Saturday, February 27, 2010

More Thoughts on Manic-Depressive Illness

My last post, written after reading Kay Redfield Jamison's An Unquiet Mind: A Memoir of Madness and Night Falls Fast: Understanding Suicide, ended with three questions:

  • How can I conceive of a God who would design our brains to be capable of the horrifying pain of an unraveling mind as happens in severe mental illness?
  • What does God expect of a person with severe mental illness?
  • What does God expect of the spouse and family of a person with severe mental illness?

Another way of asking the first question is to ask how severe mental illness fits with a view of the world as gracious, as opposed to hostile or indifferent. As I think about this, I realize that Kay Jamison herself provides an answer. She says that, as excruciatingly painful as psychosis and depression can be, this is out-weighed, for her, by the joy she has experienced in life. Kay actually values her mania, at least in its milder manifestations, and she sees her depression as the price she has to pay for the mania.

When Kay first experienced symptoms of manic-depressive illness in her teens, the mania was not extreme. It allowed her to think fast, to feel euphoric, and to be exceptionally productive and creative. In subsequent years, the mania become more extreme, but Kay remembers even some of her psychotic visions with joy. Here is what Kay says on pages 90-91 of An Unquiet Mind:

People go mad in idiosyncratic ways. Perhaps it was not surprising that, as a meteorologist's daughter, I found myself, in that glorious illusion of high summer days, gliding, flying, now and again lurching through cloud banks and ethers, past stars, and across fields of ice crystals. Even now, I can see in my mind's rather peculiar eye an extraordinary shattering and shifting of light; inconstant but ravishing colors laid out across miles of circling rings; and the almost imperceptible, somehow surprisingly pallid, moons of this Catherine wheel of a planet. I remember singing "Fly me to the Moons" as I swept past those of Saturn, and thinking myself terribly funny. I saw and experienced that which had been only dreams, or fitful fragments of aspiration.

Was it real? Well, of course not, not in any meaningful sense of the word "real." But did it stay with me? Absolutely. Long after my psychosis cleared, and the medications took hold, it became part of what one remembers forever, surrounded by an almost Proustian melancholy. Long since that extended voyage of my mind and soul, Saturn and its icy rings took on an elegiac beauty, and I don't see Saturn's image now without feeling an acute sadness at its being so far away from me, so unobtainable in so many ways. The intensity, glory, and absolute assuredness of my mind's flight made it very difficult for me to believe, once I was better, that the illness was one I should willingly give up.

When Kay first began to take lithium to control her psychosis and stabilize her moods, she was appalled at the flatness of her emotional life. She now takes a lesser dose of lithium that controls the extreme fluctuations in mood but does allow for some mood amplification followed by some mood dampening, in other words, slight mania and slight depression. The dampening is worth it to Kay because of the benefits from the amplification. Apparently, you can't have the amplification without the following dampening--you get the full cycle or none.

So, back to God. Here are some things I notice.

  • ABUNDANCE. God deals in abundance--there is an abundance of beauty and variety in minerals, plants, and animals. Within that abundance, there are things that I as an individual may not like--poison ivy, mosquitoes, manic-depressive illness. These are, nonetheless, part of the abundant whole.
  • EXTREMES. God deals in wide ranges with vast extremes--from sub-atomic particles to super-nova, from the monotone gray of an overcast sky to a flaming sunset, from the silent rabbit to the roaring lion. Manic-depressive illness is an extreme of human experience.
  • NATURAL PROCESSES. God deals with natural processes that unfold dispassionately. The universe does not reconfigure itself to avoid harming a person in the path of an avalanche, a tornado, or an out-of-control automobile. Manic-depressive illness is part of the gene pool and manifests itself in individuals with those genes.

It may be that, if God had to edit out everything that humans find unpleasant or harmful on the physical plane, the world would not be as beautiful, stunning, and fascinating.

It also strikes me that God's intentions are not necessarily our intentions. I, for example, consider a good life to be a life of financial security, physical comfort, and mental interest. God, I expect, considers a good life to be one of compassion and character growth.

I probably don't need to concern myself with the question about what God expects of a person with manic-depressive illness because I am not that person.

As for the spouse and family of a person with manic-depressive illness, it strikes me that our U.S. American society is at the far extreme of individualism, expecting individuals to manage their own problems and expecting families to manage their family members on their own. But, just as it takes a whole village to raise a child, it probably takes a whole village to contain a person with manic-depressive illness. Instead of making this the responsibility of an overwhelmed spouse or family, if this were considered the responsibility of the whole community, then the weight would be far less, and compassionate and workable solutions would far more likely emerge.

