- The armour you need for modern life
- Changing the way we see mental illness on screen
- Growing up with a bipolar parent
In mid 2013 I was in the midst of a stressful week-long intensive university subject titled Ethics and Professional Practice. A large amount of the subject was dedicated to discussion around self-care for social workers and how to avoid professional burnout.
At about 9.30am on the Tuesday, midway into a lecture, I was overwhelmed with the feeling that I had left the stove on at my apartment. By 11am when we broke class for morning tea, I was racked with anxiety about the stove, unable to concentrate on the day's content and struggling with whether I should take the half-hour drive home to check it.
I compromised by emailing my flatmate, who was on holidays in Mexico, to ask for the phone number of our apartment block's manager, so I could call and ask them to check the stove for me. In the thick of a busy nightclub in Cancun with several litres of tequila down her gullet, she changed the SIM card in her phone in order to access the phone number for me. She sent me the number and I called them. The outcome was predictable: the stove was safely off.
This was the beginning of my most recent period of mental illness.
I've learnt that knowledge of mental health practice can give us a dangerous and false sense of galvanisation against what we advocate for.
The conversation I had with the previously unknown general practitioner who recently assessed me said something to me that will always ring in my ears: “The fact that this is happening to you now will stand you in good stead for mental health practice, because you know how it feels to be ill.”
The following points are the reasons why I think that experiencing mental illness can make you a better mental health practitioner.
A good mental health practitioner…
1. Practices with empathy
Empathy is key in treatment. The empathetic mental health practitioner does not abuse their power by trying to "fix" the person or give subjective advice. The empathetic practitioner listens to and feels with the person. They stand with the person in the darkness and provide optional strategies that will empower facilitation of recovery. The practitioner knows that the person is the expert on his or her mental health recovery. Everyone has the tools, but sometimes needs education regarding how to use them.
2. Understands loneliness in all its complexity
Loneliness isn't exclusively a disconnection between persons with their family, social networks and communities. Loneliness may indicate disconnect between a person and their own soul. The loneliest feeling of all is harbouring resentment for the self. The astute mental health practitioner will provide pathways not necessarily for gaining self-knowledge in the post-modern sense, but for the person to connect with their values and fall in like with themselves again.
3. Knows the importance of taking one moment at a time
“The next four to six seconds. That's all you have to worry about” – that's one of the best instructions that has ever been given to me. The next four to six seconds is all we can cognitively handle at one time, yet we try to jam in the past and the future as well, making an utter mess of things. Exploring strategies to engage in one moment at a time is the best thing we can do, especially for a person in crisis. We need to enter each moment with calm indifference in order to be able to manage the next to the best of our ability.
4. Knows: Thought > belief > event > belief > thought
Good old cognitive behavioural therapy (CBT). The principle of acknowledging the impact of our beliefs between thought and events, and vice versa, is vitally important in understanding how misleading the stories that we write in our own heads can be. As mental health practitioners, we must pay attention to the messages that are being relayed in interpersonal communication, rather than the emotions behind them. If we react to the emotion, our interpretation is clouded by subjective beliefs. In order to hear our people, we must respond to the message rather than react to the emotion, then pass on this technique to the people we are helping.
5. Treats the symptoms of illness, while recognising the whole person
A person is not infinitely characterised by their behaviour during a period of mental illness because during that time, the behaviour is not representative of their whole self. The mental health practitioner recognises that mental illness does not define us, but is the result of biopsychosocial factors that have led to a state of crisis. Once the etiology of the illness is recognised and accepted, recovery can be facilitated and the people can know themselves, and let others get to know them once again.
6. Respects self-determination in treatment methodology
Everyone reserves the right to choose whether they take medication in order to aid mental health recovery. Medication will be the right choice for some, and not for others. Exploration of whether or not to use medication should be a collaborative engagement between the practitioner and the person. Each person should be treated as the unique individual that they are, and their treatment not defined by the most expedient option in the eyes of the psychiatry industry.
7. Cuts through the bulls--t
Friends will listen to us bang on and on about regrets and the terrible decisions we've made that have led us to where we are, in an uneducated but well-meaning encounter-group fashion. What we may actually need is for someone to say: “Stop beating yourself up about the past for no good reason, because it's sending you into a sympathetic nervous system response mode while you're actually in no imminent danger.”
When someone explains the neurological processes behind how the amygdala floods the brain with cortisol upon our own request as if pushing a panic button, we can forge new neural pathways through psychotherapy to stop this from happening. It's a relatively simple process to counteract, but it takes time and dedicated practice.
Having someone on hand who can help cut through the self-sabotaging bulls--t and recognise the cognitive processes behind needlessly engaging the fight or flight system is indispensably helpful. Help the person build the new cognitive pathways that will guard against unhelpful thinking styles.
I believe that we will all experience mental illness; just as we will all experience disability, to some extent, during our life cycle. This doesn't mean that we are weak or incompetent. It makes us human, and better equipped to help others, with the benefit of practical knowledge.
This is an edited extract of a blog post by Polly Chester. Read the full piece here.