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A Psychotherapist's Surprising Reaction to Moon Knight

From time to time I like to react to mainstream conversations of mental health. As I've gone farther along in my career, I find that how we talk and see mental health in the mainstream heavily influences how we (collectively) think about mental health and how people see professional mental health support and therapy. Today, I'm going to be sharing my therapist reaction to the Disney+ show Moon Knight.

My disclaimer

First things first, I have to say that despite my name, I'm not a big comic book fan. I've only read a few in my life but appreciate them as an art form. That being said, I won't be reacting to the authenticity of the show to the source material and how graphic novels move in the culture because I'm totally ignorant to all that, just to put that out there.

A Brief Introduction to Moon Knight

That being said, when I first heard a new show called Moon Knight was going to hit Disney+ I was mildly interested - not because I knew of the source material but mostly because I've seen so many people excited about Oscar Isaac and his work (which I don't think I've seen anything of before Moon Knight, to be honest!). But, I love superhero content and WandaVision was previously a stand out for me as a mental health advocate, superhero fan, and sitcom aficionado.

So I went into Moon Knight not knowing much of anything except for the show centering on Egyptian themes and I heard some rumblings about mental health content, which always piques my interest.

As I started the watch the show in the first couple of episodes, I found it to be pretty standard superhero fare - which is to say, I liked it. There's good action sequences and the characters are very mysterious early on, which is a bit refreshing as I've seen so many characters get a million variations (see: The Batman). Isaac's performance is a great insight into this talent - especially as he switches between the troubled, but lovable Steven Grant and the mysterious mercenary Marc Spector.

*spoilers are ahead*

Moon Knight and Dissociative Identity Disorder

I recently saw Oscar Isaac on Stephen Colbert and heard him talk about the character struggling with mental illness and DID (Dissociative Identity Disorder). I took a bit of issue with this in the earlier episodes especially as the relationship between Marc and Steven is framed as a connection forced by Khonshu, rather than something inherent to Steven's psyche. At least, this was my interpretation. If it's some spiritual/mythological kind of possession, it couldn't really be considered DID, right?

Well, I've just finished episode 5 titled "Asylum" and things make a lot more sense.

We learn that not only is Khonshu not responsible for the split/connection between Steven and Marc, we learn that the relationship between the two predates everything we've seen in the series so far. We learn that not only is their relationship one forged by grief and trauma (and is true DID) but we also learn that Steven is an alter (an alternate personality) and Marc is the OG personality and psyche.

*mind blown*

In the episode we witness how Marc came to develop the persona of Steven as a new way to feel fearless and grounded in his day to day life. Steven was created by Marc in response to the incredibly traumatic loss of a younger brother when he was a child and the lingering trauma of living with an abusive (and grieving) mother and a father who was, apparently, just trying to do his best. We learn that the recent breakdown of the alter/primary relationship is because Marc's mother has recently just died.

These revelations also make sense of the relationship between Marc and Layla, who early on in the series is insistent that Marc drop the act (of being his British version Steven) and explain his vanishing from her life with no explanation.

Clip source: Moon Knight via Disney+ YouTube

What Moon Knight represents well with DID

First of all, DID is very rare with prevalence hovering around .01% up to 2% worldwide according to various sources (like here and here). Here are a few things that Moon Knight seems to get right (so far):

• DID is often represented by distinct personality states - although most folks have multiple alters (Jane on Doom Patrol captures this well)

• Dissociative amnesia (memory loss) during episodes is common (we see this early on as Steven struggles with sleeplessness and episodes of amnesia, particularly at night)

• Created personalities tend to offer places of psychic refuge and protection for the primary personality or host (Steven helps Marc avoid his traumatic past and abuse)

• Healing and treatment is often marked by an attempt to integrate or balance the personalities (as referenced in the journey on the boat with Taweret in episode 5)

What comes next?

Now that the show has broken the dam, so to speak. I imagine that we won't get a lot more content or background on DID. As a therapist, especially one who appreciates shadow work, I think this episode did a great job at showing the journey from unconsciousness to consciousness and working towards integration of the different parts of self, which I think is something that most people could connect to (rather than DID, given how rare it is). We all have parts of us that we hide, consciously or unconsciously, and that impacts how we think and act. Services like shadow work help make meaning of this kind of material.

