Monthly Archives: March 2015

On the History of the Stigma Against Mental Illness, Depression, and Suicide

Leora Skolkin-Smith: On the History of the Stigma Against Mental Illness, Depression, and Suicide

Having now written two novels in which the main character is “mentally ill” and has spent time in a psychiatric hospital for suicidal depression, it feels right to ask questions about why, how, and when, precisely, this mental illness – specifically depression and suicide – was stigmatized. Mental illness and subsequent psychiatric hospitalization are still, at the time I’m writing this essay, what I call “impossible secrets.”

I was recently at a family affair and our host was telling us a detailed account of his physical illness where he had almost died. His account took up two hours of the dinner table talk. He spoke without shame, of course, and no one cringed at the inappropriateness of his account or was made uncomfortable by the details of his hospitalization. It seemed important to him to share this serious experience with friends and family. Support for him around the table was abundant. I couldn’t help wondering if this would have been true if he had confessed he was in a psychiatric hospital and that he had experienced a threatening, potentially fatal illness called depression. I even said to a friend who had listened to the host’s story, “What if this was a psychiatric illness? Would he have spoken so openly?” My friend answered: “Mental illness? Depression? People can’t go there. They are not willing to hear that. No, he would have had to keep a story like that to himself so as not to make people squeamish.” As much as I’d like to think the stigma of mental illness has been alleviated in our era and that the decades of the biological revolution in psychiatry have created a new societal openness to mental illness, I know the social stigma still haunts the survivors. The writing we have had these years about mental illness has been, primarily, from very bright people who survived their depressions with flying colors and were able to return to recognizable “normal” lives. Their accounts have been lucid and coherent, not the jagged raw expressions that ensue from mental breakdowns. In the fifties, “depressed” mentally ill suicide attempters had a romantic color to their experiences. I am thinking of Sylvia Path and Anne Sexton, as well as other poets and famous artists. The fifties and early sixties were a time when it was thought that brilliant, artistic people, geniuses and near geniuses, had breakdowns. This was also true at the time of Goethe and the book The Sorrows of Young Werther and, perhaps, Anna Karenina when suicide was a romantic condition, experienced by the extremely sensitive, victims of society’s rigid morality. The gritty, tragic, day-to-day, ugly struggle inside psychiatric hospitals wasn’t portrayed in these novels, nor is it portrayed with all the confusing imagery and sensibility recent books like Prozac Nation or Girl, Interrupted express. The people in these books were portrayed as completely getting over their own despair and situation, and the depth and complexity with which their depressions were explored seemed questionable. The endings gave relief to their readers, everything was sewn up, creating the effect that the main characters were over their crises permanently. When I wrote Hystera about a young woman’s breakdown, a reader wrote me and gave it a one-star review. Her reason was that my novel, in which my main character overcomes her suicidal despair but by no means is free from its recurrences, was not a fair representation of how mental illness results for those stuck for life. Not everyone overcomes the odds, she argued, not everyone goes back to a normal life, and there is no happy resolution for most people. I thought she had a very vital point; I had neglected to insert the hopelessness experienced of a future for my protagonist who was, in the end, just another bright college girl who had a breakdown but who would, because of her advantages, be able to reassimilate into society. I did feel good, however that I portrayed her breakdown with raw, sexual, and beguiling paradoxes, that I had shown, at least, the chaos and not a neat tie-up at the end. In my second novel, I wanted to go further into the aftermath of an institutionalized woman who could not, for thirteen years, find her way back to the world. The reader finds her practically living on the streets under Reagan’s cuts in the 1980s, the brutal stigmatization that does not allow her to reconnect with the world. In both cases, stigma was a prominent theme. In the first novel, the often-disturbing sexual imagery, and in my second novel, not yet published, the long ostracization by her peers and the society she once belonged to hopefully establish a depth and not facile resolutions.

The Oxford Dictionary defines stigma as “a mark of disgrace associated with a particular circumstance, quality, or person. ‘The stigma of mental disorder.’”

I have become interested in why those with psychiatric illness are still and forever stigmatized. And to give historical breadth and depth to the question, it was fascinating and horrifying to turn to history.

In his seminal book on suicide, The Savage God, A. Alvarez introduces us to the stigma and penalty toward those who try suicide by giving us an example from 1860, from a man named Nicholas writing to his mistress, Mary Sutherland.

