Beyond voice – A project overview and update

This post was originally written for the Bristol University Arts Matter blog by Dan Degerman and Jae Ryeong Sul

When we talk about silence in mental illness, it is nearly always as something harmful that we need to ‘break’. Of course, some silences in and around mental illness should be broken. Think of the silence of someone afraid to talk about their distress because of mental health stigma. Or, think of the silence of someone who wants to share their distress but can’t find the words to make others understand.

However, silence is a diverse experience, as most of us will recognise from our own lives. Silence can be painful, imposed, and disempowering. But it can also be pleasant, chosen, and empowering. While it can feel like a barbed cage that keeps us from saying what we want, it can also feel like an oasis of freedom from other people’s demands.

Why should we think that silence in mental illness is any less diverse? Our AHRC-funded Beyond Voice project suggests there’s good reason not to.

Beyond Voice is a philosophical project that sheds light on the role of silence in the lives of people with depression and bipolar. Our research engages deeply with first-person accounts of people with lived experience of these illnesses from different backgrounds. That involves analysing autobiographical accounts and qualitative research, as well as working with a research advisory group consisting of both experts-by-experience and mental health professionals who provide invaluable guidance on our research.

Mapping the rainbow of silence

So far, our research has shown that many first-person accounts defy common assumptions about silence in depression and bipolar. For one, they suggest that silence can be part of what it means to be depressed. The writer Andrew Solomon, for instance, writes that depression ‘is like going deaf, hearing less and less until a terrible silence is all around you until you cannot make any sound of your own to penetrate the quiet’.

By contrast, in the manic episodes that form part of bipolar, the loss of silence can be a source of suffering and longing, as the writer Bassey Ipke suggests in her account of such an episode: ‘The thoughts have started to flood. They tumble and race so quickly that only focusing on [the cab driver] helps slow their circling. … [M]y mind is never quiet’.

These are just two examples of the rainbow of silence experiences – to borrow a metaphor from our advisory group – that people with depression and bipolar report. The first key objective of our 18-month project is to begin to map out that rainbow.

A better understanding of the variety of silences that occur in depression is not simply a matter of dotting some ‘i’s in an otherwise complete picture of depression and bipolar.

A clearer picture of the rainbow of silence will have important practical implications for people with those illnesses and those who want to help them, including friends and family, healthcare professionals, and policymakers. The second and third objectives of Beyond Voice are to draw out those implications.

Silence matters for mental health

Some implications have already begun to emerge.

Since silence can be a part of what it is to be depressed or a desperate attempt to keep the worst consequences of mania at bay, we need to recognise the potential harm that the blinkered insistence on ‘breaking the silence’ around mental illness can have.

For example, other people’s well-intentioned appeals to share experiences or unsolicited advice can cause more harm than good to an individual whose depression is so severe that they cannot speak and do not even feel the urge to. In such cases, simply sitting with them in silence – honestly acknowledging the depth of their despair and quietly blunting their isolation – may instead be the crucial first step towards providing the appropriate support.

In other words, we must consider how we can help those who want to speak to do so without pathologising and pressurising those who cannot or have good reasons not to.

Our work will continue over the next year and we’d love to hear from you with your own thoughts on and experiences of silence.

Silence and Gaia

Guest post by Amber Sahara Donovan

Only in Silence can you hear the wisdom of Gaia

Sometimes silence is necessary to experience the truth that cannot be communicated in words. When in nature, silence can help us to access the wisdom of the natural world, the wisdom of Gaia.

Gaia is the name of the ancient Greek earth goddess. More recently, Gaia was revived by NASA scientist James Lovelock and microbiologist Lynn Margulis to name their vision of our home planet as an organism itself, an organism so large that humans are reimagined as something like bacteria. 

The presence of humans, like bacteria, is neither inherently good nor bad. Many of us would consider the bacteria that make up our gut microbiome as part of our bodies. However, when bacteria amass in our body in a less helpful way, we don’t consider this ‘part of us’ and instead call it an infection. Humans stand in a similar relation to Gaia. When our movements support this great system of life, we are part of it and when our movements are destructive, we become an infection. 

In the West, our daily movements are sadly more akin to infection than microbiome. Acts of sacrilege rather than reverence. Our culture of overconsumption does not support the internal homeostasis of Gaia; it threatens it. Facing this reality is hard. Especially when it often feels like no matter how many changes we make to our individual consumption habits, it is but a drop in the water compared to what is happening on a larger scale. 

