Versión en ESPAÑOL aquí: ‘¿Cómo vas de salud? ¿Y de salud mental?’

In this tsunami of shocking war news, heat, and stifling pace, our inner child may have helpful things to tell us.

(long article ~15 min read)

Climate crisis, wars and viruses, slap our minds to exhaustion, hardly allowing us to act and what is worse, barely giving us time to get bored or even to think. Our capacities can be diminished and affected, our social relationships are increasingly exposed and tied to the digital world, and our workforce is subjected to high demand levels, often entering risk levels. All this can generate a kind of ‘perfect storm’ in which our mental health can suffer. The best example is a fact: according to the European statistical portal Eurostat, 7.2% of the European population suffers from chronic depression.

The famous English businessman Richard Branson, in several of his books, before all the chaos generated by running a company, alludes to enjoying and having fun along the way, having dreams and trying to tame your fears. It is evident that there are only a few like this in the world, and that the conditions of each one are very different, and that most of us cannot have fun like Richard Branson and cross the Atlantic in a balloon breaking some world records with this means of transport. But I do believe that each one can enjoy certain things in their own way and in their context, and that this can come in handy to counteract certain day-to-day grievances. In line with what happened recently with the Prime Minister of Finland.

As a clarifying note, I want to stay away from the positivism of ‘if you want, you can’, since this can destroy some heads, it is simplistic and almost a lie, which does not mean that we should not evaluate options and alternatives, try things and strive to achieve those that we see fit.

From psychology, this concept of doing things with implicit enjoyment is approached from a 100% scientific perspective. One of the paradigms is the famous concept of the ‘inner child’.

Forensic and clinical psychologist Stephen A. Diamond, with more than 20 years of work in the San Francisco Bay Area and since 1999 working as a psychotherapist in Los Angeles in the Beverly Hills area, writes:

In his therapies, he advocates learning to relate to the inner child, just as a good father/mother would relate to his/her child. That inner voice is very important, sometimes more adult, sometimes more childish. It is one of the initial things to be treated in therapy, as the psychiatrist Marian Rojas tells in one of her talks.

This, in scientific studies, translates into understanding the sense of upbringing that each one has received, in order to detect possible problems much better, and use self-regulatory tools as soon as possible and as well as one can, so as not to fall in possible mental health problems. Parenting styles, according to the attachment theory initiated by the English psychoanalyst John Bowlby, and highly developed and currently the order of the day, contemplates three parenting styles: secure, insecure and disorganized. And through scientific experiments that began with war orphans after World War II, it has been shown that insecure or disorganized parenting leads to a much greater likelihood of health problems as adults.

The @psicologajaputa, publishes the meme on Instagram:

A father and son are sitting on a park bench, and the son is sobbing to the father:
-Dad, are you going to therapy?
And the father replies, hugging him: ‘No son, you’ll go’

The psychiatrist and psychotherapist Diego Figuera highlights in one of his talks that in all the cultures in which scientifically based attachment studies have been carried out, it is known that between 60-70% have an upbringing defined as ‘safe’. That safe upbringing protects against need, stress, and even attenuates some of the traits that we can genetically inherit to suffer from mental illness. This supposes an autonomy and capacity for self-regulation that will protect us against adversity and can be said to be qualities of resistant people. However, if we are in the 30% of people with insecure attachments, in whom ways of functioning outside the family nucleus are inadequately taught, there will be an added vulnerability to suffer some type of mental health disorder. This is transmitted from generation to generation, and it is not so clear that everything is biological but also psychological, and both hereditary factors are mixed with each other without having a clear separation as was believed. This was studied and demonstrated by Eric Kandel, Nobel Prize in Medicine in 2000, together with Arvid Carlsson and Paul Greengard.

All of this is of a complexity that can hardly be addressed in a written article, since the ideal would be for each person with problems in adulthood to expose their upbringing and their life environment with a psychology and/or psychiatry professional, so this textual pathway ends here.

At this point, I want to stick with the idea of ​​the inner child. But I’ll start with the ending, an ending in which a child, for whatever reason/reasons, ends up being a depressed adult.

According to the reference manual for the American DSM-5 classification of mental disorders, major depressive disorder is characterized by the following diagnostic criteria (A, B and C):

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly attributable to another medical condition.

  1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
  3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
  4. Insomnia or hypersomnia nearly every day.
  5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
  6. Fatigue or loss of energy nearly every day.
  7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
  9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The episode is not attributable to the physiological effects of a substance or to another medical condition.

