No Before Times to Be Had: Part Eight
To be able to develop an ability to follow wherever acceptance might lead, it is important to attend to the following first:
Work on mental and emotional issues now
Rest
Critique and adjust your weltanschauung (veltan-shao-ung)
Mental and Emotional Issues
I suspect that the fact that so many with chronic illness are dismissed and told that they have mental health problems and not real illness, creates an underlying resistance to mental care and work when the physical illness remains debilitating and untreated.
Doing the mental work does not mean you capitulate to the dismissive fallacy that all of your very real and debilitating symptoms are “all in your head.” The physical stuff is all real and do not waste your time and energy with those who suggest otherwise.
Physical illness is a strain on mental and emotional brain function because, rather obviously, the brain is part of the body.
Anxiety and depression are protective states for brains under stress. You can check out my piece on Depression to scour research paper references there. Essentially, hypervigilance and withdrawal protect a vulnerable, injured and sick body.
As with many systems, the cure can become the poison depending on dose. The challenge with chronic illness is that extended states of anxiety and depression begin to have negative impacts on the system that it was meant to protect.
While you may end up deciding to suppress anxiety and depression with drugs because the benefits far outweigh the risks, just know that this approach is not included in the concept of working on the mental and emotional issues you may face.
Your body reacts to things differently as someone with a chronic illness and so too does your mind. You cannot let anxiety and depression run rampant over decades and nor can you depend exclusively upon suppressive drugs to quash those states either.
As you age, you become physically and mentally more vulnerable. And that vulnerability will exacerbate anxiety and depression. But, most importantly, that exacerbation is valid. Yep. Valid.
It is valid to be progressively anxious and depressed when you are ill and aging. The mental and emotional work you have to undertake is not about invalidating your mental and emotional states; it is actually about validating their presence. I will get into more of this when I turn to item three: weltanschauung.
On this site over the years I have talked up Cognitive Behavioural Therapy (CBT) many, many times as there is such a wealth of research on its use for so many conditions. But what has only come to my attention recently, because I am fortunate enough to follow brilliant people on social media, is that CBT is a standardized process that requires individuals question their own reality so that they might integrate (or re-integrate) more successfully into capitalist norms. That sounds pretty nefarious really—your fears of being targeted or abused will be questioned for their validity and you will work with the therapist’s support to accept them as faulty assumptions that are holding you back from being a productive member of society. But what if those fears of being targeted and abused are based on factual, lived experience? Grimace.
If you would like to read more on the neoliberal co-option of various standardized methods of psychological care:
James Dudley: Clinical Psychology Training in Neoliberal Times
Noël Ingram: Suicide and Neoliberalism: An Imminent Critique of Cognitive-Behavioural Therapy [download accessible]
I particularly appreciate Sarah Peregrine Lord connecting the US army’s Battlemind program, designed to mentally prepare soldiers for combat, with the trauma industry in the society at large :
“This society also creates and idealizes the identity of trauma survivor: an enterprising, functional, and fiercely individual member of the warrior cult. Lord also explains that treatment manuals take for granted, reflect, and reproduce the highly competitive, militaristic society of the United States and teach patients to ignore the social causes of daily political suffering.”
That is not to say that numerous treatment modalities do not have value, but it does suggest that it will be important for you to have clear goals on what you want to achieve in treatment and to move on if what is on offer does not align with what you need. What you need is guidance to determine what you want to do with the lived experience, the anxiety and the fear—all reviewed in some depth in Nudging and Knowing Terroir.
I have also covered off many details on reframing mental conditions in the Mental Disorders and Illnesses Series so you can delve into the details more there.
Rest
Most would put “rest” as the number one focus for any chronic illness. There is a reason that I put it after the need to attend to mental and emotional issues: if you can only attend to one thing before you rest, it must be your mental and emotional wellbeing. It is not doing the laundry, cleaning the home, making the kids’ lunches, or even spending time with loved ones.
It is really critical to develop a relationship with your mental and emotional states at the onset of any chronic illness otherwise they subsume your entire personality over the decades.
Do you know of any 70-something folk with long-standing health issues where everything that they relay is a statement of dread? You likely know a bunch of 30-somethings with the same approach in fact. They are filled with anxiety, guilt, resentment, brittleness, lack of agency, lack of flexibility and heaps and heaps of dread and expectation that the worst will be realized. You may see small flashes of their original personality show up – a bit of joy or laughter here and there – but chronic illness has a way of taking your personhood in ways that almost seem related to dementia (although memories are of course absolutely intact for most chronic illneses).
Learning how to experience your mental and emotional states, without identifying with them as expressions of who you are, is so important for wending a reasonable path with chronic illness now and into the future.
Then you rest. You likely do not know how to rest because none of us is really taught how. We are all basically unclear on what constitutes rest.
I will look at how to rest in next week’s installment of Part Nine.
Lord SP. Interpreting the Political Meaning of Manualized Trauma Treatment: A Hermeneutic Exploration of Battlemind and the Warrior Cult. InHermeneutic Approaches to Interpretive Research 2021 Aug 23 (pp. 21-47). Routledge.
