Put Yourself Together in the Other S Shoes

PUT YOURSELF TOGETHER !!! IN THE OTHER´S SHOES !!!

A PROJECT PROPOSAL 33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

Table of contents ______3

Abstract______5

Introduction______6

Research______9

Clinical Depression: a brief description 9

The Stigma around it 11

Statistics- 12

Worldwide 12

Mexico: Level of Stress and Depression 13

Common places between depressed and non-depressed people- 19

1) Stress: a risk for falling under Depression 19

2) The culture of Emotion-Inhibition 20

3) Difficulty of solving problems: another stressor 21

The advantages of sharing emotions 22

Put yourself together!!! in the other´s shoes!!! 23

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Summary 25

Development______26

The project 26

Why theatre-based? 26

Who will be recruited? 27

What methods will be used to achieve the performance aims? 27

Who is the intended audience? 29

Implementation______30

Who are the specific institutions I am approaching for support? 30

Finance 31

Work plan 32

Marketing 32

Accessibility 33

Evaluation & Monitoring 33

Tracing 33

Conclusions______34

Bibliography______35

Further reading list______37

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

4 33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

Abstract ______

This essay researches, develops and implements a project that attacks the stigma attached to people suffering from depression. It intends to lessen this stigma by providing accurate information of this mental illness and promoting empathy by reflecting on the common places between depressed and non-depressed people. The proposed common places are: the daily stress faced in cosmopolitan cities, the culture of emotion-inhibition that contributes to the accumulation of this stress, and the difficulty of solving our problems due to this accumulation and it contributing to it. One can conclude that anyone who lives in a cosmopolitan city can develop this disabling illness, as they are highly exposed to psychosocial stressors. In this matter, the author considers that this reflexion should lessen the stigma towards depression. The author intends to expose these arguments in a theatre-based performance that will be strategically implemented based on the context of Mexico City, where she resides.

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

Introduction ______

The present essay is a theoretical and practical exercise based on a personal assumption. My hypothesis is that the stigma attached to depression results not only from a lack of information of this disorder but also due to a lack of an emotional/empathic connection with those who are depressed.

Until now, I have no knowledge of any scientific or spiritual methods that would allow us to fully experience other people’s emotions as if they were our own. Empathy, then, is probably the closest to this. I presume to create this empathy by reflecting on our own risk for falling into depression and the common places we might share with those who have already been diagnosed with this disorder.

Before writing this essay, I carried out an informal interview with two unknown middle-aged men in the street. I asked them what they thought about depression. Both men argued categorically that

-depression is not an illness; that life is too short to expend it lamenting and thus, depressed people don´t want to be happy-. Yet, one of them accepted he had been depressed for ten years after his brother died, but he was the most reluctant to believe that depression is as disabling as any other illness. I felt lost. I didn´t know what to say to this person who had experienced depression personally and still was prejudiced about it. Since then, I have had many doubts. Does empathy really exist or it is just an illusion? I honestly confess that I constantly bow to the latter. However, I gaze upon those greatest changes in history, like women´s rights, and I feel hopeful.

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An important experience that also contributed to the creation of this project is my own depressive condition. I have been diagnosed with dysthymia, a chronic depression that requires medical and psychological treatment, which I have followed for five years now. In my need to understand this condition, I searched for others like me. I found out that plenty of people suffer like me. Most of them are elderly, but there are also lots of young and middle aged people. A case in point worth mentioning is that of a twenty-five year old girl. Currently suffering depression for several years now, she hasn´t responded to any kind of treatment. Leonardo Ruiz, a psychiatrist from the National Institute of

Psychiatry of Mexico, commented, in relation to this case, that there are different levels of depression and each organism reacts different to the disorder and the treatments. At very severe levels, people can even get catatonic or, in the worst case, it may lead to suicide. I really cannot imagine their suffering, less speak on their behalf.

I realised then that I had to define the scope of my study object. Hence, I created a Gauss-bell scheme that illustrates to whom I am addressing and from which point of view am I speaking. On the left hand side reside the worst possible audience (those who, even though they suffer from depression, do not empathise with it). On the right hand side, the very severely depressed people.

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

In summary, I cannot speak for all depressed people but I can from the depression I am familiar with

(mine and others). At the same time, I believe that such a degree of obstinacy from those situated on the left hand side is hopeless, thus I am addressing those who might reconsider their prejudice towards depression.

In my previous Contextual Course Essay, Insights of Depression (2013), I widely described the symptoms of this disorder but I did not set down a project proposal. Here, I do develop one, which will be found under three major topics: The Research, which is the argument and justification of the performance, The Development, specifically the project description, and The Implementation, strategically planned in the context of Mexican culture.

