The peace we are seeking in the midst of our personal and societal storms is much deeper than the superficial labels we wear. Let’s mentalize.
As with so many things in the postmodern era, our sense of what is spiritual has become thin. As a result, mental health is weakened. Much of what I read assumes “spirituality” is a broad and universal “concept” boiled down to a personal search for meaning, purpose, hope, value, and, for some people, God. So many people are left alone in their valley looking toward a fixed horizon of imaginary wholeness which seems to be distant no matter how far they travel.
We are in need of thicker descriptions for wholeness and a broader sense of our horizons. In his book Finding Jesus in the Storm: The Spiritual Lives of Christians with Mental Health Challenges, John Swinton says the question cannot simply be “Where can I find meaning in the midst of my brokenness?” We need to be more specific, “Where and how can I find Jesus and hold on to God in the midst of this experience?” How do we find Jesus in the storm? The question is thin enough to grasp. The answer is much thicker.
It starts with describing the world
I have been culling my books, lately. But I could not part with Nancy McWilliams’ Psychodynamic Diagnostic Manual. The PDM-2 offers analytic-leaning therapists an empirically based, clinically useful alternative or supplement to the DSM (APA) and the ICD (WHO) categorical diagnoses. People never fit neatly into categories, but comparing my inkling to years of expert study makes me a better helper.
The problem is, the categories can cause more harm than good. Whenever I use a diagnostic term with a client like “narcissism” or “masochism” (which is rare) I like to make them promise not to wear is as a label. I’d rather they see the description as “weather,” or “scenery,” or as part of a “journey.” Mental health labels can become straitjackets or even identities.
Swinton is mainly focused on the label “schizophrenia” in his book and generally sides with the movement seeking to eradicate the use of the word, since it has become associated with “being schizophrenic.” People say, “I’m schizophrenic” like they say, “I am an alcoholic” or “I’m bipolar.” The labels are too thin for the thick experiences people are having.
I’m with the people who oppose the stigmatization that comes with an insurance company needing an approved label for an illness before they pay. They whole system creates “epistemic injustice.” The labels should be provisional and descriptive, but they end up being formative. I went to YouTube and typed in “how to deal with a narcissist” and found scores of entries (ironically, one by Dr. Phil!). Labeling narcissists without much awareness of the tested descriptions is a cottage industry. The fact someone can get even with an abuser by labeling them a narcissist says a lot about what the categories mean to us.
“Evidence-based” labels
In 2013 the director of the NIMH stated that the DSM did not describe authentic disorders because they had no “biomarkers” attached. Therefore, they could not be empirically verified. The diagnoses are based on a consensus about clusters of symptoms, not laboratory measurements. So the director said they were useless.
His concept of “mental illness” is that it can be fully explained on a biological basis. I think he believed he was democratizing mental health by getting the labels out of backroom dealing and into the sunlight of science. But he did not destigmatize mental health challenges by making them just another biological reality. Instead, his view taught people they no longer had an illness, they are an illness. If your genes, chemistry and brain processes label you, there is not much one can do.
“Mental illness” is not like having the measles. What is happening in our wildly complex brains, ever-developing bodies, and our changing environments cannot be reduced to a genetic marker. The biological, medical models are too thin. If Jesus showed up at the NIMH he might be labelled schizophrenic when he said he heard from his Father!
Thick spirituality
The spirituality that sneaks into clinical practice is usually reduced to a very Eurocentric model that assumes the primacy of individualism, freedom, autonomy, choice and the right of people to create their own destiny. I know my studies, even in a Christian-oriented university, baptized me behind my back and forced me into a thin description of spirituality and humanity.
What faith in Jesus brings to the discussion about mental challenges is an antidote to the detriments of the DSM. The labels are instructive, but I don’t think we benefit if all we have is a comprehensive conceptualization like the ICD categories hovering over us. The satellite image from Google Maps provides an astounding outline of my house but has no clue about what is inside. Even the street view automatically captures a moment that is now past. We need a guide walking with us on the ground, noticing the details firsthand: the bumps, curbs, turns, and everyday accidents that make the journey of mental health interesting, difficult and complex.
Jesus is a walking exercise in such phenomenology. The incarnation intrinsically questions the assumptions we use to control and disempower. “What is an hallucination?” is recast as “What does it feel like to experience hearing voices?” Likewise, “What are the best practices for dealing with these symptoms?” is recast as “Where is God in this storm? What is the suffering making me? Where can I find joy in it? How can I receive healing? How can I appreciate my goodness and sort out my collusion with evil?”
Lose the labels
My clients who are organized masochistically look toward a horizon of joy with deep skepticism. They tend to label themselves as losers. They are from some “shithole” country where trauma and anxiety rule. I try to help them see that their sense of horizon is important; we need to look toward our ideals and see how we are distorted and isolated in comparison to what we hope. At the same time, we all need to grasp that a horizon is always changing. As we keep moving, the horizon looks different from where we are now standing. An unchanging horizon is only real in the abstract; it is not an everyday experience. We need to look and listen, not just keep talking about yesterday’s snapshot from Google.
In Mark 5, Jesus has a famous conversation with a “man from the tombs with an unclean spirit.” That is a very evocative way to describe him, and it fits how many people I’ve known describe themselves, in one way or another. The man Jesus met was known to howl like the man on my block hearing negative voices. He bruised himself with stones like someone secretly cutting themselves or injecting street chemicals. Jesus spoke to the man’s inner tormentors and told them to come out of him.
Then Jesus did an unusual thing. He asked him what his name is. 1) Jesus did not treat him as a possessed man, just a man who has a name. He was not a diagnosis. 2) The man did not give his name but rather named his condition “My name is legion for we are many.” He self-stigmatized, as opposed to Jesus, who refused to go with the label he’d acquired. When the villagers came out to see about their swine, they met this man who used to scared them to death sitting with Jesus having a conversation.
Finding our way through mental health challenges can start with having a Christlike relationship with ourselves. Jesus names us as a friend, his beloved. We can receive that fundamental label. When we can’t see the forest for the trees, we can turn to Jesus who can show us the way, Even more, Jesus can be the joy we seek even in scary, shadowy places of suffering beyond our understanding.
We can all make the world a better place for people by listening to where they are and helping them see the horizon they can see. None of us is our diagnosis. We are not really trapped in a box of symptoms, even when we feel we are. No one is their lack of perfection or their inability to meet the standards of the sinful world. Jesus names us, and we emissaries of the healer.
We can help people hold on to Jesus in their personal difficulties, and as they move through these difficult times in an atmosphere of our blessing, wonderfully free of unnecessary guilt or blame. Understanding and valuing the perspective of others brings epistemic healing. Coming to rejected, lonely, humiliated and demonized people with gentleness and tenderness is the superpower that keeps peace at the heart of a soul-weary world. Let’s lose the thin labels and regain the thickness of each person finding their unique way through creation, known and loved by God.
