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Mental Health

Trauma

17 May 2023

5 min read

Lamenting the losses in life

There are paths through the thicket of loss that mental illness causes. Rachael Newham explores lament.

Rachael Newham

Rachael is an author and theology of mental health specialist.

A Victorian fisherwoman sits on a beached boat, shoulder slumped.

But O For the Touch of a Vanished Hand, 1888, Walter Langley. The title is taken from the Tennyson poem 'Break Break Break'.

Photo by Birmingham Museums Trust on Unsplash.

I am lost. I feel utterly bewildered by my surroundings and my head is beginning to spin under the strip lighting. There are people all around me, but I can’t find my bearings. This place should be familiar, it’s somewhere I’ve been a hundred times before, but I feel the panic rise as I try to find my way.

Before I had known exactly where things were, how to navigate the aisles and reach the things I needed with ease, but in the months I’ve been away, things have changed and I cannot face the thought of finding my way around the new arrangement, so I turn on my heel and leave empty-handed.

I haven’t been away on holiday or gone on a work trip, I’ve been locked inside my own head doing battle with my own mind in the shadowlands of mental illness. Stable now, with the crisis averted, I am trying to rebuild and yet the Co-op rearranging my local store has served as a stark reminder that things have changed in me and around me.

And there is no funeral to grieve what you’ve lost, no ‘closure’ as you’re still living it.

This is the where the conversation about mental health awareness falls silent; the reality of the losses mental illness stacks up like Jenga blocks while you aren’t looking. Serious mental illness doesn’t just take your mind; it takes your ability to enjoy the people you love, the work you find fulfilling, the gloriously mundane school run and the life you once almost took for granted.

And there is no funeral to grieve what you’ve lost, no ‘closure’ as you’re still living it, no five-step process to ‘get over it’. There is simply the loss and the life you’re trying to rebuild.

This loss must be grieved. I would argue that all losses must be grieved if we are to learn to live with them. It is as Michael Rosen’s childhood classic “We’re Going on a Bear Hunt” reminds us as the family go on their adventure and encounter the winds and sticky mud: “You can’t go under it, you can’t go over it, oh no! You’ve got to go through it”.

We simply have to let it have its way with us until the raw pain has faded into an ache we can tolerate.

It’s perhaps something the ancient faiths and traditions understood better than we do where there are rituals for grief; whether it be Jewish communities sitting Shi’vah or the Irish keening their songs of mourning, they acknowledge the enormity of grief and the need for communities to come together to process it.

Where the loss is more personal, we can seem to lose access to the healing found in community traditions. When the loss is because of illnesses still so misunderstood and stigmatised, these processes and traditions can feel even further away, still.

And yet.

There are paths through the thicket of loss. William Worden, a Fellow of the American Psychological Association speaks of four tasks of mourning which include accepting the reality of the loss, processing the pain of grief, adjusting to the world afresh and finally finding enduring connection. These tasks were designed with bereavement in mind, but they seem to me to speak to losses in the broadest sense and I have found them to be true in mental illness.

In the Bible we find this prophet Nehemiah, who is tasked with rebuilding the walls of Jerusalem after the Israelites exile in Babylon. They’ve returned home, but home doesn’t look like they imagined to, the place they longed for no longer exists, and they have to accept before they can begin to grieve what has passed. Author Marya Hornbacher writes that

“managing mental illness is mostly about acceptance- of the things you can’t do, and the things you must”

and I see it every day - perhaps you do too - as I take the medication and get the sleep that’s required for some kind of equilibrium to be maintained

Nehemiah grieves and weeps over the city for an estimated four months; but there is no set timescale for such things, we simply have to let it have its way with us until the raw pain has faded into an ache we can tolerate. In the Christian tradition this is called lament; it’s grief directed at God, bringing the pain before him in a way that acknowledges the twin realities of God’s goodness and our grief’s greatness. It is undoubtedly uncomfortable, but it is the gift of honesty. We do not need to put on our Sunday best for God, but can come in our brokenness and mess knowing that we will not be abandoned to it.

And then we begin to adjust to the new normal we find ourselves in. We test the boundaries of what we can do as anyone in recovery does. There is a slow almost imperceptible move towards more of life; a trip to the local shop much like I did during that disorientating visit to the co-op, a visit from a friend or a phone call answered, long avoided. Nehemiah returns to his work for the King - but even then the King asks him why he’s looking so sad. We need not rush in with fake smiles before grief has finished with us, but be honest with those around us - and with God.

We cannot lament our losses without finding a community to be a part of; whether that’s your friends, your local community group or your local church.