I will put forward arguments that are testable for what I posit, but some rely only on my assumptions and intuition, on what I firmly believe in due to my experience with depression, its stigma and the positive results of sharing emotions.

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Research ______

Clinical depression: a brief description.

I use here the term ‘clinical’ to emphasize the nature of the illness of depression but ‘been depressed’ wouldn´t need this previous term to mean that it is “a clinically diagnosable condition, an illness with recognisable symptoms1 [due to a] complex interaction of social, psychological and biological factors”.2 Instead, it is usually misunderstood as just “sadness” (a common and non-disabled reaction to a non pleasant event).

Depression is a complex and vicious cycle between chemistry imbalances in the brain (biological factor), and a pessimistic or low mood personality (psychological factor) as well as external social factors that can trigger or worsen both.

1 Fielding, Helen, Why are we all so depressed? Feeling fed up with life, miserable, anxious, gloomy? So is everyone else, The Independent, 2013. http://www.independent.co.uk/life-style/why- are-we-all-so-depressed-feeling-fed-up-with-life-miserable-anxious-gloomy-so-is-everyone-else- helen-fielding-reports-1613921.html

2 World Health Organization, 2012, http://www.who.int/mediacentre/factsheets/fs369/en

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On the biological hand, there is a lack of production of serotonin in depression (a hormone that give us the feeling of pleasure) and an increase in stress hormones such as glucocorticoids. These chemical imbalances may occur due to genetics, diet, lifestyle, hormonal changes and social or psychological stress; “Research shows that the hippocampus [a region of the limbic system] is smaller in some depressed people”. 3 We are talking then, of an undeniable biological factor in depression. However, the psychological and social factors are equally relevant.

If there is a genetic tendency to depression plus negative life experiences reinforce this, the person is more vulnerable to fall into depression, specially after a traumatic episode. Even gender is a possible condition for this, as women tend to ruminate bad feelings and have more hormonal changes than men. All of these psychosocial and biological factors turn on stress-hormones, and if there is no outlet for the frustration caused by this stress, the person might develop a pathological learning to feel helplessness according to Dr. Sapolsky4.

There are many kinds of depression5 and the level of severity classifies them. Let us take for instance minor and major depression. After some depressive episodes, a people can again fall into another and more severe one, without it necessarily having been triggered by a social factor. This means, that he already has a major depression with a dysfunctional chemistry with a tendency to get depressed.

3 Harvard Health Publications, What causes depression?, http://www.health.harvard.edu/newsweek/what-causes-depression.htm

4 Sapolsky, Robert, Stanford´s University Lecture on Depression, 2009, min. 42:14 https://www.youtube.com/watch?v=NOAgplgTxfc

5 “The ninth revision of the International Classification of Diseases (ICD) contains between nine and thirteen different categories to which a depressive illness may now be allocated”. Rowe, Dorothy, The Experience of Depression, John Wiley & Sons, Chichester, New York-Brisbane- Toronto, 1978, p. 4.

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However, whether someone falls into a minor or a major depression, both can result in a disabling situation that hinders their daily lives and their recovery won´t depend just on their will.

The Stigma around it

“The Stigma Shout survey from the UK program Time to Change showed that almost nine out of ten people with mental health problems (87%) reported the negative impact of stigma and discrimination on their lives”.6

People that are not familiar with this disorder usually think that depressed people are just sad. As we all have experienced this mood from time to time, we expect others to overcome it as we have done so. But if they do not do this, based on our expectations, we label them as lazy, victims or existentialists. This may be explained because the physical impairment of depression is not as visible as other illnesses. For instance, a person who is depressed can constantly complain to his friend of how ‘down’ he feels (and probably they will get tired of listening to him) but the latter do not see him when he is alone at night, dealing with insomnia. It may seem that he is resting in his bed, but in contrast to what people imagine, depressed people’s minds are constantly active with catastrophic thoughts. Yet, he probably will have to get up early, he will be tired all day long and he will not be able to perform effectively at work.

The negative impact of discrimination is that it makes the depressed people more disabled than they are already due to their condition. Surprisingly, people who have been diagnosed with this disorder ignore that their condition is a mix of biological and psychosocial factors. They usually do not separate between their genetic tendency, their personality and socially external factors. To be depressed then results in an auto-stigmatization; a confusion-cloud where they think their depression is totally their fault. At the same time, they are reluctant to confess to others their condition because

6 Time to Change, http://www.time-to-change.org.uk/what-are-mental-health-problems/stigma- discrimination#stigmashout

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014 they are afraid of people´s reaction and if this is negative, it is very likely that he will opt to withdraw into himself more than he was already, which becomes in a double-stigmatization.

