Knowing your illness and subtracting your self-worth

“I knew my mental health was ailing, and while I attempted to conceal from the world and myself those anxieties that felt both vast and nameless, they existed inside of me just below the surface. My self-diagnosis told me that my desperate feelings of self-worth (how I felt about myself) and the discomfort with which I occupied my body (how I felt within myself), were amiss. The flaw in such self-diagnosis was how my feelings of deep discomfort and imbalance were not heard as signals of need, entitling me to move towards nurture, but were confirming of a deep sense of worthlessness. My self-diagnosis had been accurate, but the thing about ailing minds, the struggle that individuals with poor mental health face, is that feeling psychologically and emotionally ill becomes a shaming sensation, an expression that confirmed an ingrained sense of myself – that I was not good enough.”

This story of mental ill health is not a unique one, so many people recognise their expressions of emotional discomfort and the inherent internal conflict they hold – and these truths in their self-diagnosis are accurate. However, mental illness is a deceitful and untrustworthy fellow. It proposes a twisted sense of the self, warping perceptions about champions of psychological health; entitlement, responsibility, freedom, agency, self-worth; turning them into sources of anxiety and mental ill health – overly responsible, lack of entitlement, restrictions, powerlessness or a sense of unworthiness.   Mental health problems from this perspective is about distortions in the mind’s eye, the internal view with which we see ourselves, and just like a faulty lens it misrepresents ourselves to us. But how does such “illness” come about? 

The health in mental ill health

Mental illness, like physical illness, has a history, aetiology and its symptoms portray a continuum of human hurt. Paradoxically the many forms and symptoms of mental health problems reveal a healthy process, a kind of psychic survival mechanism. Inherent within the symptoms of all mental illness is the how and why; why psychological functioning had to be channelled down alternative and less fulfilling routes, and how such roads are attempts to transcend the loss of unmet human needs.  Current perspectives on human development reveal the deep bond between the state of our mental health, for we are all on a spectrum of mental health whether “ill” or just idiosyncratic, and the quality of our historical human relationships.

“For me this knowledge was an immensely freeing experience. How normalising it was to learn that it was the imperfections in past relationships, of human need unmet, that were at the true root of my mental health difficulties. Knowing of this bond between human need and mental wellbeing gave me hope, permitted desire for my needs; and if absence of relationship was the root of my troubled mental health then the presence of the right type of relationship could be seed for change.”

Human developmental studies now reveal that our minds do not develop in isolation, nor are they based on a predetermined internal blueprint, but are organised, shaped and patterned as we interact and communicate in relationships. Our minds are malleable, social structures fashioned in relationship. The knowledge we have about ourselves, what you might call your sense of self, is something learnt as you grow during childhood, gaining self-knowledge is a collaborative process as minds are “co-constructed”.

The connection between mental health, past relationships and human need is no longer one of implication but is a physical one. Internal suffering emerges out of deficiencies in the provision of universal needs, resulting in misguided self perspectives and leading to the common symptoms many understand as “mental health disorders”. To navigate and survive an environment of thwarted human need requires healthy creative compromises. These are the adaptations and preoccupations often associated with mental health problems, but in reality they are vital for psychological survival.

“It makes sense; take the family style I grew up in. There were various restrictions on the liberty I had to explore my impulses and feelings would go unnamed or lead to my estrangement. Over time aspects of my internal world became sources of mistrust and fear within me, for one of the rules about need is how anxiety surrounds and replaces it once forbidden. For me to differ from the families emotional style would have been too hurtful, naturally I became uncertain about what was unexpressed in me, depression replaced my expressions and in so doing I survived, affording me a best fit to the family mode”.  

Gambling, addiction, uncontrollable spending, excessive working, obsessions, depression all act as monumental distractions, saviours and protectors from internal need, discomfort and an emotional world that can feel just too scary.  In reality these are the creative compromises and ingenious adjustment reactions designed to accomplish the most human relationship in environments where human connections are restricted. As follows, people tend not to approach therapy but are propelled towards it by these survival reactions, for while these creative comprises provide minimisation of emotional need they never can fully bury the yearning that is coupled to failures of love and connection.