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Forum: Literature, literary studies & mental health and addiction

Curated by Michala Beesley (Class of 2022)

Literature does more than provide a source of entertainment; it allows us to process our thoughts and connect with the ideas and lives of others. With the COVID-19 pandemic, many people have experienced mental health challenges and studies around the world have shown an increase in various forms of addiction. At the same time, there has been a marked expansion in the public awareness and discussion of these often conjoined issues.

As an English and creative writing student, I am struck by the myriad ways literature across the ages has represented mental health (Ophelia!) and addiction (Malcolm Lowry!), as well as how literary studies empowers us to consider, discuss and write about these fascinating topics. Through creative writing, for example, we are able to unpack deep and heavy thoughts and reflect on our lives – how they are and how we dearly wish them to be. Meanwhile, I have found that literature and literary studies afford dynamic opportunities to counter conventional social stigmas associated with depression, anxiety and a host of other mental health “problems.” At its best, the study of literature even helps us to create safer, more inclusive communities within which to share difficult personal experiences.

For this forum, I invited five people associated with the Department of English and Creative Writing — an undergraduate student, a Ph.D. student, a post-doctoral fellow and two professors — to answer this question: What light do literature and literary studies shine on mental health and addiction? I thank each of the contributors for their thoughtful, generous responses. I trust you will be moved and inspired by their insights.


woman with long dark hair wearing a grey jacket and standing outdoorsAbby Rush

Abby Rush is a member of the Three Affiliated Tribes of Fort Berthold. She studies creative writing at The University of Tulsa and loves to write and perform poetry in her spare time.  

Have you ever heard someone say, “I’m so OCD” in relation to their organized tendencies, or their affinity for cleaning? Popular culture has heavily influenced the inaccurate use of this word. We hear it on TV, among friends, and in many other spaces. Casual and innocuous as it may seem, the use of this term can be harmful when it is used in the wrong context.

OCD refers to a condition known as obsessive-compulsive disorder, which affects many people in a myriad of ways. By using it casually in conversations not having to do with the condition, people risk diminishing the experience of individuals with OCD. Many of us are guilty of misusing the term, but it isn’t too late to begin utilizing better alternatives to explain our habits without undermining the real impacts of obsessive-compulsive disorder. Being more attuned to the language we use opens up space for better representation and collective understanding.

Contemporary novelist John Green explores obsessive-compulsive disorder and mental illness in general in Turtles All the Way Down. The main character, Aza, illuminates some of the realities of grief, OCD, and anxiety through her own life experiences in the novel. Literature like this helps teach the importance of acknowledging mental health conditions and creating safer spaces for people with them.

 

man with short grey hair, glasses and a blue jacketLars Engle

Lars Engle, the Ida M. Chapman Professor of English, has taught at TU since 1988. He is the author of Shakespearean Pragmatism and many articles and chapters, co-author of Studying Shakespeare’s Contemporaries, co-editor of English Renaissance Drama: A Norton Anthology and co-editor of Shakespeare and Montaigne, which comes out in December from Edinburgh University Press.

I’ll answer this with an anecdote. I occasionally teach an upper-level English course entitled Middle English Literature. Sometime in the early 1990s, I decided to assign the entirety of The Book of Margery Kempe, the early 15th-century autobiography of a woman from Norwich who began, after the difficult birth of her first child when she was about 20, to experience visitations, at first from the Devil and then from Christ.

Usually, this text appears in English courses only in relatively brief excerpts — often Margery’s narrative of how Christ appears to Margery and releases her from his prior instruction to her to fast entirely on Fridays. Christ tells her that he has given her this instruction in order to allow her to get permission to take a vow of chastity from her husband, something he’s offered her if she’ll pay his debts before her pilgrimage to Jerusalem, eat with him on Fridays, and keep up the appearance of wifehood.

