Friday, October 10, 2014

Finding Strength in Vulnerability

In my last post, I discussed one reason some people reject a mental health diagnosis – because the diagnosis attacks an important way they see themselves and they reject the diagnosis to protect their own identity. Today, I want to discuss another reason a mental health diagnosis is rejected – our cultural relationship to vulnerability. We are taught to deny and fear exposure of our weaknesses to others. Since the extreme states that result in a mental health diagnosis carry a natural vulnerability, someone who is newly diagnosed might reject the diagnosis so that they can continue to see themselves, and still be seen by their friends and family, as strong people. Unfortunately, this denial can interfere with having an honest relationship with the situation, and can prevent the newly diagnosed person from seeking out and accepting the care they need to properly manage their mental health diagnosis.

Fear of vulnerability is common in American culture where strength is held supreme to almost all other qualities. No one wants to be seen as weak. Imperfections are denied and covered up, and personal histories are re-written to eliminate or gloss over previous mistakes. We see this in how much time and attention Americans spend making our Facebook profiles appear as though we have the perfect family, with the perfect job, and the perfect house. Our profiles highlight our successes and ignore any details that expose our vulnerabilities. People don’t highlight any setbacks in their marriage or with their careers. Only smiling pictures of happy times and inspirational quotes are shared. All of us feel the collective pressure to present a mask to the world that disowns any of our weaknesses or failures.

There’s no denying the vulnerability of someone experiencing psychosis. Extreme states like psychosis greatly impair your self-awareness and relationship to reality. When experiencing psychosis, the normal resources that help you navigate the world in a savvy way are not there to be called upon. When your ability to reason is as severely altered as it is when psychotic, you are left vulnerable to those who see this as an opportunity to take advantage of you.

Witnessing extreme states can cause fear in even the most sane people because it makes them wonder, “If that person can loose themselves and their identity so completely to an illness, can I?” Seeing someone in such a vulnerable state can make you fear for your own stability. Fearing this possibility can cause you to reject those who experience psychosis. It is a natural reaction for someone witnessing psychosis for the first time to distance themselves from the psychotic person. This distancing can shut down your natural empathy and can allow stigma to flourish. Those, like myself, who have a mental health diagnosis, are the mirrors that no one wants to look at. No one wants to see and own that they, too, have this basic vulnerability. The vulnerability of the person experiencing psychosis then fuels the social and internal stigma of having a mental health diagnosis.

It is no surprise that this internalized fear of vulnerability can interfere with the acceptance of a new mental health diagnosis; I know it did for me. When I was first diagnosed I immediately assumed the diagnosis was wrong. I’m not a weak person; in my group of friends, I was the rock. There was no way I could be medically diagnosed with a weakness like a mental health disorder. My denial was fueled by the cultural relationship we have to vulnerability in the US. Owning my diagnosis meant that I had to own a fundamental vulnerability.

Owning the reality of vulnerabilities is very difficult. For me, it took years before I fully acknowledged just how impaired my thinking and judgment are when I am experiencing mania or psychosis. Denying this vulnerability helped me to maintain the image I had of myself as a strong, resourceful person. It also enabled me to continue presenting a strong front to those around me. Unknowingly, I bought into the cultural message that anything that could be considered to be weak should be disowned. Unfortunately, by upholding this belief, I delayed full acceptance of my diagnosis its necessary treatment. The first step in taking care of any problem is admitting that there is indeed a problem. My fear of vulnerability prevented me from seeing that there was a problem, and left me blind to the truth of my diagnosis.

The solution to this problem is not through avoidance, which was my natural reaction, but rather through full engagement with my fear. The image of always being right and always being strong is a lie. No one gets stronger without struggle, and no one can learn without making mistakes. Weakness is not having a biological tendency to experience psychosis; weakness is denying that this tendency exists and failing to manage the illness to the best of your ability. The newly diagnosed feel significant cultural pressure to deny the truth of their diagnosis because doing so would be admitting their vulnerability. I learned that only by having the courage to own my vulnerability did I find true strength. I found a strength that enables honest reflection about the reality of my situation, and supports responsible action towards the management of my treatment. I found the strength that resides inside vulnerability. This is something all those who have been diagnosed with a mental health disorder can do, if they have the courage to be honest with themselves about their vulnerabilities.

Written by: Kate Wright

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