Statistics -

Depression Worldwide

It is important to have a worldwide knowledge of the statistics of depression to compare with those of

Mexico. In this matter, the World Health Organization7 states:

1. Depression is a common mental disorder. Globally more than 350 million people of

all ages suffer from depression.

2. It is the leading cause of disability worldwide, and is a major contributor to the

global burden of disease.

3. More women are affected by depression than men.

4. At its worst, depression can lead to suicide. Suicide results in an estimated 1 million

deaths every year.

5. “It is estimated that by the year 2020, depression will be the second most common

cause of ill health and premature death worldwide”. 8

Demographically, the elderly are the most affected from this illness (approximately 1 in 5 older people). 9 However, Bill Deakin, professor of Psychiatry at Manchester University, “…adds that it is

7 World Health Organization, 2012, http://www.who.int/mediacentre/factsheets/fs369/es/

8 Health Promotion Agency, http://www.depression.org.nz/depression

12 33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014 beginning to affect younger people and that more people are getting depressed now than in the past”.

10 According to the National Institute of Mental Health “more than a half of the world´s population will have a depressive disorder at some point in their lifetimes”, [however], fewer than half of those affected in the world (in some countries, fewer than 10%) receive treatments”.11

Depression and levels of stress in Mexico

Later on, it will be seen that stress is highly related to depression. Hence, it is appropriate to explore

Mexico´s level of stress and rate of depression in order to contextualise my project.

“According to the World Health Organization, Mexico is ranked with the highest level of stress and from the 75,000 strokes within a year, 25% are related to illnesses caused by fatigue and stress at work. […] With three quarters of stressed Mexican workers, we overpass the records of China and the United States”.12 Nonetheless, Mexico is also considered as one of the four countries that show

9 Mental Health Foundation, http://www.mentalhealth.org.uk/help-information/mental-health- statistics/

10 Watts, Geoff, Why do some people never get depressed?, BBC News Magazine, 2013, http://www.bbc.co.uk/news/magazine-16749565

11 Ross, Christine, The Aesthetics of Disengagement, Contemporary Art and Depression, Minnesota Press, United States, 2006.

12 Universia, México, México es el país con más alto índice de estrés ,2013, http://noticias.universia.net.mx/en-portada/noticia/2013/07/04/1034482/mexico-es-pais-mas-alto- indice-estres.html

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014 less prevalence in Major Depressive Episodes.13 We have arrived at a contradiction: Mexico is ranked with the highest level of stress of all countries, yet it is one that shows less depression among its population.

Gotlib and Hammen14 might unravel this contradiction:

“Many epidemiological studies have found that prevalence rate of depression varies considerably across national (and presumably, cultural) lines. […] It is possible that the different prevalence rates that were found were due to the different methods of assessing depression rather than to culture. […Others] have been attributed to cultural variation in the conception of mental illness (with Western cultures viewing emotional problems as separate from physical complaints more than Asian cultures), to differences in the amount of stigma attached to mental illness (with

Asian cultures stigmatizing emotional problems more than Western cultures), and to different levels of available social and familiar support (with Asian participants having more social support than their Western peers)”.

In conclusion, Mexico may show high levels of stress and depressed people but due to its culture, people might prevent themselves from this illness as family (a great Mexican value) can result as an important supporting network. On the other hand, it exists a great stigma towards those who are depressed and this results on a very low use of mental services. Thus the statistics on Mexican prevalence of depression may not reflect an accurate reality.15 In fact, “no national data on lifetime

13 “On average, the estimated lifetime prevalence was higher in high-income (14.6%) than low- to middle- income (11.1%) countries. Indeed, the four lowest lifetime prevalence estimates (< 10%) were in low- to middle-income countries (India, Mexico, China, South Africa). Conversely, with the exception of Brazil, the highest rates (> 18%) were in four high-income countries (France, the Netherlands, New Zealand, the USA”. Bromet, Evelyn, Cross-national epidemiology of DSM-IV major depressive episode, Biomedical Central Medicine, 2011

14 Gotlib, Ian H., Hammen, Constance L., Handbook of depression, The Guilford Press, New York - London, 2002, p. 472

14 33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014 prevalence and risk factors for DSM–IV [Diagnostic and Statistic Manual of Mental disorders IV version] psychiatric disorders are available in Mexico”.16

Some statistics do show that:

1. “6.4% of Mexican population suffer from depression. The National Health Program

(2007-2012) describes that this disorder is the principal cause of damage generated by

health problems that does not lead to death among women, surpassing illnesses such as

diabetes mellitus and ischemic heart diseases. In men, depression occupies the ninth place.

