Last week my aunt found herself crying in a restaurant for no reason that she could discern, and found that she couldn’t stop. She was with her husband of nearly four decades, a man whom she loves, and their life is good — they raised four daughters, all of whom have more kids than I can count, every one of them well and whole and hale. The bills are paid; by nearly any measure she is blessed, and yet there she sat, in the Olive Garden, unable to stop crying. As I loaned a sympathetic ear to her malaise, I couldn’t help but hear the strains of Pink Floyd, of Roger Waters singing from the landmark album Dark Side Of the Moon:
The lunatic is on the grass
The lunatic is on the grass
Remembering games and daisy chains and laughs
Got to keep the loonies on the path.
It’s not that I minimized or failed to understand her distress; in point of fact, I understood her too well — even if impromptu, irrational tears strike me as, well, a little nuts, though it feels as if it’s more about the age than about her life.
If there was an age that could broker nameless malaise without tangible source, it would be this one.
People often refer to others of good sense or emotional stability as being “well-adjusted,” which connotes a subtext that looks, upon examination, rather dire. Adjusted to what, I wonder — to the generalized, de rigeur madness of a world that evolved more in service of commerce, power and busy-ness than humanity? Fearing that might construe an intuitive leap into a logical abyss, I consulted an expert.
“The term ‘well-adjusted’ suggests a stable personality that can dynamically adjust to life’s vagaries,” offers Matthew Bennett, Psy.D., of the Ventana Center for Psychotherapy. “It’s not an easy thing to build a self — it’s a vastly more difficult endeavor than most realize. The structure of a personality must be flexible and consistent and sustainable, in the face of what are the often-extreme demands of an unpredictable world and its inhabitants. While most of us seem to manage it,” he concludes, “we do so with more difficulty than is apparent to the casual eye.”
It’s no wonder, when faced with moments of wavering stability, the reflective among us might question, in passing or at length and with trepidation, the strength of the selves we’ve built — imagining in grand Hollywood style what happens to those who lose their grip, being packed off by the dreaded men in white coats to an interminable pharmacological sojourn in small, bright rooms with soft walls, and to a somnambulant routine that’s broken only by daily respites of construction paper and craft glue.
Despite the drama and factual unreality of cinema’s model of madness, we’re right to wonder, for in many ways ours is an age of madness — of rampant depression; of anxiety; of mood, thought and personality disorders; of inappropriate word and deed and dark thought that leads to the type of unspeakably violent conclusions that too often dominate the evening news. We live in an age when both sacred and secular gods seem either to have fled or failed us, and when the moral compass spins with no inkling of true north, presaging a future that’s more readily found in Hieronymus Bosch paintings than inBetter Homes & Gardens.
I’m OK, but I’m not so sure about you …
Given the apparent downward spiral of the news of the day, and since my aunt can’t seem to stop crying or even discover the source of her sorrow, I’ve been musing on mental health — which, of course, means likewise musing on mental illness, since one seems meaningless without the measure of the other. Though our culture has long indulged in an ‘us and them’ mindset with regard to the sane and the mad (with those efficient men in white coats acting as arbiters, bearing the afflicted away as the dark ferryman Charon once ferried the souls of the deceased into Hades, never to return), what’s closer to the truth is that mental health and illness comprise a continuum of experience upon which we all reside, at widely divergent points according to the highs and lows of our lives. In his classic The Prophet, Kahlil Gibran spoke similarly of joy and sorrow, noting that “Even as one sits at your board, the other sleeps in your bed,” reckoning our experience of light and darkness as two inseparable sides of the same human coin, parallel states of being between which we regularly oscillate, riding a pendulum of mood and circumstance.
As the Pink Floyd song continues,
The lunatic is in my head.
The lunatic is in my head
You raise the blade, you make the change
You re-arrange me till I’m sane.
You lock the door
And throw away the key
There’s someone in my head but it’s not me.
“Everyone will, at some point in their lives, experience a state of psychosis,” Dr. Bennett explains. “When dealing with the dark side of personality and mind, Freud spoke of the primary process, the deepest level of our ‘mental soup,’ home of primordial fear and raw, reflexive emotion. While the vast majority of us are able to construct filters over it — described by Freud as the secondary process — i.e., veneers of society, of behavioral checks and balances, the roles and beliefs and mores that help define our sense of self, we still have access to that darkness. Some avail themselves of it for creative purposes, like Lovecraft or Stephen King, while others are driven there by trauma or other circumstance. In those cases, the trip is, if not entirely voluntary, at least temporary. But some people get stuck there, or find that it intrudes on their lives in a way they can’t control.” Dr. Bennett goes on to cite that intrusiveness as a sort of litmus test for chronic mental illness, which suggests that the darkness of primary process perhaps lurks just beneath the surface for many of us, in a way that’s none too comfortable, and we often don’t know where to turn for help with it.
I was recently enrolled in a 10-week self-help class, a splendid exercise in mind expansion and empowering discipline. Like me, a large percentage of the class was there with some personal agenda — to make more money, to find and keep love, to feel better about ourselves. Among the 20-plus aspirants was ‘Mary,’ a pretty and youthful woman of middle age, friendly if a bit world-weary — she was missed in the last weeks of the class, but dropouts here and there aren’t uncommon. We were shocked to learn, however, that on the last night of the class, while the rest of us were commemorating our ‘graduation’ and our lives with revealing projects of self-expression and personal celebration, she was quietly ending her own life. Later, when I compared notes among my classmates, none of us considered her among the several best candidates in the class for such a drastic dénouement. Sadly, even that is no surprise: in this age, we so seldom seem to see it coming. I could not help but wonder if Mary had been prone to crying jags in restaurants.
