The Mineshaft Mindset

One of the things that causes me considerable consternation as a family doctor is the seeming chronicity of mental health maladies and the fact that many individuals never seem to get better when it comes to their psychological well being. Asking why this is the case, I realise that the heart of the problem and the answer lies in the very nature of the human mind which is constantly processing the reality of ones environment. We are always considering options of where to go, arriving at solutions or realising that the solution just considered is not longer viable.

In order to deconstruct what is going on, I find this model helpful, which I have called the Mine Shaft Mindset.

Imagine you are taking a stroll in the hills in the nearby national park as part of your effort to get out into the open and unbeknown to you, you step over an uncovered mine shaft and before you know you are falling down the chute and ending up thirty feet below the surface. When you recover from the fall and look around you discover you are in a deep dark place, by yourself with no way out. Help!!

You start thinking ‘What am I going to do now?’ ‘How am I going to get out?’ You might be thinking ‘How could I have been so careless?’ Lots of thoughts of who might be missing you and whether you will ever see your loved ones again.

As you start to consider what to do, you realise that while your phone is working you have no mobile signal. There does not seem to be any steps or path to get back to ground level. You can see a tunnel but it seems to leading to an even darker more eerie place.

At this stage your spouse who knew that that you were hiking becomes concerned that you have not returned after 4 hours. They raise the alarm that you cannot be reached and seek help. Help is in the form of the police and a park ranger. Eventually, after a further two hours the search party is able to establish where you have fallen.

For the rescue to take place some things need to happen. You need first to establish communication with the rescue party. You need to make some noise or do something to know that you are there. They would want to know how you are? Are you hurt? Can you walk. What can you do? Do you have use of your hands? A plan needs to be devised to get you out of the hole and to safety.

What are the options? Could you climb a ladder or hitch yourself to a rope? Is there a way out through the tunnels?

When you realise that your ankle is so painful and swollen that you cannot walk more than a few steps you realise that you need help to get out. You will need to be reached physically to be rescued.

The next person you need to see should be someone who knows what to do to get you out. It should be some one who is willing to come down into the mine and provide assistance. The person has have a knowledge of the terrain, and a desire to help. He also needs to understand how to teach you to optimise the little that you can do to help in your own rescue.

Eventually the park ranger uses a rope ladder to descend into the shaft , assesses your situation and injuries, and with you concludes that the injured ankle would make trying to climb a rope impossible. The decision is taken to make the 1/2 mile walk down the tunnel to the exit chute. It was always going to be challenging but with the guide, by your side you have the confidence to make the way out of the dungeon to safety.

It is really useful to analyse the mindsets at work here. When you are in a deep dark place it is really helpful to visualise the rescue, and anticipate when the trouble will be over. If you lose sight of what you require, the rescue party could come close to you and still not get to you if you do not speak out. Being able to realise that you require assistance is vital, but at the same time recognising who is best placed to provide that help is fundamental. Someone who just acknowledges how it is and does not have a sense of ‘lets get this sorted’ is not useful as the person who wants to see you out of that place as quickly as possible. A friend who discovers you are down and looks to help you , akin to sending down some food and drink to the person stuck in the mine shaft, is giving valuable assistance, but their assistance should be focused ultimately on getting you out of that place. If you become too comfortable in the mine shaft, then the urgency to get out may be lost.

When it comes to depression or indeed any other adverse psychological state we should aim to empathise with the sufferers but never lose sight of the fact that what will ultimately benefit them is leaving that place to a better safer place. People should be appreciate the difficulty that people are in and desire to see them healed and restored. Support when down and encouragement to get on the journey to healing is the full package that is needed.

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