Thoughts like these have often filled my head and weighed down my heart with hopelessness and despair. What can I do?! How can I help?! Will it ever be enough?!

A tonic for such thoughts can be found in Silence. In Silence with Nature. Silence in the presence of those parts of Gaia whose status as part of her – as microbiome or vital organ, rather than infection – is indubitable.

Here I want to bring attention to a specific kind of silence that the beauty of Nature can impose upon us, where our senses drink in not only the view but also the entire atmosphere that permeates our existence. In this silent moment, our eyes widen in awe, and elation expands through our chest.  We feel a rush of connection and a primal sense of belonging so deep that our ego seems to dissolve. For a moment, we become one with the natural world and experience the profound realisation that everything is connected. We glimpse what it feels like to be a true part of Gaia: microbiome and not infection. To care as deeply about Gaia’s health as we do our own, for in that moment, we realise they are one and the same. 

This phenomenon was dubbed ‘Self-realisation’ by Arne Naess (1989), the father of the Deep Ecology movement. He suggests that this visceral realisation of the interconnectedness of all things is fundamental to environmentalism. Such an experience is most readily had in Nature. It both humbles us and reminds us of who we are. Reminds us that we are part of a larger whole: that its health is our health. 

A similar phenomenon, called ‘the overview effect’, describes the effect that seeing Gaia from space has on astronauts (Yaden et al., 2016). It is characterised by an overwhelming feeling of awe, a profound understanding and sense of the unity and interconnection of life and a renewed sense of responsibility for taking care of the environment. Interestingly, these astronauts also report lower levels of depression and anxiety after returning from space. Once again, this is an experience so arresting that it plunges you into silence. 

Importantly, attempts to render these experiences in words will inevitably fall short. Words cannot fully capture these experiences. They are ineffable and must be felt. Therein lies their transformative power. 

Yet, most of us will never go to space. And spontaneous experiences of Self-realisation don’t happen all that often. Most of the time, to have such an experience, some conscious effort is required to shift our attention. Silence is paramount here. 

In the beautiful book ‘The Living Mountain’ – often described as a love letter to the Cairngorms – Nan Shepherd reflects that the right kind of hill companion “does not detract from, but enhances, the silence”. She contrasts this with those whose incessant chatter “left [her] weary and dispirited, because the hill did not speak.” (Shepherd, 2009: 39). 

It is all too easy to walk in the hills and yet forget to be silent and allow space for the hill – for Gaia – to speak. 

We must learn to quiet the voice that wants to measure and quantify. The voice that wants to know exactly how we are going to fix things. The voice that wants to pin things down and put them in boxes. The voice that wants certainty without faith. 

When the hill speaks, it does not speak in words. It does not shame nor chastise. It does not demand solutions. It embraces. It humbles. Its imposing presence impresses our own insignificance and vulnerability upon us and invites us to accept and embrace our dependency on Gaia. 

From this place of acceptance, we are moved to take responsibility for our own actions and to treat Gaia with care and respect — not because this is guaranteed to ‘fix things’, but because we recognise that this is part of what it means to be human. This is how we, in the context of our own lives, become part of Gaia, and not an infection to be fought.

This felt understanding of the interconnectedness of all things cuts through the noise of anxious rumination. It frees us from the responsibility of ‘fixing things’ and gifts us a sense of belonging, a sense of belonging to something bigger than ourselves, to something mysterious and wonderful. Silence in nature can be a powerful tonic to the environmental anxiety which grips many of us and can lead to apathy in some. Such experiences of silence with Nature can be transformative and support our wellbeing in a deep and primal way. 

References

Naess, A. 1989. Ecology, Community and Lifestyle: Outline of an Ecosophy. Cambridge: Cambridge University Press

Shepherd, N. 2009. The Living Mountain. London: Cannongate

Yaden, D. B., Iwry, J., Slack, K. J., Eichstaedt, J. C., Zhao, Y., Vaillant, G. E., & Newberg, A. B. (2016). The overview effect: Awe and self-transcendent experience in space flight. Psychology of Consciousness: Theory, Research, and Practice, 3(1), 1–11. https://doi.org/10.1037/cns0000086

Author Bio

Amber Sahara Donovan is an AHRC-funded PhD student at Durham University in Environmental Philosophy. Her work begins with Mary Midgley’s claim that the concept of Gaia can serve as a tonic for the conceptual emergency at the root of the climate crisis. She explores how metaphorising with this concept can help alleviate environmental anxiety and help us take positive action in the context of our lives. 

