Trying Too Hard to Be Sane, or Trying Too Hard to Recover, Can Lead to Madness

Ron Unger, LCSW
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A recent article, “Screw Positive Thinking! Why Our Quest for Happiness Is Making Us Miserable” provides humorous perspective on the ways seeking too hard after happiness can make us unhappy – and, it seems, stupid as well!  I’m going to argue that the same paradox also applies to other aspects of mental health, and that some of the major problems in current mental health treatment result from failing to take this into account.

The problem with trying too hard to be happy is that “positive thinking” can often backfire; affirmations for example can make people think less of themselves, and excessively positive thinking can lead to us making foolish choices that have serious, and negative, consequences.  Also, there is a tricky effect called “ironic process” where trying to “improve” by getting rid of something in our mind often makes us amplify the very thing we are trying to get rid of (spend the next 30 seconds trying not to think about hippopotamuses and see what I mean.)

Another problem with trying to get rid of unhappiness, in order to become happy, is that unhappiness itself can be understood as part of an attempt to reach a greater happiness.  That is, I may be unhappy with a paper I am writing because I want a better paper and the happiness that comes from that, or I am unhappy with a relationship because I want a better relationship, etc.  If I suppress my unhappy feelings with my current paper or relationship, in order to be happy, I may turn in a lousy paper or fail to act to improve my relationship, which then leads to more unhappiness in the future.

I believe it is helpful to consider the possibility that pretty much everything that disturbs us can be understood as something that in some way is trying to help us.  Even something as dark as a part of us that wants to make us kill ourselves can be understood as a part that is trying to free us from the ways we feel stuck in our lives, even if it is going a bit overboard in the means of getting unstuck that it is proposing.  We may be disturbed by extreme rage, by  sexual impulses we find unacceptable, or by voices which seem completely foreign to us, and we may see these things as the enemy, and think that our recovery depends on getting rid of them, but this very effort to get rid of them could be the primary barrier to healing.  (Healing usually involves finding a place for something, where it doesn’t dominate but is allowed to make a contribution.)

A key part of “psychosis” is often the sense of having components in one’s mind which are foreign and distressing, whether these are seen as related to a brain implant, telepathy from neighbors, evil spirits, or just “voices.”  The standard approach to these experiences is to try and get rid of them, through drugs and distraction.  But if the thing disturbing us is actually trying to help us, and also if efforts to get rid of something can often make it worse (ironic process) then this whole mission of trying to get rid of what seems foreign and distressing may be entirely the wrong idea.

One voice hearer whose story illustrates this perfectly is Eleanor Longden.  She was tricked into entering a mental hospital by people who were concerned about a single, non-distressing voice she was hearing.  They convinced her she needed to get rid of this voice, that it represented “schizophrenia.”  In a few months in the hospital, trying to desperately get rid of the voice, she found it multiplied and intensified and became 12 extremely distressing voices.  She later described this process as a “psychic civil war.”  It was only when she learned to balance limit setting with the voices with being curious about how the voices might be trying to do something for her and might be conveying important messages about herself (even if often not literal messages) that she was able to recover.   She now still hears voices, but finds them more helpful than harmful.  (I highly recommend the DVD on which she tells her story in detail, and I also recommend her insightful paper on hearing voices and dissociation.)

There is a lot of evidence that fear of madness plays a key role in becoming mad; for example Hirsch & Jolley (1989) found that 70% of those with a psychotic diagnoses reported that fear of going mad was their most common “symptom” before a psychotic relapse.  It seems likely that the fear of going mad is not just a “sign” that one is going mad, but is actually part of what leads to the psychosis:  trying too hard to stop the madness actually intensifies it.  There is also evidence of the same process at work in people diagnosed with PTSD:  the more they fear going mad, the more chronic their PTSD tends to be (Dunmore, Clark & Ehlers, 1999).  The problem seems to be that if one interprets a memory or other disturbing mental content as evidence of “madness” then one is likely to try too hard to get rid of it, which leads to both the disturbing part of the mind fighting harder to be recognized, and also failure to integrate it.

