly to get out of the house, get exercise, fresh air, and find human contact in our neighborhood. They would be on a shopping outing walking down the street only to have to overcome each cross street with a set of large, foreboding curbs. My mother would have to navigate by lifting, pulling, and teetering my brother's heavy, inflexible, non-padded, un-ergonomic chair and my brother would have to brace himself to be potentially dumped or at least jostled all the way to wherever they were going.

One day, my mother became so frustrated and enraged at these physical barriers she marched herself and my brother right up and into the City Hall. She walked with my brother over to the front desk and demanded to speak to someone. The person obliged and my mother relayed with great frustration (in her third language...Bulgarian, German, then English, and 9th grade education level) the amount of distress the city was causing by not foreseeing the need to remove or minimize barriers such as curbs, and how this was limiting our ability to get around the city for basic things like shopping for groceries.

Several months later, the city began flattening the curbs.

My father had great difficulties processing his emotions around having a son with disabilities. He grew up in Germany as a small child during the second world war and undoubtedly internalized notions of disability as "personal defect" and a "dirty secret." He cut himself off from family as a young man and hopped a large steamer to 'Canada' (Turtle Island) to start fresh. When my brother was born, he refused to tell anyone in his family... fearing the judgments, stigma, and blame of a first born son who would not live up to the idealized expectations of manhood. In a span of four years during the war, under "Aktion T4" the Nazi eugenics ("mercy killing") program slaughtered hundreds of thousands of people with disabilities by gassing, drugs, then starvation for what was considered "life unworthy of living." Carrying these judgments, fear, and lacking the appropriate resources to properly care for and support his son, sprinkled with long periods of unemployment as a machinist left my father feeling helpless, depressed and angry.

None of us had the language to understand my father's 'mental health' issues at this time. All we knew was that he would periodically, suddenly, shut down and stop speaking to all of us. He would be seething and distant, drink booze secretively, and burst into rage and violence when simple things frustrated him. My brother received the brunt of this violence. I watched helplessly at the kitchen table each night as my brother, misunderstood by us all (we did not understand his speech until he was 33; he is 38 now) acted in frustration and anger undoubtedly at the fact that none of us were able to properly understand him. My brother's anger became screams, then biting himself and convulsing in protest. Our unshared language provided fertile ground for explosive family violence. In response, my father would yell, scream at, and physically assault my brother to try and 'control' him.

This did not work.

Meanwhile, my mother would try her best to intervene and would get caught in the crossfire. My brother would scream at her, my father would scream at her, she would scream at my father and brother, and I would watch silently. This started from as far back as my earliest memories. Years went by, and frustration became rage, became violence, became suffering, became rage and so on, and the family dynamics imploded. I will spare you the details, but suffice to say, all of us were traumatized as a result. When I reached seventeen, the family finally split up. I had been praying for this since I was twelve.

As an adult, I unconsciously carried the weight of these experiences - and the overwhelming emotions I had submerged as a result - with me. I sought to create a safe and stable home environment with my friends, focussed on getting myself employed and educated and created some distance from the chaos and strife of my first 20 years. In coping with these experiences, not to mention my buried sexuality and gender identity, I became so emotionally distant from my self and my family I barely knew they existed. I thought I was doing very well for myself, and by all accounts I was... until the anxiety, nightmares, sleep issues and depression creeped in.

It is very difficult to distinguish the onset of something like depression. Obviously it looks very different for each individual, but I was completely unprepared for how this manifested in my own life. I was working with others who were resisting psychiatric labels imposed on their lives, and I had no understanding of how my own experiences of trauma had impacted me. It took at least six years for me to discover that I had, in fact, withdrawn emotionally from most aspects of life. Because I was able to function at my job, pay bills, hold an apartment, and have (often deeply compassionate) social interactions, I was unable to understand what depression looked like for me. I became frustrated and defeated at the sense of a gradual loss of joy, connection and meaning with everything around me. It became apparent to me that my experience of 'mental illness' was conflated with notions of functionality. My capacity to go through the motions of life obscured the drain my soul and heart felt. When it became difficult for me to do anything other than sit at my desk, in my office, staring blankly into space for long periods of time with no feelings to speak of... and picking up a phone to speak to a client felt like dragging my body through liquid cement, I finally realized my trauma had caught up with me. Simple tasks which I intellectualized the facility of, betrayed an understanding of the centrality of my emotions and health of my spirit in my capacity to do them. This was evident in all facets of my life, and I felt overwhelmed with a desire for rest and sleep... a desire which never seemed to be quenched.


