Musings on Mental Health Activism

In a perfect world, all people would have a basic understanding of mental illness and respect that it is very real and painful. In a perfect world, if someone disclosed their mental health status and said that it affected their decisions and life, other people would respect that without requiring evidence, gory details, or an exact explanation of how serious it really was (are you sure it wasn’t all in your head?)

Alas, this is not the world we live in. Disclosing mental health status often comes with a round of questioning and well intentioned but utterly unhelpful suggestions (have you tried exercising?) that can quickly put one on the defensive. I personally have felt pressure when writing about my mental health to engage in the “just how bad was it?” defensiveness, pre-emptively listing out symptoms and consequences to illustrate that no really, this needed to be taken seriously.

Nearly every article I read about mental illness feels the need to either specify that depression is a serious illness (if it’s a scientific or research based piece) or take a large chunk of its time to describe the internal experience (if it’s on the subjective side). There’s certainly nothing wrong with that impulse, and subjective descriptions of mental illness are incredibly important to increasing awareness and understanding, but almost never do I see someone write about an experience they had that was influenced by their mental illness without focusing heavily on symptoms and vivid, graphic descriptions.

This makes sense to some extent, but it seems odd to me that we cannot have mental illness be an influence in our lives without going the extra distance to explain the exact details. In the world as it stands, there is not enough understanding of mental illness to mention it as a factor without making your statement/article/conversation about mental illness.

Here’s where I get hung up.

As someone who wants to increase understanding and awareness of mental illness and mental health issues, as someone who is aware of these dynamics and the ways in which stigma against mental illness contributes to the requirement that mentally ill people prove how hard things are for them every.single.time, do I proceed by molding myself into the Good Depressed Person and patiently describing over and over (in the level of detail required by my listener to really understand) what it’s like in my head? Or is there something radical in simply letting myself say “I am depressed and that led to x, y, or z” without backtracking, explaining, or questioning myself?

There may be space for both of these options in the world of mental health activism. It’s easy to see how speaking openly about the internal experience of mental illness is part of activism. It very clearly increases awareness and understanding, and can help others respect the seriousness of a mental illness, as well as the fact that it is not a choice or a lifestyle. There are downsides though. I worry that making personal stories a constant factor in every discussion of mental illness sets an unhealthy precedent that people’s stories are required to be public. I worry that we’re painting a picture of mental illness that feeds into certain romantic notions of things like anorexia, while playing into the voyeuristic pleasure some people get in hearing about disturbing and graphic symptoms. I see this especially in discussions of self harm when the questions immediately turn to how deep, how often, where, pics.

It might be that having both tactics is the best choice so that we can continue to educate others about mental illness in a serious way while also recognizing that sometimes it isn’t the only or overwhelming factor in an individual’s life. Sometimes it’s just a part of life, like a twingy ankle or allergies. It gets in the way, but it doesn’t destroy.

Again, ideally, this could be a great way to move forward in activism. The problem comes with the lived experience of trying to mention your mental illness without defending it. People push. People overlook it. People argue and debate and yell after you’ve said you’re triggered. People invoke all the stereotypes of mental illness that you’ve been working so hard to fight against (lazy, taking the easy way out, not trying hard enough). These things, even if you know that they are unwarranted and are ignoring a very real factor (mental illness) hurt.

I don’t think anyone is obligated to always educate others when they talk or write about their mental health. You’re allowed to say “this thing triggered me, which relates to the rest of what I’m talking about in ways x, y, and z” without having to explain how your triggers came to be, what triggering looks like for you, and exactly how real and serious the experience was. I just don’t know how to let people do that while protecting them from the less informed folks who will take that as an opportunity to berate them for not liking triggery thing, or for not being able to cope with a situation, or whatever the case may be. And I don’t know how to recognize that people 100% have the right not to explain themselves while also knowing that these incidents might not help the larger aims of mental health activism.

This is the forever balancing act of oppressed groups that want to make things better. In order to gain the rights and treatment you know that you should have, you often need to play by the damaging rules of society as it is, putting you in a place to get hurt and perpetuating those same rules. How radical can we be in acting as if the world had already accepted us? While it might be idealistic and forward thinking to expect everyone to know about mental illness, does it actually do anyone any good when it comes to securing rights and reducing stigma?

There are no clear answers here about the “right” way to approach discussions about mental health or activism, but I wish we knew better how to help improve the world around us without making ourselves so vulnerable.

