Choices are made real through action. Ethics, morality, religion, spirituality and all our laws and decisions are products of choice. We may indeed in counsel point to the higher road, but we cannot compel any free creature to walk upon it. That leadeth to tyranny, which disfigureth good and maketh it seem hateful. [J.R.R. Tolkien, Morgoth’s Ring (1993).] I believe…
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Value for Monday of Week 33 in the season of Interlude
Cultivating Mental Health
Good mental health is a necessary foundation for most aspects of life.
- Some people think you’ve chosen to sleep on the street. People don’t choose to lose their jobs or suffer from mental health problems. The vast majority of people who are vulnerably housed or homeless don’t have any other choice. [attributed to James Bowen]
- Mental health is invisible, but it’s a very real issue. [Coco Gauff]
- Many politicians, celebrities, businessmen and women, and community leaders now are open about their struggles with mental illnesses, something almost unheard of when I began. Together, we are spreading the word that mental health affects all of us and deserves our support and attention. [attributed to Rosalynn Carter]
Health and personal development have an emotional component, often called mental health, or emotional health. “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood through adulthood.” “Mental and physical health are equally important components of overall health. Mental illness, especially depression, increases the risk for many types of physical health problems, particularly long-lasting conditions like stroke, type 2 diabetes, and heart disease.” Six models of mental health have been developed.
Mental health aids in coping with stresses in life, being physically healthy, having good relationships, making meaningful contributions to our communities, working productively and realizing our full potential. Among the factors that can affect mental health are biological factors like genes and brain chemistry, life experiences, family history and lifestyle.
Respect for a person’s intrinsic human worth is “a fundamental principle of mental health care”. Social determinants of mental health, including employment status, have been extensively studied.
Mental illness has long been stigmatized, in children and adolescents, and in adults. Studies have focused on this phenomenon in Japan, Ghana, sub-Saharan Africa, Netherlands, and elsewhere. Stigmatization includes a structural component. This stigma has adversely affected public health overall.
A growing awareness of mental health as an aspect of overall health is occurring in many parts of the world. For individuals, professionals are available in the fields of psychiatry, psychology, social work and other fields, to assist people in cultivating and maintaining good mental health.
Real
True Narratives
Positive true narratives on mental health:
- Katie Arnold, Running Home: A Memoir (Random House, 2019): “ . . . she writes a story exploring how her growing preoccupation with running has been intertwined with loving and losing her father. She takes the risk of being ordinary, and therefore human.”
- Sarah Ruhl, Smile: The Story of a Face (Simon & Schuster, 2021): “. . . a rumination about faces and specifically smiles, including what they mean across cultures, and for her particularly”.
- Clancy Martin, How Not to Kill Yourself: A Portrait of the Suicidal Mind (Pantheon, 2023): “After 10 attempts and years of suffering and addiction, Clancy Martin describes facing the darkness in his raw memoir . . .”
- Meg Kissinger, While You Were Out: An Intimate Family Portrait of Mental Illness in an Era of Silence (Celadon Books, 2023): “. . . as early as age 5, Kissinger remembers her beloved mother disappearing for days at a time. By her 40s Kissinger has lost two siblings to suicide, and her alcoSolic mother has survived several attempts. Silence was the vessel in which all of her family’s desperate ululations were contained.”
- Jonathan Rosen, The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions (Penguin Press, 2023) is “an inch-by-inch, pin-you-to-the-sofa reconstruction of (Rosen’s) long friendship with Michael Laudor, who made headlines a decade after the Ginsberg reading: first in The New York Times, as a Yale Law School graduate destigmatizing schizophrenia; then pretty much everywhere, after stabbing his pregnant girlfriend, Caroline Costello, to death with a kitchen knife, confusing her with a windup doll.”