Sunday, February 21, 2010

Thoughts & Questions about Manic-Depressive Illness

I have recently read two books by Kay Redfield Jamison: An Unquiet Mind: A Memoir of Moods and Madness and Night Falls Fast: Understanding Suicide. Kay is a Professor of Psychiatry at the Johns Hopkins School of Medicine. She also has manic-depressive illness, which she is able to control by taking lithium.

Kay describes what it is like for someone with severe mental illness to watch their mind unravel. It is absolutely horrifying to be trapped inside an unraveling mind. One cannot control one's thoughts, which race so fast that nothing makes sense. One sees and hears things that aren't there, often very frightening things. One watches the distress on the faces of one's family and friends, who simply cannot comprehend one's behavior. One behaves in ways that cause one intense shame.

One often ends the pain by committing suicide.

Some of the things Kay describes, particularly concerning mania, seem incredible to me. Someone in the early stages of mania feels on top of the world. She feels invulnerable. She is full of over-the-top energy, putting her on a high. In this state, things make sense that would never make sense in a normal mood. A person in mania will often dress provocatively, initiate unwise sexual encounters, and spend thousands of dollars on unneeded merchandise. When the mania ends and a normal mood returns, this person is faced with the shame of what she has done and with the bills she has accumulated for appalling purchases that made perfect sense in the manic state but which now make no sense at all.

If the illness is not treated, it escalates. The mania becomes so intense that the person cannot stay still, cannot sleep, and cannot control her cascading thoughts. The person may become paranoid and even violent.

Eventually depression follows the mania with its all-encompassing heavy blackness that sucks all joy from life. Life becomes unbearable, and suicide is often the result. The pain of an unraveling mind and the inability to do anything to stop it is excruciating.

Yes, there are now treatments for manic-depressive illness, but for centuries there were no treatments, and even today, not everyone responds to the treatments. For some people, the current treatments don't work.

Descriptions of losing one's mind--as happens in manic-depressive illness, in depression, in schizophrenia, and in Alzheimer's disease--are truly horrifying. For me, this raises an important question: How does God fit into this? How can I conceive of a God who would design a brain capable of such horrible suffering?

I can at least begin to understand other types of physical suffering that keep the mind intact. People are able to endure these, sometimes with great grace and courage. I can also begin to understand suffering inflicted by humans. Again, people do endure this, sometimes with remarkable love and forgiveness. But how does one endure an illness that causes one's very mind to unravel. Without a functioning mind, with what does one do the enduring?

So it's hard for me to envision a way of seeing God that includes severe mental illness. It makes me wonder why on earth God couldn't design a brain incapable of such unraveling.

And what does God expect of someone with severe manic-depressive illness? It's clear that a person in mania often violates normal standards of morality in the areas of sex, finances, and kindness to others.

And what does God expect of the spouse of someone with manic-depressive illness? I don't see how it's possible to live with a manic-depressive spouse who has sex with others, runs up impossible bills, and is violently paranoid. Manic-depressive illness is devastating to the spouse, family, and friends of the person with the illness. A good friend of my mother's had a daughter with severe mental illness who simply refused to take medication to control her illness and absolutely drove her family nuts with her uncontrollably wild behavior. She also had a number of unwise pregnancies and brought babies into the world with no means of providing for them. Yes, I understand that a person with manic-depressive illness is truly ill, but what is the person's family supposed to do with a person who causes utter havoc in the lives of everyone around her? Is the family supposed to just exist in utter havoc? What does God expect of the spouse and the family in this situation?

So these are my questions:

  • How can I conceive of a God who would design our brains to be capable of the horrifying pain of an unraveling mind as happens in severe mental illness?
  • What does God expect of a person with severe mental illness?
  • What does God expect of the spouse and family of a person with severe mental illness?

Sunday, February 7, 2010

Compassion at the Heart of Faith - Karen Armstrong

Karen Armstrong's study of world religions has shown her that compassion lies at the heart of each one. Thus, we can say that at the heart of Being is compassion. Karen says that compassion is feeling with another. It is putting ourselves in another's shoes, standing where another stands, seeing through another's eyes--and acting accordingly.

Karen connects compassion with ecstasy. Ecstasy occurs when we empty ourselves of the self, when we step outside of ourselves, when we leave behind our local individualized self--and step into something larger. By being compassionate, by feeling with another, we step out of our own self-focused experience and into the experience of another.

How do we enter into the mind and feelings of another? Karen Armstrong says that one way to do this is to use our own pain. In other words, when we are treated in a way that causes us pain or discomfort, we can take careful note and resolve never to do that to someone else.

