Thursday, March 26, 2020

Your Mental Health Needs Still Matter (Even in a Pandemic)

These are tough times. Most of us are doing what needs to be done, even though it's difficult for us. We do this to protect our fellow citizens, our society, and our own physical health. This is critically important and we need to keep doing it.

The reason we do this is because human health, safety and lives matter*. We do it because we care about people. For those of us who are not particularly physically vulnerable, we need to remember the oft-repeated words "it's not about us."

We are animated these days by a spirit of selflessness--a desire to care for others. This is wonderful and necessary in the circumstances. It can bring out the best in us: something beautiful and inspiring that we can harness to enhance our own individual and collective wellness. We can truly embrace the fact that every life matters, which can be an incredibly health-promoting and life-affirming realization for all of us.

But the laudable life-and-health-affirming "it's not about us" approach can also induce or intensify feelings of guilt, self-blame, and worthlessness with which so many of us with mental health challenges already struggle. When we hear rhetoric suggesting we have no right to complain about our feelings while others (e.g., those who have lost jobs or have been infected by the virus) are suffering in a more direct, socially visible and obvious way, it can belittle and undermine the very real and potentially very serious mental health challenges that many face. The "shut up and stop whining" rhetoric is dangerous, whether it comes from others, or whether (as it often does) it comes from that harsh inner voice that regularly torments us, even in ordinary times.

I'm writing this partly to try to remind myself, but mainly to reach out to others: we're taking these measures because everyone's health matters. And that includes each person's health, however it may be affected (whether physically and/or mentally).

As many advocates have been saying for a long time, mental health is health. Lives are at stake on that front too. Even for the lives that aren't lost, there can be serious long-term consequences for those whose mental health deteriorates. We need to do everything we can to protect the physical health of those in our society, while also protecting and nurturing mental health.

It's normal to be struggling right now. Many people who have never experienced a serious mental health issue may be at greater risk for one now, and those who have already experienced mental health challenges may find their symptoms resurfacing or intensifying in frightening ways. Yet now more than ever, some people might hesitate to seek the help they need, because things are scary and confusing and it may be difficult to figure out how to do so, or they may not wish to be "selfish" and be a burden on a healthcare system that is in the midst of a crisis.

So my message is that  caring for your own health is not a selfish act in times like these. The whole message of these times is that everyone's health matters. Everyone's life matters. Everyone's safety matters. No matter how isolated or vulnerable someone may be--we are ready to do what it takes to ensure that no one will be sacrificed.

If you can, please take a moment to let that life-affirming, universally compassionate message sink in. Everyone's health matters, and that includes yours.

In times like these, taking care of yourself is an affirmation of the very thing we are all trying to protect: the commitment to a belief that all lives matter and are worth protecting. Being real and gentle with yourself about the ways in which the current crisis may be affecting you is a necessary part of that commitment.

By staying home you are saving lives and protecting human health. By caring for yourself, monitoring your own health, and asking for help from others to help you maintain your well-being, you are also protecting human health. Not only is it okay for that to matter right now, it's everything.

Things are tough, which is why we need everyone to stay as healthy and safe as they can. It can be hard for those of us who struggle with feelings of guilt, shame, isolation and alienation to feel that we are included in that. There are no magic words I can write to take those terrible feelings away (for others or for myself).

All I can say is that the spirit of these difficult times conevys a message for us all: everyone matters. It might not be easy, but we are learning how connected we all are. If possible, please try not to disconnect yourself from the beauty of that message by devaluing your own life and wellness.

If you can take extra steps to help others, that is wonderful and praiseworthy and may even help you get through this difficult time. But if all you're able to do is protect others by following public health guidelines, you are already doing enough. You don't need to beat yourself up for not doing more, or for having the "wrong" feelings about the toll it's taking on you. You are already doing something heroic just by staying home. And, if you are caring for yourself while doing so, then that is heroic too because your life and health matter too.

To sum up my view of what I hope we can each do now:  (1) Stay home (unless needed to leave your home to do essential work or do truly essential things); (2) Survive and maintain your own health as best you can (physically and mentally); (3) If you can, try to remember why we are doing it--it's because every life matters; and  (4) If you can, please try to remember that includes you.