It makes sense that if some part of our brain or mind is dissociated from our conscious awareness, but is trying to help us in some way, it will become angry and fight back if we try to get rid of it.  Unfortunately, it’s very easy to see this angry response and intensified activity on the part of something in our mind that we don’t understand as a sign of something terribly wrong, an “illness” that has to be suppressed.  This often leads both the person and the mental health system that is trying to “help” into a vicious circle of trying even harder to get rid of what is really part of the person. This then leads to that part fighting back in an even crazier way, prompting stronger efforts at suppression, etc. etc.

Of course, sometimes the drugs used for suppression do seem to “work” for at least a period of time, but this can also be unfortunate, as the suppressed part  now is unable to contribute to the psyche, and of course, many other parts of the person may be suppressed by the drugs as well.

In “cognitive therapy for psychosis,” a psychological approach that I specialize in, one of the key guidelines we attempt to convey is to “try, but don’t try too hard.”  This suggests we should try to be happy, to be sane, and to think independently of possibly domineering voices or impulses or disturbing emotions, but it also suggests that we shouldn’t try to do any of those things “too hard.”  This means we should be aware of when our positive efforts may be backfiring, and when it might be time to back off, to accept unhappiness, to accept our own crazy experiences and perspectives, and to allow voices, impulses and disturbing emotions to influence us in some ways.

This balanced approach or middle way, allows us to fight with the “mad” disturbing or dreamy sides of ourselves when we think those aspects may be influencing us too much, but also allows us to accept that all those sides of us exist and even to become proud of them as we find better ways to make use of them in our lives.  So cognitive therapy and rational thinking can incorporate “mad pride” – not pride in being dominated by “mad” sides of ourselves, but pride in including all the different sides of ourselves, including those that see things or manifest in a way that our culture does not easily understand.  Real recovery comes not from trying to be completely sane, or completely happy, but from finding a lively balance on the edge of chaos, on the edge of rationality, a balance that allows us to find a place for all of our parts and experiences, even the “crazy” ones.

(For a few more ideas on how trying too hard can cause problems, check out my earlier post, Trying too hard to recover may make it less likely.)

12 COMMENTS

  1. If I’m “trying” anything at all, I’m “trying” to be THE OWNER of my own soul and my life.

    IF I had personal, creative control over my own life – I wouldn’t be typing on this website (or any website at all). I wouldn’t be sitting in this apartment right now.

    I’ll be “happy” when I OWN MY OWN LIFE and have the power to create it … as I will for it to be (in service to MYSELF – not Humanity).

    I’m “formed” by history – the 2 decades of my life wasted in (stolen by) psychiatry. And for someone like me, psychiatric history is permanent and futuristic. This history will follow me where ever I go and I’m not going *anywhere*. I can’t “go”, since my SOUL is now condemned (no thanks to you, psychiatry).

    IF I had CHOICE…

  2. Great wisdom. I understand the “try, but not too hard” as a requirement to value and focus at the same time on:
    – acceptance (at least of past and present),
    – and hope and drive to improve things.

    The other important dilemma you mention is how to keep our mood and emotions attuned to the social context we are in, while neither letting a bad context disable us, nor letting a good-enough context make us complacent. Too much “positive thinking” sounds like a encouragement to dissociate our mood from our situation (not a good idea in general).

    And I like the option of temporarily surrendering to unpleasant or unusual states (while keeping everybody physically safe).

    Thanks for writing!

    • Congratulate yourself for having the ability (and even the right) to keep it to yourself. I am forced to be an open book, provide information and explain everything. It is one of the worst violations I’ve had to endure and the consequences are MASSIVE.

      But I like what you said about the system and how dangerous it is. On Maria’s blog about her son, Alice acknowledges: “The legal system (corrections) is a strong presence in this country. Our nation has both the highest numbers of prisoners incarcerated and the highest rates of imprisonment of any country in the world. This pushes us to be more focused on legalities as well.”

      Psychiatry CAN be a form of imprisonment, for many of us. It is next to impossible (for those who “choose” to be honest and see reality for what it is) for a “veteran” of psychiatry to be “happy” or develop a firmly established sense of “recovery”, with the ever-present threat of psychiatric re-incarceration.

