In The Fray contributing writer Joshunda Sanders recently spoke at TEDCity2.0, a conference focused on the challenges and innovations that cities across the world are experiencing today. Joshunda gave a moving talk about her mother’s struggle with mental illness (a story she also told for our blog), and the ways that cities can help, and hinder, the lives of the mentally ill — particularly those who are poor and homeless.
Joshunda’s mother resisted therapy and medication for her bipolar disorder, internalizing society’s view (especially prevalent within the African American community) that mental illness is a personal weakness. In her relationship with Joshunda, she veered between euphoria and depression, loving attention and violent abuse. The family ended up homeless because of her untreated condition, and Joshunda’s childhood was marked by evictions, stays in homeless shelters, and a perpetual hunger. Fortunately, their hometown of New York was generally benevolent in its benefits and its attitude toward the homeless — providing Joshunda with free breakfast in the summers when school was out (often her only meal of the day) and free transportation to and from shelters — even though it never really met their needs for food and housing in such an expensive city.
There are compelling reasons, Joshunda adds, that so many homeless individuals congregate in cities:
After my brother Jose got killed by a bus, my mother moved to the suburbs. So we lived in Chester for the first few years of my life. Chester is outside of Philadelphia. Most families there, in the suburbs — which are considered the heart of the American Dream — had cars, but because we couldn’t afford a car, we had to rely on public transportation. Often, without carfare to get into the core of the city, we would end up languishing in the isolation of the suburbs, and it was a little bit nightmarish. Sometimes the lights would be off, or the water would be off.
And one of the things people forget is the surprising truth about the visibility of the mentally ill in cities … there are real resources for them there. It’s not just the density and public transportation, but there is also this equal-opportunity solace from the cultural vibrancy of a city. So I urge you to think about that the next time you see someone who is mentally ill in the city. Before you think of them as a problem, consider how both they, and we, are transformed by our witness of them in the city. Think of me and my mom, just two fragile souls trying to make it through the city, with what little that we had.
Here is the video of Joshunda’s talk, which begins at the 49:09 mark:
The Examined Life By Stephen Grosz
W.W. Norton & Company. 240 pages.
I didn’t expect a collection of stories about the inner struggles of psychoanalysis patients to be so much like a detective novel. Yet, in The Examined Lifeparallels abound.
Clues are uncovered slowly in each chapter and a mystery unfolds. Hidden motivations are unearthed by identifying the meaningful in the mundane. The skillful narrator walks the reader through his ruminative process of making sense of the clues. A truth is revealed that appears to have been there are along.
Psychoanalyst Stephen Grosz has penchant for storytelling. He knows when to showcase his professional proficiencies and when to let the tale tell itself. The truth, after all, is somewhere in-between.
What was your motivation in embarking on this project?
I am sixty. I have a ten-year-old daughter and a seven-year-old son. My father had two heart attacks by the time he was my age, and my mother died when she was sixty-four. If I’m not here when my children are teenagers or young adults, I thought about what I want them to know.
The thirty-one stories in The Examined Life address what I think of as some of life’s biggest problems — problems we all face. More than that, I wanted to portray a way of thinking, a disposition towards oneself and the world that might be useful to them and others. Also, psychoanalysis requires time and money, and many people won’t be able to afford it. I wanted to set down some of the important things I’ve learned in a way that may be helpful to those who are unable to have psychoanalysis or therapy.
Given that you have a twenty-five-year history to draw from, why did you choose to include these particular stories?
I chose these stories because they have a kind of urgency, and I felt I had something to say about these fundamental life issues. My patients had taught me something that I wanted to get down on paper. Of course, I also write with my patients’ privacy in mind. Confidentiality plays an important role in what I choose to write about, and how I write.
In some ways, The Examined Lifedemystifies psychoanalysis, which has become a part of popular culture — and not always in an accurate or respectable way. How did this influence the way you told these stories?
Psychoanalysis has become something of a joke in our culture. In the book, I try to set all that aside and just give a simple picture of what psychoanalysis really is — and what actually happens between an analyst and patient.
The truth is, the people who come to psychoanalysis are in pain, and usually part of the pain is that they can’t articulate it well. They don’t have a way of telling their story. The author Karen Blixen said, “All sorrows can be borne if you put them into a story or tell a story about them.” But what if a person can’t tell a story about their sorrows? What if the story tells them?
In my work I try to hear the story my patient cannot tell and then to help them to tell it. To me, all the highfalutin psychoanalytic language — which is not in my book — is a diversion from the directness of our speech. So, I try to tell stories I think are important as plainly and directly as possible.