*Anyone who knows me will know I also value animal health, safety and lives, so I specify human health not to exclude others, but to emphasize the point at issue in this current crisis


 As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see:  

Sunday, March 22, 2020

PTSD, Mental Health, and Pandemic-Related Chaos, Uncertainty, Fear

If you clicked on this post hoping for answers or insights, I'm afraid I'm not going to be able to provide any. It took me a long time to even be able to try to write something here because quite frankly I've mostly been feeling frozen and uncertain about what I might say.

Things are scary right now, and it's okay to be affected by that. In fact, I think it's critical that we  recognize those impacts and take them seriously. In accordance with the public health directions, most of us are, of course, (I hope) doing all we can to remain home unless absolutely necessary, and to take precautions when we absolutely must venture out for essentials. But that doesn't mean we shouldn't be able to acknowledge (and maybe even complain about) how incredibly painful and difficult this can be for everyone, and for some more than others.

Self-isolating and "social distancing" is difficult, especially for those who were already struggling with feeling alienated, isolated, and alone.

The messaging around this has often tended to assume that most people have safe comfortable homes, families and loved ones with whom to remain socially distant from those outside their "household." Often the message simple says: "Stay home with your family." But not everyone has family nearby, and/or a stable home, and, for some, more time with family and/or in their home environment is not healthy for a variety of reasons (including but not limited to abuse, unhealthy living conditions, and other pressures and strains on relationships, especially as people are facing severe financial hardship and uncertainty, and increased anxiety/fear).

If you already suffer from PTSD or another mental health issue, this may very well be an exceptionally triggering, difficult time. I'm noticing it in myself, hearing about it from others, and observing it in my contacts, sometimes in very alarming ways.

For those with PTSD, the current circumstances may be ultra-triggering for a variety of reasons that I'm not going to be able to exhaustively describe (and won't try). For example, for some, the current chaos and uncertainty replicate childhood realities and fears. Further, the feeling of being trapped in a situation that can't be escaped can remind people of the trauma they experienced, whatever it may have been.

And for those of us with a tendency to be viciously hard on ourselves, this can be accompanied by a harsh inner voice demanding that we just suck it up and stop "indulging" our own pain given what's going on in the world. We may feel we should just shut up and do our part and not be a drain on anyone's energy or resources. We may feel we shouldn't seek professional help when those professionals are already overburdened (or about to be overburdened) by the current crisis.

It's true we all need to do our part to preserve our own health and the health of the more vulnerable. A necessary part of that is by practicing physical distancing, but that can't be all of it. There are also very vulnerable people and circumstances that are not visible in the statistics that we are all so carefully watching. It's important that we pause to seriously consider, listen for, discuss, and address those impacts as well. We can care about stopping the spread of a potentially devastating physical illness while also paying attention to the other ways in which our own health and the health of those around us may be affected, perhaps even devastated, by the extreme, but necessary, measures that we're taking.

