In sickness and in health

What do you do when you’re unable to do enough?

This question came up recently on one of my WhatsApp groups. We were talking recently about Apple Watch goals and how to handle them when you fell sick, and I shared a tweet of someone saying they would reduce their goals. Someone responded that it would feel like cheating to do that, which initially surprised me. Then I remembered it was just another example of a phenomenon I see every week at work, and very often in some of my favourite people.

Too often, we demand the most of ourselves right when we’re at our worst.

Not everyone is like this, of course (more in a bit), but enough of us are that it’s worth taking a good look at how we respond to being less than our best. When we’re faced with constraints, do we deny them—or do we resign ourselves to them?

That’s really a trick question, because there’s one more option besides those two: do we choose, rather than denying or resigning, to embrace constraints?

“Playing” sick

One of the many ideas you learn about in psychiatry training is what’s known as the “sick role.” It’s an idea from medical sociology, first coined in 1951 by American sociologist Talcott Parsons. He was interested in the relationship between society and the sick person and how experiencing sickness changed the unwritten contract between us and everyone around us.

The way he saw it, being unwell gave you a few new privileges: your sickness entitled you to be taken care of while being exempt from regular social duties and from any responsibility for your sickness. But those privileges weren’t unconditional: they came with the expectation that you in turn would do what you could to get well and work with those who tried to help you.

Of course, since the sick role is one you take in relation to society, the question arises: does society consider you “worthy” to take on a sick role?

Obviously—and unfortunately—the answer is often no.

There’s various ways this plays out:

• Sometimes people are actually trying to falsely take on the sick role, like when a work colleague calls in sick but we know they’ve really used up their annual leave and are just trying to get an extra Friday off to travel before the weekend.
• For some (like with some mental disorders) they are seen as “playing up the mental health card” and so their taking up of the sick role is viewed as “illegitimate”—which is also Parsons’ name for it.
• Sometimes, even people seen as truly unwell, are still held responsible to some degree for their illness (for instance, where lifestyles play a role) and that in turn undermines how much sympathy gets extended to them.
• And of course there are those who want to take on the privileges of the sick role but not the responsibility of trying to get better.
  

But it’s just not society that withholds the sick role from people. Sometimes, it’s we ourselves who refuse to accept the sick role.

Mourning until morning

One of my favourite expressions is from author and mental health advocate, Bassey Ikpi:

It’s a mantra she started using during a time of depression to get her through each night, and which has since become a real motto for many going through all kinds of hard times. It’s a reminder that no matter how dark the night, the morning will come, and you are allowed to enjoy that too.

But the way it sounds when you say it is also meant as a reminder too: that you’re also allowed to mourn. When things go pear-shaped and life hits you hard and you lose people and time and other things dear to you, mourning is not unreasonable. No, mourning is the right thing to do, and you should absolutely allow yourself to do it, especially if you’re the kind of person who tends not to, or who others somehow assume doesn’t need to.

When we choose to not deny our pain, we make way for the beauty that can follow. When we acknowledge what we have lost, we make room for us to take hold of new things.

To be human is to be prone to breaking down. When we acknowledge that, we show not weakness but strength: the strength to be honest with ourselves about our abilities. And even better, we create space to surprise ourselves by what we’re capable of when we accept what we aren’t.

Bassey Ikpi’s beautiful motto reminds me that allowing yourself mourning helps you allow yourself morning.