Can you feel me now?
Most of the people I know avail themselves of one form of anesthesia or another, from prescription meds to martinis to marijuana, sometimes in moderation but too often, as we well know, to disastrous effect. In fact, substance abuse comprises one of the cornerstones of behavioral health programs, since it’s so often a symptom of deeper problems. Of course, there are many ways that we seek either to drown or transcend the pain of the human condition — from television to mindless sex to workaholism and much more. The chemical alternative remains simply the most accessible and identifiable, thus the easiest to vilify.
“Don’t be too quick to dismiss the role of meds in mental health,” advises Dr. John Schipper, administrator of the county’s Behavioral Health Clinics in both Ventura and Santa Paula. “While many people use them or abuse them to achieve that ‘wet blanket’ effect — that is, to take the edge off — many others depend on them to ‘lift the veil’ that descends as an aspect of a chronic malady, like depression, for example. Without a pharmaceutical intervention, the ability of people who suffer from clinical depression or chronic anxiety to simply function is badly compromised.” Dr. Shipper describes many cases of clients whose true, functioning personalities would be buried under the load of anxiety, depression or worse, if not for that benevolent chemical lifeline.
Crisis, what crisis?
Just as we often recognize chemical dependency as a symptom of impending or ongoing emotional crisis, it’s often while in the embrace of those substances that we cross paths with the public agencies that serve as a safety net when societal backstops fail. From the DUI pull-over to the panicked call to 911, it frequently falls to our law-enforcement agencies to serve as ‘first responders’ to our mental or emotional crises. While in the past this often proved to be a recipe for violence and disaster, today Ventura county residents benefit from law enforcement professionals who are sensitive to those events, and trained to deal with them. In fact, Ventura County numbers among the very few counties in the nation to have achieved 100 percent participation across our many law enforcement agencies in Crisis Intervention Training (CIT), an intensive, 40-hour program designed to promote recognition of and best response to mental illness and the crisis situations through which they often dramatically manifest.
“When people don’t know where else to turn, especially when a loved one is in crisis, they call 911,” explains Jennifer Frank, the county’s CIT program administrator. “It’s so important that our officers know how to appropriately respond to such difficult situations. At this point, nearly half of our officers and almost a third of our dispatchers have CIT training, and we’re very proud of that record.” With CIT and similar programs, like the regrettably under-funded Multi-Agency
Referral and Recovery Team (MARRT), those crisis moments can lead to proper diagnosis and constructive care rather than incarceration.
Indeed, county resources run deep in support of our enduring mental health — well beyond the training of our law enforcement agencies — from hospital care to county Behavioral Health resources to the County Crisis Team, which can respond 24/7 not merely with law enforcement, but with trained and licensed mental health professionals. The crisis team provides a very effective alternative to 911, and can be reached at all hours at or (877) 3-CRISIS or (877) 327-4747.
It’s in initiatives like these that many find hope for an ever-increasing note of sanity and stability in society. “I’m very excited by a kind of ‘recovery zeitgeist’ that’s emerging in our social programs,” notes Dr. Shipper. Our mental health initiatives are taking a page from 12-step programs, to utilize broad-based peer support by enlisting the informed, empathetic aid of people still actively engaged in the maintenance and management of their own mental illness.” He notes the work of such groups as Recovery Innovations of California (RICA), which advances that recovery ethic and peer support in its Wellness and Recovery Action Plan (WRAP) classes. The classes are designed to help people examine their lives and histories, identifying behavioral triggers and points of wellness to serve as models for future stability — and RICA is not alone in pioneering such constructive work; working in similar disciplines are such organizations as the Wellness Centers, located in Ventura and Oxnard, run by Pacific Clinics.
Physician, heal thyself …
Running out of time, I asked Dr. Bennett point-blank how he thought we were doing — is the trend indicating greater or lesser sanity? “I am hopeful to the extent that people take their psychology seriously,” he replied, “and work to maintain authentic, emotional honesty. Psychology isn’t about telling people how or what to think — it’s about encouraging people to define themselves, to mobilize their personal and mental resources, and to find a place to make a stand.”
“Life is uncertain,” offers the Reverend Bonnie Rose, of the Ventura Center for Spiritual Living, who came to her ministry after a stint as a psychiatric nurse, “and rigid thinking tends to be chronically brittle. It’s scary to do, but our best hope lies in moving beyond that rigidity, beyond strict black and white thinking, being willing to submit to the unknown. Things may seem dark, but in what feels like the collapse of old structures, we often find the space to build something new.”
That feels like good advice, but it doesn’t entirely dismiss the specter of my aunt, who had been crying in her seat at the Olive Garden. At that time, still bothered by her distress, I asked her what she did to cope in that moment — did they leave the restaurant so she could at least suffer in privacy?
She regarded me with frank and dismissive disdain. “Are you crazy? We hadn’t finished eating.”