  3. Ron, thank you for putting into words what I’m slowly beginning to find out about myself.

    If I hadn’t discovered various resources who gave me a solid basis for doubting the diagnostic paradigm I think I’d be doped up on a cocktail of harmful medications and more desperately unhappy than ever.

    Instead, I find today that getting through the more difficult periods often involves simply being willing to sit with it, accept that I feel the way I do for a reason, to resist the impulse that I must get rid of parts of myself in order to be ‘happy’.

    It must have been a stroke of freakish luck that in the late ’90s when I was starting down the path of treating my humanity with drugs that I commented to the psychiatrist who’d prescribe me a succession of ADs that I was interested in weaning off the drug. His observations of my ‘family history’ and opinion that I was a ‘lifer’ (needing ADs for all of my life) got under my skin, stuck there, and I never went back. I didn’t make all of the best choices (particularly in going cold turkey), but in the intervening years I have suffered.

    And yet I look back on the medication free times I’ve grappled with my existence and honor that person who slowly came to recognize that things don’t have to be neat, tidy or blissful in order for my life to have meaning and purpose.

    I absolutely, 100% believe that if I’d desperately tried to fix my periods of insanity with medication, I was headed down a path in which I would have been horribly victimized by the psychiatry and drug industries.

    It’s been a rough year, for many reasons that are valid to me. I have had happiness, wish I had more of it, but in the end I’ve developed self talk that always begins with “Well, let’s sit with this, let it be what it is, feel what you feel, and not panic.” It’s gotten me through more than one period where I felt almost tempted to run back into the arms of psychiatry and trick myself into thinking they have anything to offer me that I don’t already know – the most important of which is when I’m unhappy, it’s not fun but it’s ultimately going to be useful to me in this strange, heartbreaking, unique and sometimes even joyful thing called life.

    Thanks for reminding me so powerfully of one of my core personal care principles: “sit with it for a while…”

  4. Thank you for writing this. It so thoroughly supports and expands what I’ve slowly been discovering about myself.

    If I hadn’t discovered various resources over the past decade that gave me a solid basis for doubting the medical model/diagnostic paradigm I think I’d be doped up on a cocktail of harmful medications and more desperately unhappy than ever, as well as in potentially far worse physical health.

    Instead, I find today that getting through periods of the blackest despair often involves simply being willing to sit with it, accept that I feel the way I do for what are probably very good reasons, and to resist the impulse that I must suppress or squash legitimate parts of who I am in order to qualify as ‘happy’ or, worse – ‘normal’.

    It must have been a stroke of freakish luck that in the late ’90s, as I was starting down the path of treating my humanity with psychiatric drugs, that I commented to the psychiatrist who’d prescribed me a succession of ADs that my ultimate goal was to get to a point where I didn’t ‘need’ medication. His observations about my ‘family history’ and subsequent assertion that I was a ‘lifer’ got under my skin that day, and stuck there. I’d seen all too well how little helped my parent had been after nearly 20 years of faithfully popping psychiatric medication. The psychiatrist who told me I was a ‘lifer’ had met me barely 6 months prior, and had spent a whopping 20 minutes with me each month: 120 minutes to know that I was always going to be broken, and he had the answers. What arrogance. A sense of “I’ll show you!” righteous anger took over; I left his office and never went back. I didn’t make all of the best choices (particularly in going cold turkey), and though some of the intervening years have indeed been hard I wouldn’t change a thing.

    If I could meet Elliot Valenstein and shake his hand for writing the first book I read after dumping psychiatry: “Blaming the Brain”, I’d out myself as the overenthusiastic person I am by shaking his hand for about a week: thank you, thank you, thank you, thank you – for opening the door to show me why my experience is not broken, wrong, unhealthy, disordered: but Human.

    When I recently read “Mad in America” and found madinamerica.com, it was further confirmation that I have been extremely fortunate that a single psychiatrist pissed me off just enough that I decided not to listen to their voodoo any more. My medication of choice is writing, and talking to people I trust and know me well.

