Legion and a Correct View Towards Mental Illness

David Haller and Lenny Busker, aka. Amahl Farouk, The Shadow King

David Haller and Lenny Busker, aka. Amahl Farouk, “The Shadow King”

“That’s the trick, the mind-killer; your disease convinces you you don’t have it.” – David Haller

When Legion premiered on FX this February, critics were quick to deride its interpretation of mental illness. Early reviews jumped to conclusions of the show’s “mental health shaming” by trivializing it or using it as a cheap narrative tool to talk about superpowers and comic book absurdities with the fake veneer of something more adult and mature. Perhaps that’s true if you sat through the first couple of episodes and then got so offended that you refused to keep going.

The opening shows David Haller grow up as a troubled teen who later attempts suicide. We then see Haller in a mental hospital produced as a sort of highly medicated prison rife with unhelpful therapy sessions, a montage of pills in cups, and unnervingly dangerous looking or totally comatose patients leading completely unproductive and secluded lives in an environment pulled straight out of One Flew Over the Cuckoo’s Nest via A Clockwork Orange (and the place is called Clockworks interestingly enough). As the first episode progresses, we learn that David is retelling the experience at Clockworks to a government agent who is investigating the extent of telekinetic powers they believe David has on behalf of something called Division 3. Their goal is to determine the extent of those powers and then to control them, or use them. The first episode ends with an action packed rescue from a group of mutants who are hidden in a retreat called Summerland. We later learn that they are protecting mutants from Division 3. The story is straightforward enough, but what happens inside of David’s head is not. Right when the viewer is convinced of one set of facts about what is real, the next episode opens with another version of something whether it’s the image of a leisure suit clad Jemaine Clement trying to explain some out-of-place philosophy while seated in a giant ice-cube or everyone in Summerland seated in Clockworks in the middle of a therapy session. In every episode we have to start over which is why the early criticisms were so wrong about what was really happening.

Throughout the show, David exhibits symptoms of a schizoaffective disorder. He hears voices, can’t distinguish between reality and mental projections, he’s paranoid, and talks to a series of characters that only he can see. He is ashamed of all of this and believes he is crazy no thanks to Clockworks reinforcing that belief. But we are presented with the idea that he is not insane, and rather has extraordinary mental powers that he has only confused with a mental illness because he can’t control them. Summerland is there to help him understand that he is not insane, but truly very powerful.

The first metaphor for mental illness we are presented with is “you are not sick, but unique and gifted.” This is a well-trodden path in the X-Men comics, the world from which Legion derives. In the comics, David Haller is Professor X’s biological son who he gave away at birth. There, David deals with dissociative identity disorder (split personality) where each of his mental powers takes on a different identity in his head. A major draw for kids to the X-Men is that in the mutant world the thing that makes you feel different or odd is also the thing that makes you special. People will always find a way to exclude. Foucault argued that the age of reason saw the confinement and casting out of the mentally ill or “mad” from society through political and social mechanisms which only lends mental illness a perfect canvas on which to paint the X-Men mythos. Even if having really amazing powers that should astound people can make you an outcast, think of all the little things about you that don’t conform to the world that will cause people to exclude you. The solution: find other oddballs, be yourself, and cherish your uniqueness in the world in a healthy community that respects you.

I get it. If Legion stopped there, it would sanitize mental illness with a nice message for kids struggling to fit in, but would be a weak exploration of the issue for a decidedly grown-up audience. It cleanses mental illness to where it does not really harm us, but makes us stronger. It’s a nice, temporary coping strategy, but it hardly respects the reality that metal illness can kill you if you don’t do something about it.

Thankfully, the story doesn’t stop there. We learn that David didn’t know he was adopted, his sister kept that secret from him, and even if all of his mental illness was just a manifestation of his powers, he still had to work through all of the same issues that any person with schizophrenia would have to work through. He still has issues that he has not worked out and they keep manifesting themselves throughout each episode. And then it goes one level deeper. What we learn is that David’s cohort of imaginary voices – a beagle, a creepy children’s book character, a blob with yellow eyes, a frenetic woman named Lenny Busker who goads him to misbehave – are all manifestations of the thing from which Professor X tried to hide him – the powerful mutant Amahl Farouk also called the “Shadow King.” This being lodged itself into David’s brain when he was a baby in order to siphon off his power until the day when he could overtake David’s whole mind and body. The cause of David’s mental illness symptoms is not something that is naturally part of him – it is a parasite.

