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精神健康的計時炸彈 | A Mental Health Time-Bomb
at 9:31am on 25th November 2019
(Please scroll down for English version)
瑞士精神科醫生伊莉莎白．庫伯勒 – 羅絲的臨終病人研究發現，病人面對死亡時會經歷五個內心階段。庫伯勒–羅絲的學說也適用於面對創傷式生命式改變的人（如香港現時所面對的）。這五個哀傷的階段分別是：否認、憤怒、討價還價、抑鬱和接受。這些階段不一定順序進行，而且能以不同強度的情緒出現。
我自己的簡樸經歷為例，我在6、7月大部分時間因為想緊貼示威與政治的最新發展而停止了日常閱讀。結果我的思想和日常生活愈來愈受示威新聞主宰。我想起了庫伯勒 – 羅絲的五個哀傷階段，明白自己和很多人一樣，因為身邊的政治紛擾和和示威受創。結果我減少觀看直播視頻，再次拿起小說，並選擇在圖書館的寧靜環境中工作，最後讓心理重新建立方向。
A Mental Health Time-Bomb
by John Batten
Amongst all the talk, commentary and fuss of the last four months of protests, there has also been some discussion about Hong Kong’s ‘mental health’. One aspect, people’s anger, is openly acted-out on the streets, but other layers of the psychology of the city is privately dealt with by individuals themselves and within and between their interpersonal relationships with friends, family, work colleagues and at school. As the protests have continued and the government abdicates its responsibility to implement solutions to the current political crisis, people have experienced various levels of hopelessness: anxiety similar with the traumatic grief experienced after a relationship break-up or the death of a loved-one.
In her studies of the terminally ill, the Swiss psychiatrist Elisabeth Kübler-Ross formulated a model of the five stages of grief a person experiences when told they have a terminal illness. Kübler-Ross’s model is also applicable to anyone who is experiencing a traumatic change in their life – such as now happening in Hong Kong. Kübler-Ross’s five stages of grief are: denial, anger, bargaining, depression and acceptance. These stages don’t necessarily run in chronological order and can be of a varying intensity of emotional moods.
We have all experienced protest-related anxiety over the last four months, and, even if we are not participants in the protests, just watching television can be disturbing. In a recent RTHK radio interview, Hong Kong psychiatrist, Liu Kwong-sun, said that his clients were suffering from insomnia, depression, anxiety and suicidal thoughts. He added that “the protests will cause long-term damage to people in the SAR, and it would affect a cross-section of the city, including protesters, students, bystanders, reporters, people watching the news on television and police.”
However, most people in the city will not seek immediate psychiatric or professional assistance for the emotional or post traumatic syndrome disorder (PTSD) symptoms they experience. Besides, Hong Kong’s mental health services are scandalously limited, and the city is chronically short of psychiatrists. Under these circumstances, many people will suffer or cope with protest-related anxiety and their confused emotions largely alone. Teenagers and young people, going through their own life-stage changes, are especially sensitive. In particular, the atmosphere in the family home, between parents and their children, with their respective generational, age and differing political viewpoints, can be a place of tension and conflict. Tolerance, of course – especially difficult in the current fraught political and social atmosphere – is a necessity when dealing with any home and family tensions.
We all have strategies to cope with our busy Hong Kong lives and day-to-day stresses, and the same strategies can be useful to counter Hong Kong protest-related anxiety. During SARS, walking in the open air was beneficial, but equally, going into a country park was to mentally remove ourselves from the urban environment and the psychological fear of SARS. Likewise, during the current protests, self-organized ‘time-out’ from the protest atmosphere should ease mental stress. So, turning off the news, and not watching social media updates and ‘live’ broadcasts – by intentionally turning-off your smartphone or television – should give some control to choose whether to know or not know about the latest protest news. Being ‘in control’ of the news is mentally refreshing, as you will avoid the shock of events as they happen.
Also, particularly beneficial is to immerse yourself in a chosen ‘other world’ through physical exercise, playing games, music, yoga, reading, horse-racing, watching a movie or taking a short holiday – to allow instant, albeit possibly temporary, rejuvenation.
In a simple personal example, during most of June and July, I stopped reading books because I wanted to be up to date on the protests and political developments. Increasingly, the protest news dominated my thoughts and daily routine. I was reminded by Kübler-Ross’s model that I – like others – was traumatized by the political chaos and protests around me. By simply reducing to watch live protest video feeds, to read novels again, and choosing to work in the quiet environment of a library, I re-orientated myself into a better mental state of mind.
In Haruki Murakami’s Kafka on the Shore, Kafka, a shy 15-year old, runs away from home but wisely understood that libraries are special, open places of acceptance, he says: “Ever since I was little I’ve loved to spend time in the reading rooms of libraries….Think about it – a little kid who doesn’t want to go home doesn’t have many places he can go. Coffee shops and movie theatres are off-limits. That leaves only libraries, and they’re perfect – no entrance fee, nobody getting all hot and bothered if a kid comes in. You just sit down and read whatever you want. I’d devour anything and everything….The library was like a second home….”
If we can’t find that ‘other world’ or a “second home” to mentally escape during Hong Kong’s current political crisis, then feelings of being overwhelmed and depression may affect us. Most of us will eventually ‘pull through’, ‘get over it’, and ‘move on’, so we can function during the current political crisis. Others, however, are seriously affected and traumatized by current events. Signs of mental vulnerability can be notoriously difficult to spot at the time. Besides obvious psychotic behavior, we should be on the look-out for such indicators as serious changes in behavior, routine and thoughts, including isolation from family and friends, or, talk about the end of the world or of suicide – identified by using such simple language as, “I wish I wasn’t here” – all these can be the first signs of a suicidal tendency or serious mental health issue.
We are all, potentially, vulnerable to self-harm and serious mental anxiety. Honest communication and actively checking the mental health and safety of our friends, colleagues and relatives is really needed during Hong Kong’s current political crisis. Hong Kong’s ‘mental health’ affects everyone, no matter their politics. In months and years to come, the city’s violent protests might re-emerge for some as recurring intrusive flash-backs and nightmares, with a diagnosis of PTSD. Our current political crisis is so much more than today’s streets protests and the government’s political inertia – it is also a future ticking mental health time-bomb.
This opinion piece was originally published in Ming Pao Weekly on 7 November 2019. Translated from the original English by Aulina Chan.