Self Care is Safety

I’ve been spending a lot of time thinking about self care lately because I’ve been trying to practice it, and as part of that I’ve been trying to pin down what are effective self care techniques for me. Soft fabrics, cats, a good glass of wine, familiar smells, books, Netflix, going for a walk in a park, not having to cook…these are all things that I use to take care of myself. And as I’ve thought about many of the things that feel like self care to me, the more I’ve realized that the essence of self care is creating a space in which I can feel safe.

A great deal of this is physical pleasures: when you are experiencing something warm, soft, or comforting, you are more likely to feel safe. But beyond that, many of the things that are self care for me involve making things familiar and understandable. Books have always been a safe space for me because they are controlled. Nature, trees, green spaces, are essentially the same no matter where you go and will always feel like childhood and playing outside. Scents are memories for me, and the moments when I can recreate the smell of home is a moment when I temporarily am at home.

These familiar things remind me of the places that I know I am taken care of, the places I don’t have to worry. A lot of people imagine that self care is about what makes you feel good, but that’s a bit too simplistic. Often it involves things that soothe or calm, but underneath what makes most of my self care successful is that it helps me to feel safe in some fashion. It makes my space my own, it distracts me from things that scare me, or it reminds me that I am allowed to be vulnerable.

This is one of the reasons why familiarity is an important part of self care. Things that are the same as places or people that I trust are the fastest way that I can feel safe. Of course human beings like routine, and things that we’re used to are more comforting than things that are new, but on a deeper level than that, for someone who has a mental illness, familiarity means the places that we trust not to hurt us. It means the places where the anxiety might turn off for a while, or where we can escape from depression. “Home” is often our safe place, and the people we are familiar with are our support system. This isn’t true for everyone: sometimes the things we see every day are oppressive, boring, or painful. But more often than not the fact that they are familiar makes them easier to deal with, and thus safer. Even more than that, our safe places are generally those that represent family or friends, things that have kept us safe in the past, or other parts of our life that are integrally part of who we are. Familiarity.

This of course makes self care more challenging if you’re in a new place or around new people, but it does offer a helpful way to reframe self care so that it might be more effective. I feel safe when I feel competent, accomplished, and cared for. These might be hard feelings to capture in a new place, but I know that when I write I feel competent and accomplished, I know that when I have a to do list I feel better when I get things done, I know that hearing from people (even from a distance) makes me feel cared for. These are not things you might immediately think of when you hear “self care”, but reframing self care from “pampering” to “meeting my emotional needs” or “safety” can elucidate new things to try. Now I’m gonna go start my novel and feel accomplished.

Why I Spend Money on Eating Out

For some unknown reason, many people enjoy judging how others spend their money. Particularly when the person spending money is poor, others like to make comments. “Why would you have a smartphone if you can barely pay rent?” “How can you spend money on organic veggies if you’re using food stamps?” “If you can afford x then you can definitely afford y”.

What’s fascinating to me about this is that there are often complex reasons that people choose to spend their money the way they do. People have different priorities, purchases can mean different things to different people, and often something that looks frivolous may serve an important role to the person who buys it. It seems to me to be yet another example of individuals assuming that everyone else views the world and interacts with the world in the same way that they do, and then becoming upset when others act differently from them.

Unfortunately however, this kind of judgment does actually have negative consequences. It leads to campaigns to take away food stamps and support programs, verbal harassment, and serious anxiety and emotional tolls on those who do spend their money in different ways due to the necessity of constantly defending their choices. Those who live in poverty already have to make difficult decisions about how to spend their money, but putting their choices constantly under the scrutiny of all of society is generally a horrible way to ensure that they can make decisions which will positively impact their lives. Most studies have found that shame is a bad motivator, and because individuals require different things (unheard of, right?), expecting all people with lower incomes to follow the same set of societally enforced guidelines is deeply unhelpful.

Let’s not even get into the fact that oftentimes large purchases were made before someone fell into poverty, or were a gift.

Now I’m sure some people out there are shaking their heads and thinking “Yeah, but everyone needs food and shelter, so shouldn’t those things always come first? Shouldn’t you always make sure your money goes to those things and then prioritize other stuff?” Yes, it’s true that everyone needs food and shelter, but not everyone is privileged enough that these are their only basic needs. Some people have chronic illnesses, disabilities, children, or other extenuating circumstances that could put their safety at risk if they are not attended to. Additionally, life is not just about surviving, and when those who live in poverty manage to have the money to do something that helps them thrive, we should not disdain them for it.

