For those of us who are diagnosed as bipolar, depressed, or having any other mental illness means only that we must approach life differently than others. Yet much of the time there is social pressure to merely snap out of it. It is felt that we who have a mental illness lack both the character and the constitution to behave the way that our society thinks we should. The stigma is so pervasive that we may believe this also. Those who are newly diagnosed or even those living with a diagnosis for years may not accept the truth. For me it was very hard to come to terms with. The truth is that having a mental illness does not make us less of a person or morally deficient. Too often we have lives of guilt ridden suffering. We must strive not to let the suffering continue. Recovery can happen. For recovery to happen we must look at mental disease differently. From my experience it takes a holistic approach. You must treat the whole being body, mind, and spirit. You also begin to accept yourself completely.
People who are color blind do not see red or green correctly. They may have a hard time recognizing signs that forecast danger. They must rely on words or pictures to understand the warning. There are some who do not walk. They have to identify a path that they can travel. Someone who is crippled by their fears, frustrations, sicknesses, sorrows, and diseases must have the compassion on themselves to accept a different way to live. This is not really surprising. Most of the world's wisdom traditions suggest that seeing things a new way may benefit us all. There is a saying, "To an expert few things are possible, and to a novice all things are possible". If you are bipolar and you suffer I suggest you be the novice. Right now you can choose to begin to see things differently, openly, and compassionately. If you open your mind and allow for a different perspective you can change your life. In another saying, "If you wear shoes, the whole world is covered by shoe leather", we can see that whatever we put on filters all that we perceive. There is another analogy that you may be more familiar with. Some people see things through rose colored glasses. To these people things seem to be better than perhaps they are. At very least they choose to limit how they see things. For a long time I was not able to accept that I had a mental issue or that it was bipolar disorder. It did not fit with the egoic picture that I had about myself. I was sick and kept suffering because I could not accept why. I also misunderstood like many people what it means to have a mental illness.
I do not pretend to have authority on any subject. I have become a pretty simple guy. I am bipolar but more than that I am human. I am not trying to tell you anything about how to run your life. I don’t necessarily know better than anyone about many things. I merely wish to share some of my experience and conclusions. All of us that have a mental illness need to get on a path of healing that is exclusive to ourselves. For me, without adopting a simple approach to life and realizing compassion for myself I would now be dead.
It is my intention to reach out to you. I have, like many, experienced suffering in my life. I offer perspectives and resources that have helped me to move through the suffering to more of a place of acceptance and recovery. I now believe that I do not have to suffer even though there will still be pain at times in life. At best I can open a few doors for you to consider. You must contemplate the path that you wish to take. There is a joke that asks, "How many psychologists does it take to change a light bulb?” The answer, one, but the light bulb really has to want to change. While this is sort of funny, the truth is that you have to be ready to change.
Just wanting it may not be enough. For me I had to have nothing left to consider. Letting go of our way of looking at things and foregoing our fears is a place of complete submission. It is a place where no resistance is left. This place can be scary. We hold so tightly to remain in control. We often feel that the suffering that we know is a far less threatening life than the vague promise of a life of equanimity. We do not know what life would be like, or could be like. This is the fear of the unknown. Alfred Hitchcock understood the power of this clearly. Often what you did not see on the screen was the most impactful. We cannot believe that peace can exist. Death may seem eminent. If you are fortunate it will lead to egoic submission. A death to the part of us that held us in suffering. Sadly too many do not survive this process and for them mental illness is a death sentence. In this way having a mental illness can be a lot like having a substance abuse problem. Remember “denial” is not a river in Egypt. As you proceed down the path toward recovery you will find that how you see things has a fundamental impact on your entire life. When you realize that you can choose how you feel about anything you begin to live free. Actually there is nothing that prevents you from being free now. It may be a bit hard to accept at this point in the journey. This is fine. Frankly this is a lesson that I am constantly reminded of.
Most of my life I have been pretty clever. I could see how many things worked. Actually, I could not stop noticing all sorts of things. Things abstract, things concrete, things philosophic, and things emotional were rushing through me. Each moment was intense. Often I did not have the ability to keep up with this stimulus. Like a boat being capsized by a wave, this torrent of thoughts captured me. It swallowed me up and became my identity. I could no longer see the difference between the suffering and who I really was. In my mind I was a bad person, a disappointment, and because I could not pay attention to things that others demanded of me a failure.
