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8b322fda8683331fb9e4f87a39a330daI have a friend called Rob, who suffers from what is today called paranoid schizophrenia. He was diagnosed when he was 17 or so, after a psychotic breakdown on LSD. He and I had first taken LSD together when we were 15, and it messed us both up – I had social anxiety and post-traumatic stress disorder for several years. But that’s nothing to what Rob has had to bear. For the last 20 years, he’s been very isolated by his delusions, in and out of NHS psychiatric facilities, unable to work, find a partner, or engage with society.

Sometimes he’s better, sometimes he’s worse, depending on his circumstances and his medication. Sometimes he is lost to this reality, too deep in the ocean of his own delusion and imagination. Sometimes he surfaces, and you can have a conversation with him, and your old friend is back from the depths.

At the moment he is better. I don’t know what happened, whether they changed his medication, but he’s suddenly more engaged with this reality, writing poetry, painting, reading, laughing. He’s come across CBT, and finds it fascinating. ‘You appear to me to be Lucifer’, he says to me, ‘but this may simply be a mental representation.’ Progress! Seneca thought people suffering from mania were incapable of philosophy, but what Rob is doing is, in fact, philosophy.

I suggested we get some food. What could be more normal and convivial than to go to a restaurant together. But the last time we’d been inside a pub, some months back,the landlord asked Rob to leave, because he said Rob’s behaviour were frightening for the other customers (it was really just frightening for him). Since then, we tended to sit at tables outside pubs, perched on the edge of polite society. But now Rob seemed and looked well enough for us to venture within. Rob said he knew a pizza place, so we went there.

Almost immediately, I regretted it. It was a very posh pizza place. The staff were posh. All the customers were posh. And I was embarrassed lest Rob said or did something weird. I suddenly felt acutely conscious of social niceties, as if I had to be doubly observant of them to make up for Rob’s obliviousness. I smiled extra sweetly to the waitress, exchanged some banter to show I was familiar with the social rules.

Rob picked up on my unease and, with uncanny psychic antennae, he clammed up and glowered at me. I tried to start a conversation – some sort of polite chit-chat like ‘so….er…..do you like this part of town?’ and Rob just stared at me bewilderedly. Our food arrived and Rob poured a huge amount of chili oil onto his pizza and devoured it, slice by slice, the oil dripping from his fingers, while ignoring my desperate attempts to make chit-chat. I was acutely conscious of the people sitting on our left and right. What must they think!

We finished our food, paid the bill and went outside. I have never been so happy to get out of a restaurant in my life. ‘What happened in there?’ Rob asked. ‘I’m very sorry’, I said. ‘It was a bad choice of restaurant.’ What had really happened in there was that my sense of social propriety and concern for the approval of strangers had trumped my sense of compassion and solidarity for Rob.

The mask and the shadow

Being an adult in a highly civilised society like ours is hard. It takes a lot of self-control, emotional inhibition and social tact. We have to learn, from the age of six or so, to read social situations – which can often be bewilderingly complex and nuanced – and out of the million possible ways of responding to ambiguous social cues, we have to select a good response.

Civilization is one long improv competition, on a stage watched by millions. To the best performers go wealth, status, power and sex. But those who miss their cues or disrupt the play end up isolated, unloved, ridiculed or ostracized.

s-l1000We have to learn to play a role, to ‘prepare a face to meet the faces that you meet’. And this takes a lot of effort, because it means controlling and hiding any aspects of our psyche which might be deemed primitive, uncouth, or shameful. Behind our masks there is in fact a whole jungle of psychic energy, and we have to police that jungle and make sure no wild beasts stray into view.

The polis (city in Greek) requires us to be polite and to police our inner selves and keep our daemons at bay. And the daemons of our nature resent this. Pan and his satyrs make faces at us from the wings and mutter ‘phony’. They try to put us off and trip us up, to get us to drop the facade and acknowledge them. We’re in a constant negotiation between the demands of civilisation and the demands of our inner lives.

When people become mentally ill, one of the things that can happen is that the polite mask starts to crumble. People’s ability to read social situations accurately and to respond appropriately diminishes. So does their ability to control their emotions and to hide their weaknesses. People lose the capacity to police the shame-barriers between their polite exterior and the jungle within, and our inner life starts to spill out into the outer world.

When I had PTSD, for example, I had a recurring nightmare where I was walking through a deserted zoo, and realized the cage-doors had been left open, and the wild animals had broken free. It was an expression of anxiety about my shadow-self bursting out and destroying my polite persona.

And my panic attacks and depression did in fact damage my ability to perform well socially. This was a blow to my social ambitions. It’s naff to admit it, but I was very socially ambitious, and had been since I was a child. I wanted to rise in society, as far as I could, and become a celebrated person surrounded by witty, glamorous people. And suddenly I developed mental illness, and it was humiliating. It brought me crashing back down to earth (humus in Latin). It was humbling.

To recover, I had to let go of my social ambitions, drop the mask, and try to accept myself ‘warts and all’. I had to accept my shadow, the jungle within, and all the wild animals which might emerge and upset my plans. I had to put humility and self-compassion before ambition and the approval of strangers.

One of the reasons mental illness is still stigmatized is that it is embarrassing. People with mental illness don’t always behave according to the unspoken rules of politeness. Indeed, often they crash right through those rules. This causes shame and anxiety in the people around them, because we have put enormous psychic energy into learning and obeying the rules. The mad upset the consensual fiction of social reality (unless they happen to be powerful, in which case everyone must go along with their fiction).

That’s why sometimes families in which someone is mentally ill would in the past (and sometimes still in the present) hide them away in the countryside, or in an attic, or in an asylum. To save face. To preserve the front of politeness and self-control that enables them to fulfill their social ambitions. They put the approval of strangers before compassion for their family member.

I think, somehow, email and social media makes this situation worse. It’s another arena of politeness, one with new and confusing social rules. I remember, when I had PTSD, I would often completely misread those rules, and send out long strange emails to all and sundry, thinking they were masterpieces of wit, and then wondered with growing paranoia why no one responded. My sense of appropriateness and my social negotiation with the world was way off kilter, and email and social media only amplified and publicized that fact.

How, then, do we cope with mental illness in ourselves and in our friends and loved ones? The Greeks saw it as a challenge from the gods of nature – or (in Jungian terms) from the unruly jungle of our unconscious. Madness – and the mad – are reminders of the limit of our control, the artificiality of our social masks, and the sheer unruly power of the daemons of nature to sweep away our sand-castles of social ambition. It’s a moral challenge – will you let go of your mask and have compassion for yourself, your loved ones, or the stranger muttering next to you on the bus? Or will you react with fear, shame and disgust?

I recovered from my panic attacks when I stopped freaking out over what other people might think, and said to Pan, in effect, ‘OK, maybe some people will think I’m weird, so what?’ I had to learn to accept myself and put moral integrity before the false morality of social ambition. Only then, when I sat surrounded by the rubble of my social ambition, did Pan stop sending the earthquakes. I achieved a fragile truce between my social self and the unruly gods of my inner jungle.

That challenge continues, with friends and loved ones when they suffer from mental illness. Will I get embarrassed, will I try to control them and get them to behave nicely, will I dissociate myself from them, or will I stand by them with compassion and humility? I failed in that restaurant with Rob. I put the approval of strangers before compassion for my friend.