As per usual, I will use myself as an example because I like to talk about me (and because I am the most readily available subject). I currently am living in poverty. I make a ridiculously low wage ($11,000/yr) and don’t get benefits. I am lucky in that I have a fair amount of savings, but I do have student loans as well and at this point in my life I’m fully independent. However I go out to eat on a regular basis. Sometimes really nice restaurants. I spend probably half of my money on food.

I very often have this pointed out to me as a way that I could cut costs and live in a more stable fashion. I’ve gotten the side eye from family members who think I’m being stupid or irresponsible. People tell me all the time “why don’t you just cook at home? It’s cheaper and better for you!” To that I laugh. One of the symptoms of my eating disorder is that I really hate cooking and having food in my home. It sends my anxiety through the roof, particularly when I have perishables around. If I have to spend more than about 15 minutes on cooking, I just won’t do it and when I try I often end up a crying mess, purging, cutting, or all three.

Because of this, the only foods that I feel comfortable having in my home (e.g. which I don’t feel leave me vulnerable to hurting myself) are those which are quick to prepare and will keep for a long time. Essentially this is ramen noodles, mac and cheese, and soup. When I eat at home, that is the extent of my diet and when I have attempted to change it, very bad things have happened. Eating this diet is not healthy. It’s not really safe for me to eat this day in and day out, especially considering my history of restriction. Going out to eat is the only reprieve I have from this. It’s not a get out of jail free card from my eating disorder, but it makes things easier. It gives me access to more variety, to balanced meals, to some joy in my food.

Spending money on eating out is for me spending money on my own health. I cannot simply choose to eat and cook at home and be healthy. So when others look at me and act as if I am being frivolous with my money by eating out, what they miss is that the money I spend is spent on something truly important. It could even be a matter of life and death (yes, eating disorders do kill and frequently). What they miss is that they have no comprehension of the complicated balancing act of pros and cons that go into my purchasing decisions.

Everyone has an entire life that goes into every action that they make. You don’t see everything they’re weighing when you see the final outcome that is the decision to spend money. So unless you have a great deal of knowledge about the life of whoever you feel the need to “help”, leave it alone.

 

Losing Ground: The Balancing Act of the Radical and the Practical

My mom and I talk often about feminism and feminist issues, as these are questions close to both of our hearts. However the two of us come from very different eras of feminism: my mother came of age in the time of free love and (supposed) bra burning. She fought to let women keep their own names when they marry, for contraception rights, against painful and oppressive clothing, against sexual harassment in the workplace, against unequal pay and unequal hiring practices. She did some damn amazing things and her generation set the groundwork for the conversations my generation is having now.

But my mom and I disagree on a lot of things. An example: one of the conversations in feminism right now is about presenting as femme and how that presentation is often devalued. Many people have come to accept that wearing make up and dressing femme are personal choices and there’s nothing wrong at all with presenting as feminine (thinking there is may actually be the problem). A lot of people are embracing fashions from Mad Men, vintage clothes, high stilettos and reimagining them in ways that they find empowering.

My mother is appalled by this. She fought so that women didn’t have to balance on spikey little heels that destroyed their backs and made it impossible for them to move or do much of anything physical. She thinks we’re losing ground. She thinks women have forgotten what it used to be like.

So who’s right? It seems to me there are valid arguments on both sides: choosing to wear clothes that hurt you and render you physically helpless seems like a pretty bad idea and fairly oppressive. At the same time, telling anyone else what they need to wear and implying that things coded as feminine are bad is really not ok. Are we losing ground or are we coming to a more complex understanding of what clothes signify and how “femme” coded things are often viewed distastefully?

Well both. Here’s the thing: feminism is always a balance of the practical and the idealistic. When we tell young women that they shouldn’t have to protect themselves against rape, that they should be able to wear the clothes they want to wear, we are imagining an ideal world and we are trying to force that ideal world to exist with our actions. When our mothers tell us “please be safe, please think about how you can protect yourself” they are desperately trying to be practical and keep us safe because they know that the world that exists now is not ideal.

We need both. I would never shame someone for their clothing choice but I also sure as hell would never leave my drink unattended at a party. Even if we try to . We live in a world that is not ideal and yet we are hoping against hope that we can make it closer to the ideal. This is a difficult place to be, because when we fall on the wrong side of the balance either we get hurt or someone else gets hurt.

