Although I am a little late with this posting, I have been inspired by the work of the organisation Time to Change and their Time to Talk Day, which was on the 1st February this year. On this day, they encouraged people to talk about mental health issues in order to offer support to those suffering, to show that people are not alone in their struggles, and to try and end the stigma around mental health. For more information on this campaign and organisation please check out their website at www.time-to-change.org.uk.
I feel that this is linked to the injunction of ‘don’t be well’. This injunction is often described as, or can be considered to contain the injunction ‘don’t be sane’. As with the injunctions ‘don’t succeed’ and ‘don’t be important’ that I described last time, this one can also be linked closely with the needs of the child (and the needs of the parent in their child ego state).
In its most explicit form, this injunction can be given as descriptions of a child growing up, for example, “She’s such a sickly child”, or “He’s so crazy all the time”. In this form, the messages can be perceived as telling the child that their physical wellbeing or behaviour demonstrates that something is wrong. There may be something unacceptable to being ill, and as suggested in the opening paragraph, society seems to deem there something shameful or taboo about mental illness. The child may therefore begin to see themselves as being unacceptable and in some way ‘wrong’ or ‘damaged’. As injunctions are taken as prohibitive, it is almost as though the child is being branded as unwell, and so consequently they believe the message of “don’t be well”. These descriptions are usually given from the parent in their child ego state as they are perhaps scared of the malady that their child has, or they are not sure how to cope or deal with it. It may also be used as an excuse for their (perceived) failings in their role. After all, it is easier to label a child as crazy rather than have to develop coherent discipline strategies.
A more implicit ways that this message might be given is if the child learns that the only way that they can get the attention they want, or get their needs met, is to be unwell. To a child, often any attention is better than no attention, and so acting out in a bizarre way, might get them a telling off, but if this is all the interaction they get, they will take it. Being physically sick will usually elicit a nurturing response from a caregiver, which may be missing in everyday life. As the child gets older and becomes an adult, they come to believe that the only way that they will get attention from others is through acting out or presenting with a problem to get a reaction (often sympathy).
This inunction may come through a learning process. Although I have said that drivers are learnt, this injunction may come from the witnessing of it in action. A parent might be unwell, and seek out a lot of care from others (often including the child). The child may not get their needs met, and so, as outlined above, they surmise that being unwell is the way to achieve this aim. The parent may actually be unwell, or simply be acting out through their own ‘don’t be well’ injunction of their child ego state.
I will at this stage mention a serious, but rare, diagnosable mental health condition that has parallels with this, which is fabricated or induced illness by carers (FII). This is also known as factitious disorder imposed on another (DSM-5) or colloquially as Munchausen by proxy. This condition can lead to extreme abuse to a child, as a parent fabricates or can cause illness in a child in order to gain attention. If you suspect a child is affected by a parent with this disorder it is a safeguarding issue, and should be raised with social services or the NSPCC (0808 800 5000) rather than through direct confrontation.
There are some parallels that can arguably be drawn with the damaging tactic used by narcissists known as gaslighting and the establishment of the ‘don’t be well’ injunction. This tactic specifically works on the being ‘sane’ part of the injunction, as it makes people question their own reality. A narcissist will deny and distort what they have said or done, even in the face of evidence, or flatly lie about events. Their behaviour will also not match what they say. In doing so, they can make their target (perhaps a child) over a very long length of time, due to its subtle and insidious nature, doubt their own sanity and perceptions of the world. An example might be a parent who promises their child that they will do a fun activity in private, but in public will deny all knowledge and make out that the child is lying or making things up. The may even suggest to the child that they are forgetful or must have a problem with their hearing. If this happens enough times, then the child might believe they actually are the problem. In adulthood, these people may fall for scams and tricks promoting cures for ailments that they don’t even possess, or become victims for new narcissists.
I have given some pretty extreme examples above, but as with the other inunctions, these can lead to changes in behaviour and decisions made about ourselves. In a despairing position, I have already described how a person may end up feeling “less than”, “broken” or perhaps unworthy of ‘wellness’. They feel that they will only be accepted by, and cared for by others if they have a problem that needs solving. This however means that they will not be free to make a full range of choices in their life, or develop their full potential. They may also develop drivers to compensate for the feelings of the injunction. If they see themselves as being ‘lesser’ in some way, they may have to ‘try hard’ to overcome this. Any imperfection may be seen as a symptom of illness and so they may strive to ‘be perfect’. The same is true for displaying any weakness, and so they may mask their issues with the ‘be strong’ driver. If they had a caring role in the family, perhaps from looking after an unwell caregiver, then they may have also developed the ‘please me’ driver. In the defiant position there will possibly be an acting out of over the top ‘unacceptable’ behaviour, for example by being sick everywhere, acting ‘crazy’, throwing tantrums and feigning extreme lethargy and immobility. This will not get a positive response, but it will at least get one.
With this injunction, I believe that empathy and compassion are a really important aspects of enabling people to overcome it. If people have the belief that they are not well and that this is unacceptable, they will need to be met with a nurturing response that allows them the freedom to explore how they feel and trust this again. This injunction may lead to a feeling of learnt helplessness if it is met from a negative nurturing parent standpoint, and so there needs to be an active encouragement for them to seek out their own solutions or paths to wellness, with stable and secure support. This can most often be provided by therapy, but this patient listening and understanding can be offered in all relationships.
As with the other injunctions, overcoming it involves a process of self-permission giving. This involves the child ego state recognising that it is Ok to be well, and that needs can be met without the need for a problem. Weaknesses are not a sign of “wrongness” but instead a realistic part of being human. Challenges can be made to the notion of being “normal”, and this can come from valuing their own uniqueness in being and experiencing the world. I offer below a few permission messages that may be of use:
- I am not crazy
- I don’t have to be unwell to included, loved or cared for
- I don’t have to feel great all the time, and I can ask for help when I don’t
- I am worthy of attention and care for being myself.
- I don’t have to act out to get attention
- My needs are important. I can ask for them to be met, or tend to them myself
- I can chose my own path to wellness, and define what this is for me
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