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DR. MARGARET JAMAL WRITES…

There is an ugly rumor going around that black women are apprehensive about getting mental health treatment.  If you have not heard that rumor, I need to be more diligent with spreading it around.  It is no secret that people like me are often referred to as an “angry black women”.  I have spent many years counseling ladies who even refer to themselves as “angry black women.”  But I have come to believe that much of what is simply attributed to as anger is in reality mental
illness.

When I was (even a few years) younger if you had told me that I needed to seek mental help, I might have told you that

you were crazy.  Even though my own mother suggested that I seek counseling, I figured that she simply misunderstood that I was just different.   Ultimately, I agreed to take a serious look at the possibility that maybe there were some issues

with my own mental health.  After I decided to study counseling, I realized that I could no longer refer to a Freudian Slip as a line of lingerie for psychotic women.   There were real reasons for my harsh communication and erratic behavior that were linked to past experiences.

• A FREUDIAN SLIP, CAN EXPOSE VICTORIA’S SECRET

In a fit of anger, a woman called her husband the same name as her dead stepfather.  We will call her step father Ray and her husband, Harold.  One day, Harold wanted to be intimate with his wife who we will call Victoria.  Unfortunately, on this day, Victoria had just watched a movie that included a brutal rape scene.  She saw this movie after having viewed episodes of popular “doggy men and whorish women” day-time talk shows.  Her head was certainly not ready to receive acts of affection from her husband.

On the other hand, Harold was returning home after being around co-workers that were excited about having a great and productive day.  In the excitement, Harold found himself sharing his good feelings with one of the female co-workers.  He had never really entertained thoughts of an affair.  But for a moment he felt stimulated by this woman.  Harold fought to push aside those feelings provoked by the co-worker and rushed home to release his passion where he thought it should be shared- with his wife Victoria.

Upon approaching Victoria, Harold was met by immediate rejection as she declared how she did not appreciate being forced to be intimate when she was “not feeling it.”  Harold’s attempts to get Victoria to “feel it” somehow escalated into an argument.  Their hostile banter quickly resulted in Victoria yelling, “just leave me alone, Ray!”  This mis-speak was an accident.  She meant to yell Harold’s name.   Sometime later Victoria revealed that her stepfather Ray had molested her when she was a child.

Although Harold was finally able to see that Victoria’s frequent rejections of his physical advances were due to previous abuse, he simply grew weary of fighting and not having his need for intimacy met.  Victoria and Harold were ultimately divorced.  While the documented grounds for their divorce was irreconcilable differences, Harold claimed that he would have considered staying if Victoria had “just tried to get some mental help.”

• IN (MENTAL) SICKNESS AND IN HEALTH…

In another situation, a relative that I had never imagined to be so committed, learned that his wife was suffering from a disorder diagnosed as “Bi-Polar.”  The extensive severity of her ailment included unnerving and sometimes violent mood swings.  When we met, his wife was friendly and a clearly outgoing fun-loving woman.  In a few years after their marriage, she grew paranoid and suspicious of his relationships with every woman, including siblings.  She even digressed to the degree that she no longer wanted to be in public because neither of them was comfortable with how she might behave.  To my delight and surprise, this relative has demonstrated his commitment to being a loving husband and committed caretaker for his wife.  I am certain that hardly any members of the family (if any) would have blamed him if he had decided to abandon his marriage under such dire circumstances.

I wonder how many of us actually think about mental illness when we state our wedding vows.  I am referring to the portion that includes “in sickness and in health…”  I wonder if there would be cause for pause if it was stated “in sickness, including mental illness and in health… .”  What if pre-marital counseling included painting a picture of a spouse being diagnosed with some mental disorder?    Would love struck couples actually re-think their plans for marriage?

• WHEN MENTAL ILLNESS HITS HOME

I must admit that this is a difficult subject for me to address objectively.   My husband has already demonstrated that he is willing to tolerate a certain level of mental instability regarding me.  However, I am not certain that he would be able to handle some of the situations that we have witnessed in other couples.  As we progress in age, it appears that we become less adventurous as well as less tolerant of conflict.

Although I am willing to stand with my husband if he suffers from mental illness, I am not certain that I would be able to handle any and every behavior without significant support.  I have seen heart-wrenching portrayals of couples dealing with Alzheimer’s disease and other debilitating mental illness.  Each time that I experience movies with such storylines, I realize that I do my best to keep from imagining myself in those situations.

There is a tasteful movie production called “A Vow to Cherish” that portrays a family faced with a wife and mother being diagnosed with Dementia from having Alzheimer’s disease.  The movie, starring Barbara Babcock, Ken Howard, Ossie Davis is filled with topics that could arise in a family forced to deal with discovering that a spouse is struggling with mental illness.  This is the one movie where I allowed myself to empathize with both spouses.  I appreciated the realism of reactions that are presented which made it more inviting for me to explore.  But if mental illness was to invade our own home, how many of us would really feel good about our responses?

