Not so long ago, I received quite the imperious email from a retired psychiatrist. This had never happened to me before, although I did get an absolutely vile one from a hand surgeon years ago, after I gave a positive review to Michael Moore’s “Sicko.” The guy told me he despised me. In those words. Swell. I vowed not to have any fingers reattached by him any time soon.
By comparison, the letter from the shrink wasn’t vile, only arrogant — the sort of arrogance that feigns patronizing concern for one’s well being, a la, “Tsk, tsk, young lady, you shouldn’t be conducting yourself that way!” This came in response to a Times Union reprint of a blog post of mine exhorting people to talk about mental illness. In it, I mentioned my husband’s and sister’s suicides and my father’s attempt, all of which I’d written about before.
I was flooded with responses from readers describing their own and loved ones’ struggles with depression, bipolar, suicidality, addiction. Not a one took issue with my premise — that we need to talk about this scourge if we’re to have any hope of combating it — until I got the email in question.
It’s a stunner. It starts out expressing sympathy, then identifies the writer as “a retired psychiatrist who understands this subject better than most people.”
Ahhh. Dr. Wisdom. Nice to meet you.
I’m tempted to quote the email in its entirety, because it’s breathtaking in its presumption, pretensions and limited view of the world. The gist of it’s this: that Dr. Wisdom thinks I shouldn’t be airing out my woes in public. Thinks no one should. Thinks Facebook revelations are “pathetic.” Thinks we’re all better off discussing such things in private, with our closest friends and family and “a skilled professional” — like, say, Dr. Wisdom.
“It is unnecessary to satisfy everyone’s prurient interest in the details of one’s life. What kind of reaction are we looking for when we beat our chests to the world about how we have ‘survived’ this or that trauma or hardship? Admiration? Pity?”
According to Dr. Wisdom, we should always to turn a stoic, shiny face to outsiders: “I, personally, wish to be seen and appreciated for my strengths and I am careful to keep aspects of my life experience that may be viewed by others with pity or contempt confined to my private sphere of relationships, if at all.”
That’s an interesting word: “strengths.” Because I’m not so sure I have any, aside from the strength that comes from realizing I’m broken. Aren’t we all weak? Don’t we all get punched sideways and pushed flat? Doesn’t a sane and happy life come from facing that? Isn’t that the paradox of being human?
The email continues:
“The best place to work out one’s issues is within oneself. Don’t look for the world at large to validate you. The world is and has always been, at best a callous and, at worst a cruel place, and, no matter how we may protest or struggle against this, it is unlikely to change.”
I have nothing against psychiatrists or other mental-health practitioners, by the way. I regard them as I do all specialists — i.e., as people to be visited on an as-needed basis, like orthopedists. But, like orthopedists, some are better than others.
After reading the email, I decided I felt sorry for Dr. Wisdom. What a miserable and lonely way to go through life, convinced that you can’t reveal yourself to anyone but those in an airtight inner circle. How confining that is. And how useless. What’s the point of living if we don’t connect with others? What’s the point of pain if we don’t acknowledge it, reach out with it, start new conversations, find new commonalities, make new friends — and maybe help out someone in the process?
Good can come from bad. But only if we talk about it. Only if we share ourselves with others.
I did zap a reply to Dr. Wisdom, noting that my husband’s death was a news story covered throughout the region. And Dr. Wisdom did apologize, but only because mine was a public loss; that made my decision to write about it acceptable. (“I was referring in my note to those who feel the need to be the ones to spread the news, which does not apply in your case.”)
I didn’t respond to this apology. It wasn’t worth it. Dr. Wisdom wasn’t worth it. But the whole exchange reminds me, once again, that we have a long way to go in discussing mental illness with compassion — and without judgment — in a manner that helps everyone, patients and families alike.
I’m going to put this bluntly: Anyone has the right to talk about anything that happens to them. When trauma hits you, whatever shape it takes, whether it happens in public or private, however uncomfortable it makes other people, you bloody well own it. You can deal with it however you need to deal with it. You can stuff it down. You can see a shrink. You can air it out. You can talk about it, write about it, sing songs about it, make art about it, push for change on it.
You can decide what to do with your own pain. It’s yours.
Figuring. Shit. Out. 
you are a breath of fresh air
Thanks so much (though some might disagree with you, there!).
Your kicker paragraph is fierce truth, Amy. What’s emerging, thanks to social media (e.g., Twitter), is a conversation about whether *anyone else* has the right to write/talk about anything that *happens to someone else* if that person has written/talked about it in public extensively. I’m interested in your view(s) about that.
Amen Ames
I think his thought might have been overshadowed by his method of delivery…there IS something to be said for dignity and maintaining a certain level of privacy. However, in order to get a dialogue going in the public at large, there have to be certain very public conversations initiated – ones with reach, ones that might influence others to join in.
Your argument is that mental illness isn’t shameful, and I 100% agree with you. Sweeping it under the rug is harmful.
