A Narrative Practices Approach to Managing Mental Health in
Times of Uncertainty
The idea of a personal toolkit, both metaphorical and literal, emerged out of recent conversations with individuals in Mumbai, and elsewhere in India, all of whom are in some form of enforced quarantine for the Novel Corona virus.
(As of April 10, India is under one of the harshest lock downs in the world.)
The milieu I work in is urban, multi-lingual and multi-cultural, and includes individuals from middle class and upper middle-class (in an Indian context) strata. Most of my co-researchers are educated and aware of privilege, even as they deal with growing difficulties around mental well-being in the current climate. We also recognize that for many Indians–as maybe the case in other countries around the world–the state enforced ‘lock down’ implies little or no access to basic facilities: those of food, shelter, electricity and clean water.
In recent therapeutic conversations my co-researchers and I looked at how it might feel to replace harsh words such as "lock-down" and "quarantine," with more comforting words such as "retreat," “seclusion” and "unexpected vacation." (Add your own to the list!)
We explored whether it may be useful to draw from existing toolkits, from the trades, such as those used by gardeners, carpenters, electricians, hair-dressers and manicurists, among others, as a reference to create unique tool kits to dip into during tricky times.
Note: Toolkits are used by virtually everyone: they are versatile and can help fix, repair, mend, plant, build, join, shape, rewire, nail down, protect…
MY LEARNING COMES FROM:
- Having witnessed a loved one’s life skills for managing her life as a ‘lock in’ from 1989-2018. She had many ways of managing self-imposed isolation, including a tightly curated daily routine. Her day was measured by meals and self-care; her nights were spent being watchful of all those who slept. She had special knowledge/s to manage morning ‘mood’ and seasonal and cyclical arrivals and departures of ‘highs and lows’*
*A separate document of her skills can be made available on request
- My understanding of "…Retelling the stories of our lives… to transform experience." (Denborough, 2014), and the important Narrative Practice idea that, "People always take actions for their lives." (White and Epston, 1990).
- Stellar projects by persons with lived experience, peer knowledges by individuals and communities working in association with Dulwich Centre, Adelaide.
QUESTIONS IN THERAPEUTIC CONVERSATIONS (occasionally scaffolded) could look like:
Q. I wonder whether it may be useful to create a unique tool kit for yourself, one that could possibly help manage ‘beasts’ and other beings which might rear their heads during this time?
...If so, what might your unique toolkit comprise of….?
Q. How might it feel to make a drawing of this tool kit as a visual narrative of tools you might use, and the actions you may take, to navigate this unexpected twist in time so as to create a preferred identity for this leg of your life’s journey?
...And, would it be useful to explore how you might use each item in your tool kit for?
A colleague from India, Y, responded to some of these questions to say, “I love the questions and all the possibilities hidden in them for one to explore life skills and micro-actions that each one responds with in trying times.”
TALENTED TOOL-KITS & POSSIBILITIES FOR UNIQUE OUTCOMES
S, 27, who was under government enforced home quarantine from March 21 to April 4, on returning to Mumbai from Africa, and remains homebound under the Indian government’s lockdown said:
"I get anxious from time to time. To take care of myself, I need to feel like I'm contributing to the world around me, especially in this time of need. For my tool kit, I chose my computer, as it's the best tool I have in my room. It allows me to work virtually, metaphorically, and in actuality, during my home quarantine. I work in Public Health, and I think this is the time for young people everywhere to rewrite many things. I want to rewrite policy around health and the environment."
R, 48, an artist who is hemmed in on a private property in a village off the city of Mumbai since March 22, with no access to road or sea travel to return created this text-drawing. She says:
“My toolkit is a mental construct which I use to reign in my thoughts. It helps to be able to put anxious, overactive thoughts into a metaphorical black box that can hold them, and open up space for being more present to what is around me. The elements in the box are totems or objects to which I give up bits that aren’t working, and embody them outside myself. Through this metaphorical box and its imbued objects, I can let go, surrender and breathe a little when my mind gets confused, overwhelmed or just weighed down by old patterns that are cropping up during this crisis.”