On the Jerusalem pilgrimage, Margery’s eccentricities expand. She cries out and weeps loudly in church when the Host is raised, she sees white objects fluttering and smells delicious smells and hears beautiful sounds when she thinks about Christ, which she does whenever she sees a handsome man. The beating of a horse makes her howl because she sees Jesus being scourged on the way to Calvary. Some witnesses wish she were dead; others honor the intensity of her piety.

Our class discussed what would happen to Margery in late 20th-century America. Most thought she would be put on anti-psychotic drugs, or confined in a mental hospital. But like Margery’s contemporaries, the class was unsure how to categorize her experiences, and in general how to deal with undignified or disruptive religious self-expression.

I had an older student in the course, whom I will call Cordelia. Cordelia worked at TU, and after the course was over we exchanged friendly greetings whenever we saw each other, which wasn’t that often.  Seven or eight years later, I ran into her outside the Student Union and she said (I paraphrase):

“Lars, you remember that course where we read Margery Kempe? I wanted to tell you something about it. Margery got me thinking about how differently intense religious experience can make people act.  I had a sister I was estranged from. She had been born again as an evangelical Christian, and she had strongly-expressed opinions about my way of living that offended me, and we weren’t speaking. But something about reading Margery made me reach out to her again, and we had several good conversations, even loving ones. I understood her state of mind better, and she appreciated my trying to do that.

“She was killed in the Oklahoma City bombing. I think my reading that book was the reason that we recovered our relationship before she died. And I think that recovery in turn has helped me deal better with her loss. So do be aware that what happens in your courses can have unexpected consequences!”

 

woman wearing glasses, a bandana around her hair and a black jacketLaura Thomas

Laura Thomas received her Ph.D. from the Department of English Language and Literature in 2019. She is currently a 2021-22 post-doctoral fellow in the department.

Depression, sadness, madness – all words that are associated with mental illness. And if we throw hysteria in the mix, it becomes riddled with gendered connotations. Also, quite often drug addiction and mental illness are conflated – which came first? The addiction or the madness?

The real issue lies in the artistic glamour of madness. I believe this is where the problems understanding and approaching mental illness and addiction originated. Artistic and literary glamorization of mental illness and addiction can be beautiful and mystical, and this is the attraction, especially for many people who have never really witnessed or lived with addiction or depression.

I am reminded of the 2001 film A Beautiful Mind wherein the protagonist is a handsome madman and mathematics genius. The title of this movie alone reveals the romanticization of a mind gone awry – in this case, the cause is schizophrenia. My father was also the “madman in the studio,” producing painting after painting and then in his “off time” solving complex mathematical equations. But life with him wasn’t necessarily “beautiful.” Instead, it was exhausting and frightening trying to decipher his mood from day to day.

To this end, I feel if one does not live with addiction or mental illness (or both), or has not lived with someone who is afflicted, then literature and its attendant studies may not adequately teach us how to approach the illness or the individual. It seems that many successful writers, some of whom committed suicide (Sylvia Plath, David Foster Wallace) are posthumously burdened with the mystery and madness that borders on the beautiful, and this is not a true reflection of addiction or mental illness.

 

woman with short hair, large gold earrings and a blue jacketLaurel Taylor

Laurel Taylor is a Ph.D. candidate in English. Her research interests include modern and contemporary literature, disability studies and queer theory.

“We tell ourselves stories in order to live,” wrote Joan Didion. AA members assert similarly that rehearsing “what we used to be like, what happened, and what we are like now” keeps them alive. So, too, many of us turn to literature when our lives feel fragmented and disoriented, finding therein tools for restoring narrative order and discovering our own redemptive arc. Yet, my proximity to addiction and mental illness, including as a doctoral student studying addiction history and literature, has taught me that recovery narratives are not always benign. As Parker Palmer writes, “the human soul does not want to be advised or fixed or saved. It simply wants to be witnessed.”

