Toeing the Line, a vocational reflection

There are aspects of a career in social service you never expect. As well as things you sacrifice for some ambiguous "saner" good. A somewhat well-behaved enough mainstream so as to not gum up the system as it seems to be working. And of course for the common contentment in knowing we are each considered sane. Yet, in my work I am reminded sanity is an impossibly straight line we toe in grey sand.

For my current role I primarily assess patients with psychic ailments to determine an appropriate level of care. I ask myself the question a lot; and I suppose I do what I do because I am really good at it. I enjoy it somedays. Mostly it just seems like a willing sacrifice, like my vegetarianism.  It frequently strikes me that somehow I found myself in a position in which I examine the sanity and insanity of every individual that comes through the doors of the hospital seeking services willingly or no and determine what course of treatment should be recommended. Occasionally, I also get moments where I revel in feeling like a counselor again. With counseling alone, this intense focus on the grey line of sanity and insanity is not usually present. With the level of symptoms and crises I presently encounter, assessing level of functioning or grasp of reality is critical. Crisis situations and debriefing require someone who can look you in the eye and tell you sanity is relative. That life will become clearer again even if you only get a glimpse of it while we speak and that will be enough for every present second moving forward, believe it or no. Or even that perhaps one so despondent may not truly want to die at all, but perhaps merely live differently. Crisis or trauma we experience is just life and chaos dancing around us, drawing us deeper into ourselves with every wound and back out again more fully conscious. If we seek it of course.

When we lose it physically, emotionally or otherwise; out of grief or sorrow, rage or madness. In these moments we are again keenly aware we are human. It is a reopening of the wound we share with this world, with one another. And we feel unstable, out of control. Everyone must question his or her sanity at least at some point in life: what it is you or I believe we know. Often we do not question reality truly. Even language is the foundation of all our present production and enterprise. We have built upon it from it's collective conception or divine bestowal. But to what ends? We never established it as a strict tool or mechanism for communication only first because primitive cultures could not have known how we would merely incorporate it into our thought process. We think in words as often if not more than in images and abstraction. Much like the myth of Babel. Intent on reaching the Divine these foolish people were wasting their blessed energies on a combined construction effort to reach their idea of God. Who must be up in the sky. For where else would he be? Language is only the foundation of a crumbling tower we built long ago. We communicate with our bodies, through movement, through silence even. We exist in a culture that overuses language and under-appreciates the space for communication and non-communication around it. This coming from a writer. There is a time and place for everything. Writing in language fosters contemplation and wisdom as much as reading cultivates knowledge and critical thought.

The cliche truth of it, this field chose me. Growing up in a community oppressive to every idea of even choosing to allow yourself to love someone you so desperately want to love is a common occurrence of gay men of a certain age bracket. Hopefully soon dwindling for future's sake. Even now I still remember who I would have kissed in second grade if I thought I could. My questioning of my own sanity, my abnormalcy was rooted early on. As we all are led to doubt as life brings conflicting messages to our minds, but not with the intensity of my closeted years growing up Evangelical. This is where I thank God for professors, mentors and counselors along my way as I came out. Somehow I found myself in good hands when it came to wisdom and advice. When appropriate I disclose even to my patients my participation in therapy. Psychology is the revival or attempt in the guise of a soft science; of the treatment of our misconceptions about our humanity and inhumanity as well as that which we could only classify as insanity, bizarre and abnormal to the larger population, present within each human entity. As a field it steps into the lost roles of shamans, medicine men and spiritual leaders in caring for the individual. It is a reimagined and attempted scientific method of getting treatment of mental illness correct with as much certainty as possible. There is very little certainty in Psychology, but lots of statistics and efficacious theories. So basically anything that is statistically significant is only 95% certain in our field with no hope of raising that bar much higher. Statistics and research are helpful but cannot compare to the certainty we come close to with a scientific method and non-human subjects that are available to other fields of Science. A false comparison of certainty seems to emerge as a result. Not that this discounts the field, but should create some more realistic expectations of what can be accomplished medically alone is quite limited when it comes to mental illness. Otherwise we would only need Psychiatry.

Early attempts at understanding the psyche were organic, phrenology a byproduct of this thought. Then came psychoanalysis, behaviorism, and the myriad of modern approaches that now inform how we should carefully listen to and assist our consumers in finding the best in themselves. As well as lights in many tunnels while coping with the heaviness of life and ingrained unhappy patterns. Learning about what it means to be fully Diane or Pat or Bob. This is the good stuff for me at least in either chair of the therapist's office. Most people are frightened of what is in them. The water is cold but the sights under the surface are as wondrous as the ocean's biolouminescent depths. It is no abyss, the subconscious and our soul. They are awaiting potential with no limit which can be perceived. As infinite as we are seemingly finite in this metaphysical world.