• SOLUTION:

As the movie indicates, I believe that prayer and support are needed to deal with mental illness in a marriage.  Even if one feels that divorce or some form of separation is inevitable, it should be done with much prayer.  I believe that connecting with God through the process will offer much needed peace through this journey.  I refer to it as a journey because being separated will not terminate the relationship and sense of obligation.  Unfortunately, too many people think that divorce or separation insures finality in a relationship.  But for many couples, the separation actually makes life even more complicated.

I strongly believe that adequate support should be diligently explored even if one feels “OK” with a decision -to stay or go- after mental illness has been diagnosed.  There is a good reason that more support services are being developed for caregivers as well as divorce survivors.  The reason that support services are being offered for caregivers is because mental health providers are recognizing the extent of trauma and stress that occurs from having to deal with the illness of a loved one.

I believe that the trauma experienced as a result of having a mentally ill spouse or from divorce is far too under assessed.  I strongly encourage those who experience either of these situations to seek active prayer as well as seek (or start) a support group.

DR. AARON JAMAL WRITES…

• BRANDON MARSHALL & BORDERLINE PERSONALITY DISORDER

Recent stories surrounding Brandon Marshall, MVP and new NFL Wide Receiver for the Chicago Bears, have started some heated discussions. Mr. Marshall has publicly declared that he suffers an emotional disorder called Borderline Personality Disorder, also called BPD. With his wife standing right by his side, Mr. Marshall answered questions about his past behavior and the disease he is trying to give voice to. During a press conference, the calm and articulate Brandon provided unrehearsed responses to a range of questions that were personal and way beyond the scope of “on the field” behavior. However, much of the reaction to his comments that followed the interview revealed the troubled stigma
associated with mental illness.

Many of the people that called in to sports oriented talk shows were probably suffering from some level of ignorance about mental illness as a whole, however, the range of emotionally charged comments ranged from wide acceptance and support for Brandon to ridicule and malicious character assaults. Brandon has not shared that he or his wife were seeking divorce. However,  it is well documented that they have experienced some turbulent and violent times resulting from his chronic disorder.

• ESTABLISHING GROUNDS FOR DIVORCE

Speaking of divorce, allow me to preface my premise about divorce with some clarity. Divorce is the legal dissolution of a marriage by a court or other competent body.   When we start talking about “grounds for divorce”, then we are not suggesting the popular no-fault divorce type. Often this type of divorce (at-fault divorce) is used when it is necessary to provide required proof by one party that the other party had committed an act incompatible to the marriage. In the case of divorce based on the grounds of mental illness, the evidence must be presented comprehensively and beyond the hearsay of neighbors, usually supported by the diagnosis of a mental health professional.

However, the fact that someone is seeking grounds for or permission to divorce their life-partner is tragic to begin with. The stories behind that sentiment are certainly more comprehensive than I have room to address in this brief blog. There are probably stories of suffering, frustration, humiliation, loneliness, betrayal, helplessness, and more. Statistics show that patients with mental illnesses that have a partner in marriage are far more likely to live longer and even adapt to an effective treatment protocol. However, the partners of those marriages are often overwhelmed with feelings of being trapped, guilt, and even bitterness about why their lives have turned into a living hell.

• FROM SYMPTOMS TO SUPPORT

How incredibly frustrating it must be to continuously offer explanations for your partner’s inexplicable behavior.  Where is the support for you?  Who is going to rescue you from the volatile and sometimes violent circumstances that hijack every “normal” day of your life?  The cumulative effects of acting with disregard for your own needs can produce a socially deprived, and emotionally starved set of needs that desperately cry out for some relief.  This is not the picture of every spouse of a mentally ill partner. Still, this picture must be represented as well.
When dating someone, the subject of mental health is rarely if ever discussed. That reality frames the attitude of being betrayed in many of the people that are dealing with unforeseen challenges from their spouse’s illness.  I know that there are those that say, “You make me crazy!” but don’t truly mean that they provoked a psychotic episode. However, there truly are triggers to many of the symptoms that unless controlled through medication and treatment can lead to violent or even deadly outcomes.

So should people be permitted to divorce on the grounds of mental illness? Even notifying a mentally ill spouse of intent to divorce could prove extremely dangerous. On the other hand, if given the right balance of support and resources, it is possible to restore the relationship that fostered your heart-felt “I do” during your wedding vows.