Some of my own random very basic ideas about how we can all do our part in a more inclusive way from the comfort and safety of our own homes (this will absolutely not be exhaustive, given the limits of my own experience/perspective):
  • Let's take extra care to be inclusive in our messaging. Let's not make any assumptions that people have a shared social reality or that we are all similarly affected. For example: let's recognize from the outset that not everyone has someone to spend their isolation with. Not everyone has safe stable housing. We aren't all going to be able to "spend more time in our homes with our families" or for some who may end up having to do so, it may be anything but healthy. Let's avoid importing the assumptions about what "normal" looks like into our messaging, thereby making people feel more alienated, isolated, and alone. Let's avoid talking in an "us" and "them" way as well about the more vulnerable as if the primary messaging is directed to the "we" that are going to be least affected, and the less vulnerable are "others" of whom we should all be thinking but who are not included as recipients of the main message. Those who are more vulnerable to the physical effects of the illness itself, to the mental health effects of what is going on, or to the financial impacts, etc. deserve to be seen, heard, and included in our messaging. Let's give tips/suggestions/encouragement in a way that acknowledges upfront (rather than as an afterthought or side-note) that not everyone is similarly situated.
  • Let's take the time to learn about each other's differing circumstances, perspectives and needs: A lot of us may be feeling helpless right now and not sure what we can do to help. There may be concrete steps we can take to help others right now and there have been uplifting stories about those who are doing amazing things in that regard. Another, often overlooked, way in which we can help others is not necessarily going to be something that can yield immediate results but it's still critically important. If we aren't able to get out there and directly help others right now, why not take the time now to educate ourselves about the experiences, perspectives and needs of differently-situated members of our society by seeking out content created by those directly affected for that purpose? Caring for others isn't just limited to what we can do in the here and now (although that's obviously very important whenever possible), but also can take time, attention and effort to truly see and learn from those around us so we can tailor our offers of comfort, support and assistance to what they actually need. So perhaps now would be a good time to learn about the experiences and needs of those who are more vulnerable/marginalized? This shouldn't be difficult to find via internet research. There are strong amazing people advocating eloquently on almost every platform on virtually every issue. So let's take the time to listen to them. Not only will this ensure that our "helping" measures when we do take them include everyone, but it will potentially help those who are often excluded to feel truly seen and valued, which could have immediate effects on morale and our shared sense of connection (assuming we do it respectfully and with a genuine sense of humility/interest).
  • Let's reach out in the ways that are still possible: Once we've practiced truly seeing and listening to each other in the above way, the next step could be to reach out and ask those who may be more vulnerable how we can be there for them and support them. I vaguely recall there is a device many of us possess called a phone that offers some magical voice (and even video) connection-options. Maybe we could take the time to reach out to people we haven't spoken to in awhile to give them a sense of company and connection (thereby benefiting ourselves too). Maybe we can share cute/funny memes and videos (I highly recommend rescued baby bat videos!) with people just to let them know they haven't been forgotten and are in our thoughts. I don't have the answers as I'm by no means an expert in connecting, but as someone very isolated in my current circumstances, I just know how much it has helped me when some people have reached out to me in that way. So let's get creative in connecting and be sure to extend that not just to the people already in our circle but also to those who may otherwise be left out.
  • Let's check in with people to see if they have what they need: These are scary times and a lot of people are afraid of what may happen next. Some people aren't necessarily comfortable reaching out to ask for what they may need, or may not have people to reach out to. So when we can, perhaps we could reach out to some people within (or on the periphery of, or outside) our circle, and ask the simple questions: "Do you have everything you need?" "Are you okay for supplies?" Perhaps they don't need anything, but it may give considerable comfort to know that someone is looking out for them, and cares if their needs are being met. And it can open the lines of communication to make them feel comfortable asking if they may need something in the future.
  • Let's keep brainstorming together how we might be able to support each other and truly be in this together: As I indicated, I have no answers and the above suggestions are really very basic (though sometimes it's the simple things that can make all the difference). These are unprecedented times. The answer to how we can be there for each other won't necessarily be obvious. Going back to basics can surely help, but also we can draw on our collective creativity and compassion in finding new ways to connect, comfort and support each other.

 As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see:  

Sunday, March 8, 2020

Self-Care in Reverse

When I'm feeling especially dark, down and hopeless, it's difficult to see the value I have. It's hard to feel like I add anything good to the world. I share this because I know so many other people struggle with these feelings too at times.

We're told that self-care is important. We're told that we should learn to care for ourselves before caring for others. But if the feeling isn't there, is this advice really useful? What good is it for me to put my own mask on before assisting others, if my own mask is full of holes?

So here's the only thing I've found that saves me in those darker moments--and it is completely the opposite of that advice. When I'm feeling most down on myself, it helps me to be there for others in as many ways as I can. Nothing helps me more. I never feel depleted by it. I feel energized by the sense of connection and purpose.

In fact, it's one of the worst things about suffering as openly as I have. Friends seem to hesitate to ask me for advice and support in the way they may have in the past. It's not just that they aren't supporting me. I've lost my chance to experience being in a supportive role to those I've cared about. I used to treasure and value that aspect of my friendships. I felt I was good at being there for my friends when they needed to vent about or think through a tough problem, involving a relationship or work situation.

Fortunately, however, through my advocacy, I've encountered a few people via social media who truly "get it," who're struggling themselves, and we are there for each other, which gives me a chance to be supportive to others again (in addition to being supported myself), albeit from three time zones away.

This means a lot to me. Even in my darker moments, I never doubt that other people have value. It always means something to me to be able to help someone else, even if only in some small way.

That's not to say that I'm advocating for people to overextend themselves and give more than they can. My ability to give to others is in fact very limited at times, just as my ability to do things for myself may be, particularly when I have a lot of responsibilities that must be carried out and I often have nothing left in me after attending to them.