Change is a recurring theme in the book. People come to you because they desire change, because they have experienced an unanticipated or undesired change. People resist change. People succeed and don’t succeed in making changes in their lives. Does hearing other people’s stories of change make it easier to do so ourselves?
“I want to change, but not if it means changing,” a patient once said to me in complete innocence. Change is difficult for many reasons. One reason people resist change is that all change requires loss. This can be hard to see, and even harder to accept. But there are many things that help us to change. I believe one of those things is hearing other people’s stories.
Some stories touch our heart. A good story can help us to think differently. Cheryl Strayed’s Wild, Katherine Boo’s Behind the Beautiful Forevers, Andrew Solomon’s Far From the Tree — these recent books made me think differently. If you are able to think in a new way, you can act in a new way. Thinking differently is the first step towards change.
As I wandered around a local craft festival last November, my mind was on my seven-month-old niece. I wanted to give her a Christmas gift that was thoughtful, soft, and sweet. When I’d almost given up hope, I spotted a small stand outfitted with handmade stuffed animals that, upon further inspection, were all velveteen. This, I decided, was the softest, sweetest thing I could give my baby niece.
I picked out a gray rabbit with long, floppy ears. I envisioned the little girl snuggling up to her new sleeping companion, a subtle yet constant reminder of her loving aunt. Unfortunately, this idyllic picture would not come to pass. A few weeks after I bought the bunny, I got a phone call from my brother that irrevocably changed our relationship.
The days leading up to the call had been sleepless and emotional. My brother disappeared for three days, leaving his pregnant girlfriend in a state of panic. She and I were in constant communication, and feared something horrible had happened when my brother didn’t answer his phone and was nowhere to be found. He had left late at night, saying he had an errand to run, and no one had heard from him since. The thing is: this wasn’t the first time this had happened. Actually, it happens all the time because my brother is an addict.
When he re-emerged, my brother called me and acted as if nothing had happened. His girlfriend and I, he insisted, were simply overreacting. I couldn’t pander to his addiction-driven whims anymore, but I didn’t want to turn my back on my family. I didn’t want to give up hope that my brother could get clean.
I tried to set healthy boundaries by telling my brother I was worried about his well being. I tried to make a plea for the safety of my niece. Within moments, our conversation exploded. My brother yelled. I yelled back. He said I was unlovable. I called him a junkie.
Accusing an addict of being an addict is a surefire way to end a conversation. But I was so tired of feeling taken advantage of. I was through with my brother’s lies and enduring his verbal abuse. There is a particular exhaustion that comes from fear-based worry, a specific kind of anxiety that manifests during the hours of wondering when the phone will ring with the news of my brother’s self-imposed death. Desperate to make this misery end, I told my brother never to contact me until he was ready to seek treatment.
I drew a line in the sand, so my brother drew one of his own. He cut me out of his life completely and banned me from contacting his children. He warned that if I sent Christmas presents, he would burn them. And I knew I should believe him.
When my brother hung up on me, my heart broke open and filled with regret. Although I knew I needed to look after my own emotional health, I couldn’t shake the feeling that I’d made a grave mistake.
Instead of ridding myself of the unhappy relic, I kept the velveteen rabbit in a bag near my bed. The tender toy was a sad reminder of the ways my family was disappearing. Two years before, my mother died suddenly of a heart attack after spending her final years in a state of depression I knew intimately, but didn’t know how to address. In the midst of my grief, my older brother’s alcoholism proved too much for me to handle. One day, we stopped speaking and still haven’t reconnected. I found it excruciating for my intimate world to be shrinking so quickly, but then something happened that changed my perspective.
While writing a magazine article on addiction and rehabilitation, I discovered a program that had been operating discreetly in my hometown in California for almost thirty years. Located on a tree-lined street in Downey, a small Los Angeles suburb, Woman’s Council is an outpatient rehabilitation program for mothers for whom treatment of active addition is a court-ordered condition to regain custody of their children — and it was changing lives.
When I visited Woman’s Council, I had already spent three months observing Narcotics Anonymous and Alcoholics Anonymous meetings, visiting recovery centers around the city, interviewing recovering addicts, and speaking to counselors and medical professionals about the process of getting clean. But my first encounter with this program blew me away.