I think from here, it's likely that even though we witness the death(?) of Steven in the episode we will likely see an integration of Steven and Marc, which will allow them to get back to the superhero business at hand and prevent Harrow from fully releasing Ammit and finding some sort control in the relationship with Khonshu.

This is, of course, all speculation on my part and I have no idea what's like to come next! That's the best part of watching this kind of show. When you step into a whole new world, you never know quite what to expect. The point I love about stories (in writing, tv and film, etc.) is that maybe it affords a helpful place to think about our own stories with mental health...and be well entertained in the meantime.

Are you watching Moon Knight? What do you think of the show and its portrayal of mental illness?

The Hidden Danger in Your Social Media Feeds

Social media is a part of everyday life for many of us. We view curated stories from friends, celebrities and brands that are of interest. We keep in contact with people who mean a lot to us, or once did, in a world where many of us end up relocating from our hometowns in search of new adventures and opportunities.

These reasons make sites like Facebook, Twitter and Instagram a huge positive in our lives, but there could be a hidden danger to your mental health lurking everyday in your social media feeds. This danger is vicarious traumatization. In the past, this has been a particular concern for mental health providers, but is a phenomenon that anyone may experience.

We haven't been prepared to understand the implications of social media. Experiencing vicarious trauma (sometimes out of our own immediate control) is a risk we take when we engage in social media regularly these days.  Open any feed and you will readily see photos, images or videos of violence and injury. You’ll also hear stories of suicide or recovery from mental health or addiction issues. While the latter stories help us authentically connect in ways that we haven’t before, all of this exposure can also negatively impact our mental health.

The idea of social media negatively impacting our mental health isn’t new, but few have talked about the impact of indirect experiencing, or vicarious trauma, intentionally. To better understand what vicarious trauma is, it’s important to take a look at a basic description of Posttraumatic Stress Disorder (PTSD).

PTSD is a mental health condition characterized by a cluster of responses (or symptoms) after experiencing a traumatic event. These indicators may manifest as:

• Intrusive thoughts or memories of the event(s)
• Physical reactions to cues reminding you of the event(s) ranging from discomfort to dissociation and even re-experiencing traumatic event(s) in the present
• Intense and significant responses to being exposed to triggers (such as sights, images, videos, sounds, smells, etc.) that remind you of said event(s)
• Thoughts of self-blame, guilt or hopelessness
• Feelings of sadness, fear, guilt, anxiety, etc. and greater difficulty experiencing positive feelings such as happiness, peace, joy, etc.

All of these symptoms must have been experienced in the context of some traumatic event(s). In the past, this only included events like war or sexual assault, but the criteria for PTSD has become broader over time. Now, the diagnostic criteria indicates it is possible to experience PTSD even if you did not directly experience or live the triggering event yourself. Fear or threat of seriously bodily injury to someone you know also qualifies as an activating event. That means that you could potentially also experience PTSD if you knew a friend or loved one experienced terrible events.

What does that have to do with social media?

Consider that you’re a Black mother. Routinely you log on to Facebook and encounter racist rhetoric or see yet another video of police abuse of power resulting in the death of a young Black person. How might you feel to see these videos over and over again? How might that impact your ability to see the world as a safe space for your child(ren)?  How might that impact your mood and ways you navigate different spaces with your child(ren)?

Now imagine you’re a trans woman of color and you predominantly have  found social safety and security online. Almost every week not only do you encounter transphobic rhetoric in comment sections of posts and articles, but you also cross news story after news story of yet another young trans woman of color dying at the hands of someone else. How would that make you feel?

You may end up feeling pretty unsafe walking in the world. You might become less prone to interact and trust others. You might wish that you were someone else. You might wish that the identities of your loved ones weren’t reflected in these kinds of horrific stories. You might feel hopeless and powerless. Everyday, on every social feed, you’re reminded of how your life is viewed as less than. You question the validity of your worth in the world. You wonder if anyone would care if that happened to you or your loved one.

You might hide. As that mother, you might wake up in the middle of the night in terror that your young son is out late. As a trans person, you may not perform gender in the way you might ideally for fear of bodily injury or worse.