I am not a naturally compassionate person, but I can think of at least one very small way that I practice compassion. (Recognizing this very small way helps me to grasp what compassion is and how it feels to practice it, and then hopefully to expand upon it.) Here is my very small baby step in compassion. First, I have noticed a particular type of situation that causes me discomfort. Sometimes when I am telling a story or sharing a thought with one or more other people, an interruption will arise. For instance, if we are at a cafe, the server may come to take our order or another person may arrive and join our group. After the interruption, the conversation may veer elsewhere, and I don't get a chance to finish what I was saying. When this happens, I feel disappointed.

Knowing how I feel when this happens to me, I try not to let this happen to others. When someone is telling a story or sharing a thought and an interruption occurs, I try not to let the conversation veer away before the person has the chance to finish. I do this by saying, for example, "Jane, I want to hear the rest of what you were saying about Edgar Allan Poe." This allows Jane to finish what she was saying without seeming to put herself forward, in case she feels uncomfortable being the one to reintroduce her story. (I've even started extending this compassion to myself. Since I've been doing this for others, I find that, after an interruption, I can more easily say on my own behalf, "I'd like to continue what I was saying about Alice Walker.")

I find that I experience a nice warm feeling when I can do this for others and when I can do this for myself. I also think that this is what it means, in a very small way, to love one's neighbor as one loves oneself. In this conversational type of situation, I show the same consideration both for my neighbor and for myself.

I would say, too, that to be compassionate in one's work, one needs to feel what it is like to be on the other side. A doctor or a nurse who has been hospitalized with illness or injury can more readily feel with his or her patients. Psycho-therapists are required to undergo psycho-therapy themselves in order to feel what the process is like for their clients. A teacher of English to speakers of other languages would do well to take a course in Vietnamese or Arabic or Hungarian to understand what it feels like to be confronted with learning a very different language and culture.

Self-emptying, compassion, and ecstasy also occur when we lose ourselves in contemplation of something greater--as a scientist does in her lab, an architect in his building, a lawyer in her client's case, a painter in his studio, a musician in her composition, a dancer in his movement, a reader in her story, a writer in his characters, a chef in her cuisine, a teacher in his subject. This loss of self in something greater can occur both as a creator and as an admirer: it can occur for the artist who sculpts a statue and for the art lover who admires it, for the chef who prepares a beautiful meal and for the gourmet who savors it, for the poet who composes a poem and for the reader who enters into it, for the gardener who creates a garden and for the flower lover who basks in it.

Karen Armstrong has found that she experiences self-emptying, compassion, and ecstasy through her study of and writing about world religions. She has learned to have compassion, to feel with, people of other faiths. On page 290 of The Spiral Staircase, Karen says, "It was not enough to understand other people's beliefs, rituals, and ethical practices intellectually. You had to feel them too and make an imaginative, though disciplined, identification." Karen explains how she did this when writing about the Prophet Muhammad. On page 278 of The Spiral Staircase, Karen says, "I had to make a daily, hourly effort to enter into the ghastly conditions of seventh-century Arabia, and that meant that I had to leave my twentieth-century assumptions and predilections behind. I had to penetrate another culture and develop a wholly different way of looking at the world. It required a constant concentration of mind and heart that was in fact a type of meditation. . . . I was learning the disciplines of ecstasy." In fact, on page 287 of The Spiral Staircase, Karen says, "I was finding in study the ecstasy [and, I would add, the compassion] that I had hoped to find in those long hours of prayer as a young nun."

On page 63 of The Case For God, Karen Armstrong speaks of Socratic dialogue as a means to self-emptying, compassion, and ecstasy. Karen says, "In a Socratic dialogue, therefore, the 'winner' did not try to force an unwilling opponent to accept his point of view. It was a joint effort. You expressed yourself clearly as a gift to your partner, whose beautifully expressed argument would, in turn, touch you at a profound level." On the same page, Karen says, "Like any good initiation, a successful dialogue should lead to ekstasis: by learning to inhabit each other's point of view, the conversationalists were taken beyond themselves." I love that: "learning to inhabit each other's point of view."

Compassion, then, is the heart of religious faith. A very legitimate question to ask about any religion is this: Does this religion lead to a compassionate life? That is the gold test.

Saturday, February 6, 2010

Thoughts on "The Queen of Sheba & Her Hairy Legs" - C. G. Jung Society Presentation by Ronnie Landau

Last night David came over for supper. (I baked homemade cornbread, which was delicious, and we also had tossed green salad, cheddar cheese, fresh fruit, Fruits Rouges hot tea, and dark chocolate.) Then we took off for a presentation at the C. G. Jung Society titled "The Queen of Sheba and Her Hairy Legs" by Jungian analyst Ronnie Landau. (Ronnie is a woman.)