What I think that man was ranting about was a certain tendency developing in this society to share everything, all the time. Reality tv. Relationships played out over FB. Gossip magazines, newspapers, tv shows, etc. People who think we need to see a photo of very meal they’ve ever eaten. People who think that the act of sharing their worst excesses or lowest points absolves them from it or saves them, for whatever reason. He’s right – this is not a good trend.
But there’s a difference in the things and the ways that people share the hard parts of their lives. I can’t always describe it but I know it when I see it, and you are NOT part of the population that is indulging in pointless navel gazing, Amy. You are doing important work, and should keep doing it. You can influence people to make positive changes. You probably already have. Ripple effect for the win, right? Hang in there.
Dan,
This is exactly the conversation many of us in the “ePatient” and participatory medicine community are having re: social media: do someone forfeit her/his right to be upset or offended if attacked in public for being public? Who, if anyone, has the right to judge the point at which public self-disclosure moves from instructive to therapeutic to self-indulgent? And how do those of us who teach and train people about using social media for education and advocacy raise these issues and help work them out/through without adding injury to insult in the public arena?
Sometimes you just need the world to look at your gaping, ridiculously vicious wound and say, ‘holy crap that IS unfathomably awful! How are you still standing?’ That kind of acknowledgement helps you feel less broken on those days when standing is next to impossible. As for Dr Wisdom, I fell sorry for the patients who paid him to bear witness to their wounds. Just goes to show you, Phd and lofty accreditations notwithstanding, a dick is a dick.
I’m not sure why people feel it necessary to judge others, condemn them, insult them, hurt them. Where is the compassion that should be innate to any human being? Some people don’t like to talk about what is inside them; others desperately need to talk and to connect. Some people like to post everything from what they have created in the kitchen to requests for prayers as they navigate a difficult situation. Some call these “public outreaches” attention getting;some call it bragging; some call it exposing one’s self. Why do we have to call it anything at all? We can choose to ignore things or people that annoy us, or we can choose to click “like”-just a tiny, one-second connection to another human being, much like a smile or a hug. Why do we have to be so condemning, so harsh, and why do we feel so compelled to criticize and tell people how to live their lives? If you don’t like something keep scrolling or walk away. But, if you can find it in your heart to be affirming, compassionate, and supportive, you might give someone just what he needs to make it through one more day.
Let’s think about those who really are struggling with mental illness– who are we to determine how they are to cope? Do you know what it feels like to be anxious every minute of every day? Do you know what it feels like to be afraid to leave your house? Do you know what it feels like to truly believe you are worthless? Do you know what it feels like to be hopeless and in a perpetual state of sadness? Do you know what it feels like to be unable (not unwilling) to focus? Do you know what it feels like to truly be unable (not unwilling) to get out of bed in the morning or to be unable to sleep all night? People with mental illness struggle every single day to manage every aspect of their lives. No one should judge them or their actions or their words. It is paramount to telling someone with cancer to “get over it” or to stop complaining or to find a way to stop being sick. If you don’t want to hear about another person’s pain, either from the person himself or from someone associated with that person (especially the one who spends every day living with his loved one’s struggles), walk away, but don’t tell others of your disgust in the “weakness” of that person. Don’t judge another human being’s words or his level of dignity. Instead, give him dignity. If you are fearful you’ll say the wrong thing or fearful you don’t know how to help just say that. You don’t have to nor probably can you “cure” the person, but you can listen. And if the idea of listening or giving any affirmation at all to another person’s struggles causes you discomfort or causes you disgust, then walk away, avoid the person because your feelings, opinions, and/or judgments will only add to his or her pain.
It’s really quite simple: when you come to the end of your life, and you look back and reflect, what do you want to see? How do you want to feel about the life you have led? Do you want to see a bitter, harsh, judgmental person who had no regard for others or their struggles? Or do you want to see a person who thought he knew everything, who was superior to others, who had all the answers and who made others feel like crap? Or do you want to see a life spent trying to understand; trying not to judge; trying not to hurt; and, when possible, trying to bring dignity, respect, maybe even a little joy to a family member or friend, or even some random person who is, in any given moment, in need? Basically, it is what you give in life that comes right back to you.
Beautifully said, Jane. Thank you.
Jane, beautifully said. I held off posting anything because I was trying to work out some of the mixed feelings I from Amy’s blog.
Amy, is perhaps the Dr. decrying the growing frequency of people speaking of their here-to-fore personal business on social media? Is that perhaps the real thrust of his/her comments? Meredith alluded to the controversy in social media over it.
Is perhaps what s/he said touching too close to home, made worse by what seems to have been a less than desirable delivery?
I definitely agree with your sentiment about the need to speak out about mental illness. One can see in the responses to this blog the pain that accompanies mental illness from the the individual and their families. Hiding it exacerbates the pain and does not promote healing.
And as it turns out, just last week I was invited to be on a panel that will be proposed for the Stanford University Medical School’s Medicine X Conference in September on the topic of online disclosure, empowerment, etc. There are four of us working out the particulars of the abstract and proposal. I sent a link to Amy’s post earlier today with the strong suggestion that my colleagues read the comments. We’re now having a great conversation among ourselves and how to expand our presentation to include issues having to do with mental illness, thus underscoring, once again, why I so love how digital technology has the power to illuminate the dark places.
