Given the work I do, and the fact that I teach hundreds of young adults entering the helping professions, I encounter many women and men facing mental health concerns. Most of these women and men have difficult or painful experiences, but are able to surmount these obstacles to lead successful and productive lives. Most mental health concerns come to light because the people experiencing painful symptoms and consequences of depression, anxiety, or bipolar disorder actively seek help. In many cases, the hardest people to help are those who do not believe that they have a mental health disorder at all. Almost half of the people diagnosed with a psychotic illness do not believe that they have these disorders. This lack of insight into their own conditions obviously poses huge obstacles to
Rachel Aviv’s New Yorker story, “God knows where I am,” is a perceptive and humane account of Linda Bishop, an appealing and intelligent woman who was never able to recognize the basic fact of her severe mental illness. In her comments to others and in her private writing, Bishop combined striking lucidity with an adamant inability “to modify her self-image to acomodate the fact of her illness,” even as she found herself living in a vacant farmhouse subsisting on backyard apples while “awaiting further instructions” from God. Those instructions never came, with catastrophic results.
If you haven’t seen this piece, you definitely should. I don’t agree with everything Aviv has to say about deinistitutionalization and other matters. But it is an amazing, heartbreaking read. If I could only write like that, too.