Because I was clever I was expected to achieve many things. Because of my emotions and the focus on my dramas I rarely did. I was told often and in many ways that I was a disappointment. Teachers, my mother, father, and the world at large reinforced this message. I saw myself as a "bad person". This added fuel to the fire of my suffering. This is too often the case for us. One of the core issues that people with mental illnesses face is the breakdown of important relationships. Parents give up flabbergasted with outrageous or incomprehensible behavior. Teachers over taxed recognize issues but can’t deal with them. Employers tired of the deficiencies that they see fire us. Husbands and wives part with hurt and distrust. These people, many with their own suffering and pain, simply are not equipped to either understand or support us. Can you blame them really?
As these relationships deteriorate we begin to lose many of the basic building blocks that are required to have healthy and stable lives. As jobs are lost and incomes falter we face the possibility of losing such things as, housing, access to medical care (a vastly important part of staying stable), we may also lose the ability to even acquire food, and for many their liberty:
Based on admission rates reported in Bureau of Justice Statistics Bulletin, Census of Jails, 1999 nearly two million new jail admissions are of people with mental illnesses—35,000 individuals a week.
More than 16% of jail inmates have a mental illness, according to the United States Department of Justice.
Seventy percent of jail inmates with mental illnesses are there for nonviolent offenses
Abraham Maslow a professor of psychology did a study and published a paper in 1943 A Theory of Human Motivation. In this work Maslow suggests that a human must have some basic needs met in order to become what he called a “self actualized being”. These needs are generally broken down into five levels. Four levels are considered as what are necessary for base psychological needs. These are often referred to as “d-needs” or “deficiency needs”. The fifth level is where human psychological growth is possible. To Maslow this is where people like Einstein, Gandhi, and the Dali Lama hang out. All though these people are exceptional examples: growth, understanding and well being are available to all of us. We can receive nourishment and nourish others when we have our basic needs met. When we begin to understand our individualized needs, we begin to find our path toward recovery.
In brief, Maslow's hierarchy of needs can be expressed as:
Physical needs of an organism or that of homeostasis (These are the basic human needs to sustain life. If your lacking food, water, warmth, or the body is chemically imbalanced all of your energies will be dedicated to assuring that these needs are met. Other needs farther up the chain will go unmet.):
Breathing
Eating
Excretion
Sex
Safety needs (As physical needs are relatively met an individual’s safety needs take the stage and dominate behavior. These stimulate behaviors and emotions to assert control over our environment.):
Personal security
Financial security
Health and wellness
A support or safety net against accidents, illness, or impactful events
Social needs (Humans are naturally social beings. This involves emotionally based relationships. Humans need to feel accepted and needed.):
Intimacy
Supportive family relationships
Esteem needs (People need to have self-esteem, self-respect, and respect from others. They need to feel that they contribute and are accepted by others.)
Growth needs (At this point with more basic needs being met a person can have their behaviors and emotions stop being motivated by the basic or deficiency needs and can start to grow.)
So far my experience of being bipolar is concurrent with Maslow’s assertions. In my life much of the supporting relationships were lost. I was divorced, lost jobs, lost housing, lost my health, was jailed for not being able to pay child support, and as a result I was spiraling ever downward. One thing that I have learned is that I was not a bad person for not being able to cope and neither are you. I did not see a way how to deal with this disruption of my basic needs that are due to a bio-chemical and psychological problem. Under these circumstances anyone has a significant probability for failure and misery. Those who judge people harshly in this light are perhaps not considering things with good reasoning. Maslow suggests that, “anyone who attempts to make an emergency picture into a typical one and who will measure all of man's goals and desires by his [her] behavior during extreme physiological deprivation, is certainly blind to many things". Simply, a person in panic is likely to act irrationally. This has nothing to do with judgment of whether they are good or bad. This is true for ourselves and those that look upon us and attach a stigma because of our illness. It also illustrates further why those with a mental illness fail. While in the throes of our struggle to live we are least capable of doing so. We are seen as faltering on our responsibilities. Society expects us to do our part and take care of our business and it is actually reasonable for them to do so. Though there may be some things we cannot do ourselves, there is nothing we can't get done. With resolve, an open heart, and willingness to learn we can be responsible and apply what we can do. We can work with our medical practitioners to find the right medication. We can find cognitive support. We can find methods to deal the challenges as they come. Being responsible is in how we respond to our abilities. Take leadership in your recovery. You have to take the initiative to find the tools and support that work for you. There are many options for finding the care that best serves your needs. This may not be limited to specific medications or therapies. A good relationship with a therapist, a good diet, regular exercise, spiritual practice, and the establishment of meaningful relationships do not necessarily find you. You must be determined to find these things. Without your determination you will not see results in recovery.