    Today, I look back on the medication-free times I’ve grappled with my existence and I honor that person who’s slowly come to recognize that things don’t have to be neat, tidy, explainable, rational or blissful in order for my life to have personal meaning and purpose.

    I absolutely, 100% believe that if I’d continued trying to fix my periods of (relative) insanity with medication or by allowing others to diagnose me as broken, I would have continued down a path which would have seen me becoming terribly victimized by the psychiatry and drug industries.

    It’s been a rough year, for many reasons that seem to come with the territory of big changes. Yet I’ve learned to return to a dialogue with myself that more often seems to begin with “Well, let’s sit with this for a while and let it be what it is.” It’s gotten me through more than one period where I felt almost tempted to cry uncle, return to seeing myself as a psychiatric ‘diagnosis’, and trick myself into thinking that paradigm has anything to offer me that I don’t already know – the most important of which is when I’m at my worst, it’s not fun, but there are reasons for it that mean I’m as human as the next guy. Chances are my darkest periods will ultimately give me insight into this strange, heartbreaking, unique and sometimes even joyful thing called life. It’s happened enough for me that I’ve learned to trust it. It doesn’t necessarily make the hard times easier, and paradoxically I’ve begun to recognize those times as a signal that I’m not paying attention to something about myself, and learning from me right then is needed.

    Thanks for reminding me so powerfully of one of my core personal care principles: “sit with it for a while…” I’ve stopped trying to fix what the ‘experts’ would call broken, and instead I’ve accepted it as part of a valuable process: me getting to know myself better – the person I nearly ignored as a teen and young adult – and offering that person one of the greatest gifts we humans possess – a little patience and compassion in times of greatest vulnerability, and the willingness to listen.

  5. Ron,
    In your article, (about adjusting to happiness~vs~unhappiness, while people work through their lives toward healing physiologicaly), Your comments were extremely enlightening, as you expounded upon my own feelings and experiences, in you own special way of expression.

    Lets face it, Everyone Is Mentally Ill, According to Modern Or Early Fathers of ‘The Psychiatric Industry’. I include All of Mankind in the Quest toward Happiness. I believe that some individuals relate happiness with “Doing Oppressive Things To Other Individuals Who are Humble, “Because They Can.” Im am a ’49 yr’ old woman. At this point in my life, I believe that people who do mostly good things for themselves and others are “Black Sheep”. Black Sheep are Easier to Spot, Hunt, or Kill. Also, less compassion exists in these types of scenarios.

    I awoke from a fairy tale in 2010, when i discovered sores were appearing on my nape of the neck and also way up, inside my nose. I realized from that day on, that most people who consider them selves Doctors, Dentists, Psychiatrists, Social Workers, Counselors (because they participate in the madness), or Authority Figures. The group I just listed, I believe contains the Highest Number of Participants who are ‘Destructive by Nature to Humanity’ (past or present day included).
    Also, a person can find many Participants in Mental & Emotionally Destructive Behaviors in places where they seek refuge from one bad situation to the next throughout their lives of struggle to thrive.

    Thanks to a compassionate person unlike any other taught me about So Many Things That Help Counteract against Social Patterns of Oppression against people who are ‘Less Fortunate, or Undeserving’, I have began to develop a new set of coping skills in which to deal with the Stress That
    Is Counterproductive to ones self. However, one of the hardest skills to learn is that when a person begins the awkward process of Recovery, in particular, Withdrawal from Psychiatric Cocktails~ ‘Happiness’ becomes just another verb, such as Fairness, or Human Rights, or Freedom, or Equality, or Non Prejudice”. These are merely words that were perhaps derived from some sort of a Story, that we were taught by the Propaganda and Educational Authorities.

    As you withdraw from these Bio~Hazardous Chemicals that we swollowed up like The Lies Behind their Origin, A Veil or Curtain of Reality Comes Crashing Down When You Realize that all along, you and I, and everyone who is a Victim of severe Oppression in life, of one form or another. That veil can quickly become like a plate of glass that you fall against thats “Too Small to Matter”, but Big Enough to Cut You into So Many Little Pieces. ~Evanescence ~ https://www.youtube.com/watch?v=MOTAYyXftik