Sitting around a circular table, women gathered four times a week to share their stories, vent their frustrations, investigate their personal psychological triggers, and purge themselves of their chemical demons. During each woman’s time to speak, she revealed every hardship and heartbreak, every triumph and tragedy she had endured that lead to current circumstance. The group was facilitated by trained counselors who had their own experiences with addiction, and they provided guidance on how they overcame their own challenges early on in recovery. Despite participation being mandated by the judicial system, the women I spoke with all reported that the program was crucial to their well being.
Week after week, I sat silently in that meeting room and took notes on a legal pad. Although I tried to maintain a professional distance, at times I had to excuse myself and run to the bathroom before my sobs broke through. As I gasped for breath in the stall, a series of emotions ran through me: devastation at the horrifying misfortunes these women had endured, anger at the trauma their addictions had brought upon their children, sorrow for my brothers, myself, and my family. But I always returned to the room with as blank a face as I could muster and forced myself to listen more.
I knew something powerful was happening in that room because something powerful was also happening to me. In empathizing with the mothers in Women’s Council, I was learning how to empathize with my brothers as well. I was beginning to understand the stigma of addiction and how cycles of abuse get perpetuated. Having myself abused drugs and flirted with disaster in an abusive relationship, I saw that the biggest thing distinguishing me from these women was that I’d had a little more luck.
When my article was published last December, I gave the velveteen rabbit to a woman named Nicole who I’d met at Women’s Council and had an daughter named Sofia who was the same age as my niece. Despite it being an unceremonious act of giving, I felt extremely moved by the exchange and became the Women’s Council’s first regular volunteer. I jump in where ever I am needed, cooking food for the graduation ceremony or helping with administrative tasks. My hope is that I can make a difference in the lives of these women in a way I wasn’t able to in my own family.
Before I began volunteering, I had to sit with my family experiences as though they were secrets. I still haven’t reconciled with either of my brothers. But now, whenever I enter the Women’s Council building, their lives and mine make a little more sense and are less cruel in equal proportion.
Obsessive-compulsive disorder dominated my life until the birth of my child pushed me to find sanity.
By Abby Sher
Abby and Sonya.
From the time she was born, my daughter Sonya has watched me kiss our mezuzah one, two, sometimes fifty times as I walk through our apartment door. I kiss that prayer scroll before I kiss her, most often before I even say hello. She also knows that Mama prays once a day, which means I go into our basement with a candle, and no one disturbs me for thirty minutes.
“Why Mama pray?” my four-year-old Sonya asked last week.
“Because she has to. Because she wants to. Because — I’ll be back in a little bit.”
I’ve been in treatment for severe obsessive-compulsive disorder for most of my life. I’ve cut myself, starved myself, and scrubbed my hands raw. Daily prayer is the one healthy practice I’ve kept the longest, and it’s grounded me when I feel most unmoored. It’s also been the hardest to explain.
I had a mezuzah in the house where I grew up, but I never saw my parents kiss it. We belonged to a Reform Jewish synagogue and had chicken soup and challah for Shabbat every week. My mom taught my brother, sister, and me to say the Shema prayer before bed each night. It gave closure to each day and made my mom smile, and that was all I needed.
But soon one Shema wasn’t enough for me. When I was eleven years old, my aunt and father died in quick succession. I was sure I’d made them die, and I had to atone before I struck again. After Mom tucked me in, I added five, ten, twenty recitations of the Shema, a song of thanks, and a list of sick people I needed to heal. I remember nights when I woke up frantic and hot, furious that I’d fallen asleep despite more prayers to say, more kisses to blow to the heavens.
Did I do it right? Did I do it enough? Did I sound devoted? Did I please Him?
In high school I snuck into dark closets — not to kiss boys, but to chant Psalms. I went on medication briefly in college, but took myself off for fear it was blasphemous, and my mom would die next. When I moved in with Jay, who is now my husband, he watched me kiss my mezuzah urgently.
“I wish you felt like you had to kiss me 250 times when you walk through that door,” he said sadly.
My prayers got longer, my lists and songs multiplying. If Jay wanted me, he had to accept my beliefs without question.
Our daughter Sonya was born on October 5, 2008. As I lay with her slippery skin pressed to mine, I knew this would be the scariest day of my life. It was the first day in twenty-five years that I ever willingly skipped prayers. There was no place to cloister myself in a shared hospital room, much less with a seven-pound newborn mewing for milk. Sonya was someone I had to take care of with my hands, instead of with my pleas.
I looked through the hospital window and smiled shyly at the sky. I wanted Him to know I was so wildly grateful for this child that no words could suffice. I held Sonya tightly and babbled at her to fill the empty space of my fear. I could no longer try to control the universe from behind a closet door. I was a mother with vital responsibilities.