Carl Rogers was a prominent professor of psychology. He taught at several leading universities. He states, "Psychotherapy does not supply motivation for such development or growth (the personality and behavior). This seems inherent in the organism, just as we find a similar tendency in the human animal to develop and mature physically, providing minimally satisfactory conditions are provided.” There is a part of you that given a chance will rise to the surface and grow. In this whole process you are the one who will have to do the work. Your doctors, therapists, mentors, spiritual advisors, family, and friends cannot do what has to be done. Mostly they cannot do it because the work that has to be done is on the inside of you. I think that it would be fair to say that Dr Rogers builds on the concepts that that Maslow suggests: given sufficient support of basic needs that people are capable of growing psychologically.
This work by Dr Rogers is now not practiced widely. This is perhaps due more to the practice of his theories than the principals themselves. His thesis that you must develop the person behind the disease simply makes sense to me on the most human level. This is where psychology and the needs of the soul meet. It is the place where I do my work with others. The key to this working is that it must be genuine. You can’t play this. You must be open also. Not to getting caught in the drama but remaining open enough to always see the person beyond the behaviors. You do not have to support destructive behaviors. If you are able to build a relationship with someone on this basis it is far less threatening for you to tell them how you feel about it. I am sure it is heresy to suggest that this simple and humble view is one of friendship. This may feel perilous for many practitioners. To do this you have to be very open. They may fear involvement in your drama as much as you do. I have seen this many times. This was a significant trap for me. I realized that most of the practitioners that I have experienced could not go to this level. Though I have found this to be the case often, I do not condemn them. They after all deserve the same human consideration that I am talking about. They too have their own fears, frustrations, doubts and pain. I have though found some very notable exceptions. My appreciation for the work of Carl Rogers is due to one such practitioner. He demonstrates this in his practice and for that I am grateful.
Establishment of the person is of paramount importance. Personhood is not merely the sum of one’s social roles; it is not merely any label that you may affix to yourself. It is broader than that. It is a matter that starts at the heart. It is the living essence that we all share. With time and inquiry you can learn to let the person in you shine. As we begin to move our awareness from being saturated by our dilemma we become less caught and more free. To do this it helps us to perhaps listen to the wisdom of the Buddha. Buddhism if nothing else is an exquisite form of psychology. Buddha says that the reason we suffer is because of our attachments. For example we may believe the only way that we can be happy is if we have a particular car, that certain job, that special relationship, that anything. The problem with this is that all of these things are in time and time at the very core of time's definition is change. It is also relative. Neither of these things allows us to keep those things that are external to us. Cars breakdown, jobs are lost, people pass in and out our lives. To believe that we have any real control other than how we choose to see these things is pure deception, at least in this context.