It has also been demonstrated that depression is more disabling than other chronic

diseases such as arthritis, diabetes and hypertension”.17

2. “One out of five individuals will present at least a mental disorder in their lifetime. The

three metropolitan areas [Mexico, Guadalajara and Nuevo Leon] present the highest

prevalence of anxiety disorders (37%) [in which depression is allocated]”. 18

15 “In spite of the important burden of disease that mental health problems represent, the last data from the National Enquiry of Epidemiologic Psychiatry points that there is a low use of the services [bound to this kind of disorders]”. Berenzon, Shoshana, Saavedra Solano, Nayelhi, Medina-Mora, Ma. Elena, Sistema de Salud Mental en México (IESM-OMS), México, 2011, http://www.who.int/mental_health/who_aims_country_reports/who_aims_report_mexico_es.pdf

16 Medina, Borges, Benjet, Berglund, Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample, British Journal of Psychiatry, http://bjp.rcpsych.org/content/190/6/521.long

17 Heinze, Gerhard, Camacho, Pedro, Guía clínica para la atención de Trastornos Mentales, Instituto Nacional de Psiquiatría Ramón de la Fuente Múñiz, México, 2010

18 Medina-Mora, Ma. Elena, Borges, Guilherme, Lara Muñoz Carmen, Benjet, Corina, Blanco, Jaimes Jerónimo, Fleiz, Bautista, Villatoro Velázquez, Jorge Rojas Guiot, Estela, Zambrano Ruiz, Joaquín, Casanova Rodas, Leticia, Aguilar-Gaxiola, Sergio, Prevalencia de trastornos mentales y uso de servicios, Red de Revistas Científicas de América Latina, el Caribe, España y Portugal, 2013, http://www.redalyc.org/articulo.oa?id=58242601

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

3. “While psychiatric disorders are common in the Mexican population, very severe mental

disorders are less common and there is an extreme under-utilization of mental health

services”.19

4. “According to the Mental Health Program from the Faculty of Medicine at UNAM.

[National Autonomous University of Mexico] the depressive syndrome occupied the first

place among all the diagnosis, with a 48% average regarding the student population”.20

With reference to this last point, it might be difficult then to have a realistic overview on depression rates in Mexico but it certainly face several stress factors that indicate us that possesses a high rate of this illness.

A serious study of this made by The Legatum Prosperity Index proposes some indicators that relate to lifestyles with mental health. This is a study of 142 countries that ranks them into the happiest or saddest according to 8 indicators, such as stable political institutions, freedom of expression, good education and healthcare, personal freedom and a feeling of being safe and secure. Mexico occupies the 59th place of 142 in this index21. Compared to the other 142 countries, Mexico might appear not as

19 Berenzon, Shoshana, Saavedra Solano, Nayelhi, Medina-Mora, Ma. Elena, Sistema de Salud Mental en México (IESM-OMS), México, 2011, http://www.who.int/mental_health/who_aims_country_reports/who_aims_report_mexico_es.pdf

20 Armienta, Saul Ruiz, Depression, Universidad Autónoma de Guadalajara, http://genesis.uag.mx/posgrado/revistaelect/salud/sal003.htm

21 Legatum Institute, Legatum Prosperity Index, 2013, http://prosperity.com/#!/country/MEX)

16 33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014 the best but not as the worst place to live, and this is probably true. Nonetheless, Mexico has deep deficiencies in many of the indicators.

Poverty

A poverty measurement carried out by the National Council of Politic and Social Development

Evaluation22 between 2010 and 2012 states that 53.3 million people (48.4% of its population) live in some kind of poverty.

Unemployment

While employment (ranked at 5.2%) seems not as bad compared with other countries like the UK with

7.2% or Greece and Spain with 27.2% and 25% accordingly, the ranking of Mexico takes into account informal employment (without social security, benefits, and retirement pension) that may also feign a

‘good employment situation in Mexico’.

22 CONEVAL, http://www.coneval.gob.mx/medicion/Paginas/Medici%C3%B3n/Pobreza %202012/Pobreza-2012.aspx

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

Salaries

Mexico occupies the lowest level regarding the minimum wage compared with the following countries:

* http://infogr.am/salarios-minimos-en-el-mundo?src=web

Education

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“Low education was significantly associated with MDE [Major Depressive Episodes] only in Israel, the USA, Mexico and Ukraine”. 23 “Mexico occupies the last place on education level among the 37 countries members of the Organization for Economic Cooperation and Development (OECD). This latter also points that in Mexico, from 100 children only 62 will finish the primary school; 45 will conclude the secondary school and 27 the high school. Only 13 will graduate from a bachelor degree and only two or three will get to a master degree”. 24

Delinquency and insecurity

Mexico has an average of 10,935 crimes for each 100,000 inhabitants.25 According to the OECD

Mexico is on top of the crime and insecurity comparative among the 36 countries members of this organization. 26

Although happiness or levels of satisfaction can be very subjective and ‘been unhappy’ doesn´t necessarily mean to be depressed, they do reflect part of the society´s well being and its vulnerability to mental health disorders.