From the dark side:
- Susan Sheehan, Is There No Place on Earth for Me? (Houghton Mifflin, 1982): an account of a schizophrenic young woman’s life in a psychiatric hospital
- Marin Sardy, The Edge of Every Day: Sketches of Schizophrenia (Pantheon, 2019): “According to her mother, Sardy’s father was swept away in a tsunami in Hawaii in the mid-80s. He drowned and a stranger took his place. This man was very helpful and began taking care of the family, and after a while nobody noticed anymore that he wasn’t their real dad. Sardy’s mother knew the truth, though. He was a replacement. She called him Mr. Ree.”
- David Peace, Patient X: The Case-Book of Ryunosuke Akutagawa (Knopf, 2018): a biography of the troubled man whose short story inspired the film Rashomon
- Susannah Cahalan, The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness (Grand Central Press, 2019): “It’s the kind of story that has levels to it, only instead of a townhouse it’s more like an Escher print. On one level: A profile of Rosenhan and his study. On another: Cahalan’s own experience of researching the book. And on a third: The fraught history of psychiatry and the pursuit of scientific knowledge.”
- Anthony David, Into the Abyss: A Neuropsychiatrist’s Notes On Troubled Minds (Oneworld Publications, 2020): “. . . a short-story-style collection of curious case studies from David’s long career as a neuropsychiatrist”
- Jason Adam Katzenstein, Everything Is an Emergency: An O.C.D. Story in Words and Pictures (HarperPerennial/HarperCollins, 2020): “Katzenstein’s hand-drawn medical memoir reaches back to his early childhood. He recalls his first fears . . . and a world that starts to crack when his parents divorce. A therapist encourages him to start creating stories, giving him a temporary sense of focus and, ultimately, a career.”
- Catherine Cho, Inferno: A Memoir of Motherhood and Madness (Holt, 2020): an inquiry “about the factors (biological, cultural and environmental) that make some women vulnerable to episodes of acute, severe mental illness in the period after they become mothers.”
- Esmé Weijung Wang, The Collected Schizophrenias: Essays (Graywolf Press, 2019): “Exploring Her Own Experience of Psychosis”.
- Donald Antrim, One Friday in April: A Story of Suicide and Survival (W.W. Norton & Company, 2021): “A Survivor of a Suicide Attempt Writes of His State of ‘Eternal Dying’”.
- Rachel Aviv, Strangers to Ourselves: Unsettled Minds and the Stories that Make Us Up (Farrar, Straus & Giroux, 2022), “delicately balances two truths that prove remarkably difficult to hold in tandem. We all have our own minds, our own experiences, our own suffering; we are also social creatures who live among others, and social forces have at least some bearing on how we understand who we are.”
- Tanya Frank, Zig-Zag Boy: A Memoir of Madness and Motherhood (W.W. Norton and Company, 2023): “. . . Tanya Frank looks back on her son’s epic struggle with schizoaffective disorder.”Alice Carrière, Everything/Nothing/Someone: A Memoir (Spiegel & Grau, 2023), “recalls her coming-of-age as the daughter of artists, and her eventual slip into dissociative disorder.”
- Jonathan Haidt, The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness (Penguin Press, 2024): “The two major themes that dominate the structure of the book are Haidt’s concern for the loss of a play-based childhood and the arrival of a phone-based childhood. He weaves the story of how children and adolescents need an abundance of free play in order to learn basic skills that will increasingly allow them to master more advanced communal relations.”
- Sarah LaBrie, No One Gets to Fall Apart: A Memoir (HarperCollinsPublishers, 2024): “. . . LaBrie chronicles her mother’s descent into what would eventually be diagnosed as schizophrenia, while also exploring the through-line of mental illness that snakes through her family history.”
- Antonia Hylton, Madness: Race and Insanity in a Jim Crow Asylum (Legacy Lit, 2024): “Hylton tells the story of Crownsville Hospital, a segregated asylum on 1,500 acres in Anne Arundel County, Md. Based on the ludicrous but stubbornly persistent theories of Dr. Cartwright and others, at the turn of the 20th century, Maryland lawmakers claimed to notice rising insanity in Negroes, which they blamed on freedom — willfully ignoring subhuman conditions, including the well-documented lynchings common during the Jim Crow era.”