A man was hanged who had cut his throat, but who had been brought back to life. They hanged him for the suicide. The doctor had warned them that it was impossible to hang him as his throat would burst open and he would breathe through the aperture. They did not listen to his advice and hanged their man. The wound in his neck immediately opened and the man came back to life, although he was hanged. It took time to convoke the aldermen to decide the question of what was to be done. At length the alderman assembled and bound up the neck below the wound until he died. Oh my Mary, what a crazy society and what a stupid civilization.

In this series, I hope to wander back through history, from Plato up to the present, in an attempt to determine whether our attitudes towards suicide and depression have really changed, or if the stigma is still there, manifesting itself differently through the ages. What can be learned by recognizing the continuum of social ostracization in regard to mental illness, specifically to suicide and depression? What does the future hold as a remedy for the stigma against mental illness, depression, and suicide?

The Election in Israel

The election in Israel this morning, Tuesday, is a place that especially speaks to me and brings me much sadness, frustrations, and not a little anger. Netanyahu publicly came out saying he would not allow a “two state solution”, that is– he would never allow an independent Palestinian State.

Most people don’t understand the beginnings of Israel, even less the facts that Jews and Arabs lived in a mutual respect once back in the 1930’s. Most people also don’t know that it was the Water War that started the hostilities we are seeing in every increasing border wars. Originally, because the Jews in Israel needed water and Syria blocked any chance they could have to create a water route, the border skirmishes, long ago were about what was later called “The Water Wars”. Only Transjordan would allow the Israelis to have access to the abundant water wadis.. But Transjordan had the old city under their military control in (1963, the era of my novel _no Jew was allowed passage into the ancient city, not to the Wailing Wall or other Jewish holy sites, and not to the Jewish graves on Mt. Scopus where my own grandfather is buried.

I am not good at expressing my feelings in non-fiction or essays so I very much want to offer the last few paragraphs of the novel I wrote called “Edges. “Edges” tells a story of a young American girl, Liana, taken by her native Palestinian mother’s birthplace during the Cold War. These years were right before the 1967 war in when Israel captured old Jerusalem and began the refugee issues that still are a haunting violence between two groups, Muslim and Jewish, who, during her mother’s time in Palestine, were once working together in business, living together as neighbors,

The question of why we write looms again large in my mind. I wrote “Edges” thinking all this Palestinian/Israeli history was not known by the world at large and now reading about the current election it feels like the historical context has been buried for good. Apologies if this sounds arrogant on my part, my own mother’s Palestinian family goes back to my great-great grandparents in Jerusalem and my grandfather, thinking business would restore old Jerusalem into cooperation between Muslim and Jewish families started the first department store in ancient Jerusalem in the 1920’s. His brother, Reuben, brought over the first “primus”, a small stove, to sell to the people of Jerusalem. Before and under the British Mandate except for some fanatic Islam groups and fanatic Zionist Jewish groups, the neighboring Jews and Muslim families lived in peace and mutual accord with one another. Business interests and doings like my grandfather brought them together as partners,

I wanted to share a part of Edges, which, I think expresses Liana’s bewilderment at the modernization of Israel in the 1980’s. Where she had run away and lived in secret with a lover in 1963, on the West Bank, she now sees only a faint shadow of what was once TransJordan and Israel.. In the novel, she witnesses an innocent Arab boy killed in crossfire between the Arab and Israeli militia. All he was doing was climbing a tree in a vacant spot on the West Bank. This truly was the symbol I used to create the horror of the contemporary divide between Palestinians and Israel now.

This section I hope brings some fictional life to these ideas and memories. Liana, struggles to understand the modernization of the city she had loved so dearly, Jerusalem.

