The one core ingredient on which any recovery from “mental illness” depends is the one that curiously and grievously never makes an appearance in any medical handbook or psychiatric diagnostic manual—that is, love. The word is so strongly associated with romance and sentimentality that we completely overlook its crucial role in helping us to keep faith with life at times of overwhelming psychological confusion and even sorrow.
Love—from a friend, a partner, an offspring, a parent—has an indomitable and impenetrable power to rescue us from emotional distress.
Anyone who has experienced intense emotional suffering or mental health concerns and recovers will do so, whether they consciously realise it or not, because of an experience of love. In one way or another, no one has ever experienced “mental illness” without having suffered from a severe deficit of love somewhere along the line. In a way, love is the guiding strand running through the onset of, and recovery from, our overall worst episodes of mental unwellness.
What then do we mean by love, in its life-giving and mind-healing sense?
What frequently assails and derails us when we are suffering emotionally is a continuous punishing sense of how horrible we are. We are lacerated by an intense feeling of self-hatred. Our own charge sheet against us is definitive: we are “awful,” “terrible,” “nasty,” “bad.” A primal self-suspicion bursts through our defences and overtakes our faculties, leaving no room for the slightest kindness or gentleness towards ourselves. We are implacably appalled by, and unforgiving of, who we are!
In such agony, a loving companion can make the difference between suicide and keeping going. Such companions do not try to persuade us of our worth head on and with cold reason; nor do they go in for any showy displays of affection. They demonstrate that we matter to them in a thousand surreptitious yet fundamental ways. They can tolerate how distressed we are and will stick by us however long it takes. We don’t have to impress them; they won’t worry too much about how scary we are looking and the weird things we might say.
They’re not going to give up on us, even if it takes a month or six years or sixty. They’re going nowhere. We can call them at strange hours. We can sob or we can sound very adult and reasonable. They seem remarkably to love us in and of ourselves, for who we are rather than anything we do. They hold a loving mirror towards us and help us to tolerate the reflection. It’s pretty much the most beautiful thing in the universe.
Part of what can make the attentions of others oppressive is the note of patronising pity we detect beneath their apparent kindness. The well-ones have come to see us in order to help, but we sense how much they cling to a fundamental difference between the mess we are in and who they think they are. We are the “insane” ones and they will always fly the flags of health, rationality and balance. They feel sorry for us from afar, as if we were the proverbial drowning man and they the observer on dry land.
Loving companions bear no such hints of superiority. They do not judge us as beneath them when we lie crumpled in our pyjamas at midday, because they do not fundamentally see themselves as “above” someone who is mentally unwell. We may happen to be very ill at the moment, but it could very easily have been them. They don’t oppress us by covertly clinging to their belief in their own solidity and competence. All of us are potentially ill enough to be in the asylum, and those of us who are actually there may not be the most afflicted.
At the heart of many mental traumas is an early experience of abandonment. Someone, when we badly needed them, was not present, and their neglect has thrown us off balance ever since. We may find it hard to depend on others in grown-up life and lack faith that someone won’t run away, or take advantage of us, in turn.
A loving companion intuits this about us and is ready to fight to earn our trust. They know that they cannot blithely assert their loyalty, they will have to prove it, which means not deserting us at moments when others would be tempted to give up. We may try to incite despair and frustration in those who offer kindness as a way of testing the relationship. We may say some awful things to a caregiver we love and pretend to be indifferent to them. However, if the companion is wise, they will listen and remain unruffled—not because they are weak, but because they understand that they are being tested and that a basic piece of repair work around trust is underway.
We have to be given a chance, which we may have missed out on in childhood, to be a bit more demanding than usual in order to witness conclusively that this isn’t enough to destroy love. We can be ill and still acceptable to another. How much more real love will feel once it has been shaken by this and still survived.
The future for someone in emotional distress can be a source of ongoing and limitless torment. A lot of questions hover: what if someone gets very angry with them? What if someone wants to take them away? What if someone tries to kill them? What if the voices in their head never go away?
The loving companion does their best to quieten the panic, by presenting the future as unknowable in its precise details but fundamentally safe and bearable. They hold open options: it will always be possible to leave town, to live very quietly in a small cottage, to be at home and lead a domestic existence. No one expects them to perform great feats; just being is enough. There doesn’t have to be pressure to earn money, to impress strangers, or to be heroic. Surviving is all that matters.
The loving companion doesn’t get bored of instilling the same fundamental message: I am here for you and it will be OK. Even if this OK isn’t what one would ideally want, still it will be OK, better than death—which usually remains the alternative in the sufferer’s mind. Quite how the years ahead are going to pan out can’t be determined yet; details will have to be examined later, but what is known already now is that the future won’t be unendurable, because there is love.