The fourth task is that of finding connection. For some it will be found in their friendships, others in their faith communities or peer-led community groups. Whichever way it happens it’s how life grows again around and alongside the loss. Worden I think meant it as a way to continue the connection with a lost loved one, but in the story of Nehemiah we see it as the Israelites first come together to rebuild the wall and then to celebrate it. We cannot lament our losses without finding a community to be a part of; whether that’s your friends, your local community group or your local church, we have to find spaces where we can share ourselves, our stories and know we are not alone. It is perhaps one of our most fundamental needs - it is certainly been mine - to know that I am not alone in my loss and I’m not alone as I survey the wreckage and tentatively begin to rebuild.

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Mental Health

1 February 2024

4 min read

We need to weep over the wreckage of mental illness

While its now OK to talk about mental illnesses, we need to weep over the harm caused and how we’ve tried to treat them, writes Rachael Newham.

Rachael Newham

Rachael is an author and theology of mental health specialist.

A grey and white wall graffited with a tag a image of a person crumpled and crying.

Today, February 1st, is Time to Talk Day. It's part of a long-running campaign encouraging people to have open and honest conversations about mental health. It's aim is to break down the barriers of stigma and misunderstanding. It has been a staggering success - what was a fringe issue talked by those only affected by mental illness a decade ago is now part of common parlance. Mental health training is widely available, and the charity’s work has been seen to have a significant positive impact on the mental health conversation

However, as our familiarity with the language of mental health has grown so too has the way we use it. People might talk about having PTSD after a bad date, or their friend being ‘so OCD’ about the way they organise. Unwittingly, as psychotherapist and author Julia Samuels points out, “[we have] awareness without real understanding.”

However, awareness without understanding means we actually don’t reach those most impacted by mental illness. We know about mental health in the way we know about our physical health - but we are no more aware about the serious, sometimes lifelong mental illnesses which rob people of hope, joy and vitality - sometimes leaving them with lifelong disability.

If you ask most people about mental illness they may tell you about depression and anxiety; the two most common mental illnesses which have become the acceptable face of mental illness. It’s reflected in the way funding is channeled to interventions that get people with mental illnesses back to work, or to NHS ‘Talking Therapies’ which offers short term psychological therapies (both of which are important initiatives) but have cut the number of inpatient beds from over 50,000 in 2001 to under 25,000 in 2022[3] which means those at the more severe end of the spectrum of mental health to mental illness are left to travel 300 miles for the care they need.

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma.

Whilst it’s right that we have raised awareness about the most common conditions, we can’t ignore the illnesses which are termed ‘severe and enduring mental illnesses’ which include those such as bipolar disorder, major depression, schizophrenia and complex post-traumatic stress disorder.

For people living with these conditions, the general mental health advice that we give; for example getting enough sleep and time outdoors may not be enough to keep the symptoms at bay. Just as general physical health advice like getting your five a day will not cure or prevent all severe physical illnesses. Medication, hospitalisation, and at times even restrictions of freedom like being detained under the mental health act might be necessary to save lives.

These are stories that we need to hear. The debilitating side effects of life saving medications that can raise blood pressure, cause speech impediments. The injustices to confront (such as the fact that black people are five times more likely to be detained under the mental health act than their white counterparts) and the adjustments to life that those with disabilities are required to make to their lives.

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma. We have to listen to the perhaps devastating, perhaps uncomfortable stories of those who live with severe and enduring mental illness. The mental health npatient units miles from home, the lack of freedom, the searing - unending grief.

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them.

By hearing these stories, we are accepting them as a part of reality. For those of us in churches it might be that the healing didn’t come in the way we expected, it might be also be all of us accepting that the systems designed to care for those with mental illness have in fact, caused more harm. It’s seeing the injustices and understanding that we, our systems and professionals need to change our attitudes.

Understanding and acceptance of the injustice are the way forward- that’s the only way change can come.

It might look like standing in the rubble, it might feel too huge and all but hopeless.

And yet in scripture and in life that is so often the only way we can begin to rebuild.

In the book of Nehemiah, one of the Old Testament prophets who had lived in exile far away from home for his whole life, we see that upon hearing about the state of the walls of Jerusalem, before he did any of the things we expect heroes and innovators to do- he wept. In fact, it’s estimated that for four months he wept over the state of the place that had once been the envy of the ancient world.

Perhaps we too need hear the stories and then weep.

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them and then slowly, we can begin the work of rebuilding.

It isn’t a work that can be done alone by a single agency much less a single person - it requires society to hear stories of the more than just ‘palatable’ mental illnesses with neat and tidy endings to the messy and sometimes traumatic stories that are there if we just care to listen to them. It might be reflected in the petitions we sign, the way we vote, the stories we choose to read.

So ,this Time to Talk Day - I’m saying let’s continue the amazing work of talking about mental health - we need to keep talking about anxiety and depression. But let us also make conversations wider, so that they encompass the whole continuum of mental health and illness.

We’ve seen the difference Time to Talk can make - now it’s time to talk about severe and enduring mental illnesses, too.