23 Bromet, Evelyn, Cross-national epidemiology of DSM-IV major depressive episode, Biomedical Central Medicine, 2011, p. 5, http://www.biomedcentral.com/content/pdf/1741-7015-9-90.pdf

24 Al momento Noticias, México último lugar en nivel educativo: OCDE, Gobierno del Distrito Federal, 2013, http://www.almomento.mx/mexico-ultimo-lugar-en-nivel-educativo-ocde/

25 INEGI (National Institute of Statistic and Geography), Tasa de incidencia del delito e inseguridad por cada 100,000 habitantes 2009, National Insecurity Survey (INEGI), 2009, Mexico. http://www3.inegi.org.mx/sistemas/tabuladosbasicos/default.aspx?c=26738&s=est

26 Morales, Yolanda, Mexico a la cabeza en inseguridad y violencia, El Economista, 2013, http://eleconomista.com.mx/finanzas-publicas/2013/11/05/mexico-cabeza-inseguridad-violencia

33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

Common places between depressed and non-depressed people

The following topics comprise three major things that I believe depressed and non-depressed people share in common.

1) Stress: a risk for falling into depression

Dr. Robert Sapolsky finds that stress is what really triggers depression27. Whether you own a genetic tendency and/or a pessimistic psychology, it is always a stressful social event that triggers the first depressive episode. When we over-produce stress (specially, high levels as in cosmopolitan cities) it can degenerate into affections such as diabetes, colitis, hypertension and other illnesses, and in this case, psychological pathologies. In contrast, a study among the Kaluli tribe from Papua New Guinea conducted by the anthropologist Edward Schieffeling (1847-1947) shows that living in a more natural environment prevents people getting depressed:

“ He interviewed over 2,000 men, women and children regarding their experience

of grief and depression and found only one person who even came close to meeting

27 Sapolsky, Robert, Stanford´s University Lecture on Depression, 2009, min. 45:20 https://www.youtube.com/watch?v=NOAgplgTxfc

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the diagnostic criteria for depression. Dr. Ilardi, author of The depression Cure,

2009 feels the answer is very clear: -The more modern a society’s way of life is,

the higher the rate of depression. The human body was never designed for the

modern post-industrial environment. He contends that our bodies have always been

designed for a more rigorous lifestyle where physical exercise, diet and even

sunlight exposure helped maintain a positive mood. Yet, today we spend more time

sitting, eating processed food and living under fluorescent lighting. To summarize,

the evidence is showing that the epidemic of depression can be explained by changes

in the way we live”. 28

Dr. Stephen Ilardi argues that our lifestyle is the principal cause for depression. He posits a

Therapeutical Lifestyle Change (TLC) 29 to avoid falling into depression such as diet, exercise, healthy sleep, sunlight, anti-ruminating activity and social connection. In the next topic, I focus on this social connection, specifically on human emotion communication.

Stress can lead anyone to a minor or a major depression (depending on their genetics) simply because it evolves on psychological and physical complications that are very difficult to work out among all the demands of the present life.

28 Lykes, Diane E., Principal of Synergy Counselling Associates in Alban, http://www.crlmag.com/articleDetail.cfm?id=245

29 Ilardi, Stephen, Depression is a disease of civilization, Tedxtalk, 2013, min. 10:32 https://www.youtube.com/watch?v=drv3BP0Fdi8

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2) The culture of Emotion-Inhibition –

“Society has closed up so that people feel themselves to be individuals rather than part of a group. It's a loss of an emotional network, people for you to care about and to care about you. We are a much more isolated and lonely society than we were 50 years ago.”

- Simon Armson, the Samaritans' chief executive - 30

Aside from stress, I find that depressed and non-depressed people silence their most major personal problems. The first ones, probably because they are afraid of being discriminated, but also, and as for the second ones, because we have learned to hide our emotions based on the culture we live in.