Thus, in my dissertation, I focus on recalcitrant texts like Djuna Barnes’s Nightwood and William Burroughs’s Naked Lunch, which summon us to relinquish our narrative expectations and moralizing impulses, nourishing, instead, our capacity to pay close attention, practice empathy, and hold space for the hard feelings and contradictions that characterize embodied experience. As life in the midst of a global pandemic and in anticipation of environmental crisis demonstrates, the stories we have told ourselves will not always, in the same forms, sustain us. Literature faithful to the varied and complex experiences of addiction and mental illness has much to model for us by way of navigating these disorienting times not with attempts to recover the status quo, but with an openness to new narrative forms and new modes of being human.

 

man with short dark hair, glasses and a blue patterned shirtDon James McLaughlin

Don James McLaughlin is an assistant professor of English specializing in 19th-century American literature, the medical humanities, queer health, disability studies and the history of emotions. His current research focuses especially on Fitz-Greene Halleck, Walt Whitman, Sarah Orne Jewett and literary representations of psychological debate. 

In The Varieties of Religious Experience, William James includes a close reading of Leaves of Grass. James is talking about “the gospel of healthy-mindedness,” a life-orientation characterized by unflagging optimism. “The supreme contemporary example…is of course Walt Whitman.” James first praises this quality: “The only sentiments [Whitman] allowed himself to express were of the expansive order;…a passionate and mystic ontological emotion suffuses his words…persuading the reader that…all things are divinely good.” Still, James proceeds by confessing skepticism: “[H]is gospel has a touch of bravado…and this diminishes its effect.” To say Whitman has “a touch of bravado” is like saying the sun is a touch bright. But Whitman’s bravado itself belongs to a cycle of dawns and twilights, and the accuracy of James’s evaluation deserves examination.

From here, James “turn[s] towards those persons who cannot so swiftly throw off the burden of the consciousness of evil, but are congenitally fated to suffer from its presence.” He proposes that religions such as Buddhism and Christianity accommodate this dilemma through rituals of “deliverance.” Interestingly, James cites his own experience of panic disorder, noting that “the fear was so invasive and powerful that if I had not clung to scripture-texts…I think I should have grown really insane.”

The psychologist became best-known as a pragmatist. In an often-cited diary entry, James determines, “I will go a step further with my will, not only act with it, but…believe in my individual reality and creative power. My belief… can’t be optimistic—but I will posit life (the real, the good) in the self-governing resistance of the ego to the world.” One of the most striking details of James’s career is how he was open about mental health struggles, while also insisting on this inextinguishable creative power of the human spirit.

Whitman was an optimist. Peruse “Song of Myself,” and there will be no doubt. However, Whitman also believed in being honest about the diverse emotions he knew well. Following his time volunteering in Washington’s hospitals for injured soldiers during the Civil War, Whitman reported symptoms suggestive of post-traumatic stress disorder. He wrote pieces for The New York Times encouraging Americans to recognize the psychological needs of veterans. As my students observed recently, friendships formed in the hospitals brought Whitman both fulfillment and heartache. “The Dresser” concludes by describing how the memories continued to visit him:

Thus in silence, in dream’s projections,
Returning, resuming, I thread my way through the hospitals;
The hurt and the wounded I pacify with soothing hand,
I sit by the restless all the dark night—some are so young;
Some suffer so much—I recall the experience sweet and sad

James and Whitman were distinct visionaries. Nonetheless, this similarity warrants consideration. Like James, the strength of Whitman’s voice coincided with a determination to prioritize the psychological wellbeing of himself and his neighbors. James’s assessment of Whitman’s message assumes new meaning when we explore the poet’s corpus as a whole: “The only sentiments he allowed himself to express were of the expansive order.”

 

 

 

TU, LIBR partnership at the forefront of mental health research 

The Laureate Institute for Brain Research opened its doors 10 years ago to address one of Oklahoma’s worst health factors, mental health. As scientists and researchers discover the ways in which a person’s mental health is directly linked to their overall physical condition, LIBR, in collaboration with The University of Tulsa, is using new neuroscience tools and resources to answer old questions about Oklahoma’s health crisis.

