The Role of Love in Mental Health
The one ingredient on which any recovery from serious mental illness depends is also one which, curiously and grievously, never makes an appearance in any medical handbook or psychiatric diagnostic, namely love. The word is so fatefully associated with romance and sentimentality that we overlook its critical role in helping us to keep faith with life at times of overwhelming psychological confusion and sorrow. Love – whether from a friend, a partner, an offspring, a parent – has an indomitable power to rescue us from mental illness.
We might go so far as to say that anyone who has ever suffered from mental illness and who recovers will do so – whether they consciously realise it or not – because of an experience of love. And, by extension, no one has ever fallen gravely mentally ill without – somewhere along the line – having suffered from a severe deficit of love. Love turns out to be the guiding strand running through the onset of, and recovery from, our worst episodes of mental unwellness.
What then do we mean by love, in its life-giving, mind-healing, sense?
– Unconditional Approval
What frequently assails and derails us when we are sick in our minds is a continuous punishing sense of how terrible we are. We are lacerated by self-hatred. Without any external prompting, we think of ourselves as some of the worst people around, even the worst person on earth. Our own charge sheet against us is definitive: we are ‘awful’, ‘terrible, ‘nasty’, ‘bad’. We can’t really say much more – and efforts to get us to expand in rational terms may run aground. We often can’t even point to a specific crime or if we do, it doesn’t seem to onlookers to merit quite the pitiless opprobrium we devote to it. In our illness, a primal self-suspicion bursts through our defences and overtakes our faculties, leaving no room for the slightest kindness or gentleness. We are implacably appalled by, and unforgiving of, who we are.
In such agony, a loving companion can make the difference between suicide and keeping going. Such companions do not try to persuade us of our worth head on and with cold reason; nor do they go in for any showy displays of affection. They demonstrate that we matter to them in a thousand surreptitious yet fundamental ways. They keep showing up by our bed day after day, they make pleasant conversation about something that won’t in any way make us anxious, they’ve remembered a favourite blanket or a drink, they know how to make a few jokes when these help and suggest a nap when they feel us drifting away. They have a good handle on the sources of our pain, but they aren’t pushing us for a big conversation or confession. They can tolerate how ill we are and will stick by us however long it takes. We don’t have to impress them, they won’t worry too much about how scary we are looking and the weird things we might say. They’re not going to give up on us; the disease might take a month or six years or sixty. They’re going nowhere. We can call them at strange hours. We can sob or we can sound very adult and reasonable. They seem – remarkably – to love us in and of ourselves, for who we are rather than anything we do. They hold a loving mirror to us and help us to tolerate the reflection. It’s pretty much the most beautiful thing in the universe.
Part of what can make the attentions of others oppressive is the note of patronising pity we detect beneath their apparent kindness. They – the well-ones – have come to see us in order to help, but we sense how much they cling to a fundamental difference between the mess we are in and who they think they are. We are the insane ones and they will always fly the flags of health, rationality and balance. They feel sorry for us from afar, as if we were the proverbial drowning man and they the observer on dry land.
Loving companions bear no such hints of superiority. They do not judge us as beneath them when we lie crumpled in our pyjamas at midday because they do not fundamentally see themselves as ‘above’ someone who is mentally unwell. We may happen to be very ill at the moment, but it might as well have been them, were it not for the accidents of psychology and of neuro-chemistry. They don’t oppress us by covertly clinging to their belief in their own solidity and competence. All of us are potentially ill enough to be in the asylum, and those of us who are actually there there may not be the most afflicted.
Our companions throw in little sentences that indicate that they too find life very taxing, that they too are a bit mad, that they too might one day be in our place. They don’t shed crocodile tears from an impregnable spot, they are down at our level, holding our hand, suffering with and for us.
At the heart of many mental traumas is an early experience of abandonment. Someone, when we badly needed them, was not present – and their neglect has thrown us off balance ever since. We may find it hard to depend on others in grown up life and lack faith that someone won’t run away, or take advantage of us, in turn.