Health comes from overcoming the struggle and that means not identifying with one’s mental illness.

This is the grownup moment in how the show deals with mental illness. No responsible psychologist or psychiatrist should ever tell you that to treat a mental illness you should just take drugs and accept it as a part of your identity. They will tell you that you also need to be social and find a community of healthy friends, eat a healthy diet, get some exercise, and sleep among other strategies like meditation or yoga. Cognitive Behavioral Therapy (CBT) teaches you strategies to mine your brain for those negative messages that you tell yourself and rather than accept them, reverse them and change them through action and practice. It’s like playing table tennis against a champion. You need to learn how to return the ball and reverse its spin in order to keep playing the point. This requires practicing a set of learned skills. It’s difficult. But make no mistake, mental illness is an opponent in your mind and body that you have to work hard to compete against daily in order to be healthy and happy. The struggle with mental illness should always be a temporary event like a runner who struggles with soreness and exhaustion or a scientist who needs to step away from an experiment that keeps failing in order to let it all simmer for a new insight to emerge. Life is never healthy when it is a constant struggle. Health comes from overcoming the struggle and that means not making one’s mental illness the core of one’s identity. Counselors want their patients to get to a point of accepting that they have a mental illness rather than they are identified by their mental illness.

One method of therapy similar to CBT is centered around “self-directed neuroplasticity.” In short, this is grounded in the theory that patterns of thinking and action not only change habits of the mind and body, but literally transform synaptic patterns in the brain. Therapies have been developed around this theory grounded in research at UCLA and the clinical data supports it as a way to think and act your way our of destructive patterns of behavior. Clinicians have used this method to treat patients with even severe OCD issues. What emerges from these therapies is a focus on retraining the brain and body to act in ways counter to their mental illness symptoms in order to produce healthier, happier, and more whole people. No mental illness is permanent in the way that it currently is believed to exist in the brain. Also related is the argument that emotions are not hard-wired in the brain and sit there latently until some external stimulus provokes each of them into being. Rather, a more nuanced theory is that emotions develop as concepts that we learn to associate with certain stimuli. This view, supported by research from Lisa Feldman Barrett of Northeastern University, means that we have far more control over how we feel the world around us and how we make sense out of those feelings. What we believe literally shapes our feelings, relationships, and perceptions of the world. Correcting beliefs that produce unhealthy feelings and behaviors can change much of how we understand mental health conditions even when some of those symptoms benefit from medication.

Those times when I least want to do the things that will make me the most healthy are the most important times to do them.

As someone who has had a mental health diagnosis, I understand that interpreting mental illness as an immovable facet of one’s identity is both alluring and destructive. It’s nice to know that others struggle with it and that you are not alone. But accepting constant struggle as something permanent is a miserable way to live, if we can call that living at all. At the root this is a belief that produces learned helplessness, and it’s not true.

After many years of struggle, I refused to continue to believe that I had to accept my illness as a part of my identity. But I had to change my thinking and my behaviors dramatically in order to reverse the spin. It required patience and discipline to develop a new set of habits. I was playing table tennis with a master of deception and I had to study all of the things that made it powerful. I had to practice new ways to challenge the messages it was tossing at me knowing that early on it would be difficult. But with enough time and practice I would eventually master it. I had a parasite in my brain. It was my Shadow King, my Amahl Farouk, my Lenny Busker. Cunning, deceptive, and powerful with years of practice, I had let it kick my ass. It was only when I accepted that I had something in my brain that made me unhealthy that I learned a set of strategies to make me healthy.

This is why I identify with David Haller’s narrative arc of mental illness. But unlike Haller, I can’t just trick my unfriendly mental resident into leaving. It lives there permanently and even though I know how to lock it away in a tiny little corner where it won’t bother me, once in a while I forget to check the locks on the door and it sneaks out. So I will run, sleep, eat healthy, spend time with healthy people, walk the dog, get some sunlight, clean my living space, etc. This toolbox of strategies that I have found to work are my ways of reversing the spin on the ball and acing the serve almost every time. To be healthy, I need to accept the challenge, play the game, and win. There are many times when I don’t want to play table tennis with this parasite, but I have to do it anyway. Those times when I least want to do the things that will make me the most healthy are the most important times to do them. When I do, I kick its ass and it leaves me alone for a good while. Not accepting a mental illness as a natural part of my identity took patience and discipline to achieve and it was, and still can be, exhausting. But I have tried all of the alternatives and they just don’t work. What I know for sure is that identifying with the very thing that makes me sick is about as unhealthy a strategy I could ever devise. I wouldn’t do this with pneumonia. Why would I ever do it with Bipolar II. Kudos to Legion for getting it right.