Rosemarie, I understand. I decided not to quote more of the email, but it included a long, dismissive diatribe that lumped together Facebook over-sharing with people who choose to discuss their personal pain with outsiders. It essentially equated the two, which struck me as unfair and fallacious reasoning. The suggestion that such people are speaking out on some cheap pop-cultural quest for validation (or admiration, or pity — the email’s words) distresses me greatly.
This was the point of the email: to inform me that I’m seeking this same validation, admiration or pity, and to warn me away from doing so.
Yes, in the largest stretch I can feel a little sorry for Dr. Wisdom (Dr A) but really I am most sorry for the people he has treated in his career. How pathetic his practice and God help his clients if he taught them to keep their pain a secret.
Please lets all keep writing and talking about suicide, trauma, mental illness, addiction, sexual abuse, sexual trauma, domestic violence. WE can make cultural changes. For how many years DV was a family secret and a shame to the victims. WE are turning that one around.
One in four families has a loved one with a serious mental illness so relay when we share we are actually giving permission to others to lessen that pain and shame.
Amy–keep going.
Oh, what the hell, double-dipping to leave this comment: It has taken decades for me to more fully understand how my mother’s multiple suicide attempts shaped who I was and who I’ve been able to heal into being. I have *never* written about this stuff for fear of appearing self-indulgent or being accused of working my shit out in public. The truthiness of your writing, Amy, has inspired me to be more open about the mental illness threaded through my family.
Bless you, Meredith. There are more of us folk floating around in the ether (and in the analog world) than any of us realizes. Thank you for reading my blog with such compassion — and for putting yourself out there yourself.
Reblogged this on outspoken. and commented:
Awesome blog post on speaking out about mental illness and other such issues. “we have a long way to go in discussing mental illness with compassion — and without judgment — in a manner that helps everyone, patients and families alike.
I’m going to put this bluntly: Anyone has the right to talk about anything that happens to them. When trauma hits you, whatever shape it takes, whether it happens in public or private, however uncomfortable it makes other people, you bloody well own it. You can deal with it however you need to deal with it. You can stuff it down. You can see a shrink. You can air it out. You can talk about it, write about it, sing songs about it, make art about it, push for change on it.
You can decide what to do with your own pain. It’s yours.”
Many thanks, Amanda.
Ultimately, I think one finds what one needs to heal him- or herself. One mans TMI is another woman’s salvation. See, I think he’s a schmuck because he offered you unsolicited advice (which I’d say is often true in social media)..
The way society needs to put an Ozzy and Harriet facade on everyone’s dysfunction is what contributes enormously to intense feelings of inadequacy. Nothing is worse for mental health in this society. People all think they are freaks because they have the barometer of TV and film to which they measure themselves. The myth that everyone is well-adjusted and normal needs to be destroyed.
Thank you, Roger. And for what it’s worth, Dr. Shut-Up-and-Soldier-On is part of the problem. Having had several people in my extended family and one dear niece who took her life at age 22, I concur that talking through it and connecting with others was not merely an impulse, but a necessary part of making peace with a traumatic event that will never, ever make sense.
I understand the Dr.’s general feelings about living in a world where every foul element of life is hashed out in public for amusement. He’s right. But speaking frankly about something so essential as suicide (and the circumstances that precede it) is different. It’s not gratuitous, and it’s not something that anyone puts out there for entertainment. It’s vital to address it, to know just how many others have experienced it, and to recognize that this “thing” that happened – this awful, unspeakable thing – must be shared in order to shed light on a place that we are still so reluctant to go.
Your true bravery is your very human vulnerability. It’s complex, messy and in some magical way, elegant. Amy, you really show me how the world really can be. Thank you.
Amy,
I’m so glad that Meredith pointed me in the direction of this post. And I appreciate your courage and passion in speaking out. One of the issues that I take up repeatedly is that it is essential that we stop acting as though emotional struggles are confined to a few “really messed-up” people. Because we all face pain and challenge–we need role models who are telling us the truth about that pain and challenge. The approach advocated by Dr. Wisdom appears to be a version of the same “edited reality” that he so objects to online–“put on the happy face, so that we lose touch with the essential human struggle that we all deal with.”
As for your final paragraph–wow. Powerfully said. Great stuff!
Ann
Thank you, Ann. I’m glad Meredith pointed you toward me, too. I agree: I think the “edited reality” persuades too many people that suffering is somehow abnormal. And the irony is, we’d suffer less — we’d feel less alone — if we only acknowledged how universal it is, you know?
Reblogged this on Ann Becker-Schutte, Ph.D. and commented:
This is wonderfully said–a powerful argument for pushing back against stigma & silence in mental health.
Note to Dr Wisdom….Don’t we all go to movies, read books and appreciate the music that says/shares “been there” and thank god someone else gets it? So please keep on girlfriend. Kudos for sharing your thoughts with us Amy. Much to think on. xxoo
Many thanks, Cathe.
Amy,
So glad you’re here talking about this issue, and standing up to supposed professionals with outdated and harmful ideas.
Beatriz