During the coronavirus public health crisis, many of us have come to understand that we do not walk alone. While retaining individuality, we are stronger by acting as one, following guidelines for protecting ourselves and those around us. Heroes and heroines have arisen, some who are “hidden,” but all are alike in wanting to make a difference. In short, overall, during this fight, individuals are more alike than different.
This “movement” has also affected how we view the “mad” or “labeled” who walk or hide amongst the “normals.” The line between the “normals” versus the “abnormals” or “non-normals” has blurred.
In the past, certain behaviors were viewed as abnormal. These included wearing unusual headgear (for example, covering one’s head with aluminum foil), not allowing others to come into their homes, secretively peeking out windows, being suspicious, not wanting to be touched or touch others, and keeping people at a distance. Staying isolated in one’s home constantly and avoiding attempts by others to connect with us physically was viewed as strange or bizarre.
During this pandemic, these behaviors make sense or are deemed to be appropriate for the most part in light of what is happening now. What were defined as “symptoms” of being “mentally ill” are experienced by many of us—particularly depression and anxiety. Even suicidal ideation makes sense in this “coronavirus world,” not that it should be ignored. Words that would have been viewed as delusional, even psychotic, are not immediately taken as fact that the speaker is truly mad. In short, the “normals” and the “mad” can be viewed as much more alike than different at this time.
In addition to our “similar” behaviors, thoughts, and reactions to this crisis, many of the “mad”—some of whom have felt disempowered and have been routinely stigmatized—have risen to the challenge of making a difference. Those who have been viewed as mad are engaging in urgent advocacy efforts, are making face masks, are writing letters to those who are isolated and at high risk of being exposed to and dying from the coronavirus, are using the power of the pen, and are finding and using their voices.
Likewise, the wall between mental health consumers and mental health providers has leveled to a certain extent. The power differential is not as clear-cut. We are more alike than different. Mental health providers are experiencing many of the same emotions as the mad (including fear, anxiety, anger, and frustration). Like the mad, mental health professionals are making rapid-fire decisions about how to prioritize tasks and efforts when time is precious for all of us. Just like us, they are making mistakes. Plates are falling despite their best efforts.
Most, if not all, mental health providers, will face dealing with major ethical issues. In their quest to reach as many consumers as possible, to streamline the process, to be as efficient as possible during this pandemic, was the therapeutic process truly helpful? Were key components of what “should” happen between both parties still prioritized?
These components include shared-decision making and promoting personal choice: Allowing consumers to chart their own lives and make decisions about treatment options. Will the consumer decide to follow through on what is recommended? Will mental health providers remember that consumers are the experts on what has worked in the past and what is unlikely to work now? It is way too easy to provide recommendations rather than suggestions during this pandemic, when streamlining the process has to be prioritized.
During this time period, were therapists and psychiatrists working with the mad in finding ways to be empowered even during this pandemic, to distinguish between what we could control (such as our reactions to what was happening in the outside world) versus what we could not control? Or were we, in effect, basically told what to do, think and feel? How many of us were told that our mental health providers were doing the best that they could, and that certain questions could not be addressed because they were too busy?
By disempowering consumers along the way in their quest to streamline the therapeutic process (an assembly line approach?), were the mad coddled? Were we treated as if we couldn’t handle the pressure associated with the pandemic, couldn’t make decisions, and needed them (who still thought they knew best) to make decisions (even provide orders) for us?
The bottom line is that making progress in the recovery journey is hard work. We are survivors—perhaps at varied levels. And by facing so many challenges in our lives and overcoming them, we have developed the strengths to survive what is happening now.
Some of the mad take advantage of peer support programs in which they can find support from and forge healthy connections with peers. However, were these programs promoting self-empowerment and making personal choices, preparing us for whatever headed our way, teaching us how to advocate for ourselves and others, and promoting recovery in all realms? Or were we being treated as children who could not think for ourselves?
When we needed to be prepared for dealing with any challenges and thinking for ourselves, were programs focusing on socializing, promoting social events as ways to connect, offering “busy work” to keep engaged (such as adult coloring to reduce stress)? Or was programming offered to develop skills needed to survive in the outside world, to retain individuality while receiving support, to find ways to connect in healthy ways, and to use a variety of mechanisms (tools) to promote recovery? And were they using trauma-informed care approaches in all interactions?
Having these approaches in place at any time makes sense, in efforts to make programs “safe” for all participants. The pandemic is a major trauma, adding to having been traumatized and re-traumatized in the past.
The bottom line is that the mad and the normals are much more alike than different in this rapidly changing, evolving world. We are all alike in facing the risk of being exposed to the coronavirus, of becoming ill, and of dying. This fact may sound brutal but it is true nonetheless.
One could argue that a “gift” from dealing with this pandemic together may be a marked decrease in us being stigmatized by those who are “not-so-normal” anymore.
In closing, please be aware that I am viewed as abnormal. I have the label of “Bipolar Disorder” with periods of psychosis and mania—fortunately, not recently. But during this pandemic, I am alike with others in trying to make a difference, even if my efforts are small. For example, I am working on developing writing exercises, preparing examples, and networking with other writers to help promote writing as a therapeutic tool during this pandemic. I am going to be helping print letters to patients in psychiatric hospitals who cannot have visitors.
Small steps to make a difference. But I am fully aware that, for me, the wall between me and the normals has blurred. While the following comment may be viewed as insensitive at this time—I feel more empowered than I ever have during this urgent public health crisis.
Stay safe and well.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.