In this respect, Pennebaker says that:

“ [We are living in] the age of inhibition” “…where although we know that

talking about our problems can be good for us, …we also know that we should put

on a happy face and look at everything in a positive light. We also know that

whining and complaining about our problems will get us nowhere”.31 -“[We] feel

ashamed about having psychological problems because [we] believe--wrongly--

that no one else like [us] is having those problems. People like [us]--strong,

30 Lorna Martin, The depression epidemic: We've got more freedom, wealth and opportunity... so why are so many women unhappy?, Main Online, 2013, http://www.dailymail.co.uk/femail/article- 1270763/The-depression-epidemic-Weve-got-freedom-wealth-opportunity--women- unhappy.html#ixzz2mw2EB1Cp

31 Pennebaker, James W., Opening up, The healing power of Expressing Emotions, The Guildford press, New york, 1990, p. 11, 12.

22 33239215 Put yourself together!!! in the other´s shoes!! DR71098A – 29 April 2014

smart, successful people—do not have psychological problems. Only weak,

limited, inept people do-. Although silence may serve as an extended form of

communication which can contain a great spectrum of emotions that speech

wouldn´t be able to describe, it is not always healthy to remain in silence when

this is synonymous of stress”. 32“ Over time, the work of inhibition serves as an

accumulative stressor on the body, increasing the probability of illness and other

stress-related physical and psychological problems”. 33

3) The difficulty of solving problems: another stressor

As Dr. Sapolsky points out, we need an outlet for the frustration caused by stress. Hiding our emotions contributes to this frustration, but how can we share them if we are not even conscious of them?

It is not easy to self-reflect nowadays. This is basically because there is no time and energy to even listen to our emotions or be conscious of our problems, less to solve them. Therefore, ancient traumas

(i.e. from childhood), and recent psychological and social problems accumulate.

32 Leibow, David, The Shame About Shame, The College Shrink, 2011, http://www.psychologytoday.com/blog/the-college-shrink/201101/the-shame-about-shame

33 Pennebaker, James W., Opening up, The healing power of Expressing Emotions, The Guildford press, New york, 1990, p. 9.

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Having enough time can be very subjective and depends on how people manage it. However, it is undeniable that in Mexico City, work and transportation take a lot of time from us. In private companies, working hours have increased from 10 to more (depending on the workload).

“Over 20 million people live in the metropolitan zone of Mexico City. [They

spent an average of between 1 to 1.5 hours a day on transportation]. 11 million of

them inhabit the State of Mexico [a zone that surrounds the capital and from which

people spend from 3 to 4 hours a day to get to their work and home]. In June

2010, the IBM Commuter Pain Survey revealed that traffic negatively affects 56%

of work performance in people that live in Mexico City. On a scale from 1 to 100,

where 1 is the lowest level of traffic and 100 is the highest, Mexico and Beijing got

99%”. 34

People are getting home approximately between 8 and 9 pm and have to deal with family and/or home stuff. It is not surprising they end up with very low energy for even wanting to think on how to solve their problems. No wonder why some stultifying entertainment such as TV or social networks are in order! Two solutions are very obvious to me: decreasing working hours, and finding a way to reduce traffic. Yet, since these solutions are not in my hands, what I propose is emotion-sharing as one way of venting stress.

34 CNN México, La disputa por el Estado de México, 2011, http://mexico.cnn.com/nacional/2011/04/08/8-de-cada-10-personas-que-salen-del-df-se-van-a-vivir- al-estado-de-mexico

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The advantages of sharing emotions

Communicating our emotions to others can bring very positive advantages:

1. The simple act of exteriorising emotions/problems prevents people from accumulating stress.

It works as a relief; just like crying. We must remember we are social beings and we are not

meant to be isolated, neither physically nor spiritually.

2. Verbalising our emotions/problems can lead us to be conscious of them and ease their

solution.

3. Talking to people is a way of finding out that others think like us: an excellent way to feel we

are not alone in this world.

Since as far back as I can recall, I am a person who digs into others’ feelings. My method consists in sharing my emotions and problems. Some people react at the beginning with suspicion but, over time, they learn to trust me and finally share theirs. Similarly, the method of my performance is informative but at the same time confessional and sincere in order to achieve the above advantage number 3.

Put yourself together!!! in the other´s shoes!!!

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Not everything in my performance is meant to have this sense of ‘digging into others’ emotions in a light and non-threatening way’. What I am about to discuss may seem a little bit aggressive:

When people discriminate against us (depressed people) they usually imply – ‘Get over it!’ – as if it is something we could do magically. Consciously or unconsciously, they are asking us –to make a titanic effort to get out of our stupid depression! –35 I would argue back – Fine. I´ll do that when you solve the problems you are always complaining about –. They would probably say that they have no time, no energy (or even, that they do not have problems). I would then answer – Well, make a titanic effort! Be your own boss and don´t work in that company, buy a helicopter to avoid traffic, do not play with your children after work, do not watch TV and then you´ll find more time and energy! –.