Those first twenty-four hours were a terrifying relief. As it turns out, no one died because I skipped my prayers. But the bliss of those first coos and milky grins soon hardened. On the fourth day of Sonya’s life, I left her upstairs with Jay while I went down to our basement and sat on a pillow, sore and shaky. I wanted desperately to thank Him for this miracle, to pray with an honest, open heart. No mindless repetitions and rituals would suffice. I was too evolved, too in love with this new human to simply follow a pattern blindly.
Yet, motherhood could never be a remedy for a mental health disorder. Everything about being a new mom felt groundless and out of control. I left Sonya in Jay’s arms each morning so I could pray regularly, insistently.
My life outside the basement became a series of new, unwavering practices too. Repetition was supposed to be comforting for children, I reasoned. Every evening, I massaged Sonya’s toes and sang a series of lullabies. When I felt too exhausted and cut off a verse, the tug of fear closed in.
If I don’t sing to her, I’m unfit to be a mother. If I don’t beseech G-d, Sonya will disappear too. Cradling my daughter fiercely, I read the same book in the same cadence night after night for an entire year:
Somehow the soothing part got away from us. Sonya wasn’t following my lead. She fell asleep in the middle of a meal or refused to nap in her carrier. One night I tried to light the Shabbat candles with her, and she banged on her high chair howling until I blew them out. She had her own rhythm, her own needs, and they were completely out of sync with mine.
Each time she squirmed away during the massage, I pinned her down and started again, both of us whimpering. I coped in the only way I knew how — by adding more ritual and repetition. Sonya followed my lead, running headlong into the spiral I know too well.
Our bedtime routine turned into a one-act drama: kisses on her toes and lotion on her belly. A review of her day and an outline of how her sleep would unfold with fairy-tale dreams. After two books and a cup of water, turn out the light and tell a story. Walk to the crib, press play on her lullaby CD, then one kiss for Waldorf (her toy duck), one kiss for Pepto (her toy pig), and one kiss for Sonya.
We added a kiss for each palm, in case she got up during the night and needed another. Then there was the butterfly kiss and the kiss through the bars of her crib. Finally, there was the kiss called Last Kiss. We said (in unison) as we leaned in to touch lips, “I love you I love you I love you I love you I love you.” Five times. A tight, fast hug. Then I would close the door to the sound of her wails.
Sometimes I didn’t even make it out of her room before she started crying. I pulled away from our goodnight hug just in time for her to yell into my face, “Lastkisslastkisslastone!”
With her tiny shoulders hunched and her lips pinched, she panted as if being hunted by wildebeests. I explained firmly, “We just did a last kiss and a last hug. Three of them, actually.”
“Last ooooone!” she moaned.
“Last one,” I repeated.
I leaned down to give her one more. But she still screamed as I left.
Some nights I went up there three or four more times, trying to slay both our demons. Other nights I sat at our kitchen counter and came up with all the fatal illnesses she could have.
Hours after I’d been up, I heard her whimper drowsily, “Lastkisslastonelast …”
The crucial task left unfinished.
I worked with my doctor, tried new medications and breathing exercises. I started with a cognitive behavioral specialist and added exposure to my therapeutic tools. As always with obsessive-compulsive disorder, it took lots of lurches and stumbles to get to more stable ground. I knew I was working not only for myself, but for my child too.
There did come a day — not too long ago — when I was able to tuck my daughter into bed, read her two books, sing her a lullaby, and simply walk toward the door.
“Wait!” Sonya yelped. “Last —!”
“If you say last kiss, it has to mean last kiss,” I said calmly. “Otherwise it’s just words.”
“But that kiss wasn’t a good one it was —”
“Stop.”
I cut us both off. We waited in the dark, hearing each other pant. Then I landed a question: “What do you think happens after last kiss?”
This was the open-ended unknown she had witnessed in me every day. The tension and also the hope.
Sonya thought for a moment, and then said, “Mama go to sleep and have cup of tea.”
“Exactly,” I told her proudly. Chronology was unimportant. It was her trust that meant everything. We were both here for each other, the world would keep spinning, and it was safe to close our eyes.
From Metta World Peace to Rudy Eugene, African Americans confronting mental health challenges are often portrayed as isolated examples of crazy or deranged people rather than members of a marginalized community suffering an illness. Beyond the black blogosphere and social networking events, the dismal state of black mental health treatment and awareness hasn’t been adequately covered by mainstream media.
