Some trainee therapists and I are running an anxiety-management workshop in a drop-in centre in London. The administrators of the group, all four of us, were discussing how to run the group and how to get the most out of it. One of the therapists said: “Well, all four of us are fully functioning, we’re neuro-normal, but a lot of the users [ie patients] are sub-normal. The IQs of the mentally disfunctional are often lower than that of the mentally functional.”
I’ve never thought of mental illness in this way. I don’t think you can draw a line and say, everyone on this side is ‘normal’ or ‘neuro-normal’, and everyone on that side is ‘sub-normal’, or ‘malfunctioning’ or ‘mad’. You can’t have a model of psychology where the psychologists are all on the other side of the line, peering over the wall at the sub-normals, taking notes.
Then, you end up with basically a war between the sane and the insane. In the workshop after the meeting, one ‘user’ was complaining bitterly about the psychology profession: “They’re all arrogant. I dislike them all. They all try to control me, to belittle me.” She was making the same mistake – drawing that line between psychologists and the mentally ill, imagining (or being made to imagine) that psychologists were somehow above her, superior, better.
There is no line. Anyone can experience mental illness. It can be a psychotic episode – you could, like my best friend Neil, abruptly descend into schizophrenia in your adolescence. But it could also be minor forms of mental illness – you could take too many drugs and develop social anxiety, like I did. You could get mugged, and develop post-traumatic stress disorder. You could have a bout of mid-life depression. It happens. Mental illness happens to ordinary people, all the time.
I had an anxiety disorder for several years, but I’m not sub-normal. My IQ is not below the average. Think of all the mentally ill people who were far above the average IQ – was Nietzsche sub-normal, or Artaud, or Jung, or Wittgenstein, or Stephen Fry? Their IQ was actually far higher than normal. They were excessively sensitive, that was part of the problem.
I asked the therapist in question, during the workshop, what methods she used to deal with anxiety. We were going round the group asking everyone else to share, and I wanted the other therapists to share as well, because everyone has bad moods to some extent, and methods of coping with them. I wanted to break up the boundary between the therapists and the users. She said: ‘well, I don’t really get anxious’. Her comment put up a division between her and the users, the weak people who suffer from anxiety. It was basically saying ‘I’m a neuro-normal, I’m functioning, I’m on the other side of the barrier’.
Good psychologists, it seems to me, are prepared to cross that barrier, to accept that madness is a part of them, is a part of being human. Think of Jung and his crazy visions. Think of Albert Ellis, the founder of CBT, who was chronically afraid of talking to women, or of Aaron Beck, the other founder of CBT, who was a depressive child. These people could talk back to mental sickness because they could talk its language, they had visited the country, rather than just seen postcards that other people had sent.
And when patients hear that a psychologist has had his or her own experience of mental illness, with all its humiliations and frustrations, they will be less inclined to put up barriers themselves, less inclined to view the psychologist as an arrogant or superior person trying to put them down.
It’s a frightening, but necessary, step of empathy that the psychologist must take – recognizing they could lose it too, they could become mentally ill, they could find themselves among the dreaded ‘neuro-abnormal’.
That realization fosters a humility, an awareness that we all share a common human nature, and that nature is to some extent mysterious, and destructive, but also beautiful. Our nature can suddenly turn on us, wreck our ambitious plans, demand that we take time out of our busy lives and tend to it. Nature sometimes forces us to our knees, when we have got too cocky. As psychologists, we have to learn the tragic patience, acceptance and humility before nature that the mentally ill already know.