". . . little shall I grace my cause

In speaking for myself. Yet, by your gracious patience,

I will a round unvarnish'd tale deliver . . ."

(William Shakespeare's Othello, I.iii.88-90)

Wednesday, April 10, 2013

When Crazy Is Not Crazy

I saw this excellent article linked on Facebook.

The Depression Epidemic

It's long. But if you or someone you love has ever struggled with depression, it's worth your time to read. One of the things I particularly liked about it, apart from the Christian underpinnings, consisted of some observations about both the causes and the treatments for depression that I think are frequently missing from the discussion. We are accustomed to hearing these days that depression is primarily a physical problem that can be traced to biological causes: genetic predisposition, chemical imbalance, vitamin deficiency, etc. We are also accustomed to hearing that the most effective treatments for depression are those which focus on helping the depressed person manage his "condition" either biologically with medication and diet or psychologically with cognitive behavioral therapy. What I appreciated about this article was an acknowledgment throughout that there are causes for depression, and for its increasing incidence in modern society, that exist outside of the depressed person. No, depression is not merely feeling sad about sad things.  Everyone does that. At the same time, bad things do happen. And sometimes so many bad things happen, and they continue for such a long time, that an individual can find it difficult to carry on normally. Frustration, anger, lack of motivation, and hopelessness set in and sadness turns to something more.

This paragraph on cognitive behavioral therapy (CBT) in particular stood out to me:

But cognitive behavioral therapies have been criticized for focusing on the person as such and ignoring the context of the person within society. Psychotherapist Robert Fancher believes the CBT approach "devalues those attributes of mind most likely both to create culture and to take us beyond the status quo—imagination, passion, and the courageous, painful process of bringing new ways of thinking and living to birth. It amounts to an endorsement of the middlebrow life under the authority of 'good mental health.' " To put it more simply, cognitive therapy tends to reinforce the social norm, focusing almost exclusively on assisting the individual to adapt to the environment.

Did you get that? Sometimes people have a hard time adjusting, or being happy with life, because of life! Who would have thought? Could it be that the depressed person is contending with a troubled home environment or a dysfunctional work situation? Are those things that one should have to learn to adapt to? Is it healthy for someone to learn to function in an unhealthy situation?

I do understand that when faced with things that are beyond one's control to change, the sensible course of action is to learn strategies for dealing with them. My mother lives with me. It is difficult at times. In the way that I react to certain things, I can either compound the difficulty or ease it. Best to seek out strategies for doing the latter! At the same time, there is a limit to what coping strategies can accomplish. There is also a limit to what they should accomplish. There are certain things we should not have to get used to.

I am reminded of the name originally used for many public schools in this country. They were called "normal" schools because their purpose was to "normalize" children--to make them behave in a certain prescribed way that was thought desirable by the government. We still see this carrying over in institutional schools today. Those children who easily acquiesce to the specified expectations--who are obedient, malleable, and accepting of structure--are "normal" whereas those who rebel against the arbitrary nature of the system are "problems." I say this as one who was one of the "normal" ones. What is abnormal about a child who would prefer to play outside, interact with people, and engage in truly stimulating activities rather than sit in a desk, be quiet and do mind-numbing worksheets all day?

We live in a world in which "normal" is going about one's business and looking the other way while newborn babies are stabbed in the necks by doctors who say that in doing so they are providing "health care." Those who try to bring attention to the horror are "extremists." No, nothing to be depressed about there.

In one of my favorite books, Catch-22 by Joseph Heller, the main character Yossarian is faced with a dilemma. He is a WWII bombardier who doesn't like war and doesn't want to die. A possible escape hatch would be the attainment of a Section 8 (a discharge for those considered mentally unfit). The problem is that to get a Section 8, one must request it. But if one requests it, one thereby demonstrates one's sanity, which in turn disqualifies one from the requested discharge.

Some years ago a friend's baby died. The child was born with a congenital disease and lived barely a week past birth. For a time my friend and her husband were supported in the unimaginable grief that they were enduring. But there came a point when people expected them to get back to normal. Why were they still having so much difficulty? When would they return to full functioning? Unfortunately some of this came from the Lutheran church and school this couple served.

The world and its institutions--our workplaces, our schools, our churches, and yes, even our friends and our families--call upon us to adjust. But sometimes the sanest thing we can do is refuse. Barry Goldwater said, "Extremism in the defense of liberty is no vice." Perhaps behaving "abnormally" in the face of abnormal conditions isn't either.

 Crazy like a fox.


Susan said...

Thanks for your comments. I think I'm going to have to find some time to read that article. In light of your paragraph following the extended quote from the article, I just want to remind you that Jeremiah was called "the weeping prophet." Hmmmm.

Anonymous said...

Thanks! I recently got the "adjust" lecture from a close relative.

Jane S.