We find ourselves again in another cumbersome and inappropriate terrain for a merely informative article. The sole intention is the definition and exposure of what is now known as depression (diagnosis of Major Depressive Disorder according to the official manual). A frequently mentioned term, but little known in depth. Emphasize the importance that depression itself is a serious mental illness, which in the worst cases can end in suicide, or in little or no fulfilled lives. It must be treated with the utmost importance and delicacy, and move away from concepts such as ‘it’s that you have to cheer up’, ‘don’t worry so much’ or ‘it’s no big deal’, since meeting these diagnostic criteria is so important as any other disability, and so complex that only health professionals should deal thoroughly.

However, I intend to shed a little light and a little hope, since there are many intermediate phases between health and disease (be it depression or any other pathology such as an anxiety outbreak, personality disorder such as narcissism, eating, delusional, etc.) and sometimes it is up to us to let ourselves be carried away by the most negative intermediate states and events, or use our own tools to keep ourselves sufficiently distant from the risk zone that can give rise to this type of mental illness.

And it is here where, going back in time to this adult with the possibility of depressive states or diagnosis (or any other mental illness to which he is vulnerable), the child returns to play. This will be the case of a sufficiently educated child. The case of the majority of the functional population (60-70% mentioned above), leaving the other more complicated cases for dealing with health professionals. This is a child who generally lives in a well-living adult, and it is unlikely that a negative life event will radically change his life. However, there are some poorly managed problems/traumas/events in your life. Nothing serious. However, with a series of unfavorable external conditions, either isolated events or the sum of several, such as permanent stress, psychological effects attributable to substance use or other medical conditions, a major loss in your life (loved family member, partner, great friend, child, etc.) or a traumatic event (natural disaster, economic ruin, etc.), the person may end up breaking up (the World Health Organization clearly warns us about this).

And here finally comes the positive part, the part to apply before breaking.

As a preliminary note, it is important to emphasize that the best thing today in the face of a personal crack in mental health is to put yourself in the hands of professionals in psychology and psychiatry as soon as possible and even if it costs. It’s much better to do a few sessions and take some pills a few months before you break mentally, than to break down and have to stabilize and rebuild again. Increasingly, mental health is going to turn to the preventive route because it has been shown that in all fields (health, social, financial, etc.) it is optimal.

On the plus side, there are tools to tone down, unplug, and even the ability to spot small cracks in that mental health limbo of in-between grays. That limbo of distance, let’s say, between someone stable, strong and ‘mentally functional’ and a person who begins to decline and suffer from some flaw in his mental health.

And one of them is the theater.

According to the psychology of attention, it is widely demonstrated that the more stress factors, the more the amplitude of a person’s attentional focus is reduced. For example, there are scientific studies with air traffic controllers, who, in a situation of acute stress, are able to see fewer things on a screen. This is 100% human, since stress at a certain point is positive and adaptive, because in the face of an emergency or important event, our body reduces the sensitivity of attention in certain senses, and focuses it on certain others. However, it has been shown that a situation of persistent stress can end up causing more or less serious declines in health. So far nothing new.

Going a little deeper, a situation of intermediate stress also reduces people’s capacity for introspection. In the same way that we focus our attention on the seriousness of the issue that stresses us, we reduce our self-awareness of our emotional state. We reduce our capacity for enjoyment, we reduce our imagination, our ability to pay attention to a child, we reduce our ability to listen in general, and we even reduce our emotionality or affection that we would be able to give in a ‘normal’ state to our loved ones.

And here comes the theater again. In theater it must be expressed. In theater they give you a gift and you should be surprised (unless you are playing a gloomy, gloomy, taciturn person). In theater you play and fly with a child. In theater you love, you laugh, you cry and you get angry. In theater you get emotional. It is a spectacular tool to reconnect with our most emotional hemisphere. Theater is used in occupational therapy to reconnect people with severe mental illness. Theater is that fresh air that enters that ‘vacuum jar of jam’ that each of us has in our heads. Metaphorically speaking, that more or less tight lid gently turns until it can be unstuck, and those first breaths that enter are pure emotional food for our minds.

Why not use it more on a daily basis as a way to connect and keep our brain ‘oxygenated’?

And I’m not talking about going to sit in a chair for an hour and a half and see who comes out and what they say out there (also). Rather, I am obviously referring to the theater performed by each one, that they give you a character and tell you: ‘learn these phrases and we are going to test how it turns out’. Without fear, without complexes, as a way to play a bit.

Hegel said: “To become oneself, one must become another.”

Theater is one of the forms of play for adults. A very educational game. You train memory, mobility, empathy, active listening, expressiveness, etc. Myself, acting as a waiter, I can tune in to a way of life that can give me lessons. In the same way, a person dedicated to the world of restoration acting as an engineer, can recognize emotions or experiences that he may have more or less developed and that may be more or less useful. But what is clear is that playing other people with other types of problems makes you see more clearly how you are when you play yourself, and this can help to downplay the problems of your day to day, and to recognize them better emotionally and rationally. And, in addition, it forces you to bring out certain emotions that perhaps without it you would not normally bring out. And this renews and airs the head with great freshness.