LIBR
Director Martin Paulus

LIBR was founded by the William K. Warren Foundation when then scientific director Wayne Drevets and five other colleagues from the National Institutes of Health in Washington, D.C., transferred to Tulsa in 2009. Today, the organization includes seven principal investigators (PI) who have tenure track or tenure appointments in the OU-TU School of Community Medicine. The goal then and now is to conduct neuroscience-based research that will improve the diagnosis or prognosis of individuals with mental illness. LIBR Director Martin Paulus said the institute strives to respect the dignity of each patient while leveraging leading talent and technology to discover the causes of and cures for disorders related to mood, anxiety, eating and memory. “We’re trying to use neuroscience to find better ways to develop mental health interventions,” he said.

T-1000

When Paulus joined the LIBR staff in 2014, he set a goal to create a large data set that would allow researchers to investigate mental health prognosis and diagnosis through behavioral processes, neuroimaging, neuromodulation, psychophysiology and bioassays. LIBR’s largest research project, the Tulsa 1000 (T-1000) study, began recruiting participants with mood, anxiety, eating and substance disorders to complete more than 24 hours of baseline testing. The 1,000th and final individual was enrolled in 2018 with the goal of determining whether neuroscience-based measures can be used to predict outcomes in patients with mental illness.
Data Analytics Lead Rayus Kuplicki (B.S. ’09, M.S. ’11, Ph.D. ’14) has been heavily involved in the technical setup and analysis of T-1000 since its inception. He said the standardization of this initial data collection at the institute is critical for quality research. “My work has made it possible to take raw data from thousands of participants and compute the quantifiable traits that we compare across groups,” he explained.

LIBR
TU graduate student Bart Ford

Data analysis of T-1000 participants continues and has generated more than 40 scientific papers, currently in progress. TU graduate students in the areas of psychology, engineering and biology contribute to T-1000 research through subsets of data analysis. Biology doctoral student Bart Ford is collaborating with LIBR PI Jonathan Savitz to examine the link between latent viruses and depression. “It is well established that early life stress and childhood trauma increase the risk of physical and mental health problems later in life, but the biological mechanisms by which this occurs are not well understood,” Ford said. “Dr. Savitz and I wondered if people who experience childhood abuse and neglect are perhaps more vulnerable to a common latent herpes virus called cytomegalovirus (CMV).”

The virus is usually harmless in otherwise healthy individuals but can weaken the immune system over time. Savitz and Ford studied a group of individuals with major depressive disorder and found that higher levels of self-reported childhood abuse and neglect were associated with a greater likelihood of testing positive for CMV. They then used the T-1000 cohort to replicate the study and discovered the same results with similar effects in size. The findings were published in the prestigious “JAMA Psychiatry” journal earlier this year.
“We interpret this to mean that the stress of abuse and neglect during development may render a person susceptible to a CMV infection,” Ford stated. “This could suggest CMV contributes to later life health problems that are often seen in survivors of abuse.”

According to Savitz and Ford, T-1000 is beneficial in understanding the biological causes, mechanisms and outcomes of mental health disorders, and consequently, can help identify therapeutic targets that will lead to treatments of the sources and after-effects of mental illness.

ABCD

In addition to T-1000, another primary project ongoing at LIBR is the Adolescent Brain Cognitive Development (ABCD) initiative, a study of more than 11,878 children, ages 9 and 10, at 21 different sites nationwide. LIBR researchers have conducted detailed assessments of 743 of the participants. Follow-up visits and scans will continue for 10 years to examine the course of wellness and mental illness during the second decade of life when mental health disorders tend to emerge. One of the first papers the data generated in 2018 was accepted to the journal “NeuroImage” and entitled “Screen media activity and brain structure in youth: Evidence for diverse structural correlation networks from the ABCD study.”

TU Tough

LIBR
Professor Robin Aupperle

Robin Aupperle is another LIBR PI and assistant professor of community medicine who uses neuroscience and psychological research to improve mental health and gain insight into the causes of anxiety, depression and trauma. She is interested in identifying factors that support resilience to college-related stress and strategies to optimize a student’s psychological well-being. Paulus said meta-analyses show one in three students will develop significant anxiety and depression during their first year of college — a major reason why some students choose to drop out of school. That’s why Aupperle developed the four-week TU Tough program that teaches the skills and mindset necessary for mental toughness to effectively respond to stressful or challenging situations. “This is the idea that our abilities are not set in stone — that we can learn, improve and adapt,” she explained. “Likewise, our ability to be resilient in the face of stress is not hard-wired but can be built and strengthened through practicing certain skills as we seek out and face challenges.”