I know it sounds really stupid but this is what they are actually asking us to do: something far beyond our physical capacity, at least in the time they expect us to do it. It is as absurd as asking someone that has not eaten for several days to run a race. He simply has not the physical energy to move. As depressed people, we have no physical energy or clarity to think properly. Getting over a depression can take years (maybe a lifetime) and the existing treatments do not offer a cure, but only control actions.

35 Of course, this is just my interpretation, yet is very valid as all the discriminating phrases that depressed people have experienced and share found in blogs such as:

* Green, Charlotte, The 10 Stupidest Things You Can Say To A Depressed Person, Thought Catalogue, 2013, http://thoughtcatalog.com/charlotte-green/2013/09/the-10-stupidest-things-you- can-say-to-a-depressed-person/

* Deborah, Worst Things to Say to Someone Who’s Depressed, Wind of madness: depression mind, 2010, http://www.wingofmadness.com/worst-things-to-say-to-someone-whos-depressed

* Yahoo Answers, Stupid things people say to you when you're depressed?, http://mx.answers.yahoo.com/question/index?qid=20130609120856AAUqD1i

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Summary

I have found that more similarities than differences exist between depressed and non-depressed people. Although, the genetic predisposition to depression can be an important difference compared to those who aren´t depressed, the scheme below shows that they share common psychosocial stressors due mostly to psychosocial causes.

Stress Emotion-inhibition Difficulty of = Can causes + causes + solving lead to problem s causes

Severe Neurological Neurological depressio caused by n Depressed & Psychosocial depressi on and or Psychosocial social stress suicide

Non- Neurological depre Psychosocial Psychosocial caused Depression ssed by social stress

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Development ______

The project

As previously pointed out, the principal aim of my piece is to inform and generate empathy. It is a theatre-based performance (1 hour approximately) that includes an open talk session with the audience about the topic and the effectiveness of the performance for further adjustments.

The key element of the performance is a carefully written text in the form of a narration in colloquial language that will provide information and statistics about depression. Along with this narration, artistic media such as Video, Lighting, Music and Robots will illustrate this text imbuing the performance with graphic metaphors. There is also a character present (who is a depressed person) who will lie on a bed almost until the end, and from which he/she will get up and directly face the audience in complete silence trying to make an eye-emotion connection with them.

Why theatre-based?

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Though my piece is not a ‘conventional play’ (with characters or dialogues) but rather a multidisciplinary performance, it is in theatre where I have experienced the kind of empathy I want to achieve. For me, the wise interaction between elements such as music, text, video, lighting and acting can reach beyond reasoning and promote mutual understanding through a deeper emotional experience. I aim for an indoor theatre because ‘obscurity’ is also an important element for my piece.

Who will be recruited?

The whole ideology of the performance plus the direction and production of the performance relies on me. However, I would have to cast an actor or actress who would have a strong personality on stage.

There are also some technicians who I would have to hire such as:

1. A Lighting operator

2. Ushers (2)

3. A Robot designer and manufacturer

Regarding the latter, Hugo Carmona is an aeronautic engineer and an industrial mechanic who will help with the robots. The other positions haven´t been filled yet.

What methods will be used to achieve the performance aims?

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I looked at other performances on mental health for inspiration such as Julie McNamara´s and Bobby

Baker´s performances. However, I did not feel a real connection with them. I come mainly from a background in music. I have only recently approached the performance world and have not attended enough performances in order to reference a similar work to mine. To be completely honest, I have not even had much interest in looking at others’ theatre works.

My ideology is very similar to what Slava Polunin36 writes:

“The most important thing is to understand what I want to say. As soon as I understand it, it takes

a certain form. […] You´ve just got to learn to have a free mind in order to think only of what you

want to say, and not how to show it. […] Now, there´s no difference for me between ‘what to do’

and ‘how to say’; it turns it on by itself. Of course, I do analyse something, but I try to do this as late

as possible. […] When you´re trying to do it ‘scientifically’, you produce carrion. […] So the

more anarchy, freedom, intuition are there, the better, not forgetting though, about consideration.”

If I chose a colloquial, but soulful, text in the form of a narration, it is probably because I wanted it to be accessible and touching. If I chose Video in the form of –children drawings- it was for the same reason. The actor is a melancholic presence whereby life passes in front of him without noticing. The robots represent this life and are also an entertaining devise to get a dynamic performance.

36 Polunin, Slava, Kazmina, Natalia, A monologue of the Clown or a Pie of ten layers, Julie Delvaux, http://es.scribd.com/doc/106971542/Slava-Polunin-A-Monologue-of-the-Clown#download

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Regarding my support team, I will provide them with this document and the script beforehand for all to read. After that, I will lead two or three sessions to discuss our points of view.

