Last week, I was in touch with my friend and mentor, Tufts University professor of psychiatry Dr. Ron Pies after the summer break. He mentioned that Elyn R. Saks had written a commentary called "Some Thoughts on Denial of Mental Illness" for the September 2009 issue of The American Journal of Psychiatry.
I can't download this journal article without paying a fee, so Ron kindly offered to mail me the piece, which arrived yesterday. As you may recall, I wrote a lengthy post about University of Southern California Associate Dean and Professor of Law, Psychology and Psychiatry Saks and her "memoir of madness" The Center Cannot Hold – back in April.
What I didn't mention then was that I detested her use of language. It made me cringe. Saks is a fine writer, but her language screams with embarrassment, shame and for the most part, exposes her chronic denial of her florid psychoses and her lifelong battle with schizophrenia.
It took Saks years and years, far too many years, to be able to admit to herself that she had a mental illness. It was and is still clear in the way she writes that she's ill at ease and grappling with her diagnosis of schizophrenia.
Her commentary is rational. Emotions are irrational.
It seems to me that she is actually in recovery, but doesn't know it or doesn't want to know it – despite her extraordinary academic accomplishments and her meaningful and rich life. She's happily married and a highly respected academic.
Right now, I'm not going to challenge her rationale simply because I don't have time. Saks has degrees in literature and philosophy besides law. She is a brilliant woman, an excellent writer, and her "thoughts" are argued with the precision of a closing argument in a murder trial.
It's Friday afternoon. I've just returned from teaching one of my classes. It's been a long week. My editor is leaving in an hour and a half, and I need to digest what Saks has written to challenge her ideas. But I will.
For now, I will muse a bit about denial and mental illnesses on my own. This is a rich subject. I will leave my journalistic jousting with Ms. Saks for another day.
First, as you know, I am not in denial of my mental health issues or my mental illness – I always feel a little odd using the term "illness" when discussing the mind. I do not believe the much-hyped theory that mental illnesses are brain diseases caused by chemical imbalances in the brain. That's simply not been proven and it's too simplistic, as far as I'm concerned.
I've never been in denial. I grew up believing, naively perhaps, that going to a psychiatrist to talk once a week was healthy and smart – like going to an allergist once a week to have allergy shots.
As an adolescent, I used to complain to my mother, "Why do I have to go to see Dr. McQuaid every week?" She would simply say, "If you had a broken leg, you'd go to a doctor who would put it in a cast to heal. Well, if there's something wrong with your mind, you go and talk to a psychiatrist every week and you feel better."
Coming from a predominantly medical family where everyone was either a doctor or a psychiatric social worker, I was socialized to believe that going to a psychiatrist was de rigueur even though I was the only kid I knew who did, back in the early 1960s.
I live my life out loud today because it never occurred to me that there was anything wrong with having a mental illness. I consider myself lucky.
Over the years, people have always confided in me, but always in whispers.
Several years ago, I was invited to speak to a group of women at the Ontario Ministry of Government Services. The event, which celebrates Women of Influence and Inspiration, took place during Mental Health Awareness Week in May. Linda Lane, the creator of the event who asked me to speak, selected me as one of that year's Women of Influence and Inspiration, but asked me to stay clear of anything that smacked of mental health. Instead, she wanted me to focus on my journalistic career and women's issues.
When I arrived, there were more than 250 women seated in a large conference room. I started listening to the other speakers, all extremely successful, high-ranking women in government who had clearly broken through the glass ceiling. (I've always thought that glass ceiling was really a layer of men, but that's another story.)
As I listened, clearly, I knew I couldn't stick to my script. After all, I'm an advocate. Place me in front of an audience and I can't resist, especially during Mental Health Awareness Week. When my turn came, I started talking and slipping references to my mental illness into my speech. Funny references. Self-deprecating quips to show that having a mental illness doesn't mean you can't have a good life and a great career. It's all about having a positive attitude.
The audience laughed in all the right places and seemed relieved that I wasn't talking about government business. Clearly, they were enjoying themselves. You could hear a pin drop.
After I finished to a resounding round of applause, there was a break. I had to leave and go right back to my office. As I slipped out of the room, a woman approached me. I'll never forget her. She was slightly hunched over. Her body language screamed out "Denial" – I knew what she was going to say. And I was right.
In a barely audible whisper, she said, "I have the same problem as you, but I would never tell anyone. I've had it for 16 years."
I listened to her as she told her story of loneliness and isolation. She spoke about how she kept it a secret. How she was afraid she would lose her job if anyone "knew"... and how hard it is not to be able to talk to anyone at work about it, especially when "I'm not feeling at my best."
You have no idea how many times I've heard this. And worse. Parents in denial for their children. Rather that seek the appropriate help, they take their troubled adolescents to every specialist in the world, except a psychiatrist or psychologist. In one case, when no "physical" problem could be found, a young boy of 15 was kept at home, out of school, far from friends, cloistered, and hidden away because his parents couldn't accept that perhaps he had an emotional or mental health issue.
That's one reason why the new website Working Through It so powerfully mitigates denial by showing that mental health issues are not only prevalent but treatable in a wide variety of ways and real people are doing the talking.
Often, I'm told that I'm very open. This surprises people, this openness of mine. But I also find that when I'm open, others open up to me. They share the burden of their denial. And they feel better.
I'm convinced that there is no normal. That we're all "next to normal" and diagnoses can and often do more harm than good. Even in cases of psychosis and schizophrenia, there are so many people finding ways to recover.
And in recovery, they overcome their denial.