Breakdown or breakthrough?

This really interesting question came up in a session, and it has stayed with me subsequently.

For the client, they experienced their breakdown as the beginning of a breakthrough. After the breakdown, they felt able to see their life differently. They felt more enabled to make choices and also felt able to be less critical of themselves; less critical of their past patterns of behaviours and their present behaviour, and more accepting of them.

Indeed, some years later, they were saying their life had taken a different trajectory and, broadly speaking, they were pleased with where this had led them. They had kept some of their previous patterns of behaviour and changed others. This, I feel, speaks of the client's determination, resilience and desire to change. I strongly suspect that they were helped by some very skillful and compassionate professionals and this deserves to be acknowledged.

For me, and I think this broadly aligns with the majority of the public’s view, my opinion was that a mental breakdown is a catastrophe and, as a result, the person suffering a breakdown is going to be enfeebled and medicated for the rest of their life. They will never be able to achieve the heights of success they had previously achieved and they were to be pitied and treated softly, gently, kindly.

I am glad to say that, after a lot of training and personal counselling, this is no longer my view.

So how about the person who is going through a mental breakdown?

First of all, I would offer that the 'going through' implies it is not permanent i.e. there is a beginning and there will be an end to the episode. Secondly, in order to understand the significance of the breakdown, it is necessary to understand the factors that led this person to experience a breakdown. Thirdly, it is necessary to try and understand the symptoms of the breakdown that the person suffers.

To consider this I feel it would be better to consider the three points in reverse order.

The symptoms are as varied as the people who experience them but can be generalised on a spectrum. A spectrum that ranges from: 

• not being able to get out of bed
• lack of personal hygiene
• lack of self-care (feeding)
• disturbed sleep patterns
• withdrawal from friends and family as well as society
• inability to answer the phone or open mail
• persistent self-doubt and negative views of themself
• doom-laden views of the future
• feelings of inadequacy
• incompetence
• failure as a person
• guilt

Do any of those sound familiar? None of them or all of them?

Personally, I would not wish them on any other person - whether I like or dislike them.

So, to the second point. What have we been allowed to know about the circumstances that led the client to the breakdown?

Some of the contributing factors will be external i.e. the death of a loved one or pet, the unsustainable demands of work or family. There might also be previous trauma or adverse childhood experiences (ACEs). Some of which might be disclosed by those close to the person undergoing a breakdown and some will come from that said person. 

Third, there might be feelings of guilt, shame, feelings of inadequacy or difference from others. Or it could also be that the person can no longer meet demands on them. Demands of themself or expectations of others - short-term or long-term. These are not exhaustive descriptions but are merely offered to illustrate how varied the feelings experienced can be. The importance is that these are what are felt by the person. Those reasons are the person's experience of reality and are very real to them and very valid because of that.

So, having knowledge of the above points, we come to the first point. The person is going through a mental breakdown and is not necessarily permanently afflicted with the crisis they are experiencing. The person may feel like it is never going to end, indeed that might be part of the breakdown but, from the outside, we know that people do recover and move on from breakdowns.

What about the breakthrough, you might ask? Well, with counselling, medication, care, patience and willingness to change, the person affected can achieve a return to a 'normality' that is acceptable to them. Medication, counselling, and accepting care can all be seen as admissions of weakness but, are they really weakness? I think not.

When my car breaks down, I go to a garage. When my laptop plays up, I go to someone skilled in IT . Why should it be any different when our lives/existence breaks down?

By seeking out the right help, we are able to resolve problems. Problems that can cripple us, but problems that can be resolved.

That normality might be very different to the normality that was experienced prior to the breakdown, but it is worth considering if and how that normality led to the breakdown. 

If the new normality is going to be positive and ongoing, then it is implicit that the new normality involves change. The change may be along the lines of being able to set boundaries, for instance being able to say no whereas previously that would not be acceptable to them or others. It might be that the person is able to seek out and pursue a career change.

It could be that the person is able to be more open about the times when they are struggling and to see that as a sign of strength. By being able to speak about their struggles, they open the window of opportunity for others to help. As well as them being able to receive help whereas previously they did not. Quite often a problem shared is a problem halved. It may be that the person is able to have their own pursuits, hobbies and interests and that is not selfish. Who can say, honestly, that they are entirely selfless?

More seriously, it may be that the person is able to change their abusive partner. It may be that they live by their own validation and no one else's expectations. That they no longer live according to the roles family or society expects of them. 

So, to finish, breakdowns are never pleasant or welcome. The effects can be devastating for the person and those in their lives. Breakdowns often require outside help and the consequences of that are not slight. However, breakdowns can lead to a different, and I would argue better, way of being post-breakdown! If we, as a society in general, are able to see the person having a breakdown as a person who is going through a life event and allow the person the time and space to go through the breakdown and come out the other side, we can all benefit. The person will be more self-accepting and whole. 

I cannot finish an article without a bit of Carl Rogers, so here goes. The fully organistic person is able to experience new stimuli and respond accordingly, whereas a person who is rigid and inflexible will ignore new stimuli until they can no longer do so and then break (down). Paraphrased but true to the meaning. Finally, Maslow, Rogers and Prouty speak of the self-actualising tendency. Simply put, a person (organism) will always do what is in its best interest at any time and in any circumstances. Maybe a breakdown is an extreme expression of this - I believe so.