When we’re mentally ill, we can often be tedious—what a number of anxieties we desperately need to go through with others!
Loving parents know that the minds of little children are comparably filled with anxiety-inducing and sometimes peculiar questions: is there a tiger under the bed? What if someone laughs at me at school? The temptation can be to rush and give an answer full of blustering, impatient confidence. Of course, it will be fine! Nonsense there’s no tiger! And so on.
But the properly loving response is to take the worry as seriously as its progenitor does and address it head on, without scoffing or denying the scale of the concern. Love gives us the patience to enter imaginatively into the other’s worried mind and to try to settle it by sensible examination of what there might be to fear.
To Just “Be”
Many of us have suffered all our lives from a feeling that we are not, in and of ourselves, good enough. We work hard for decades, in order to prove to someone sceptical that we are respectable and worthy after all. Some of us may crave money and status and power to shore up a ghastly feeling of not being able to matter to people unless we have first attracted society’s baubles and prizes.
When they break down, what remains unbelievable to these exhausted warriors is that they could ever be loved outside of their performance in the worldly race. Surely it is only their earning potential that counts? Surely it has to be their popularity that matters?
However, now that they are ill and without any of the usual tools to impress, the mentally unwell stand to discover a more complex and salutary lesson. According to the values they have been subsisting on, they are a disgrace. But with any luck, in the presence of a loving companion, they can start to believe in something far more nuanced and miraculous: that they could be loved without prizes, that true love isn’t about impressing or intimidating someone, that an adult can love another adult a little like a good parent loves their child: not because of anything they have done, but simply and poignantly just because they exist.
“But What Will Others Think?”
A good loving companion looking after a friend in emotional distress can heal through their power of not caring very much about what other people think. There are people out there sniggering. There will be some people who judge the sufferer, say that they’re faking it or that it’s deserved and that the sufferer was awful to begin with.
But the hasty judgements of all these others are inappropriate and lacking proper understanding. That is no reason to panic. Let them laugh, let them be superior, let the idiots be idiots; such are the consoling messages of love that we need to hear when we are defenceless before the judgements of a cruel world.
Our loving companion know where their loyalties lie, they aren’t going to give up on us because a mob is jeering. Love is not a democracy. They don’t care if they are in a minority of one in loving us. And that is why we will stay alive.
Both we and our caregiver may be deep into adulthood, but if their tenderness heals us, it is likely to be because in diverse covert ways what they are doing through their ministration is repairing a deficit of early love. They will be reparenting our broken child selves.
Every child needs to be cuddled, spoken and sung to, played with, held close and looked at with enthusiasm—and will as good as die inside without such care. Every child needs to experience what one could possibly term “Primary Parental Delight,” a basic feeling that they are limitlessly wanted by those who put them on the earth and are capable of generating intense pleasure through their very being.
Without this, a child might definitely survive, but it can never thrive. Their right to walk the earth will always be somewhat in doubt, they will also grow up with a sense of being superfluous, disruptive and, at very core, unappealing and shameful.
Such emotions feed directly into a broad range of emotional distress, such as chronic anxiety, self-harm, suicidal ideation, and depression. These experiences all have roots in the feeling of not mattering enough to anyone, developed over long years of childhood.
This defines the challenge for the carer in adulthood. Some of the work will have to involve rectifying an appalling failure of early provision; they will need to convince the wounded inner child that what they didn’t receive decades ago could be available today; that there might still be joy, reassurance, play, and kindness bestowed.
It could seem highly patronising to tell an adult that they need, above all, to be reparented. But it’s in fact the height of maturity to recognise that the small version of us must, if we’re ever to get better, be allowed another chance to experience what it feels like to matter, limitlessly, to a kindly and thoughtful companion.
The Bottom Line
We shouldn’t be so surprised at the enormous levels of “mental illness” at large in society; we need only consider how bad we collectively are at love, how poor we are lending sympathy, at listening, at offering reassurance, at feeling compassion, and at forgiving—and, conversely, how good we are at hating, shaming, and neglecting. We consider ourselves civilised but display levels of love that would shock a den of thieves.
Furthermore, we’ve opted to wash our hands of the issue and handed responsibility for the same to the professionals—the scientists, the psychiatrists, the pharmaceutical industry—as though they could possibly create a solution to the absence of love through their pills.
We completely ignore that the cure largely lies in the emotional realm: in getting better at appeasing each other’s fears, at being generous about our transgressions, at no longer tormenting and maltreating one another for our failures, and at sitting together through the darkness of night in a spirit of infinite care and kind forbearance. At loving one another.
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.