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Caroline’s death gives us a glimpse into the messy reality of mental health


A theme emerged during sessions with several of my patients this week: the extent to which they had been impacted by the loss of Caroline Flack, who took her own life a week ago today. Most found it hard to articulate why, but mostly they understood what it’s like to lose all hope that things can get better and to see suicide as the only way out. They saw Caroline in themselves - her fate could have been theirs had they not been able to step back from the abyss. They saw the impact of suicide on those left behind and lamented the waste of life of such a young, beautiful and likeable woman. I could only nod along in sad agreement - I felt this loss too.


In December, a few days after the news that Caroline has been arrested for assaulting her boyfriend Lewis Burton, I sent her a private message on Twitter offering a space to talk to a local professional. I hoped that she might spot my message in amongst the hundreds of messages I imagined she was receiving, but I assumed she would be avoiding social media. According to the blue tick it had been read, but I never received a response.


Like other fans of Love Island I found the reality show entertaining - a silly, often funny and occasionally moving piece of theatre. But I also found it psychologically fascinating in its exploration of interpersonal relationships and group dynamics. Clearly a fan of the show herself, Caroline was at its heart and seemed personally invested in helping others to find love in the way she hoped to find love herself, however unlikely in this artificial setting. She fought for the underdogs, commiserated with the spurned and icily grilled lotharios in post eviction interviews - everything we, as viewers, would do.


In anticipation of the inaugural winter version of the show, I imagined how excited Caroline must be to see the show expand to twice a year - and to Cape Town no less. When news of the alleged assault and arrest broke I was shocked and confused. This wasn’t the Caroline we knew from social media and on TV - if we were to believe tabloid reports Caroline was usually the one treated badly by the men in her life. The tabloid press had found a new victim and article after article speculated about the incident in lurid detail, led with hateful headlines and published photographs from the scene.


I felt for Burton: if he were a victim of domestic violence (which he denies) it must have been a horrific and lonely experience, especially as Caroline was so beloved. I work with men who suffer at the hands of women (and vice versa) and the shame and anxiety they live with is unimaginable. But I simultaneously felt Caroline’s loss. Whether she was guilty of the violence and had to live with this mistake or it was an accident, as she claimed, she must have seen the life she had built for herself slipping away in an instant. My instinct to reach out to her was borne out of a fear that she might want to harm herself given the guilt, humiliation or injustice she may have felt. I wanted to offer a safe space, free from judgement, for her to process these events and their repercussions.


But then I kind of forgot about Caroline, assuming that she was receiving support elsewhere and that she would be back hosting the next series of Love Island after a period of contrition or indeed vindication. I tuned into the brand new series and watched Laura Whitmore in Cape Town where Caroline should have been but nonetheless settled into the familiar format where everything was kind of different but the same. Until an alert on my phone last Saturday informed me that Caroline had died. My heart sank - I knew instinctively that she had taken her own life.


Caroline was a young woman who wore her heart on her sleeve, but this seemed like the regular, relatable ups and downs of being a young woman in the public eye. She hid her more acute mental health difficulties behind a sheen of social media as many celebrities must do. But the signs were there - a tumultuous love life was a gift to ravenous tabloids who would capture every moment. As Whitmore said, Caroline: ‘lived every mistake publicly under the scrutiny of the media.’ In an Instagram post in October, Caroline posted about her mental health, admitting that ‘when I actually reached out to someone they said I was draining’. This is a sad yet familiar refrain from my patients - despite being encouraged to reach out more and talk they often get similar responses from friends or family. In the age of positive psychology and self-help, we are encouraged to delete ‘negative’ people from our lives and surround ourselves with people who make us feel good. But what about those who are suffering and can’t always muster that reality TV smile?


Far too often only the palatable side of mental health is portrayed in the media - Prince Harry’s dignified grief and anxiety, stories of addictions once sobriety has been achieved or reality TV shows offering celebrities therapy for self esteem or relationship difficulties - all valid and helpful, but they don’t nearly capture the full range of symptoms that severe mental health difficulties can engender. Violence, drug use, promiscuity, chaotic and abusive relationships, jealousy and possessiveness, feelings of emptiness, self harm and suicidality are a daily reality for many people. The darker, less acceptable side of mental heath is messy, ugly, chaotic and raw and usually hidden behind closed doors.


It was reported that the police footage of Caroline’s arrest in December, probably offering a candid glimpse into a the scene of a mental health crisis, is what Caroline was most ashamed of being seen at a trial. We will perhaps never know what happened between Caroline and Lewis that night, but I’m sure that whatever it was came from a place of pain and desperation. Reading between the lines from an unpublished Instagram post reported by Caroline’s parents after her death (‘the blood that someone SOLD to a newspaper was MY blood and that was something very sad and very personal’) leads me to believe that Caroline was self-harming and perhaps lashed out when Burton tried to intervene, either accidentally or otherwise. I say this, not to further add to the speculation, but to highlight the reality of mental health.


Caroline was any of us who have suffered with our mental health, but she had to do it in public, hounded by the press and made an example of by the Crown Prosecution Service (keen to be seen to be tackling the real issue of domestic violence) despite her clear vulnerability. Celebrities may have the means to afford help, but with such high stakes, the threat of ‘cancel’ culture and a press without morality, how can they trust anyone beyond their immediate circle? Even a therapist may be too much of a risk. I see several high profile people in my consulting room - many have found it very difficult to open up and wait years before seeking help because of how dangerous a confidentiality leak could prove. Caroline’s haunting instagram post from October foreshadows events of this week: 'I certainly hate talking about my feelings. And being a burden is my biggest fear.... I’m lucky to be able to pick myself up when things feel shit. But what happens if someone can’t. Be nice to people. You never know what’s going on. Ever’.


I can’t help feeling that I should have tried harder to reach Caroline. Poignantly, I recognised her home from news reports  - not only did we live in the same borough, we were neighbours. If only she would have responded maybe I could have helped when she felt so alone with no way forward. But this is the therapist’s curse - we can’t help everyone. Therapy is not a panacea but it can and does save people from taking such a permanent, devastating step by giving room to voice to those dark thoughts and feelings, without fear of repercussion or of being a burden.


I think of Sophie Gradon and Mike Thalassitis, former contestants of Love Island who also took their own lives. Three suicides linked to the programme is a shocking record and serious questions need to be answered. But as Whitmore said this week: ‘The problem wasn’t the show, the show to work on is loving, and caring and safe, and protective. The problem is the outside world is not’. Love Island merely reflects the world out there in all its cruelty and pain as I see every day in the NHS, where extremely vulnerable people are tirelessly cared for behind closed doors. Mental health awareness can’t just be this year’s trendy cause or millennial hashtag  - we need to understand it in all its guises so that we can help those it afflicts.


Caroline is another victim of the deadly consequences of a tabloid media driven by clickbait tallies, the human weakness for schadenfreude and lack of understanding of the reality of mental health beyond a basic awareness. Please be kind to each other, talk about your feelings, find a therapist that you can trust and surround yourself with people who can take you at your worst as well as your best.

Love Island episodes have stacked up on my Sky box - life goes on, apparently. But for now I can’t watch it; it makes me too sad.

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