Guns and Mental Health

Numbers to chew on in the wake of another school shooting:

  • 70% of all homicides are firearm related.
  • There are about 26% of adults with a diagnosed mental illness.
  • 6% have a “serious mental illness.”
  • Only 3% have a serious mental illness and are not institutionalized.
  • Violence is not even a symptom of something like schizophrenia. Mentally ill people are most likely to harm themselves by an overwhelming margin. Suicide is the most lethal form of violence.

Yes we need better attention to mental health care. But no, this will not make a dent in gun violence. The numbers just don’t support witch hunts for the mentally ill as a solution to gun violence. The beast to slay is looking at how to cut down on homicide in general.

  • Young men between the ages of 25-36 are doing 95% of the killing.
  • 99% of killings occur away from school grounds.
  • American children die from gun inflicted wounds in the US up to 12 times more than in other industrialized nations.
  • The US has the highest child poverty rate among the most industrialized nations.
  • Drugs, poverty, unemployment, race, culture, gender inequality, and weak social systems and support are ALL correlated with different forms of homicide.

None of these data are new!

No folks, more guns won’t solve the problem. Following the example of other nations that seem to have found ways to solve the problem will. Finding ways to reduce economic inequality and poverty are two huge factors to mitigate gun violence. We can also focus on harsher penalties for breaking gun laws if we actually enforce them. But that is a band-aid for a massive social sickness in the US. As we become poorer and more afraid of people taking our liberties and stuff (real or imagined), this violence will continue.

Equality, health, and education can overcome violence.

Those who want more guns on the streets and who are also cutting funds to education are partially responsible for the disproportional rate of homicides by gun violence.

Hiding in Plain Sight: College and the Mentally Ill

Stigma and mental illness

There are students in deep pain and struggling with emotional problems and mental disorders all over college campuses.

Most of us have no clue who they are.

As Kay Redfield Jamison, co-Director of the Mood Disorders Center at Johns Hopkins University, recently said to a group of Northwestern University Students:

“No one noticed that I was in any way different,” Jamison said. “I had no idea how I managed to pass as normal in high school, except that other people are generally caught up in their own lives and seldom notice the despair in others if those despairing make an effort to disguise their pain.”

Jamison is not only a leading scholar of mood disorders, she is also diagnosed with bipolar disorder. She wrote her story of suffering, recovering, and managing her own illness in the book An Unquiet Mind.

If we sense that something is “wrong” in someone’s behavior, the attitude of the “rugged individual” might take over.

If only that person would just be happier, calm down, keep their mouth shut, stop being so impulsive, stop being so rude, or stop being so quiet and awkward. Mental illness is just a phantom problem. It’s really an issue that the individual must resolve on their own. If people would take more responsibility and just act differently, all would be ok.

A few facts:

  • Public rejection of the mentally ill is far more common than not. Socall & Holtgraves (1992) argued that “a mental illness label, regardless of a person’s behavior, can result in public rejection” (p. 441).
  • Stigmas about mental illness seem to be widely endorsed by the general public in the Western world” (Corrigan & Watson, 2002).
  • A CDC report (2012) found that while most adults believe treatment of mental disorders is effective, less believe that people are caring and sympathetic to people with mental illness.
  • Coverage of mass shootings and the near immediate link to mental illness do not help public sentiment towards the mentally ill. Rather, in a study published by the American Journal of Psychiatry (McGinty, et. al., 2013), “The stigmatization of people with mental illness may lead to a reluctance to seek treatment or raise other barriers to care” (Barry, 2013).
  • Those with mental illness may internalize public stigma and as a result will be less likely to self-disclose their problems. This is in spite of the growing body of research showing that self-disclosure has positive effects for the mentally ill person and to reduce public stigma (Hyman, 2008).

Disclosing a mental illness is a big risk. If one encounters public stigma about a mental illness the results can damage reputation, employment, friendships, etc. Even if these are not facts, the risk of further alienation is a problem that most of the human race would rather avoid.

For those who aren’t even sure that they have a mental illness but just feel different about the world and their identity, reaching out for help might be compounded by all of these factors. They will go undiagnosed and untreated for illnesses that they have no personal power to manage without help.