The deadly and the beautiful

Guest post by Lucy Haydon

The silence in manic psychosis is deadly and deafening. It connects dots of imagination and untruths in the loudest of ways whilst not saying anything out loud.

This silence is the scariest I have ever experienced. This silence should not be allowed to exist. This silence needs kind company, trust, time, love, and often even medication to overcome and navigate through and out of.

This silence is not fun. I would not wish it on my worst enemy.

As a complete contrast, another type of silence I have been lucky enough to experience is the one where you are sat under a beautiful tree, back against the bark, alone in body but oh-so connected to something so much greater than just yourself. 

In this quietness, you can hear the birds of hope, feel the warmth of the sun, the bliss of the breeze and you know all will be more than ok.   

I write about these two types of silence to give you an idea of just some of the many experiences someone may have when thinking of the concept of ‘silence’.

A group of six people with lived experience recently met up with three facilitators from the University of Bristol in a workshop to share time together and discuss ideas and experiences of silence.

It was a very intriguing and interesting topic, bringing up themes of connection and isolation amongst others.

Silence is more than a word and much more than just something to be ignored, with a spectrum of emotions and experiences counted. It needs to be explored in greater depth, and, hopefully, that’s what this project will do.

Author bio

Lucy Haydon is a Bristol-based artist.

Some Conversations Aren’t

Guest post by Cat Papastavrou Brooks

When I was at my most depressed, I lived with someone who was also depressed, and a silent and wretched-looking lurcher we had bought after seeing a Gumtree advert which just read “Dog. £150. First come, first served.” Left with time, and no ability to fill it, we sometimes played a kind of word-game where we attempted to describe how depression felt.

“It’s like feeling very light and empty and insubstantial, but also very hard and heavy and dense all at the same time.” 

“It’s like being in love with someone, but instead of obsessing about them, you’re just obsessively thinking about how you are the worst person in the world and how much you want to kill yourself.” 

That episode wasn’t my first time being severely depressed. The last time round (in my early 20s and more alone in my suffering) I’d been fanatical about a book called ‘Wittgenstein’s Private Language’. This aimed (amongst other things) to unpack the connection between pain, language and isolation in the philosopher Wittgenstein’s work, a subject I think has a particular pull for unhappy or depressed people. In it, the author (Stephen Mulhall) writes that we could see: 

the provision of a language for pain to someone immersed in inarticulate suffering as a means of giving him some perspective on his own condition- at least enough distance from it to articulate that condition, and thereby to place him in the position of acknowledging the state he is in, which must include acknowledging that it may end, that he may be comforted, that he might transcend that state, if only in his imagination.”

Coming up with our depression similes years later, it became clear that this approach did not work for our particular problem. Talking about depression did not give us any perspective on or comfort in our condition, which was all-encompassing and surely endless. Attempting to say the truest, most secret name of depression had not – in fact – given us power over it. But then why would it? We also played Boggle for hours and hours a day (a far more popular word game than our invented one), which – shockingly – didn’t magically end up curing us either.

After I finally got well, I told my friend he’d saved my life. He was nonplussed by this and said, “But I was just there, I didn’t help you, I was just there”, but then that was the extraordinary thing. The form of care he gave helped me get better because it didn’t require me to say or do anything to be understood and loved. Depression is both so incredibly mind-numbingly boring and makes you so incredibly mind-numbingly boring to others – we knew that inside-out. In that state, what could I possibly have had to say? So, his main role (apart from the difficult work of keeping me alive) was just being there, mostly unable or unwilling to talk either, just waiting it out together.

This is not how UK mental health campaigns tend to suggest that caring for your friendly neighbourhood depressive is supposed to work. Things like the recent “Time to Talk” campaign (“Some conversations are scary, some aren’t”) emphasise how easy and un-frightening it is to use words to connect a mentally ill person, both as a necessary precursor to and as a form of care in itself. The artist, activist and researcher Rachel Rowan Olive, has an excellent parody of this campaign, styled in the same way, but the text says “Screaming Awareness Week. It’s way past time to talk; it’s time to scream. Let’s bang our heads on the wall.” The top of the poster reads: “Every week from now until the end of time #aaaaargh.” Aaaaargh indeed – truly the only form of silence-breaking adequately suited to mental illness (and to dealing with mental health services).