Moving Forward

Working in a formal mental health care environment and experiencing things that are quantified as mental illness carries a particular gingerness in terms of self disclosure, and seeking help. For me, there was this desire to deny that I indeed, needed help, because I was the helper. I was supposed to be giving help. Furthermore, in many social services and healthcare settings who do specific work with folks labelled as having 'mental illness,' there is a silent *othering* and distancing of agency and staff dynamics from the possibility of sharing in the complexity of emotional needs and support that are the crux of diagnoses. This distancing indicates a desire for those occupying the institutional helping machine to uphold some sort of immunity from the baseness that begets a stigmatized status as mental health consumer. In the same moment that such agencies are advocating alongside survivors for the right to equity, humanity, centering of resiliency and emotional connectivity, toxic staff and management dynamics make true advocacy and support of mental health and the recovery of spirits and souls invisible, self-reinforcing issues. The desire for authentication and reification of 'professionalism' in such institutions perpetuates a medicalized, distancing, 'objective' approach to broken hearts that manifest in a mental health mismanagement system, and the neglect and death of spirits. The impacts of this broken system are especially felt on those spirits disproportionately carrying the weight of years of systemic, intergenerational traumas, colonization, racism, genocide, and scapegoating of their bodies and souls.

So, how do we disrupt this medical model machinery from the inside, in support of those hearts most vulnerable, and affected? If we are to work at the task of helping others heal from terrible, inhumane systems, we must do everything in our power to make those systems human again from the ground up. Taking responsibility for our own health and wellness by seeking therapy, counselling, spiritual guidance, friend and family support and so on, is imperative. By engaging in a reflexive process of accountability, healing, and cultivation of joy we become better able to relate to others, especially our colleagues, in compassionate, grounded, authentic ways. Bringing an emotional presence and awareness to one's daily life, and the group processes that often bog down interpersonal relations in well meaning systems of care, can go far in changing the affective tone and conditions under which systems impact others attempting to heal, or simply survive from their traumas. Bringing a heart centered lens to interactions with all levels of the systems we are entrusted with can enable a welcoming and greater centering of client/service user/community member needs, desires, strengths and capacities.

Beyond this, shifting the language used, especially in medical settings, that constantly seeks to erase personal experience and narrative and replace with pathos and reparative, knee jerk treatment, can bring about the slow process of shifting conceptualizations from illness to wholeness. Centering a language of trauma, and contextualizing trauma in relation to systems and processes, while emphasizing resiliency, strength and coping strategies in all conversations of wellness and health management can subtly usurp the fundamentally flawed notion of objectivity. The idea of practicing *on* others' bodies, can be sublimated and considered in the context of additional weighted options for care, as opposed to the be-all of care or assistance. Inserting a language of radical affirmation and validation, particulurly when problem solving with medical practitioners regarding clients dealing with complex issues resulting from intense, sustained and repeated experiences of trauma, can re-introduce the centrality of the spirit as a driving force in recovery. Over time, shifting of language away from detached rationalization and immediate problem solving to the gradual recovery of the heart from traumatic experiences through supportive, lateral relationships with fellow humans can transform individual practice and connectivity, team functioning, institutional frameworks and systemic practice as well.

The roles of psychiatric classification and medicine can begin to be deconstructed as flawed tools that often isolate and harm individuals and groups. If such tools are seen as having disproportionate power of imposing definitions of functionality on individual experiences, and this logic of individual pathology is replaced with understandings of resiliency and coping in reaction to oppressive systems - the stigma of diagnosis can be externalized. Medical options can be weighted in addition to building upon healthy resistance strategies that positively impact health and well being. Understandings from instruments like the Diagnostic and Statistical Manual of Mental Disorders can be extracted in discussion with, and if they hold meaning for the individual, while distancing from the all encompassing patholigization of being.

Indigenous (feminist) communities have been practicing what we (social justice activists and practitioners) call community strengthening and resiliencey for years. Consideration of all aspects of a spirit's health, wholeness, and happiness, by addressing indadequate housing, food access, culturally sensitive, client centered health care, relationships, and the connection of all these things and more to the pain and heartbreak experienced by individuals labelled with mental illness can transform a heartsick care system.

What role can you as a community member, family, friend, activist, worker, or supportive other play in this? If you are already practicing or living with these concerns and awareness, my challenge to you is it fully bring heart centered practice (and what that means to you) to all of your communication and relations and break the cycle of emotional violence that disconnects us all from each other. This does not mean toning down our passions or our fight, but it is a challenge to incorporate empathy and compassion even when we are demanding accountability and change within those fights.