Technical and Analytical Readings
- Theresa L. Scheid and Tony N. Brown, eds., A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems (Cambridge University Press, 2009).
- Graham Thornicroft, George Szmukler and Kim T. Mueser, Oxford Textbook of Community Mental Health (Oxford University Press, 2nd edition 2025).
- Charles A. Rapp, The Strengths Model: Case Management with People Suffering from Severe and Persistent Mental Illness (Oxford University Press, 1997).
- Charles A. Rapp & Richard A. Goscha, The Strengths Model: Case Management with People with Psychiatric Disabilities (Oxford University Press, 2006).
- Charles A. Rapp & Richard J. Goscha, The Strengths Model: A Recovery-Oriented Approach to Mental Health Services (Oxford University Press, 3rd edition, 2011)
Photographs
Documentary and Educational Films
Imaginary
Fictional Narratives
From the dark side:
I realised that something new had come into my soul, and had poisoned the life I had lived up to that hour. We reached our destination in the evening. The whole day long I remained struggling with despair, and finally conquered it; but a horror remained in the depth of my soul. It was as if a misfortune had happened to me, and although I was able to forget it for a while, it remained at the bottom of my soul, and I was entirely dominated by it. [Leo Tolstoy, “Diary of a Lunatic” (1884).]
Novels and short stories, from the dark side:
- Akwaeki Emezi, Freshwater: A Novel (Grove Atlantic, 2018): “Emezi draws in part from her own life to tell the story of Ada, a young Igbo and Tamil woman haunted by the ogbanje — the ‘godly parasite with many heads, roaring inside the marble room of her mind.’ The story is narrated by Ada’s multiple personalities, and occasionally by Ada herself.”
- Noah Hawley, Anthem: A Novel (Grand Central Publishing, 2022): “How do we bring children up in today’s increasingly dangerous and divided world? Will they rise? Or will they fall? With the recent rash of articles about the fragility of adolescent mental health and America’s uptick in teenage suicide rates, these questions are urgent.”
- Julie Otsuka, The Swimmers: A Novel (Alfred A. Knopf, 2022): “'You wake up one day and you can’t even remember your own name (It’s Alice). But until that day comes you keep your eyes focused on that painted black line on the bottom of your lane and you do what you must: You swim on.'”
- Barbara Molinard, Panics: Stories (1969): “Molinard’s characters are haunted, confused, wandering as if in a fog, forgetting who they are and where they are meant to be.”
- Cormac McCarthy, Stella Maris: A Novel (Knopf, 2022): “. . . 20-year-old Alicia Western, a doctoral candidate in mathematics at the University of Chicago, has checked herself in because she’s been hallucinating. Central among her visions is a shambolic dwarf with flippers and a bent sense of humor known as the Thalidomide Kid. Alicia is also carrying a plastic bag stuffed with $40,000, which she tries to give away to the receptionist.”
- Betsy Lerner, Shred Sisters: A Novel (Grove Press, 2024): “According to the dubious science of birth order and the recent internet, big sisters are the disproportionate load bearers of the family: responsible, organized, high-achieving, resentfully overburdened. According to Amy Shred, her big sister is reckless, self-absorbed, volatile, manipulative. A danger to herself and others.”
- Izumi Suzuki, Set My Heart on Fire: A Novel (Verso, 2024 - first published in Japan in 1983): “One thing young people and the despondent have in common is myopia. An existential nearsightedness — as persistent as it is understandable — is comorbid with both conditions. The narrator . . . is doubly impaired, being both young and miserable. To see the world through her eyes is to behold a very limited view indeed.”
- Anjet Daanje, The Remembered Soldier: A Novel (New Vessel, 2025), “dissects the consciousness of an amnesiac veteran of World War I who has spent four years in a Belgian asylum only to be retrieved by a woman who insists she is his wife.”