When we bring these issues into an environment where often thousands of young adults live, work, and play together it can be a cauldron mixing together a dangerous brew. When we add substance abuse to mental illness the problems worsen. It is then that violence is more likely. More students may bring their drug habits on campuses that started in high school. Add to that fact, 80% of college students will drink and half of those will binge drink.

Students need to feel safe in order to self-disclose that they have either been diagnosed with a mental illness or feel that they might have something wrong. College is a petri dish of social experimentation and dysfunction and mental illness is just not a good fit.

The environment must do a better job of reducing social stigma and giving the mentally ill a safe space. Colleges have made a strong effort to give women and minorities a safe place on campuses, and it is time for them to do the same for those with mental illness if anything is to improve.

Jamison spotlighted Harvard’s improvement in mental health services as an example of the important role universities play in advocating for students.

“I think if (support) does not come from the president’s office, you may as well kiss it goodbye,” Jamison said. “The president’s office has to take this really seriously, and commit money to it, and time.”

___________________________________

Sources:

Barry, C. (2013). Media coverage of mass shootings contributes to negative attitudes towards mental illness. In Johns Hopkins Bloomberg School of Public Health. Retrieved 10/09/2013, from http://www.jhsph.edu/news/news-releases/2013/webster_mass_shootings_mental_illness.html.

Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, National Association of County Behavioral Health & Developmental Disability Directors, National Institute of Mental Health, The Carter Center Mental Health Program. Attitudes Toward Mental Illness: Results from the Behavioral Risk Factor Surveillance System. Atlanta (GA); Centers for Disease Control and Prevention; 2012.

Corrigan, P., and Watson, A. (2002) Understanding the impact of stigma on people with mental illness. World Psychiatry. February; 1(1): 16–20.

Hyman, I. Self-Disclosure and Its Impact on Individuals Who Receive Mental Health Services. HHS Pub. No. (SMA)-08-4337 Rockville, MD. Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2008.

Socall, D., and Holtgraves, T. (1992). Attitudes toward the mentally ill: The effects of label and beliefs. The Sociological Quarterly , Vol. 33, No. 3 (Autumn, 1992), pp. 435-445.

My Education: My First Manic Episode

My first manic episode happened during finals week in the middle of my M.Div. program. I may have slept 10-12 total hours that week. I didn’t know I was manic, I just knew I felt great and was getting a lot of shit done.

One of my buddies down the hall had an espresso machine. A couple of times that week we shared a demitasse or two in the wee hours of the morning. I tried to go to sleep but couldn’t.

Bipolar I types can go so off the rocker that they may be found running through the streets naked, have both auditory and visual hallucinations, and exhibit many signs of paranoid schizophrenia. Then they have a hard and deep crash which is where suicides can occur. If you make it out alive hammered up the scale like the ball of a high striker strong man carnival game only to come down again.

My type, called Type II, is a little less obvious and a little more insidious. My highs could get just high enough that I forgot about sleep, I got hyperfocused, and behaved more like someone with an acute ADHD episode. I’ve had debates about abstract postmodern philosophy while chain-smoking and drinking gin with a touch of tonic. I am not sure what meth is like, but it looked like a scene in Breaking Bad where Badger and Skinny Pete debate critical differences between zombies.

The lows just suck. They last longer and go a tad deeper. On either side of the fence, sleep can help solve a lot of the roller-coaster ride along with an effective medication cocktail.

During my entire experience at Princeton Theological Seminary I had several highs where I studied like a mad man and wrote papers that were much more detailed and researched than they needed to be. I remember writing a paper on St. Augustine’s influence on St. Thomas Aquinas’ understanding of evil. I followed St. Thomas’ doctrine of evil through the entire Summa Theologiae  in a matter of a month. For a 15 page paper, I wrote 30. I took the class pass/fail just so I could go all out. Who does that?

I also wrote a 180 page thesis in a week. I would sit and write up to 30 pages in a day, forget about sleep, skip meals, get jacked on coffee and just work. I would go to my little job sitting at the Continuing Education building and work there too. If that wasn’t enough, I had a few finals to prepare for at the same time. I got it all done, and scored all A’s. The fact that I did all of that makes me anxious and kind of freaks me out a little.

What is most profound is that neither I nor anyone else saw it as strange. My then wife would call me up to remind me to eat. Even in college I would be hyperfocused on something so much, a party that literally happening around me could not distract me. I wore hypomania as a badge of honor, but it would catch up with me one day. I’ll leave that for another story.

If you want to learn more about this illness, this is a nice little article that quotes a very good source from Johns Hopkins University.