A loving companion intuits this about us – and is ready to fight to earn our trust. They know that they cannot blithely assert their loyalty, they will have to prove it, which means not deserting us at moments when others would be tempted to give up. We may try to incite despair and frustration in those who offer kindness – as a way of testing the relationship. We may say some awful things to a carer we love and pretend to be indifferent to them. But if the companion is wise, they will listen and remain unruffled – not because they are weak, but because they understand that they are being tested – and that a basic piece of repair work around trust is underway.
We have to be given a chance – which we may have missed out on in childhood – to be a bit more demanding than usual in order to witness conclusively that this isn’t enough to destroy love. We can be ill and still acceptable to another. How much more real love will feel once it has been shaken by our disease – and survived.
The future for a mentally ill person is a source of ongoing and limitless torment. A thousand questions hover: what if someone gets very angry with them? What if someone wants to take them away? What if someone tries to kill them? What if the voices in their head never go away?
The loving companion does their best to quieten the panic, by presenting the future as unknowable in its precise details but fundamentally safe and bearable. They hold open options: it will always be possible to leave town, to live very quietly in a small cottage, to be at home and lead a domestic existence. No one expects them to perform great feats any more, just being is enough. There doesn’t have to be pressure to earn money, to impress strangers or to be heroic. Surviving is all that matters.
More importantly, the loving companion insists that they will be there to personally ensure that the future will be manageable. When it gets terrible, they can be in each other’s presence and hold each other’s spirits.
The loving companion doesn’t get bored of instilling the same fundamental message: I am here for you and it will be OK. Even if this OK isn’t what one would ideally want, still it will be OK, better than death – which usually remains the alternative in the sufferer’s mind. Quite how the years ahead are going to pan out can’t be determined yet, details will have to be examined later, but what is known already now is that the future won’t need to be unendurable, because there is love.
We are, when mentally ill, often extremely tedious in relation to the number of anxieties we desperately need to go through with others. We may want to return again and again to the subject of whether or not we said something terrible to someone at a party hosted by our workplace seven years ago. Or whether we might have unwittingly upset a sexual companion five years before. Or if we might go bankrupt because we didn’t warn our accountant of a small move in our tax affairs.
Loving parents know that the minds of little children are comparably filled with anxiety-inducing and sometimes peculiar questions: is there a tiger under the bed? What happens if one of the trees comes into the room and takes me away? What if someone laughs at me at school?
The temptation can be to rush and give an answer full of blustering, impatient confidence. Of course it will be fine! Nonsense there’s no tiger! And so on. But the properly loving response is to take the worry as seriously as its progenitor does – and address it head on, without scoffing or denying the scale of the concern. We might get out a pad of paper and a pen and run through all the many anxieties about work. It doesn’t matter if this is the first or the fifteenth time we have done so. Love gives us the patience to enter imaginatively into the other’s worried mind and to try to settle it by sensible examination of what there might be to fear.
We may be called upon to kill imaginary tigers night after night – and, on the floor with a torch, should always be ready to go through the many reasons why these big cats have – after all – decided to leave us completely in peace.
– Just the way you are
Many mentally ill patients have suffered all their lives from a feeling that they are not, in and of themselves good enough. They are likely to have become extremely high achievers, and have worked hard for decades, in order to prove to someone who was sceptical about them at the outset that they are respectable and worthy after all. They may have craved money and status and power to shore up a ghastly feeling of not being able to matter to people unless they had first attracted society’s baubles and prizes.
When they break down, what remains unbelievable to these exhausted warriors is that they could ever be loved outside of their performance in the worldly race. Surely it is only their earning potential that counts? Surely it has to be their popularity that matters?