From Edges, O Israel, O Palestine:

“IN 1986, I WENT BACK TO ISRAEL WITH MY HUSBAND. I wanted to show him the land that had formed me. My mother lived in New York City by then, but she went back every few years to visit Doda Esther and attend various occasions with her old friends. Jerusalem had been cold that February day.
My husband and I took a sherut from Ben-Gurion airport, following the glistening route which passed new- sprung Jewish settlements and towns full of jerrybuilt apartment houses. New gray buildings were everywhere, renovations in progress—teams of back hoes and bulldoz- ers lay in wet mud. Israeli checkpoints were now bullet- proof closures with reinforced steel doors.
The highway through the Judean Hills was unrecog- nizable, except for the rusted tanks and Fords from the War of Independence that were still cradled in heaps of shrubs and rocks. The sky that morning looked bruised by the lowering winter clouds, my mother was no longer here to enchant the stonescape and clay; the lavender was dark. Soon, the gardens of Jerusalem appeared outside our window; crocuses and Jerusalem roses drowned in floods of thawing ice. The air was raw and cruel, scratchy, the biting wind didn’t flag, and there had been more rainfall than the land could soak in. Vapors fumed from the sodden fields, drenched city benches. Some blue Arabic villages lay behind blocked hillocks on the West Bank, closed-off, their rickety watchtowers overlooking the barren soil I remem- bered. The borders were marked only by yellow warning road signs in English, Hebrew, and Arabic which pointed towards Jordan.

Leora Skolkin-Smith 189
The monastery still existed somewhere, I believed, in the far away, impoverished vista of limestone and dust. I brushed my hand against the window to clear a vision of a ravaged distant land.
Entering the center of the new city, a light snow began to fall. The snowflakes looked like mixed salt and pow- der. The old tailor shop and one pharmacy were deserted hovels in rubble, the places I remembered walking with my mother to buy toothpastes that smelled like lemons and aspirin pills the size of playing dice. The harsh metal- lic feel I remembered in the Jerusalem air was gone, the snow melted in the sand and stone heaps, it drizzled into the abandoned alleys, a white liquid painting shapes and ghostly forms. I sank into my seat, wondering if it would have turned out different for me had I known long ago what the war for the water would become. If I had known the border skirmishes as different than the rage and struggle inside me. Would I have decided to go to the Israeli police station instead, in my old army shorts and sandals, report- ing the death I still saw in my night dreams with the young Arab’s face? He had my own face back then, my physical confusions, my formlessness. Soldiers in olive uniforms still guarded the bus stops with heavy rifles. They walked in groups on the new sidewalks now, clicking against each other. It was rush hour on King George Street. The boule- vard was filling with cars and red buses. Lines of Israelis were forming at the kiosks to buy lotto tickets, municipal parking tickets, chewing gum, and stamps.
Ahead, the King David Hotel shone as if rebuilt into polished white steel.
My eyes blinked, spotting a Thai restaurant in a strip of modern boutiques.
…I tried to remember it as it had been to me in 1963—a geography, undifferentiated, hungry for definition, wanting water. I peered out at the dun-colored terrain, at all the bor- ders and boundaries still so explosive and fragile. The view towards Jordan was obstructed as it was from my aunt’s room upstairs, apartment houses in the way of my vision. “

A New Series on the History of Mental Illness

“On the History of the Stigma Against Mental Illness, Depression, and Suicide”

