Sticker on street furniture near the Pompidou Centre, Paris.
NB It feels important to note that there are some alternative routes you can take around managing your own mental health, and that support is available from a range of organisations including Mind (I had a good experience of therapy in 2000 with Mind in Darlington), Relate and Samaritans. Of course, there will be a range of possibilities for people with a range of life experiences. My point here is not to advise.
This is a shortened version of notes on mental health in the age of Covid-19 over at my own website.
I left therapy after a decade in May 2019. It was the right thing to do and happened on my own terms, although it was negotiated over a long period with my therapist. This integrative and humanist therapeutic relationship helped me to save my life. It enabled me to hold and contain myself as I relived past trauma, and as I experienced a second breakdown after my Mom’s passing.
I have been thinking about what I have taken from therapy into the world as we now experience it. I have also been thinking about how I would have coped/not coped had I still been in the eye of the storm (I would have found the switch to virtual therapy incredibly difficult, in part because the human is so important in the therapy room and I feel that is missing online).
This morning I saw a retweet about how difficult it is for many to access therapy, either because NHS-funded therapy is time-limited, focused upon cognitive behavioural methodologies (a herd immunity for the soul), and has long waiting lists, or because private therapy is too expensive (although some therapists will undertake pro bono work). The original tweet focused upon crowdsourcing advice for people who are struggling, and a call to ‘share the wealth’, as if the assets that define good mental health are resources to be accessed like those on the Commons.
I have always struggled with this kind of call, although I completely respect the intention that lies behind it. In the same way, I struggle with calls for people to focus upon a positive mental attitude, or to be mindful or resilient (or to engage in mindfulness so they can be more resilient), inside a world that is alienating, and where a corporeal and physical, viral, destabilising force has infected that world. Too often, I see these calls as short-termist, or as an attempt to suture an alienated Self so that it can cope in a world that is increasingly unliveable and toxic.
When I was in therapy, I had a sense that the work was operating on multiple levels. First, my embodied trauma and what had been, because we may be through with the past, but the past is not through with us. Second, the everyday, alienating reality of an unjust world, in which we have to sell ourselves over and over again, and watch as others are brutalised, exploited or expropriated. Third, the closing down of the horizon of possibility for life, given the politics of austerity, climate heating, ecosystem collapse, economic populism, and so on. Fourth, how to struggle for the alternative, at the level of myself, my communities and the world.
Now each of these levels have been infected and recalibrated by the virus. Whilst I give thanks that I have worked through my embodied trauma, and I am able to find the courage and faith to struggle against an unjust world, and to accept the enclosure of our futures whilst attempting to do the right thing, I grieve that this is not universally or equally experienced. This brings me back to the idea that we can share the wealth in terms of mental health, in-part because the process and journey through therapy is so individual (although hopefully experienced in a wider, communal ecosystem of friends, carers, families, communities), and in-part because the idea of equality or equal access under capitalist social relations is nonsensical.
For instance, we know that many precarious members of our communities, or those who are black or minority ethnic, are anxious about the role of the State during any lockdown as they are at other times. We know that, in spite of the work of mutual aid groups, local councils, voluntary action groups, and so on, people are separated and isolated, and lack the day-to-day support they need. We know that the State and corporate response is on business continuity, business resilience, maintaining some form of capital circulation through monetary intervention, so that productive capacity can be shored-up in the medium term. We know that care has been marginalised because we see how the State fails care-workers and health-workers. We know that those who are regarded as economically unproductive, with apparently lesser human capital (in terms of productive skills, knowledge and capabilities) or social capital (in terms of access to networks), and who are marginalised by dint of race, gender, disability, sexuality, will be further disciplined or ignored.
In the full blogpost I detail 17 things I have taken from therapy into this situation. Three that feel relevant in this moment are noted below.
7. Feeling is everything. Acknowledging feeling is everything. Reducing the cognitive content, and respecting how I feel is everything. It took a long time for me to go with the feeling, and to sit with the feeling, and to trace its contours and its lineages. Sometimes staying with the feeling is fucking impossible, because it hurts too much. My Mom’s death taught me this in spades. For too long in my life, the fear, anxiety, grief, anger were displaced. In spite of this, I make sure that I acknowledge and respect and listen to how I feel. Those around me have to get used to my occasionally drawing their attention to their feelings.
13. Therapy is a process and it is not linear. Life is not linear. I did not know this in my heart until I was in very deeply. Now I see my life as a process, unfolding in countless, indeterminate and determinate ways, through myself, my loved ones, my communities and this world. What matters is the concrete: the lived reality of place and people. The Corona-crisis is part of that unfolding, and we must struggle for what makes sense to us, rather than the abstract ways in which people and institutions (including families) exercise power. This means a rejection of certainty, a weighing up of options, and an ability to live with the consequences of my own decisions (be they going to a pharmacist for a friend or not seeing my Nan or approaching my work in a different manner). Moreover, as my life unfolds in a non-linear way and is a process, I work to trust that good enough is good enough.
15. Therapy taught me that sometimes all I can do is hold on for tomorrow, even when sometimes existing from minute-to-minute feels fucking impossible. Persevere.
The Reconciliation Statue at Coventry Cathedral. This is all there is.
I am not sure how sharing the wealth helps with this for those who are isolated, made marginal, suffering structural oppression or exploitation, or in abusive relationships. Perhaps it is all we have in these days of social isolation, when we cannot hold each other physically close and we have limited mental stimulation. We know that the uncertainty is incredibly stressful, and that the psychology of isolation is damaging to our physiology as well as our psychology. Finding any port in a storm demands new connections, possibilities and hopes, and some form of mental and physical activity. Finding any mechanisms for controlling our existence, like establishing a routine, however limited in nature, is crucial. And here I am privileged again because I have a yard in which to sit, a partner, a mutual aid group, a roller for my bike, some t’ai chi I can do, I have books and writing, and 10 years of therapy in the bank. I have resources, activities and some control.
Maybe mindfulness or CBT techniques are better than nothing; that said, over time our collective and individual PTSD will require much more. When we have moved to our new position, we also need to recognise how our way of building the world and our social metabolism with the world has left us so mentally and physically vulnerable. This capitalist society has left shockingly paid people to keep the wheels turning, and to cope with deaths in hospitals and care homes. It has left people with limited resources to have to make decisions that put themselves and others at risk. It has left us divorced and separated from each other and the world, in a dystopian solitary confinement. It has left us so depleted that we are sharing CBT tricks on Twitter and building from the bottom as a just-in-time form of social solidarity. The virus has amplified the horrendous, alienating reality of capitalist social relations, and we deserve to live rather than to scrabble for survival.
It is the power of long-term, collective commitments that offers a new hope and a new shared wealth based on unequal individual and collective lives. In this way, I see my therapeutic experience as part of a wider ecosystem that I hold and to which I contribute, and that is shifting and moving. In this way, my thinking about mental health, ill being and moving beyond, replicates some kind of facilitated, mutual aid, in which survivors, self-help groups, voluntary organisations, friendships and professionals develop some alternative practices for-life that can be open to all. From each according to their ability. To each according to their needs.