But now that they are ill and without any of the usual tools to impress, the mentally unwell stand to discover a more complex and salutary lesson. According to the values they have been subsisting on, they are a disgrace and should kill themselves. But with any luck, in the presence of a loving companion, they can start to believe in something far more nuanced and miraculous: that they could be loved without prizes, that true love isn’t about impressing or intimidating someone, that an adult can love another adult a little like a good parent loves their child: not because of anything they have done, but simply and poignantly just because they exist.
– Independence of Mind
A good loving companion looking after a mentally sick friend heals through their power not to care very much about ‘what other people think.’ Of course, out there, some people are sniggering. Of course, out there, some people judge and say that the illness isn’t legitimate or that it’s deserved and that the sufferer was awful to begin with. The good companion knows enough about the perversities of the human mind not to mind in the least when they encounter everyday prejudice and meanness; daftness is to be expected. The hasty judgements of thousands of people will, of course, be askew and lacking proper understanding. But that is no reason to panic or give up one’s original analysis. Let them laugh, let them be superior, let the idiots be idiots; such are the consoling messages of love that we need to hear when we are defenceless before the judgements of a cruel world. Our loving companion know where their loyalties lie, they aren’t going to give up on us because a mob is jeering. They aren’t democrats when it comes to love. They don’t care if they are in a minority of one in loving us. And that is why we will stay alive.
– Parental Repair
Both we and our carer may be deep into adulthood, but if their tenderness heals us, it is likely to be because – in covert ways – what they are doing through their ministration is repairing a deficit of early love. They will be reparenting our broken child selves.
It’s one of the eternally paradoxical things about babies and small children that they need love as much as they need milk and warmth in order to develop properly. They need to be cuddled, spoken and sung to, played with, held close and looked at with enthusiasm – and will as good as die inside without such care. Every child needs to experience what one could term ‘Primary Parental Delight,’ a basic feeling that they are limitlessly wanted by those who put them on the earth and are capable of generating intense pleasure through their very being. Without this, a child might survive, but it can never thrive. Their right to walk the earth will always be somewhat in doubt, they will grow up with a sense of being superfluous, disruptive and, at core, unappealing and shameful.
Such emotions feed directly into a broad range of mental illnesses – chronic anxiety, self-harm, suicidal ideation, depression – all have roots in a sense of not mattering enough to anyone over long childhood years.
This defines the challenge for the carer in adulthood. Some of the work will have to involve making good an appalling failure of early provision; they will need to convince the wounded inner ill child that what they didn’t receive decades ago could still be available today; that there might still be joy, reassurance, play and kindness.
It could seem highly patronising to tell an adult that they need above all to be reparented. It’s in fact the height of maturity to recognise that the small version of us must – if we’re ever to get better – allow ourselves another chance to experience what it could feel like to matter limitlessly to a kindly and thoughtful companion.
– The Night
Way back, the night was the time when we were especially afraid, and especially needed love and reassurance. The same will be true in our periods of acute mental illness. The night will terrify us, stretching out as a vast and threatening space in which our worst fears and most critical voices will have unlimited dominion.
We need someone who can help us during these tortuous hours, perhaps by remaining awake next to us, or by sleeping in an adjoining bed or room or by giving us permission to call them whenever panic descends.
We will know we are properly loved when we can wake up at 3.30am and have the right no longer to be completely alone with our racing hearts and fearsome anxieties.
We shouldn’t be so surprised at the enormous levels of mental illness at large in society; we need only get clear how bad we collectively are at love, how poor we are lending sympathy, at listening, at offering reassurance, at feeling compassion and at forgiving – and conversely how good we are at hating, and shaming and neglecting. We consider ourselves civilised but display levels of love that would shock a primitive tribe or a den of thieves.
Furthermore, we’ve opted to wash our hands of the issue and handed responsibility for it wholesale to the scientists, as though they could culture a complete solution to mental illness through their pills. We ignore that the cure largely lies in the emotional realm: in getting better at appeasing each other’s fears, at being generous about our transgressions, at no longer tormenting and maltreating one another for our failures and at sitting together through the darkness of night in a spirit of infinite care and kindly forebearance.