Friday, January 25, 2013

This Way or the Highway: Fundamentalism and Mental Health

The other day I was thinking about one of my favorite therapy clients from a former job. "Enrique" was in his late 30s, gracious, soft-spoken, and eager to please. Although he had trouble keeping paid employment, he loved doing volunteer work. Enrique also had schizophrenia, for which he took a medication that worked well. Until he got involved in a neighborhood church whose pastor didn't believe in medications. In fact, this pastor told Enrique that his schizophrenia was a sign of insufficient faith, and that he had to try harder to get close to God.

Enrique panicked. He didn't want to be rejected from this church, since it provided an almost-instant sense of community and identity. He liked helping out the pastor; he also cared deeply about his Christianity and did not want to be seen as unfaithful. So, Enrique stopped taking his medications and started praying regularly. After a while, prayer became a compulsion for Enrique. He mumbled constantly, stopped bathing, and lost weight. He withdrew into a private world in which the hallucinations and delusions of his illness became indistinguishable from religious concepts. One day, Enrique encountered two police officers in his hallway. Believing they were sent by the devil and that he was God, Enrique assaulted one of the cops. I was present in court when Enrique was sentenced to four years in prison, and I'll never forget the way he slumped his shoulders and stared at the floor as he was escorted out in handcuffs.

I don't hate Enrique's pastor for any of this. He was a well-intentioned man who didn't understand that his inflexible position on medications was hurting Enrique. In a larger sense, the pastor did not understand the ways in which fundamentalism—not a bad thing, in and of itself—can interact with mental illness in a potentially harmful manner. (I have decided to use the term "fundamentalism" throughout this post to refer to any ideology, movement, or set of beliefs that tends toward a pole or an extreme; is intolerant of other perspectives; and encourages strict adherence by its followers. In this use, the word is not meant to be derogatory, but merely descriptive. Nor does it refer to any particular religion or movement.)

I understand what Enrique was going through; I've lived it, in my own way. During periods in which my depression left me vulnerable, I have encountered fundamentalism in many forms: religions, diets, spiritual groups, parenting manuals. In fact, because depression caused me to view life in starkly polarized terms (i.e., I was "all bad" because I wasn't "all good"), I absolutely gravitated to fundamentalism. It met my urgent need for answers, absolution, salvation. It gave me something to cling to. Unfortunately, in my effort to be found, I ended up more lost than ever—because I didn't know when to say when. I took everything to its literal extreme, until I was entrapped, with no voice or opinion of my own. I have learned that this is a common experience for people with mental illness; the principles of a particular group or movement become fused with the symptoms of mental illness and actually make them worse. When viewed from without, the person with mental illness may simply appear to be admirably devout. Because of this, others often don't recognize that something harmful is taking place.

In every case, there came a time when I recognized that I was heading for destruction—and then came the scary part. I had to forcibly break free from fundamentalism, which at that moment felt akin to drowning. I had to trust that remaining kernel of self that said, "You still know how to swim." This was always difficult and disorienting at first, particularly when I lost friends and mentors as a result. But the reward came soon enough: My mood lifted. Joy returned. My world made sense again—intuitive sense, not the "sense" imposed by a given belief system.

Yet the next time depression struck, some other form of fundamentalism would seduce me. I needed to go through a long series of these brainwashing/reprogramming cycles before the lesson was really learned: Lisa, this stuff isn't good for you.

I've come to appreciate that the moral absolutism contained within fundamentalism was always my point of peril. A religious leader telling me my eternal fate was in danger; an infant expert telling me my child's emotional foundation was at stake; nutrition gurus warning of cancer and death unless entire food categories were eliminated; they were all the same dynamic. The fear engendered by this absolutism became a driving force for me, obscuring self-awareness and common sense, and leaving me utterly trapped.

It was awful to feel trapped in a movement that others found freeing; to find misery where others found happiness. It made me feel as if there was something terribly wrong with me. Now, I realize that the only thing "wrong" was my choice to go down a road that, for me, was dangerous. Conversely, the only "right" is what is right for me. For me, there is much peace and wisdom in the simple slogan, "Live and let live."
But I know why this has been such a slow, hard lesson. Fundamentalism can be very appealing, especially to ambitious high-achievers. It can drive positive change, even revolution. There are many people who thrive on it, who derive from it self-actualization and a higher purpose. I've noticed that, ironically, these people tend not to be 100% literal about every aspect of their given movement or cause. They pick and choose from the given set of ideas, based on what works for them and makes sense to them. Their emotional stability allows them to explore new ideas in safety. This is why I have friends who loved the same parenting manuals that tormented me; who were happily immersed in the same spiritual groups that left me confused and terrified. I envy them this freedom, though of course they are unconscious of it themselves.

At the same time, I'm grateful to know what I need to do to stay healthy. I can use this knowledge to help others with similar struggles. What's more, because I have to work hard to cultivate healthy skepticism and flexibility, I don't take those things for granted. I am keenly aware of the potential for any movement or belief system to go too far, get too extreme, because I've experienced that myself. This awareness has shaped my interest in politics and social justice, and given me a unique perspective on various cultural phenomena. Even my "normal" friends sometimes rely on me to tell them when they might be taking something too far!

So, world, here I am. No banners to fly, no labels to wear, no revolutions to start. I've learned that if I keep a healthy distance from anything too extreme, I have the freedom to learn, grow, and deepen as a person. I am free to have quiet but passionate convictions, because they are mine and no one else's. I may not be flashy or controversial, but I am happy just trusting my gut, and raising two kids who will hopefully do the same. It works for me.



Lisa Sniderman, LCSW received her M.S.W. from the University of Chicago in 2003 and has been a licensed clinical social worker since 2005. She is a past member of ETD's Mental Health Advisory Board and one of our storytellers. Click here to check out Lisa's posts.

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