To be clear, I’m not entirely against talking. I think words can be vital in dispelling the shame, self-hatred and loneliness that are part of depression, and I believe in good therapy. However, I also think that a combination of the failures in the UK mental health system, an increased mental health awareness in the general population and the dominance of cognitive therapies like CBT have led to people being more likely to have a stab at wrangling their depressed loved ones into speaking about their depression, in a desperate but misguided attempt to alleviate it through rational argument. For me, the idea of your loved ones somehow talking you out of being depressed or giving you the right space to talk yourself out of depression baffles me. It reminds me of the tweet, turned popular meme, which reads [sic] “guys r like don’t kill urself ur so sexy aha”, funny for many reasons, but at least partially because of the ridiculousness of the idea that being told you’re attractive could ever stack against the terrible, terrible logic of depression. What words could?

We’d had the dog for a whole horrible, hot, and silent summer, when she got over excited running in the park, and finally let out a sharp series of barks. We were taken by surprise and ran after her shrieking and whooping, which completely freaked her, something that was so comical to witness it made us laugh as well. Which- for me – was the closest that speech had got in that time to making me feel well again.

To purchase Rachel Rowan Olive’s “Screaming Awareness Week” artwork (and others), visit her website

Author bio

Cat Papastavrou Brooks is a PhD candidate at the University of Bristol, working on the impact of community violence as part of the TRUUD programme, and a researcher at the SPIRED Clinic, SPFT NHS Trust working on eating disorder research. 

Her X handle is @TheBeetleBox

Circles, around and around in circles

Guest post by an anonymous contributor

Too articulate for support. Named as a ‘Personality case’ by a Health Care Assistant. Although this led to a lot of distress and a complaint, I now know on reflection that this assistant is the most honest person I have come into contact with the mental health system. At least I know where she stood and how she would treat me.

Requesting to be reassessed, as have no connection with EUPD. However, no one wishes to listen. I’m silenced as no one hears. Then, the angrier I get about this, the more of a “personality case” I become. Silenced due to judgement and stigma.

8:30 pm: Left my home for a walk, I had tried everything to stop the suicidal thoughts, voices, and visual hallucinations.

10:00 pm: Rang Crisis Team in distress. Told to look at my coping mechanisms book. I was walking along a dual carriageway, but I was not asked where I was so I did not say. Silenced by choice? 

11:00 pm: Rang crisis line. Was told to breathe; I feel unable to speak, now on a motorway junction.

12:00 pm: Rang Assist Line as needed someone human to listen to me, and just be with me so I could clear my head enough to work out what I really wanted… They heard the cars and asked where I was. I told him and he called the emergency services. I told them it was a waste of time and went to the bridge, which was the plan. Stood and cried. The police came. The crisis line tried to convince the police to take me home, offering no further support. Silenced by no one being prepared to care or listen. 

Police detained me under section 136 of the Mental Health Act. I said it was a waste of time as I felt the mental health system did not care at all.

After 4 hours of broken sleep at ‘the Place of Safety’, I woke.

At the assessment, I was told:

  • ‘We all have negative thoughts, people just do not talk about them’ (Literally being told to be silent)
  • ‘Look at me, try to look out and not inwards because that’s just making it worse’ (I am using every bit of my energy to answer questions… let alone look at you. Is this my fault? Should I be silent?)
  • I know I am seen as a personality case – ‘I know you have had many discussions about your diagnosis. Personally disorders, is such a horrible term as what it really means is that people experience trauma and then create unhelpful coping mechanisms’. (So I am the problem…).

I stop talking…

‘You have so many positive things in your life we are going to let you go home’, the mental health team concluded.

A waste of time. No one was listening. Silenced.

The Burden of the Story

Guest post by Sally Latham

‘Tell us your story…’

It is widely assumed that asking the ill to tell their story offers them empowerment and liberation through being heard. But the demand for illness narratives, well-meaning as it may be, can place an additional and damaging burden on those already suffering.

In recent years, there has been a huge growth in illness narratives, especially digital stories, as online accessibility increased. Stories of suffering and recovery, particularly concerning mental illness, are now common, and published by everyone from school children to celebrities. Part of the motivation behind this growth was the desire to move away from a biomedical model of mental illness where knowledge is guarded and dispensed by medical professionals and to move toward a more holistic, patient-centred approach.

These are all good intentions, yet we now have a phenomenon where narrating illness is on the verge of becoming a social imperative. For example, the sociologist Arthur Frank argues that we need to acknowledge our ethical responsibility to narrate one’s illness. One must narrate to aid one’s own recovery but also to show solidarity with fellow sufferers, to inspire others and to highlight the place of suffering in life. There are also expectations about how that story should be told.

