One of the biggest determinants of mental health is the ability to—or the belief that one is able to— live in choice. To be in choice is to make informed decisions on a daily basis regarding your well being. Choice is the purest expression of free will – the freedom to choose how to shape our lives exactly how we wish.
When we are not able to act in choice in the moment, we may feel frustrated or disappointed. A small example of this would be someone arriving to their favorite restaurant (they’ve been craving something specific all day) only to find that it’s closed. Disappointing, right? Another example would be someone requesting the day off from work and their boss denies the request. Frustrating, disappointing, a real bummer. These are minor examples of not being able to make the choice that you would like for your daily life. We can probably think of a few examples in our own lives over the last day or two. They may cause a brief disturbance, but the isolated occurance of “not getting our way” shouldn’t cause serious longterm alteration in mental wellbeing.
However, when we live in a prolonged or chronic state of lack of choice, or prolonged or chronic state of limited choice (a choice with reduced viable options), it leaves us feeling helpless, out of control, and depressed. Helplessness is, in fact, one of the most commonly identified feelings describing trauma. An example of this would be someone applying to the few apartments they can afford in a town they’ve lived for years, ultimately being denied for each one based on their credit score. Now since this person cannot afford to stay in town, they must make a decision that based on a limited choice to leave their community to live with a distant relative. Another example — someone has recently been diagnosed with a heart condition that requires them to take medication, stop all physical activity, and undergo frequent hospital treatment. This requires paying for lofty medical bills and medications that they can’t afford given their insurance policy without taking out a loan. They may feel incredibly helpless and depressed given this reduction of autonomy and limited choices. Another relevant example is someone who is attempting to immigrate to the US, fleeing violence and the effects of climate change and imperialism that have left them unable to sustain themselves with their small farming business. They are forced to make a limited choice due to historically oppressive systems to leave their home and what’s left of their community only to be detained by ICE at the border who denies their right to due process. Now this person is unable to act even out of limited choice. Their personal autonomy has been entirely stripped. Obviously, this is just a very small range of examples. A prolonged or chronic state of lack of choice, whatever the circumstance, often results in serious decline in mental wellbeing with the result sometimes being fatal. This is trauma.
The key question in these situations — even if there is technically a “choice” that could be made, is it a limited choice based on systemic oppression?
We can think about all the many ways that this applies on a broader scale. Consider oppressive immigration laws and the effects of imperialism as demonstrated in the example above, or our system of capitalism, abusive housing policies, institutionalized racism and slavery, historic and modern colonization and left of Indigenous land and sovereignty, systems of punishment and control (incarceration), lack of access to health care, discrimination against people with disabilities, the ongoing abusive effects of the patriarchy, homophobia, transphobia. Climate change, a global pandemic. When these factors are compounded, it leaves us in a state of nearly complete lack of choice. Freedom does not exist within these systems. True liberation is impossible while any of these systems stay in existence.
Indeed, it is possible to experience a lack of choice and still function, feel content, feel joy even. This is often considered to be resilience. People can attribute their positive mental state to community support, shifting expectations, their faith, disbelief or unawareness that they’ve been wronged, or hope that things will improve — all of these can be valuable skills to rely on. The problem with our cultural emphasis on resilience is that this places the responsibility for mental health on the struggling individual. It completely absolves our society and state of responsibility for the suffering of people. This is a convenient excuse for policymakers to sidestep their obligation to shape systems that are more equitable and less oppressive. To claim that people, workplaces, and communities need to “learn resilience” is to admit that there are conditions within people’s environments that require such a skill. But imagine if we could entirely take away the system of oppression that deny us choice. Would there be such a high need for resiliency? What if we lived in a world where we are not coping with and navigating the systems of oppression as a requirement to survive? What if our mere existence did not require us to be quite so battle-ready?
This is a crisis. If we are to truly support our mental health and wellbeing, we need to reclaim our choices. We need to recognize that there are systems in place that limit or deny us of our autonomy, and we need to organize ways to abolish these systems and create new ones, where choice and community sovereignty are at the forefront. We all deserve to feel empowered to make the best choices for ourselves with ALL of the available options on the table, not just the limited options provided by our current society, government, welfare system, etc. We cannot continue to address issues like depression, hopelessness, and anxiety as though they are solely individual problems. They are not. They are a result of and compounded by the inability to make a full range of choices due to oppressive social systems. Healing from trauma requires that all people are liberated to act out of choice, and surrounded by a community of care that is also healing and able to act in choice.
Collectively, we need a complete overhaul. My practice as a mental health clinician is political – it always has been and always will be. We have the right to be in choice, the right to be liberated from these oppressions, and the right to live in communities in which we experience freedom, solidarity, belonging, sovereignty, integrity. And for this to happen—for change to be real—we need to imagine and create entirely new systems.