Apparently the Queen of Sheba was extremely beautiful. She also had hairy legs--very, very hairy. The story goes that, when the Queen of Sheba came to visit King Solomon of Israel, Solomon (who had heard of the hairy legs) arranged a path for her to approach his throne that would involve lifting her skirts to step over some watery areas. This allowed Solomon to verify that, yes, the Queen of Sheba did indeed have extremely hairy legs. The Queen of Sheba agreed to an application of creams to remove the hair before further involvement with Solomon. The Queen of Sheba then stayed a while in Israel, consorted with Solomon, and finally returned to her country.

So, in the Queen of Sheba, we have a very beautiful woman with very hairy legs. Do we see the hairy legs as a deformity or as part of her beauty? If we see the hairy legs as undesirable--why?

We do seem to be averse to body hair, at least for women. Yet women naturally have body hair--arm hair, underarm hair, leg hair, and pubic hair. Many women shave their underarm hair and their leg hair, and some even shave their pubic hair--at least they try to have just a small confined area of pubic hair, and they certainly don't want any pubic hair to show around the edges of their bikinis. Women who pose nude for Playboy have usually removed all but a very small amount of their pubic hair. Even men, I think, don't want to have too much body hair. A man with lots and lots of body hair probably feels like an oddity.

Why is this? Drawing on points raised in the presentation "The Queen of Sheba and Her Hairy Legs" and on my own additional reading and experience, I would say that this is because body hair is adult-like and animal-like.

First, body hair is a sign of adulthood. Children have smooth bodies, while adults have body hair. Feminists in the 1970s pointed out that women were traditionally supposed to remain childlike, while men took on adult roles. The husband earned the money and made the decisions for the family, while the wife raised the children, did the housework, obeyed her husband, and was financially supported by him. Men dominated all professional fields and ran the country, while working women confined themselves to teaching, nursing, and secretarial work, and women weren't even allowed to vote. The visual sign of body hair complemented the adult role of men, while the visual sign of a smooth and hairless body complemented the childlike role of women.

In the 1960s and 1970s, many women stopped shaving their legs and underarms. They allowed themselves to be naturally hairy. I believe that this was a way of saying, "I am an adult. My body hair is a visual sign of my adulthood. Adults have body hair. I will relate to you as a fellow adult."

Second, body hair is something that we humans share with animals. Animals, particularly many mammals, have body hair, or fur. Certainly, the primates do. Body hair connects us visually to our animal nature. It seems more traditionally acceptable for men to have this animal connection than for women to do so. Even men, though, don't want to be too animal-like--excessive body hair for a man is not considered attractive. We seem to feel it important to separate ourselves from the animals, from our instinctual nature, from our sense of smell. (It was pointed out at the Jungian presentation that head hair is very acceptable, probably because we are happy to adorn the site of our brains and intellectual functions with hair. Our head and intellect are seen as exclusively human, while our bodies are seen as connected with animals.)

As David pointed out, the 1960s and 1970s celebrated hair. Not only did many women stop shaving their underarms and legs, but many men grew their head hair quite long and acquired beards. I do think that this was at least partly to celebrate our animal nature. Sex, in all its sensual appeal, was celebrated--its smells and sounds and tastes. I believe that hair was part of the primal enjoyment of sex that came to the fore in the 1960s and 1970s.

So, to reiterate, the traditional practice is that men don't want too much body hair so as not to be too animal-like, but that they do want enough body hair to show that they are adults. Women, on the other hand, don't want any (or want very little) body hair so as not to be animal-like and so as to remain childlike. Traditionally, there has been something shadowy about our animal nature for men and women and about adulthood for women. This shadow is represented by a hairy body, or by the Queen of Sheba's hairy legs.

What would it look like for us to embrace our shadow--for men and women to embrace our animal nature and for women to embrace our adulthood?

Well, I think we would be openly hairy. We would openly enjoy the sensual side of life--not only sight but also sound, touch, taste, and smell. We would enjoy all these sensual aspects of sex. In addition, women and men would openly be peers, fellow adults. Women and men would stand together as fellow adults, embracing our animal nature, in all our hairy glory!

Our hairy glory. We consider head hair beautiful. Can body hair not be beautiful, too? When we embrace the animal/adult shadow, we will have "The Queen of Sheba and Her Beautiful Hairy Legs."