In China there is a story about a farmer. One day, this farmer is out in his field tending to his duties. He notices that his horse has strayed from his farm. His neighbors tell him how unfortunate this is and he remarks, “Maybe”. The next day the farmer heads out to work and sees that the horse has returned along with 7 others and the neighbors say that this is fortunate. Once again the farmer simply intones, “Maybe”. During the next day the farmer’s only son is working to tame the new horses and is thrown, breaking his leg. The neighbors of course feel that this is unfortunate and again the farmer says, “Maybe”. Soon conscription officers arrive. They tell the farmer to give them his son so he may be drafted into the army. The farmer shows them that he has a broken leg and that he is of no use to them. They agree and let him pass. For this the neighbors rejoice and comment on the farmer’s good fortune and at this the farmer merely suggests, “Maybe”. The judgments that we make about good and bad are what hold us. These judgments of good and bad are based on the context that we put them in. For the farmer good or bad judgments are arbitrary. In the beginning of the story his loss seems to be unfortunate. In the end our friend the farmer gains more horses and gets to keep his son from the army. In it's isolated state the loss of the horse may have seemed to be a bad thing. In the end it may have saved his son. Our attachment to the belief that we have to feel bad will kill us. I do want to be clear about judging good and bad. I am not saying that there is no morality. I am saying the why of people acting in immoral ways is far more likely due to a person who sees that he/she is bad before they acted that way. If you see yourself as bad you are bad. As I said throughout this chapter you can start right now on a path of recovery. Please do not be attached to the belief that there is no hope. Have the compassion on yourself to release your fears and judgments. Willingness to accept yourself starts this new journey. Once you have this open place your life will never be the same. In life I will tell you that there may still be pain. You do not have to suffer. Awareness is key to the door of a healthy and happy life. Let me quickly share with you the difference between pain and suffering. Simply stated, you are suffering if the only thing that you are is pain. When you are in pain, even significant pain, and you are still aware of things that give reason around pain you are just in pain. You are what you identify with. One example that I can use is stubbing your toe. As an adult we understand what has happened, we understand that although it is very painful it will go away. An infant however might have no way to put the pain into context. It seems come out of nowhere. Nothing else exists or is perceived. You could think of suffering like being swallowed up by a wave. There is nothing but oppressive water. No way for you to catch a breath. You are confused about which way is up. How do you survive? You are caught reacting not responding. Responding at least brings you the power of choice. Imagine the suffering that occurs the moment we are first hungry as an infant. You have absolutely no experience with anything, how do you cope? You suffer. As this happens in cycles of hunger and feeding and we learn that this is likely to continue, this suffering changes to a category of pain or annoyance. You may recognize this at work in your own experience with mental illness. You are so overwhelmed that you cannot even identify the specific pains in your life. It is faceless pain. It is suffering. It is not merely sad or angry it is blurry and very hard to live through. This is where good cognitive support like talk therapy may help. Often clients will come in and say that they are miserable and feel that they can't express the core issues. They can only speak of incomprehensible pain. There is no clarity only confusion. A good therapist will help you contextualize things. As you gain perspective you can naturally move from suffering to a place of peace. This is the basis for gaining perspective on your life and to start you have to learn to see things more broadly, compassionately, and lovingly. This open awareness will arm you to grow as a person and put you well along on a recovery path.
Where do you start on the path to recovery? Well if at this point you are in an unsafe place or have emergency needs get them taken care of. If you are really bad off go to an emergency room or call the police. I have been in county run hospitals. I have been in private hospitals. To be honest it was not always pleasant. They all have one positive attribute. I am still alive because of them. The Buddhists will tell you that every step that you take in life is as valuable as the rest. You may feel low at this point but it can be the start of getting better. I will talk more about various resources later. Remember what Maslow told us about d-needs. If you do not have basic safety in life it will be hard to move on.
The establishment of compassion for self is where the healing begins and will ever continue. Without this you will not have a mechanism for changes at the most basic levels of this process. Your ego has built in defenses against changes and is an interesting challenge to the process. The ego tends to trust it’s self. This is true even if its perspective has nothing to do with the truth. It trusts the good/bad judgments that it has made based on its experiences. As I suggested in the previous chapter experiences that are based in suffering may occlude the truth considerably. It can be very hard to accept that your suffering may be due to a disability. Our egos do not want to except blame for a disease because our minds have the misconception that we are less of a person because of it. I remember once telling a person that I felt that I was insane. She said that it was an understandable under the circumstances but that it was not ok to stay that way. In other words it was alright to have a mental illness. It was an issue of biology and some horrible experiences. I was not a deficient person but like any other illness it has to be treated. A good quality of life is available given a prudent approach that is right for you. Her words somehow got through to me. No one had ever put it to me so clearly. No one had communicated so simply. No one else had made it ok to have a problem. No one who gave me hope that it was manageable. There was no one who helped me to see that there was no fault in being me. Being bipolar is simply one aspect of me that requires attention and consideration. Heck from time to time we get haircuts. Again this is an aspect of us that needs which needs attention. It is nothing more. Obviously being bipolar is often more impactful to our lives but still means nothing more than we need to take care of ourselves.