There are many people with a whole host of different identities that may be reflected in the stories you see and read in social media. And the reality is, if you’re on these sites multiple times per day, you’re consistently faced with images of people who look like you experiencing violence, at worst, and sometimes snarky comments and/or personal attacks.

How do we navigate this confusing world of endless connectivity?

The answer may not be to disconnect from social media completely. After all, if you disconnect you will miss out on the positivity and connectedness you experience from your online communities. Taking time be more intentional and mindful about your use, as opposed to following each impulse to check your feeds, could be a wise way to manage your connectivity and moderate your exposure to traumatizing material.

The next time you log on, ask yourself, "What am I hoping to gain right now?" One simple question might drastically change your relationship to social media and how you use it. Until then, happy scrolling.

Mental Illness in the U.S.

"One of the things that baffles me (and there are quite a few) is how there can be so much lingering stigma with regards to mental illness, specifically bipolar disorder. In my opinion, living with manic depression takes a tremendous amount of balls. Not unlike a tour of Afghanistan (though the bombs and bullets, in this case, come from the inside). At times, being bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of. They should issue medals along with the steady stream of medication." — Carrie Fisher, Wishful Drinking

Mental illness is a confusing topic for some and is fraught with a lot of stigma for many. There is a lot of misinformation out there about what mental illness is, and the extent of its impact.  This graphic represents the reality of American mental illness. Check it out below.

Thanks to the MSW@USC, the USC Suzanne Dworak-Peck School of Social Work’s online Master of Social Work program, for sharing this information.

If you are in crisis, please seek help immediately. Call 1-800-273-TALK (8255) to reach a 24-hour crisis hotline (visit link to chat), call 911, or go to the nearest emergency room.

Helping the Helpers: Why Physicians Die by Suicide

As a culture, we often look at doctors as our everyday heroes. They are there for us in our most troubling times, helping us survive through disaster or helping us cope with the horrors of illness and what it means to be human.  Doctors, in particular, have been a part of all our lives at some point. They helped us or our loved ones combat symptoms of an illness, heal our sick children and are typically the first of those around us to witness our grieving. What happens when doctors are the ones trying to battle through illness and grief themselves?

Why Physicians Die by Suicide: Lessons Learned from their Families and Others Who Cared by Dr. Michael Myers gives us insight into the realities of mental health issues in doctors. What we learn from this text is that those who are sworn by oath to "do no harm" often find themselves doing harm to themselves by not receiving adequate mental health care.

Surprisingly, there is a lot of stigma when it comes to doctors accessing professional mental health support. Whether it's therapy or medication, doctors can sometimes struggle to battle through the same stigma that the rest of us face when we encounter mental health challenges.  In addition, since they are so heavily invested in the role of healer and problem solver, there is an added pressure to keep their mental health issues quiet, powering through in order to be the overachievers and perfectionists that school and training have often taught them to be. After all, in their professions lives are at stake daily.  In Myers' estimation, it seems that doctors forget that their lives are at stake too.

In Why Physicians Die by Suicide: Lessons Learned from Families and Others Who Cared, Myers shares of his personal connection to suicide. He lost a young colleague, and roommate, by the name of Bill early on in his medical career to suicide. It's no doubt that this experience has influenced Myers' trajectory and passion about de-stigmatizing mental health issues for medical doctors. In his book, he also shares stories and vignettes from doctors and other family members of those who have dealt with depression and suicide.  The anecdotes are staggering, and are reminiscent of some of the conversations I have with family members who have loved ones who struggle with thoughts of suicide.

It's difficult to talk about suicide in any context. Many therapists and mental health professionals struggle with that as well. This is exactly why we need a book like Why Physicians Die by Suicide. We have to continue to de-stigmatize the realities that people of all walks of life can be dealing with depressive thoughts and or suicidal thoughts and plans. Myers warns us that we also have to be particularly watchful of our doctors because they can often find very creative ways to mask their depression and other mental health challenges.  As a therapist, this is an eye-opening text and will absolutely change the way that I think about my work with those in the helping professions who often find themselves giving so much to their clients and patients.

Why Physicians Die by Suicide: Lessons Learned from Families and Others Who Cared is available for purchase at most major book retailers such as Barnes and Noble and Amazon.