When I look at the differences between earlier waves of feminism and today’s feminism, that question is often what I see: should we aim for the practical or the radically idealistic? Those of us who are working on feminist issues today are in the incredibly privileged position that we even get to look at the ideal. For my mom, that was not always an option: asking men to respect you whatever your clothing choices took second fiddle to actively protecting yourself from rape, assault, and abuse, and if that meant wearing a different set of clothes then so be it.

There are all kinds of issues that this crops up in: we only get to debate the ideals of consent because our forebears put in place protections against rape that have given us the space to breathe. We need both the practical and the idealistic, but we always need to be keenly aware of who might be hurt and who might be helped by any of our rhetoric.

It also seems that if we reimagine the differences between the various waves of feminism in terms of where they draw the boundary of radical and practical, we may come to a better understanding of why people did what they did and how we can build off of their successes. Perhaps this can also lead current feminists to be less defensive about their choice feminism and recognize some of the practical aspects to their choices: while it’s great to imagine a world in which femme-coded clothing is on par with masculine clothing, in the here and now that clothing was designed to be limiting to your body and your abilities, and that is a reality that needs to be taken into account.

I’m not sure where the balance is on a lot of these questions. I do take steps to protect myself from rape, even as I try to explain to the men in my life how they can keep from putting women in uncomfortable and bad situations. I have no idea how possible it is to act consistently while being both radical and practical. I’m sure that there will always be swings back and forth between them.

One thing the feminists of today do need to keep in mind is that the space we have now to imagine the ideal was not always there and is not a guarantee. We do need to remember what things have been like and why, and remind ourselves that whatever steps we take in moving forward, we must be careful to protect ourselves from the potential of moving backwards. Perhaps instead of reclaiming heels and tight skirts we could work to create a new sexy, a new femme, because we remember the oppressive nature of those items in the past.

What does seem clear to me is that many of the debates that are happening in the feminist world right now are about how safe we feel and about whether we want to take clear, practical steps in the world as it is to protect ourselves or whether we want to begin to act as if the world is the ideal one we aim for. If we were all perfect, brave, impossible feminists, we would make this world our ideal. We would not flinch when we act radically outside of the norm and put ourselves in potential danger. But I can never fault someone for trying to keep themselves safe and healthy in the world that they live in here and now.

The Disgust of Dirty Food

Note: this post has a lot of thoughts packed together that have not been clearly pulled apart. I’m really intending to write more about this, and a lot of these thoughts are preliminary attempts to work through some ideas that I think are extremely important. Any insights are welcome.

 

In my DBT group we’ve been talking a lot about emotions recently: how to identify them, what they do for us, how to regulate them, etc. One of the emotions that we went over which was a little surprising to me was disgust. I suppose that somewhere in my mind I knew that disgust is an emotion, and actually a fairly common one, but as I looked at the prompting events of disgust, the physical symptoms of disgust, and the interpretations of disgust, I realized that disgust is a hugely important element of eating disorders, and that there is a wide body of literature that discusses some of the roots and backgrounds of disgust that never gets touched on in eating disorder treatment. It’s pretty clear that people with eating disorders often feel disgust towards themselves or disgust towards food, but what is disgust? Where does it come from? What purpose does it serve? And what can this tell us about eating disorders?

 

So what is disgust at its most basic? In general, disgust is the feeling we have towards things that might contaminate or poison us. Likely we evolved this feeling for a really good reason: to avoid things that would kill us if we ate or touched them. In many ways, disgust has to do with bodily boundaries. You want to keep the good things on the inside and make sure that the bad things remain on the outside. We are disgusted by things that break down our boundaries: things that can come in through our mouths or ears, things that come through our sexual organs, things that break our skin and leave us without a boundary, or things that can get inside our body through our skin in some fashion or other. The purpose of disgust is therefore beneficial: it can keep us safe from potential pathogens, from sexual fluids, or from things that may invade our bodies. We want to remain pure, because purity will keep us safe and keep our boundaries intact.

 

However disgust has expanded from these origins into moral and religious contexts. Particularly in the Abrahamic religions, this moral tint to disgust came from Judaic purity laws, which mixed together the disgust emotions of purity with other moral issues in order to strengthen both. Judaism extended conceptions of purity and boundaries from literal filth into things that they believed would keep them spiritually pure, as well as keep their society as a whole safe from contaminants. Holiness was equated with purity, because purity is health and safety. If you look at Leviticus or other law books in the Old Testament, most if not all the laws are about keeping different things from mixing together, or from keeping impure and bad things out. A clear example of this is that a woman on her period is expected to remain separate from the community, and anyone who touches her must ritually cleanse himself (Leviticus 5:19-20). In general, blood is considered a pathogen. It’s not something you want to touch. However in order to enforce that boundary, religious law was invoked to create an ethical and moral consequence to becoming impure.