There is only a line we all choose to believe in when it comes to sanity. That it exists at all. The mentally ill are by and large a harmless sub-population. Most suffering from chemical imbalance and an inability to ameliorate that effectively or not practicing good self-care given their state of mind. The causes of their affliction are even still unknown. We have yet to fully recognize they are beyond the reaches of mere medicine and perhaps would be better suited to a more organic and unconventional therapeutic approach yet to be more widely embraced and applied to the population. And from the "sane" population as a whole, seem to be from where the more insane acts and atrocities arise. Why are we so shocked at random acts of violence? We do not seem to expect them because we do not recognize that very potential within ourselves given the life situations of another and the conditions we allow them to be cultivated within. Not to claim, but share responsibility for these tragedies. They were committed by a fellow sapien after all. One that could not be properly cared for, whose needs were stifled or unmet. These human atrocities are no surprise each time I hear them now. They are only a sadness. But there is hope always as humanity becomes progressively more aware and develops more enlightened and humanistic strategies to improving the human condition.

There is a man, a reclusive author best known for Zen and the Art of Motorcycle Maintenance who through the power of writing and some therapeutic interventions was able to write himself out of mental illness. Robert Pirsig bases the novel on himself and names his character, Phaedrus. And it is fascinating how he tells his tale with reuniting psychically with his whole self. Through a process of awareness and the expectation of a journey. Miles on highways and sideways, currents and jetstreams. He wrote about this incredible passage that strikes me on so many occasions working with the severe and persistently mentally ill. Reading this one also can begin to understand that his bliss, his passion for knowledge and understanding of this imperviously undefinable concept he pursued to the point of madness we already know as Quality. We know it, but try to touch or define it and you repel it almost immediately. This was his maddening conundrum that overlay his mental illness. To have a professor challenge my vision of reality in a college classroom like Phaedrus did his students would have been a challenge I would have eagerly accepted. Alas, philosophic and existential inquiry has been lost in higher education. Philosophy is assumed in each school behind the academics and instruction already in place rather than subject matter brought into the light and exorcised as inquiry among students. Theology of course regimented to religious camps due to their dogmatic historical practices and perspectives. And Science seemingly remains sole stockholder of all relevant knowledge for our ongoing survival as a species. The products of science are shiny and new and we wield this philosophy in the natural course of our curiosity. Natural processes we adapt or harness based upon our world and these environmental conditions existing exactly as they are in this moment. Science is only a part of our toolbox that informs very strongly this vast unknown; our humbling and inspiring existence. It is good and necessary to be anchored in such a way in this great ocean. Important to not lose sight of science as both a psychology and philosophy of humanity. As much a psychic construct as language.


It is also part of my personal and ethical responsibility to seek counseling when the time comes. The burdens and troubles of my profession added to my own at times can be overwhelming. Processing this in a way that is careful and deliberate allows resilience and present-centered contemplation. To find meaning in the seeming madness of life and the lives of others. Most importantly to move forward and not stagnate. To take chances. Say things that unspoken would leave regret. Find possibility and hope in a world where true connection and intimacy amongst others can be difficult to find. Yet always worth the pursuit as much as one pursues his or her self-understanding. Failure or disappointment only intended to nudge you along or challenge you to persist further but never to snare you in the past.

I never expected I would be doing this as a career until I was in my second year of college. Or that it would feel as much a part of my bliss as envisioning our people turning back to attend to our world. Finding roots and quenching thirst, remembering our greater selves- our souls, and in doing so discovering we are in need of compassion and forgiveness as much as anyone. Together we are an organism unlike any other as far as we can see or probe in this universe. And as a whole we suffer daily. There are ways to minimize suffering and maximize our potential as a species. This we can know because we can see the need wherever it may lie within our vision, within our respective professional roles and fields. Where something is lacking in lies an opportunity to re-imagine greater. This life is movement from the centuries in which we inhabit onto aeons that await. However we choose to measure we must resist the urge to define that which we measure and observe by that measurement alone. It is difficult and complex to think this way. It is practicing and developing inner and outer awareness.

Simply by breathing intent, ayurvedic breaths. In. And out.  Enter the Stillness. The body remains. Relax into nothingness. Suspended or floating, perhaps even to nirvananic bliss. It can be in a moment. Inhale. Be present. See the robin, her prize. Snowpiles and sunspots burning eyes. Breathe.


In this state of mind, where exists the line?