Poetry
Out of a cell into this darkened space—
The end at twenty-five!
My tongue could not speak what stirred within me,
And the village thought me a fool.
Yet at the start there was a clear vision,
A high and urgent purpose in my soul
Which drove me on trying to memorize
The Encyclopedia Britannica!
[Edgar Lee Masters, “Frank Drummer”]
Music: Composers, artists, and major works
How might we deal with illness and the certainty of death? Franz Schubert faced that question after he became ill as a young man. His String Quartet No. 14 in D Minor, Op. posth., D. 810, “Death and the Maiden” (Der Tod und das Mädchen) (1824) (approx. 33-43’) (list of recorded performances), “is one of the pillars of the chamber music repertoire.” All four movements are set in a minor key. “In 1774 the poet Matthias Claudius (1740-1815) published a short poem titled ‘Death and the Maiden.’ The poem is designed as a dialogue, contrasting a young woman’s fear with the reassurance of death. Claudius creates opposites and connections between the two figures.” Having set the poem to music in 1817, Schubert composed this string quartet seven years later. “The quartet was written in 1824 when his health was a cause for concern. He wrote to a friend, 'Imagine a man whose health will never be right again, and who, in sheer despair over this, even makes things worse instead of better. Imagine a man, I say, whose most brilliant hopes have perished…’ This music, then, is a reflection of Schubert’s state of mind. It’s filled with that resignation he spoke off, as well as an all-pervading anguish and yearning. Not only was his body sick – so was his soul.” Top recorded performances are by Busch Quartet in 1936, Quartetto Italiano in 1965, Fine Arts Quartet in 1986, Takács Quartet in 1993, Jerusalem Quartet in 2008, Belcea Quartet in 2009, Artemis Quartet in 2009, Pavel Haas Quartet in 2013, Chiaroscuro Quartet in 2018, and The Ruysdael Quartet in 2021.
Edward Elgar, Symphony No. 2 in E-flat major, Op. 63 (1911) (approx. 52-55’) (list of recorded performances), is the composer’s musical exhortation to remain cheerful in the face of difficult world conditions. “Elgar described his second symphony as 'the passionate pilgrimage of a soul'. The score is headed by a quotation from a poem by Shelley: 'Rarely, rarely comest thou spirit of delight!'” Top performances are conducted by Elgar in 1927, Boult in 1944, Barbirolli in 1964, Solti in 1975, Sinopoli in 1987, Slatkin in 1989, Andrew Davis in 1992, Colin Davis in 2006, and Oramo in 2013.
Music of Luigi Nono is full of anxiety, expressing the dark side of mental health:
- Variazioni canoniche sulla serie dell’ op. 41 (1950) (approx. 23’)
- Varianti (1957) (approx. 17’)
- Incontri per 24 strumenti (1955) (approx. 7’)
Other compositions:
- Franz Schmidt, Symphony No. 1 in E Major (1896) (approx. 45-47’) (list of recorded performances): this “expansive and genial work” covers a range of emotions in a sunny major key, suggesting good mental health. In a similar vein is Schmidt’s Symphony No. 3 in A Major (1928) (approx. 41-51’) (list of recorded performances), “an odd work: charming, tuneful, and shot through with a surprisingly high level of persistent yet gentle chromatic dissonance that renders the symphonic discourse almost completely tensionless.”
Albums:
- Pink Floyd, “The Wall” (1979) (81’) is a rock-music narrative about overcoming alienation.
- The Touré-Raichel Collective, “The Tel Aviv Session” (2012) (64’): employing easy-driving rhythms with the reassuring voice of the kora, this album is joyful, lively and embracing
- Steven Halpern, “Radiant Health and Well-Being” (1993) (56’)
- HBH Trio & Julian Priester, “Signals from the Mind” (2018) (57’): “The six ‘Signals’ include a series of dots and dashes . . . A mixing of mouthpiece effects teams with buzzing bees and squeaks that sound like either the piano seat or the screws for the strings need some oil.”