 

So early religions often had purity concerns as a way to enforce this sense of disgust and keep individuals safe. However these purity concerns grew into much more than that, and they took the sense of disgust and expanded it to apply to anything that was considered unethical. Again however we see a lot of questions about purity. When someone lies, you are not likely to feel a whole lot of disgust (even if it’s about something pretty horrible). When someone is raped, or brutally murdered and mutilated, or even humiliated, we feel a great deal of disgust for the perpetrator. These are instances in which someone’s boundaries are violated, either literally with rape, or their body’s boundaries are destroyed in the case of mutilation, or their boundaries of self-respect and self-identity are violated in the case of humiliation. This might be part of the reason we find sexualized immorality more disturbing and disgusting than other sorts of violence or crime: because sexuality is nearly always associated with penetration of some sort.

 

So we have these conceptions of boundaries, and this idea that we need to keep certain things in and other things out, and when things get inside our boundaries or threaten our boundaries we feel disgust. What does this have to do with the disgust of an eating disorder? In my opinion, everything. Eating disorders are all wrapped up in the concept of disgust. If you’ve heard someone with an eating disorder talking about food or about how they feel after they eat, they tend to use words like sick, gross, icky, nasty. They are words that connote disgust. Many eating disorder patients act as if food is unsafe or will hurt them in some manner. These together seem to indicate that people who are avoiding food they deem disgusting to keep themselves safe are concerned with keeping their bodies pure.

 

Food is one of the few things in our lives that we have to put into our bodies. We feel disgust towards eating things that might be a danger to us, and many religions have put purity taboos on certain foods. Food is all wrapped up in questions of boundaries and what is acceptable to put into our bodies. Particularly in modern America, there is a narrative about good food/bad food, which paints certain foods as toxic. These could be foods with chemicals or foods with fats or foods with sugars, but the language around them generally labels them as poisonous. In conjunction with this, there exists the idea that women in general need to be pure. They need to be saintly. They must be morally good, sexually good, and they absolutely can’t let bad things into their system because it could ruin their beauty and worth. If you look at the sheer number of cleaning commercials aimed at women, you might have some indication of how cleanliness is apparently the basis of our self-worth.

 

For many people with eating disorders, the food becomes a question of worth, of morality, and of saintliness. The less you eat, the better you are as a person. The more saintly you are. The more pure you are. This rhetoric makes perfect sense in the context of disgust: we feel disgust at things that come inside us, at things that are foreign in our bodies. If you begin to identify food as something foreign that you can choose to let into your body or as something that you can keep out, you begin to think that you can keep yourself safe, just as religions with certain food rules do, by keeping the bad things outside of your body and by being in control of the boundaries of your body. That sense of bodily integrity is one of the most important feelings of control that we get as human beings. The most important thing we can control is how our body interacts with the world around us: what we put in it, how we keep others out. These are the most important for our safety, as well as for our sense of individual identity. When these things are violated, of course we feel disgust. And when you’re barraged with the idea that the world outside of you is dangerous, dirty, and bad, and that you need to be clean, this feeling of disgust can get out of control.

 

If an individual is feeling as though their boundaries are violated often, or they feel as if they have no control over the safety of themselves as an identity or as an individual, they may take radical action to make themselves feel safe by keeping out the bad. This can take the form of an eating disorder. And the feedback loop on it is strong: you feel disgust towards something, you don’t eat it, and you feel safe and secure because you didn’t die. This is also given a moral element by stories of asceticism. Keeping the whole world out of your body has come to be equated with spirituality, with purity, and with saintliness. It apparently makes you better than other people if you keep your body clean from anything associated with the world (because the world is dirty). Restricting taps into this cultural conception, and allows you to feel morally superior for every time you skip a meal. It also tells you that you’re protecting yourself from anything that is unclean or dirty.

 

We don’t often think of America as having a strong purity culture, and our purity rules are not clear: we have a variety of different rules that are not always consistent. It’s no surprise that many people feel confused about what is appropriate with food and purity. It’s no surprise that with all the shaming that happens around food, some people feel that the only way to be safe is to cut food out entirely.

 

I believe that there are important insights to be gained from the disgust towards our own bodies as well, and that these might have ties to sexuality, sexual morality, boundaries, and the world as dirty. I’m hoping to do two follow up posts to this one, on identity and purity, and on sexuality and purity.