For the shameful, highlight that it is a very gradual process, nobody arrives the first day and begins to read and interpret complex texts. You start playing with small dynamics that little by little touch that child that each one has.

And here comes a more specific variant of theater, improvisational theater. I can say that both have brought me great pleasures, laughter and experiences. They are undoubtedly the game of adults (at the levels of initiation and attending classes in which I have managed).

Improvisational theatre, or better known as ‘improv’, is an activity that has brought me many quality disconnections in the last year. In improv you create characters, spaces, stories, relationships, problems and solutions. Or at least some of these things. In improv you invent, represent, innovate, surprise, make happy, or give a 360º turn to the stories.

A title generated by any person is given, such as ‘Tomorrow I’ll meet Maria’, and from there, one or more improvisational actors begin to create a story based on that title. One of the maxims of my improv teacher, Jorge López, is the triple A: “Accept, Adapt and Move On”. Suddenly a colleague can turn you into a taxi driver, or a platypus, or a piece of furniture. And you can’t say no. That’s where the game begins.

I can assure you that improv and theater have made me sleep better, disconnecting from day-to-day problems, zooming out and recharging batteries to maintain strong levels of work and creativity. And I feel like my inner child enjoys it. And my affections are better. In short, theater and improv are good for my life in a strong way.

The WHO tells us about Stigma and taboo:

Stigma (or what amounts to the same thing, the rejection, label, bad reputation and multitude of negative prejudices about mental health), particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and are therefore not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem and the taboo in many societies to openly discuss it. To date, only a few countries have included suicide prevention among their health priorities and only 38 countries report having a national suicide prevention strategy.

Raising community awareness and breaking down the taboo is important for countries to make progress in preventing suicide.

Data quality

Globally, the availability and quality of data on suicide and suicide attempts is poor. Only some 80 Member States have good-quality vital registration data that can be used directly to estimate suicide rates. This problem of poor-quality mortality data is not unique to suicide, but given the sensitivity of suicide – and the illegality of suicidal behaviour in some countries – it is likely that under-reporting and misclassification are greater problems for suicide than for most other causes of death.

Improved surveillance and monitoring of suicide and suicide attempts is required for effective suicide prevention strategies. Cross-national differences in the patterns of suicide, and changes in the rates, characteristics and methods of suicide, highlight the need for each country to improve the comprehensiveness, quality and timeliness of their suicide-related data. This includes vital registration of suicide, hospital-based registries of suicide attempts and nationally-representative surveys collecting information about self-reported suicide attempts.

Volunteer, whatever

And here, to finish, all this maelstrom of data known for a few years, but generally digested slowly over time, led me to sign up for a mental health volunteer. 7 years ago I was the coach of an indoor football team in the mental health league of Madrid (LigaSaMe). The result was secondary, the important thing was to do some sport, team, breathe, coordinate and from time to time we scored a goal. Disconnect to reconnect.

For me, September means the beginning of the school year, almost with more purposes than the new year. And the end of September and the beginning of October are also the periods in which the most mental health cases happen.

Last September, it was a theater workshop for people with mental illness called ‘Create’ (Create yourself). In Crearte we have played, we have interpreted, we have improvised, sung, danced, laughed, cried, celebrated, in Crearte we have created. What I learned in theater or improvisation I took to Create you. And in the end they did a performance in June. It is a way of feeling that something is left as a legacy of value for the other.

Dream

I dream of a future in which a diagnosis of schizophrenia is treated with the same importance as a meniscus operation. I dream of unconsummated suicides avoided in the style of the ‘Minority Report’ movie, with their consequent recovery, total repentance and 100% effective reincorporation into functional life.

I have lost close people, colleagues and friends because of suicide.

Imagine what we would have lost if Nash had not been able to survive the course of all the problems in his life. All the Game Theory and other mathematical abilities that are widespread today might not exist. And not only of the well-known important personalities of prestige. Imagine that you lose a fifteen-year-old daughter to suicide. Teen suicide rates have increased 400% over pre-pandemic levels (in Spain).

We must plan more. Feel more. Stop. Disconnect. Slow down. Conscious a lot and judge little. Listen and adapt.

It is the result of deep debate, but it seems shared that only if we combine the human knowledge that we have been accumulating through the humanities, with scientific knowledge, will we be able to progress in the best way and thus obtain the best of our species. And let’s take better care of our children and adolescents. They are our present and our future.

Paraphrasing Eleanor Roosevelt with her profound statement ‘The future belongs to those who believe in the beauty of their dreams’, it could be said that the best dreams are the most magical, and the best magic can only be achieved with the best union between humanities, science and technology.

19:50 29/08/2022