Writing as therapy: the narrative of anxiety
Professor Tanya Byron, author of The Skeleton Cupboard, explains how narrative can help those suffering from anxiety, and how it has helped and shaped her in her career as a mental health practitioner.
by Tanya Byron
Working as a mental health practitioner is a real privilege. Over the last 25 years of my career as a clinical psychologist I have met extraordinary people who have had the courage to seek professional support for their mental health challenges.
To seek help for physical illness can be terrifying, but it is something that most of us do with very little thought as it is ‘acceptable’ to consult medical practitioners when bits of our bodies feel broken. However, when I meet those in the grip of mental health problems, many come to me much later than the onset of their difficulties because the stigma of mental illness has gripped them by shame and rendered them anxious and helpless.
We can all get overwhelmed at times and we can all struggle mentally as well as physically. We live in a world defined by anxiety. Twenty-four hour, multi-platform news media keeps our fear alive as we watch and hear endless stories of tragedy and trauma. Stress infuses every waking moment as we work unhealthily long hours or panic in the face of mounting debt.
Anxiety – the fight / flight / freeze response – is an inbuilt, instinctive reaction to a threat. If we feel in danger, we prepare to run or to fight or, if totally gripped by panic, we freeze rooted to the spot. As blood flows to our heart, lungs, and muscles, parts of our brain unnecessary in that moment of survival switch down, including our frontal cortex, our rational, thinking brain. No time to hang around and ponder, only to react and stay alive.
However, if we feel that our minds are ‘breaking’, we panic and that acute anxiety pulls us away from our rational problem solving ability so that we become aggressive to those who show concern, or we withdraw, or just freeze feeling powerless and helpless. Add in a large dollop of stigma-induced shame and suddenly the actual difficulty is infused with additional layers of mental slurry and we feel our sanity is leaving us; we fear that we are going under.
we enable the person we are working with to pull together the sometimes terrifying fragments of their memories and experiences to create a coherent narrative
In my job I attempt to empower people to make the journey through the chaos into clarity – to understand themselves, to feel ownership of the story that explains how they got to where they find themselves.
Narrative is powerful. We use stories to teach children important life lessons and we ask questions to understand the behaviour of others. The ‘what’ and ‘why’ of life is essential to us making sense of an often very confusing world.
In clinical psychology, the narrative that we help our patients construct is called the formulation. By formulating, we enable the person we are working with to pull together the sometimes terrifying fragments of their memories and experiences to create a coherent narrative. In doing so, the chaos begins to take shape with a beginning and middle and the therapeutic task is to then work together to create an ending that becomes the gateway to learning about and acceptance of oneself and the platform from which to move on.
In my book The Skeleton Cupboard, I write the stories of some of the incredible people I met when training to be a clinical psychologist, altering details to retain confidentiality. Through their narrative, I attempt to show how powerful understanding can be in a process of acceptance and of healing.
I had been thinking about writing the book for twelve years and, interestingly, when I did get down to it, I found that creating the narrative also enabled me to understand more about myself, to reflect on what I didn't know about mental health – indeed about life – when I started my own professional journey. In writing, I began to see myself as the then naïve, young woman in her early twenties, whose own narrative is so important within the process as her anxiety sometimes got in the way of her thinking. So the narrative of the book helped me to look at my own journey from chaos into clarity and understand that the line between practitioner and patient is not always clearly defined: we are all vulnerable, often anxious, and that's OK because we are merely human. And that's nothing to be ashamed about.
The Skeleton Cupboard is Professor Tanya Byron's account of her years of training as a clinical psychologist, when trainees find themselves in the toughest placements of their careers. Through the eyes of her naive and inexperienced younger self, Tanya shares remarkable stories inspired by the people she had the privilege to treat.
Gripping, poignant and full of daring black humour, this book reveals the frightening and challenging induction faced by all mental health staff and highlights their incredible commitment to their patients.
Picador author Sarah Rayner on her experience of writing about mental health
More information on Mental Health Awareness Week can be found on their website.
Main image (c) Frederic Guillory
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