Excerpts from a conversation with J, 28, a working professional, who has returned to her adoptive parents’ home in Bangalore, India, till the ‘lockdown’ ends.
A: I wonder if it may be useful to create a unique toolkit for yourself, to manage some of the beasts that might rear their heads during this time?
J:…I don’t know…but okay…If I had to look at it I would think of it as packing for a holiday/adventure/journey to a place we’ve never been before. Even if we’ve never experienced what the weather feels like there, the principles of packing remain the same – we prepare for what we might face with what we have. An umbrella/ raincoat for the rainy days, socks for cold nights, shorts for a bright sunny day. I think it’ll be a mix – some cold/rainy days and some warm ones. The quarantine makes me feel a little trapped. Not physically. It’s the time cage that bothers me – there’s a rush to reconnect with old friends, resolve old wounds, confront things I’ve been avoiding, have conversations I’ve been avoiding, accept change, heal, grow. It feels like we’re all running out of time on an all-important exam and there are no re-takes. Feeling metaphorically trapped like that makes me feel anxious. Sort of keyed up, unable to sleep well. Makes me suck in my stomach and not let enough air into my lungs. Curl up my toes and not let go. The nervousness and tightness in my heart builds up. I also just feel scared all the time of losing people. Grief feels like a large, looming shadow that will consume me, and I’m afraid I’ll be too weak to emerge. And at times, for reasons I haven’t understood, I want to cry. I guess those are the beasts I think I will be reckoning with on this journey. But believing I can pack for this journey/ build a toolkit to draw from, makes it less intimidating. Makes me feel a little in control; like I can decide/ monitor on what side I come out. Makes me breathe a little easier. I feel less unsure of myself because I know what weapons I have to fight with.
A: Glad to hear that…and, would you like to share some ideas around what your toolkit might include?
J: Let’s see…
- Pen & paper for writing
- Paints & brush for painting
- A phone : for music, or staying connected
- A warm shower
A: Would it be useful to make a drawing of this toolkit as a visual narrative of what you might use to navigate towards preferred outcomes? Would it be useful to explore what each of the items in your toolkit would enable you to do?
J’s drawing of items in her toolkit and their functions:
- A regulator to be able to dial back the pressure, or to regulate what I let in
- Listening to music or taking a warm shower helps tune out of the chatter in my head
- A phone to reduce the distance with people who aren’t around.
- Milestones – for when I feel overwhelmed; to serve as a reminder to take things a step at a time and in smaller doses; so that each day doesn’t blur into the next; to remind myself of how far we’ve come, that we’re moving and not stuck, that there things to celebrate like weekends and birthdays.
- Paints and a paintbrush – to be able to express amorphous feelings when I can’t find the words, or just for a bit of colour
- Paper and pen – to articulate and process my feelings
HOPES AND DESIRES FOR THIS PROJECT
This project is at a nascent stage on April 10, 2020. I have a hope for it. I would like to see it travel across the world, possibly, as a source of hope for many people. Especially for those whose mental health difficulties may be put to additional test in these trying times. My desire is for professionals and individuals to use, modify, and share this document in ways that will be useful for the contexts in which they work. I am deeply grateful for the learning imparted by my teachers and trainers at Dulwich centre, Adelaide, David Denborough, and David Newman, Sydney Narrative Practice.
Sparkling thought: Perhaps ‘Tool kits for Trying times,’ will become a global sharing of “ways to feel better in times of trouble.”
REQUEST: Please do tag me on social media if you share/use/develop the material from this project. Credits would be appreciated. I would also love to hear from you. My email is firstname.lastname@example.org and my website is www.anupamehta.com.
Mumbai, April 6, 2020
Denborough, D. (2014) Retelling the stories of our lives: Everyday narrative therapy to draw inspiration and transform experience. New York, NY: WW Norton & Company.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: W. W. Norton and Company.
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