Having now written two novels in which the main character is “mentally ill” and has spent time in a psychiatric hospital for suicidal depression, it feels right to ask questions about why, how, and when, precisely, this mental illness – specifically depression and suicide – was stigmatized. Mental illness and subsequent psychiatric hospitalization are still, at the time I’m writing this essay, what I call “impossible secrets.”
I was recently at a family affair and our host was telling us a detailed account of his physical illness where he had almost died. His account took up two hours of the dinner table talk. He spoke without shame, of course, and no one cringed at the inappropriateness of his account or was made uncomfortable by the details of his hospitalization. It seemed important to him to share this serious experience with friends and family. Support for him around the table was abundant. I couldn’t help wondering if this would have been true if he had confessed he was in a psychiatric hospital and that he had experienced a threatening, potentially fatal illness called depression. I even said to a friend who had listened to the host’s story, “What if this was a psychiatric illness? Would he have spoken so openly?” My friend answered: “Mental illness? Depression? People can’t go there. They are not willing to hear that. No, he would have had to keep a story like that to himself so as not to make people squeamish.” As much as I’d like to think the stigma of mental illness has been alleviated in our era and that the decades of the biological revolution in psychiatry have created a new societal openness to mental illness, I know the social stigma still haunts the survivors. The writing we have had these years about mental illness has been, primarily, from very bright people who survived their depressions with flying colors and were able to return to recognizable “normal” lives. Their accounts have been lucid and coherent, not the jagged raw expressions that ensue from mental breakdowns. In the fifties, “depressed” mentally ill suicide attempters had a romantic color to their experiences. I am thinking of Sylvia Path and Anne Sexton, as well as other poets and famous artists. The fifties and early sixties were a time when it was thought that brilliant, artistic people, geniuses and near geniuses, had breakdowns. This was also true at the time of Goethe and the book The Sorrows of Young Werther and, perhaps, Anna Karenina when suicide was a romantic condition, experienced by the extremely sensitive, victims of society’s rigid morality. The gritty, tragic, day-to-day, ugly struggle inside psychiatric hospitals wasn’t portrayed in these novels, nor is it portrayed with all the confusing imagery and sensibility recent books like Prozac Nation or Girl, Interrupted express. The people in these books were portrayed as completely getting over their own despair and situation, and the depth and complexity with which their depressions were explored seemed questionable. The endings gave relief to their readers, everything was sewn up, creating the effect that the main characters were over their crises permanently. When I wrote Hystera about a young woman’s breakdown, a reader wrote me and gave it a one-star review. Her reason was that my novel, in which my main character overcomes her suicidal despair but by no means is free from its recurrences, was not a fair representation of how mental illness results for those stuck for life. Not everyone overcomes the odds, she argued, not everyone goes back to a normal life, and there is no happy resolution for most people. I thought she had a very vital point; I had neglected to insert the hopelessness experienced of a future for my protagonist who was, in the end, just another bright college girl who had a breakdown but who would, because of her advantages, be able to reassimilate into society. I did feel good, however that I portrayed her breakdown with raw, sexual, and beguiling paradoxes, that I had shown, at least, the chaos and not a neat tie-up at the end. In my second novel, I wanted to go further into the aftermath of an institutionalized woman who could not, for thirteen years, find her way back to the world. The reader finds her practically living on the streets under Reagan’s cuts in the 1980s, the brutal stigmatization that does not allow her to reconnect with the world. In both cases, stigma was a prominent theme. In the first novel, the often-disturbing sexual imagery, and in my second novel, not yet published, the long ostracization by her peers and the society she once belonged to hopefully establish a depth and not facile resolutions.
The Oxford Dictionary defines stigma as “a mark of disgrace associated with a particular circumstance, quality, or person.
‘the stigma of mental disorder’

I have become interested in why those with psychiatric illness are still and forever stigmatized. And to give historical breadth and depth to the question, it was fascinating and horrifying to turn to history.
In his seminal book on suicide, The Savage God, A. Alvarez introduces us to the stigma and penalty toward those who try suicide by giving us an example from 1860, from a man named Nicholas writing to his mistress, Mary Sutherland.

A man was hanged who had cut his throat, but who had been brought back to life. They hanged him for the suicide. The doctor had warned them that it was impossible to hang him as his throat would burst open and he would breathe through the aperture. They did not listen to his advice and hanged their man. The wound in his neck immediately opened and the man came back to life, although he was hanged. It took time to convoke the aldermen to decide the question of what was to be done. At length the alderman assembled and bound up the neck below the wound until he died. Oh my Mary, what a crazy society and what a stupid civilization.

In this series, I hope to wander back through history, from Plato up to the present, in an attempt to determine whether our attitudes towards suicide and depression have really changed, or if the stigma is still there, manifesting itself differently through the ages. What can be learned by recognizing the continuum of social ostracization in regard to mental illness, specifically to suicide and depression? What does the future hold as a remedy for the stigma against mental illness, depression, and suicide?

An American Sniper

An American Sniper.