Journalists, writers, and experts cite many reasons why mainstream media doesn’t cover African American mental health responsibly or consistently. Among them are racism, lack of context about how African Americans interact with the health care system, and stigmas that remain entrenched in the black community and discourage those who struggle with depression, schizophrenia, or other mental health problems from discussing them. Rarely do mainstream media outlets have the luxury of assigning a reporter to cover only mental health since most are now responsible for several beats simultaneously.
“Mental health in general has been a sub-beat in the mainstream media,” says journalist Amy Alexander, coauthor of Lay My Burden Down: Suicide and the Mental Health Crisis among African Americans. “It used to be that no one would write about mental health, and the way it would be covered would be piecemeal in the context of a report coming out from the Centers for Disease Control [and Prevention] or the National Institutes of Health. Or you would see a story pop up around a horrific event.”
Since Alexander’s book was published, little has changed. The bizarre case of Rudy Eugene, an African American in Miami who chewed off a homeless man’s face in May before being shot to death, made “bath salts” a buzz phrase nationwide. Eugene took his clothes off along the MacArthur Causeway from Miami Beach before attacking Ronald Poppo in what the Miami Herald called a “ghoulish, drawn-out assault in plain view on a city sidewalk.”
The head of the Miami police union publicly speculated that “bath salts,” synthetic stimulants believed to be the cause of psychotic episodes elsewhere around the country, prompted Eugene’s actions. But, according to the Miami-Dade Medical Examiner’s office, only marijuana was found in his system.
More likely, Kristen Gwynne wrote for Alternet, is that Eugene had a history of mental illness. “But pinning a tragedy to a drug scare is easier (and perhaps more lucrative) than explaining a nonexistent safety net for the mentally ill,” she wrote. “Bath salts, the mainstream media naively believes, can be banned and eradicated. Treating mental illness is a far more complicated story.”
Other than sensationalized portraits of individuals, the only consistent coverage of mental illness in the black community focuses on the psychological fallout of depression and other mental health issues facing black celebrities. These portrayals are opportunities for mainstream media to explore larger questions about the escalating suicide rate among black men, the entrenched stigma of appearing weak and vulnerable in the black community by seeking help, and the dearth of African American mental health professionals. Journalist and author Ellis Cose says these examples explore “celebrities much more so than the black community.”
Even when the topic is more about black celebrity than race, mental illness, particularly in famous athletes, is viewed as “evidence of a criminal character,” says David J. Leonard, author of After Artest: The NBA and the Assault on Blackness and associate professor in the Department of Critical Culture, Gender, and Race Studies at Washington State University.
“Media go immediately to focusing on the purported pathologies of the players themselves and don’t want to see what the broader context is,” Leonard says. “The history of race and mental health is a history of racism and the white medical establishment demonizing and criminalizing the black community through writing about their ‘abnormal personalities’ and being ‘crazy.’”
That history plays out in mainstream media coverage, but it also affects public discussions about mental health because it has so often been used to justify exclusion, segregation, and inequality in mental health treatment for African Americans. Recently, Bassey Ikpi, a writer and blogger working on a book about her bipolar disorder diagnosis in 2004, founded The Siwe Project, a global nonprofit for African Americans to share experiences about mental health in the black community. On social networking sites such as Facebook and Twitter, African Americans worldwide share stories of navigating mental health in a culture that actively discourages blacks from seeking talk therapy, Ikpi says.
At least partial resistance to mainstream reporting on black mental health is tied to blacks’ historical stoicism and belief that religion can serve as a substitute for professional therapy or, when necessary, medication.
“We have survived Jim Crow, beating, lynchings, and fire hoses,” says Mychal Denzel Smith, a mental health advocate, commentator, and writer. “We pride ourselves on strength. I spoke at a high school, and the teacher said, ‘Black folks just don’t have time to be depressed.’”
The Siwe Project is an important starting point for conversation outside mainstream media about the importance of self-care, Smith says.
“It’s about taking control and being proactive in defining our narrative for us instead of waiting for other people to do it. We know that there’s something wrong in our community. We have to be more proactive in addressing these issues and making sure that we take our health into account.”
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In The Fray contributing writer Joshunda Sanders recently spoke at TEDCity2.0, a conference focused on the challenges and innovations that cities across the world are experiencing today. Joshunda gave a moving talk about her mother’s struggle with mental illness (a story she also told for our blog), and the ways that cities can help, and hinder, the lives of the mentally ill — particularly those who are poor and homeless.
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