For example, in the US, the Substance Abuse and Mental Health Services Administration (SAMHSA) produced a 70-page guide titled Share Your Story, A How-To Guide for Digital Storytelling: Supporting the Recovery and Healing of Self and Others Through Messages of Hope. In this document, adorned with stock photos of smiling families, the sufferer is told that sharing their story will reduce negative stereotypes, encourage others to seek help and empower the narrator. They are guided in how to ensure the story comes from a ‘strong foundation of recovery’along with ‘messages of hope’ or a ‘call to action’. An illness narrative must have the right amount of hope, resilience, inspiration and recovery.

But this expectation is dangerous. It risks isolating those whose stories do not fit this genre of hope and inspiration, overlooking those stories that highlight anger, despair and even neglect and inequality in healthcare that needs to be addressed.

Not only does the demand for illness stories alienate those whose stories do not fit the accepted genres, it also alienates those who do not wish to narrate at all. We fail to recognise that ‘suffering in silence’ is a legitimate choice rather than something inherently bad, externally imposed and oppressive. This assumption is highlighted by the philosopher Dan Degerman who has claimed we should challenge the ‘fetishisation of silence breaking’. There are different types of silence, some of which are a choice. Some suffering cannot be put into words and to do so would distort it. Putting pressure on the ill to narrate their story at all (let alone through socially sanctioned genres of hope and inspiration) is an extra and unnecessary burden which could lead to further distress.

If silence can be the way to honour suffering, then we need to learn to honour silence.

Author bio

Sally Latham is in her final year of a PhD with The Open University researching narrativity, non-narrativity and mental health and is a recipient of The Royal Institute of Philosophy Jacobsen studentship. Her most recent publication, co-authored with Mark Pinder, is ‘Is it Good to Conceive of One’s Life Narratively?’

Silence and Writing

The world is noisy. It’s been about a week since I moved to Bristol from Durham. I notice how different this city is to Durham. There is a lot going on here, and the hustle-and-bustle seems to be the constant theme of this city. Amidst the constant buzz of traffic and chatter, achieving some level of silence for my mental health has felt like an uphill battle. So, I resort to what I know best: writing. Regardless of whom I write for or what I write, I have noticed that my writing involves a somewhat mysterious (?) element. Sometimes, this element helps me to achieve and maintain the kind of silence I am looking for, sometimes, well, not so much. I hope there is someone out there who can relate to this post! 

When I write out what I want to say using my hand (well, with pen and paper), the words that come out at the end of my pen capture all my attention. Actually, this is not quite true. I’m not focused on each word I write. Mostly, I’m focused on what is already written and what is yet to be written. When writing, I feel this momentum that propels my hand from the already-written words to the not-yet written words. It’s almost as if the already written words push my hand to write the next words so that they can be a part of a complete sentence. I feel this tension between what is actually there on the paper and what is not there yet, and, through writing, I resolve this tension. 

Now, what’s mysterious about this experience is that in this moment of tension everything (including myself) falls silent. All that inner chatter in my head  and everyday life concerns I have just go away. The general acoustics of my surroundings, say, the sound of my colleagues coming into the office, pulling their chairs, adjusting them, yawning, sniffling, clearing their throat, typing away, and, sometimes, even calling my name (sorry! I couldn’t hear you) – all this – go away too.  The world just gets tuned out. Everything falls silent, and I am at peace. 

Does this mean that writing always helps me to achieve this peaceful silence? Short answer: No. Sometimes my hand cannot keep up with what I want to say. Words are too long and too slow. So,  I “write” in dots, shapes, lines, and arrows. I find this not at all peaceful nor helpful. My concerns come back, and I start to comment on what I write as I write. Whenever this happens, I stop and just go for a walk. 

So, for better or worse, I write. 

Now that I have written this out, I realise that perhaps this experience is unique to me. But I doubt it. I suspect that we all have these kinds of experiences – perhaps, when we are playing games, cooking, cleaning, painting, or meditating? What do you think? Do you also have this kind of experience? We would be very grateful for your input! 

Welcome!

This is the website for ‘Beyond Voice’, a research project about experiences of silence in depression and bipolar.

It will host blog posts by collaborators and the core team, project publications, events, and other useful resources for people who are interested in learning more about silence and mental health.

If you want to get involved or you have any suggestions for the website, please get in touch through the Contact page!