Recently I saw a breath-tak8ng movie. Afterwards, I had to question my excitement. The film was “American ‘sniper” directed by Clint Eastwood, starring Bradley Cooper. A near-perfect suspenseful script, brilliant acting, and a rendering of the Iraq War was moving, searing in fact. ‘Against a background of destitute limestone buildings and impoverished towns, the American sniper, played by Bradley takes aim and kills any Iraqi who carries a lethal weapon against his own American fellow soldiers. In his first shoot, a young boy is killed because he was carrying a grenade to take out twenty of the soldiers in the American offense. That one moral question reverberated so severely through the audience’s emotional systems, the other perhaps more urgent moral questions were buried by its intensity. The difficulty the Bradley Cooper had with his marriage after his PTSD, returning home to America and staring aimlessly at walls, unable to communicate with his wife and children furthered the pathos of the film, rendering a soft and tender emotional layering which obscured and hid the film’s more ambiguous moral issues. The viewer soon puts the Iraqi landscape of impoverishment and military inferiority and the near serial killer instincts of the Bradley Cooper away, as the compelling story of this one man, the American sniper, is explored with dramatic excellence. Though I was fully entranced, lurking in my conscience were eventual questions about the general morality of our involvement in Iraq after 9/11 and the moral attitude of forgiveness towards an emotionally driven killer, the Bradley Cooper sniper who with zeal and high moral purpose killed over 150 Iraqi people, including putting an innocent Iraqi family at risk so they were executed by the extremists. Being from the Middle East in heritage I have seen such impoverished villages and towns on the other side of the Israeli border. I am no stranger to the brutality of Islam extremists as well, but because Iraqi families and homes were raided in this film, and thrown like so much flesh to a hungry shark, the killing of innocents and the plight of innocents in the real skirmishes we witness today in the Middle East were glossed over. The focus on our dubious hero sniper dominated the film, defined its moral perimeters.
Later, I read that the actual sniper the film was based on was hardly viewed as a hero by his own army. By all accounts he was a disturbed and driven soul. It was also not true that the sniper, as in the movie, killed the central terrorist character. As I heard more, the likeness of the real person to his movie character grew dimmer and dimmer. At best, the real sniper, a man named Kyles, was of questionable motivations.
Having felt the Iraqi war was a large mistake and lapse in judgment it should have been easy for me to hate this movie, which glorified our soldiers’ roles and the determination of the sniper to protect his fellow men. The fact that I didn’t, the fact that I loved this film was troubling beyond words. I confess my intense attraction to Bradley Cooper, an actor I find about the sexiest and finest around, contributed to my awe of the movie. I also confess that Clint Eastwood has proven to be a director extraordinaire, that his sense of timing and suspense is superlative. He can set up tension and scenes like a cinematic magi.. So the question I want to explore is: does it matter? That is, in movies and books, does it matter if the material is noxious and immoral but the artist renders it brilliantly, taking one in completely, does its value diminish because of the bad morality that is its bedrock, and because it doesn’t stay true to actual people (who are called their real name in the picture)?
I haven’t answered the question yet. It reminded of the time when I found out my favorite philosopher, Martin Heidegger was a Nazi sympathizer and worked with Hitler’s national socialist party, admitting in his famous “black books” that he saw Nazism as a glorious new frontier and wanted to support it, including its anti-Semitism. In no way could I throw out his genius. His “ Time and Being” remains a landmark in philosophy, makes no mention and gives no hint of his Nazism. As is true with Ezra Pound, a great poet by any standard, and a Nazi sympathizer as well, Heidegger will remain as the father of existentialism, its most ingenious theorist.
I did, I admit, cringe and hate myself for admiring this film when the Bradley Cooper called the Iraqis “savages” that have to be destroyed or they will infiltrate America, and when the hero worship grew tedious and unearned once the sniper had killed more Iraqis, and there continued to be an unbalanced, uncontested treatment of the Americans as heroes who could do no wrong, as well as the Bradley Cooper character experiencing his victims, like a serial killer, with no guilt, remorse or self-reproach. The question of a preemptive strike against innocents by George Bush’s declaration of war against a country that had little or nothing to do with 9/11 simply did not figure into Eastwood’s depiction of the Iraqi War. Or seem to trouble any of the players.
I thought these were valuable misgivings. It’s another example of how excellent artistry and brilliant directing and acting can so easily overshadow one’s judgment, watching a great film like this. I still tell friends to go see it, but warn it is painfully difficult to admire it so very

Interview in The Brooklyn Rail

Thanks to Andrea Scrima and Storyplant for posting my interview at the Brookyn Rail.
A great interview with Leora Skolkin-Smith about her re-published book Edges!
http://www.brooklynrail.org/2014/12/books/mother-tongue

MOTHER TONGUE LEORA SKOLKIN-SMITH with Andrea Scrima
It’s nearly impossible to imagine from today’s perspective of heavily guarded checkpoints and border controls and ugly, towering walls, but Israel was a very…
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