- Paramore, “After Laughter” (2017) (43’): the lyrics are about depression and hope but the upbeat sounds but everything in a positive light.
- Alessia Cara, “The Pains of Growing” (2018) (46’): “. . . she is a singer with an agile voice but a young woman still figuring herself out.”
- Halsey, “Manic” (2020) (48’) “flips lonely self-awareness into a kind of strength.”
Compositions from the dark side:
- Some of Robert Schumann’s compositions reflect the depression with which he struggled throughout his adult life. For example, 9 Waldszenen (Forest Scenes), Op. 82 (1851) (approx. 21-24’) (list of recorded performances): “Don't be fooled by the breezy title, these are not woodland depictions without complications. Clara, Schumann's beloved wife and muse . . . found some of the individual scenes upsetting and chose not to play them.”
- Michael Hersch, Images from a Closed Ward (2010) (approx. 66-69’): pieces for string quartet, based on a visit to a Rhode Island asylum.
- Morton Gould, Jekyll and Hyde Variations (1956) (approx. 20’): “The Jekyll and Hyde alludes to the duality and ambivalence of the human character . . .”
- Jennifer Hidgon, blue cathedral (2000) (approx. 11-12’) grew out of her brother’s death from skin cancer. She explained: “I wanted to create the sensation of contemplation and quiet peace at the beginning, moving towards the feeling of celebration and ecstatic expansion of the soul . . .”
- Malcolm Arnold, Symphony No. 8, Op. 124 (1978) (approx. 26-27’) (list of recorded performances): “Not too long after finishing this symphony, Arnold took a seven-year hiatus from composing, as he was hospitalised and treated for severe depression. It is said that the Eighth Symphony reflects how Arnold might have been feeling at the time of composition.”
- Wolfgang Rihm, Jakob Lenz (1979) (approx. 66-94’) (libretto) “is based on Georg Büchner’s novel about a young man’s descent into insanity.” Lenz “seems to have suffered from schizophrenia and eventually died homeless on a Moscow street”. Here are links to a highly regarded audio recording, and to staged performances in Bologna and in Berlin.
- Thomas Adès, Violin Concerto, “Concentric Paths”, Op. 23 (2005) (approx. 17-20’) “tours the boundaries of madness, with ecstatic babblings, orchestral cataclysms, stammering brass, and limping dinosaur treads.” Adès writes: “It is the 'slow' movement, built from two large, and very many small, independent cycles, which overlap and clash, sometimes violently, in their motion towards resolution. The outer movements too are circular in design, the first fast, with sheets of unstable harmony in different orbits, the third playful, at ease, with stable cycles moving in harmony at different rates.”
- Ernest John Moeran, Cello Concerto, R89 (1945) (approx. 26-29’) (recordings) “is a far more dark and troubled work than one might expect or indeed initially sense. Moeran's last years were shadowed by increasing worries about his inability to focus or concentrate and the concern that this might foreshadow a descent into total mental collapse.”
Albums from the dark side:
- Kid Cudi, “Passion, Pain & Demon Slayin’” (2016) (87’) addresses depression, anxiety, self-care and personal growth.
- Mac Miller, “Swimming” (2018) (59’): “. . . Mac Miller sings deftly about heartbreak and his mental state, capturing his resignation without turning sadness into a performative spectacle.”
Music: songs and other short pieces
- Empire of the Sun, "Walking on a Dream" (lyrics)
- Florence + The Machine, "Shake It Out" (lyrics)
- Logic, ft. Alessia Cara and Khalid, "1-800-273-8255" (lyrics)
- Shawn Mendes, "In My Blood" (lyrics)
- Macklemore & Ryan Lewis, ft. Leon Bridges, "Kevin" (lyrics)