Who is the intended audience?

It is essential to address people that suffer and do not suffer from depression (from young to elder).

Hence, health institutions such as psychiatric hospitals, health centres and asylums are targets.

However, any kind of venue will be suitable, for another of the performance’s aims is to reach people who might be uninformed or who have a relationship with this illness.

The performance could work within school systems, because the performance is intended to be accessible and entertaining but, for now, I cannot guarantee this until I have written the script and I am sure it will be intellectually understandable to children.

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Implementation ______

Who are the specific institutions I am approaching for support?

Health centres and Institutions

- National Institute of Psychiatry Ramón de la Fuente Múñiz - Mexican Institute of Social Security (IMSS) - Institute for Social Security and Services for State Workers (ISSSTE) - Psychiatric Hospital Fray Bernardino - La Luz al Ocaso asylum, Queretaro, México.

Organizations that fight against discrimination

- CONAPRED. Council for prevention and elimination of discrimination - INDEPEDI. Institute for the integration and development of disabled people in Mexico City

Academic institutions

- RADIO-UNAM

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- MUAC, Academic Museum of Contemporary Art (UNAM)

Art Festivals

- IKUS International Festival 2014 (from 22 – 24 October 2014, Mexico City)

For financial support specifically

- FONCA/CONACULTA scholarship grants with £ 5,119.2 in a year and with the first payment due in October 2014. - CONECTA, Business Incubator grants with £ 2,000 Finance

The following is the first financial draft taking into account the minimum amount of money that some business incubators are offering.

I am aware that I will need more money for ushers/artist salaries for each performance. Perhaps some donations could be requested at each performance for this. If I am granted the Fonca/Conaculta scholarship, part of the money will be used to hire an agent to promote the performance.

Work plan

The work plan covers seven months. This means that the main performance season is intended for

October 2014. After this date, the tracing of the project will be found later on in this document. The scheduling of the work is as follows:

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STAGES APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER MAIN SEASON Development Script Making Robot Manufacture

Performance Casting Rehearsal Rehearsals Adjustments Video and Music Making Promotional Video Making Blog management Institution Get a first approach venue to perform for video recording purposes Approach to all institutions mentioned Business Incubators approach IKUS Festival application done FONCA CONACULTA application FONCA results First performance Implementation and Audience Evaluation

Marketing Rehearsal on venue IKUS FESTIVAL

Marketing

There are two strategies for this: Marketing on my own, and with the support of the institutions/organizations. Some of the latter may provide programs, flyers and web marketing for the event. As for me, I will run a blog that will allow people to discuss the subject and get free notifications through email on the coming event. I also intend to create promotional videos/ads to post on the web prior to the performance.

Accessibility

All of the venues will have to be equipped with appropriate installations for disabled people such as ramps and nearby bathrooms, at the least. Regarding asylums or psychiatric hospitals, they will have to provide health carers or relatives to assist the patients before, during and after the performance.

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Evaluation & Monitoring

There is a first evaluation of the performance due in June 2014. Feedback between the crew and the audience will monitor the clarity of the information and the effectiveness of the artistic media. It is also intended to be a confessional-room for people to say what their personal opinion is about depression (an illness or not an illness?) and/or their experience with it. The talk will be recorded for performance-adjustment-purposes due in July 2014.

Tracing

All of the performances will be documented for further applications:

- The Radio UNAM institution and its venue support is an option for presenting the

performance in February 2015. The project has already been sent to them.

- Further applications for other scholarships from Fonca/Conaculta represent a major financial

support after the performance has already been launched and/or invited to participate in an

International Festival.

Conclusions ______

Depression is a disabling illness that can affect any kind of person. Although genetics can definitely signify the difference between someone moderately depressed and someone severely depressed, psychosocial factors such as stress accumulation still remains as the main cause of triggering or worsening depression. Mexico is considered a country with high levels of stress due to several factors. 35

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It is also a quite uninformed society with regards to the real nature of depression, the realistic amount of people that cope with it and the treatment alternatives. Hence, it tends to discriminate, exclude, miss-diagnose and miss-quantify those people who suffer from it.

I believe there is no real understanding unless we put ourselves in the other person´s shoes on an emotional level. In this pursuit of empathy, my project consists of providing information, but also reaching beyond the data and affecting people emotionally (sometimes poignantly and sometimes aggressively). These three ways are conceived as an experiment that will be tested throughout the performances and the evaluation talks.

I am also conscious of my limitations. As an artist, I have no experience in negotiations or how to sell my product. Thus, I will seek help through a business incubator that will guide me in the pursuit of interested parties and provide me with financial resources.

Bibliography ______

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