Aupperle is a mentor to graduate students such as TU clinical psychology Ph.D. student Tim McDermott. His predoctoral training grant application to the National Institute of Mental Health received a qualifying score for funding, which will support McDermott’s research to study the brain circuits underlying people’s ability to manage their emotional reactions. Understanding the brain circuits involved in the processing and regulating of emotions could potentially inform future anxiety and depression treatments. “We will examine whether individuals can learn to regulate their prefrontal cortex activation during emotional processing in response to feedback about their brain activation during functional magnetic resonance imaging (fMRI) scanning,” he said.

As an assistant in the TU Tough project, McDermott has led lectures in TU Tough modules and supervised small group leaders during breakout discussions. He also has managed data processing and analysis for fMRI neuroimaging scans performed before and after TU Tough treatment. Prepared by lead author Elisabeth Akeman (BS ’15) as well as Aupperle and McDermott, a recently published manuscript in the journal “Depression and Anxiety” reports findings from the first two cohorts of TU Tough. The research shows students who complete the program (compared to those who did not) experienced lower rates of self-reported stress and depression symptoms throughout their first semester of college, particularly as measured during finals week. Aupperle explained TU Tough is a strong example of LIBR research that can improve the overall mental health of Oklahomans. “By taking measures to improve resilience to stress and mental health among TU students, we are benefiting the community in general,” she said. “Supporting the health and well-being of our students is the equivalent to supporting the health and well-being of our community.”

LIBR
TU graduate student McKenna Pierson

Other ongoing treatment studies at LIBR use behavioral activation or cognitive behavioral therapy (as part of ongoing studies in Aupperle’s lab) or novel intervention approaches such as the Float Clinic and Research Center led by PI Justin Feinstein. His studies use flotation as an intervention approach to mental illness, providing patients with a way to disconnect with the world and reconnect with signals firing in their bodies. His research was featured on the CBS This Morning’s “Pay Attention” series in 2018.

TU and LIBR’s unique partnership

Paulus is pleased with the substantial data collection, analyses and treatment LIBR has been able to provide to residents within its first decade. Although Oklahoma has a long way to go in improving its overall mental health, he explained LIBR intends to serve as the starting point for large sets of basic health information that support a biotech approach to mental health treatment and diagnosis. “We want to know how far we can develop, how advanced is our research and can we potentially establish startups that can be developed into effective treatments and commercial products,” Paulus said. In one example, LIBR Chief Technology Officer and physicist Jerzy Bodurka, created a way to use a real-time MRI to train a specific part of the brain to give instant feedback on if the training is effective. Paulus explained the training has reduced levels of depression in research participants, and Bodurka now is developing a turnkey system that will allow for scalability of the intervention at any site with MRI imaging capabilities.

LIBRBehind every principal or associate investigator stands a team of student researchers eager to get involved, serving as valuable assets for LIBR’s mission. When asked if TU depends on LIBR or if LIBR relies on TU, Paulus said the partnership is unique in that it is based on both concepts; while the institute focuses on quality research, TU is a generator of knowledge. “TU’s primary mission is teaching, but the goal of our faculty is to be top-level researchers,” Paulus said. “The research provides training opportunities for students, and we couldn’t train them if we didn’t have this relationship with TU.”

Close ties to LIBR are an incentive for students, especially those at the graduate level, to choose TU for advanced experience in their field of research. Students are invited to participate in rotations through the institute and contribute to the facility’s mental health mission. Although LIBR’s primary method of research is brain imaging, Paulus said there will be opportunities for additional biology-based research in the future as researchers pursue exciting advancements into the new decade.