Divorce is a legal process that should always be a last course of action. Mental illness is veiled with so much misinformation and stigmatization that it is difficult to imagine any life that would resemble “normalcy”.  My hope is to just scratch the surface of this complex problem in order to provoke more conversation and inspire more education about the social and societal problems associated with marriage and mental illness.

Many experts describe these disorders to be active over days, weeks, months or years before diagnosing that there is a mental disorder. These disorders are not typically measured in increments of minutes or hours. On the other hand, behaviors such as spending sprees, promiscuous sexual activities, gambling, excessive drinking, or using drugs are different disorders that though they can and often are compulsive, do not meet the same consideration as bipolar or borderline personality disorders. Dementia is among the most tragic and degenerative mental illnesses that challenges marriage.

What is also confounding to partners is when co-occurring disorders of paranoia cause the mentally ill partner to protect themselves from being victimized. Science is still gaining progress in battling these chronic disorders. However, for the partner of a mentally ill spouse, the clock may appear to be standing still.

IT’S YOUR FAULT I’M LIKE THIS!

There is also a propensity for blaming others for the way you feel when you are dealing with many personality disorders. Similarly, those struggling with Substance Use Disorder, (SUD) often resist taking responsibility for the collateral damage and choices that have led to their circumstance.  “I got caught.” seems easier for many of them to admit than to reflect on how reckless, self-centered, or deceitful their behaviors have been. Having written that, there is also a strong stigmatization associated with mental illness of any type. For centuries, people with mental illnesses have been rejected as socially unacceptable and therefore relegated to being institutionalized rather than supported.

• “IN SICKNESS AND HEALTH, IN POVERTY AND WEALTH

Christian models of marriage typically include vows that promise to endure through sickness and health, poverty and wealth. However, the model does not define the extent of that sickness before permitting divorce. Jesus spoke to the people about divorce saying in Matthew !9: “8 “Moses, because of the hardness of your hearts, permitted you to divorce your wives, but from the beginning it was not so. 9 And I say to you, whoever divorces his wife, except for sexual immorality, and marries another, commits adultery; and whoever marries her who is divorced commits adultery.(NKJV)

The behavior associated with the “hardness of your hearts” is not explained in this Scripture reference, however, it has been argued that God does not want anyone to suffer in their union, trapped by a ceremony of inequality and oppression. What I think is critical in reaching a conclusion about justification for divorce is that we reframe from using a broad brush to define what is going on, or to determine the resolve for the complexity of problems they face. However, since the focus of this article is divorce and mental health, I will refrain from elaborating at this time.

• THE DESTRUCTIVE-NESS OF DIVORCE

Speaking from my own personal views, I believe that divorce is a destructive and sometimes violent/civil process that should be a last course of action. I also believe that most of the relationship challenges within a marriage are treatable and able to be placed in the past for those couples that are willing to do the work. I also recognize that the depth of damage caused through adulterous relationships can inflict irreparable setbacks to the trust and integrity of a marriage. However, there have been those that have survived adultery as well as mental illness.

Mental health issues are often addressed after a great deal of trauma has happened to the family as a whole and even friends and/or neighbors. PTSD (Post Traumatic Syndrome Disorder) is sometimes diagnosed for survivors of traumatic events. If that survivor is also victimized by an unrelated chronic disorder, the diagnosis for treatment becomes profoundly more complex.

Imagine a young girl that is suffering from the effects and trauma of being molested/raped as a child. If that surviving child grows up and marries a partner who also has a mental disorder that manifests itself because of stress, loss of job, hopelessness, etc., there could be multiple traumatic episodes that would leave this young girl struggling through co-occurring symptoms similar to PTSD and BPD.  However, if properly diagnosed and treated, this couple could recapture their desire to spend the rest of their lives together even though both have degrees of mental illness that may prove difficult to navigate through.

Education, prayer, and competent palliative care models could prove quite successful in providing significant improvement of mental health resulting in the restoration of this marriage.

• IN CONCLUSUON

In conclusion, I don’t want to pass judgment or make recommendations for a spouse regarding the viability of the suggestions listed above and/or the culpability of mental illness regarding you getting a divorce. My greatest hope is to educate people to some of the factors that should be considered in their decision making process. If you are considering divorce then you are probably in a great deal of anguish and I do not want to contribute more to that. My prayer is that you find love, support, unspeakable peace, and hope to experience the rest of your life while prospering.

The following links provide supporting support and details about this subject.

http://www.borderlinepersonalitydisorder.com/resources-news/articles-about-bpd/

http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=108438

http://blogs.psychcentral.com/wellness/2012/03/moody-or-bipolar-disorder/

http://en.wikipedia.org/wiki/Palliative_care

http://www.toddlertime.com/dx/ptsd/partners-with-PTSD.htm