What I am saying is there's huge value in finding small ways, big ways, or any ways to be there for, be kind to, or be helpful to others, even when we can't be kind to ourselves.

If we can't put our own mask on, if our own mask is broken, it still gives a great sense of satisfaction to use what energy we have to reach out and help someone else with theirs.

And it may even save us.

In my darkest moments, I feel I haven't added value to the world. Nothing can persuade me otherwise. I have an answer for everything as to why x,y,z that I've accomplished doesn't really count.

But then sometimes comes an answer that means everything: from someone I care about, from someone I know counts, I hear those magic words, "But you've helped me."

Don't get me wrong. The darkness in my brain can still argue with that. Maybe they're just trying to make me feel better. Maybe if I hadn't helped them, someone else would have. Maybe they had it within them all along and didn't really need me.

BUT what I can't say in those moments is that accomplishment, if true, doesn't count. If I've really been of service to someone in some small way, that is something real. I will never say to that person, "But helping you doesn't matter." It does and it's everything.

My own mask may still be broken, but in that moment, it's like someone else is offering me theirs.

I can breathe. I can see meaning. I can see a kind of value that even the bleakest parts of me can't discount.

So I advocate for self-care if you can do it. But self-care doesn't have to be an isolating solitary activity: a major part of self-care can be caring for others. It's not wrong to prioritize that if that's what truly matters to you, if that's what helps you breathe.

As I've said before, even when we can't love ourselves and be there for ourselves, it doesn't have to be the end of the story. If we can't put our own masks on, we can help each other do so.

My advice based on my personal experience: If you can't be kind to yourself, one of the most healing things can be to extend the kindness you possess, but can't personally access, to others. If you can avoid it, don't stay in the dark room alone hoping that the spark of self-love will appear. Share in the warmth of kindness in whatever way you can, and maybe someday it will spark something for you too.

And if someone has helped you, tell them so. You could be giving them the strength they need to continue along a difficult path.

As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see:  

Saturday, March 7, 2020

Mental Health Diversity is Okay: Let's Embrace It

The way we talk about mental health and mental illness is important. We need to aim to avoid stigmatizing language. We need to try to ensure that the way we portray mental illness is helpful to those who may be suffering. There are practical concerns as well. Because physical illnesses are often perceived as being treated more compassionately, there's often a feeling that we need to show the ways in which mental health is "no different than" physical health.

But that doesn't mean we all need to see it the same way all the time. We have to be careful not to stifle open dialogue and diversity for the sake of the one right answer that we feel serves us and whatever practical imperative we are trying to advance.

Is mental illness exactly like physical illness or are there important differences? Is the concept of illness even helpful for all of us? Are physical illnesses even so well-understood that we can readily  use the comparison? Is the medical approach de-stigmatizing and healing, or unhelpfully reductionistic?

For those of us whose mental health conditions were caused by trauma, is it better to see what we suffer from as an injury rather than an illness? Or is the idea of being "damaged" in some way (via injury or illness) unhelpful when we were merely responding normally and naturally (maybe even heroically) to the things that have happened to us?

And there are implications for treatment options. Does medical science have all the answers? Might some of us favor medication options while others reject them and opt for therapy or other methods of healing (spiritual, lifestyle-based, improving social conditions, fighting oppression/violence, etc.), some of which may be frowned upon by the medical establishment, resulting in us being lumped in with and mocked as much as Gwyneth Paltrow for daring to think differently and questioning medical orthodoxy? (Note: I'm not a Paltrow fan--I know almost nothing about Goop and I totally get there are definite problems with celebrity-promoted-wellness-options that need to be pointed out and corrected, but when the response to it descends into mocking those who don't automatically submit to the correctness of doctors saying "Do as I say. I have the answers. I'm a doctor," I grow deeply uncomfortable. I value medical science. It's incredibly important to learn what it has to teach us. But it absolutely doesn't have all the answers and I find a lack of humility and suitable caveats in medicine even more concerning than a lack of caveats and humility from some Hollywood mega-star who obviously doesn't have an MD or the position of authourity it entails).

The questions are endless. For my part, I have definite strongly-held views about many of these questions, some of which would put me out of favour with those leading the charge of certain "mental health awareness" campaigns.
  • The idea of illness is not generally helpful for me, and in some ways has been profoundly damaging. I do meet the criteria for mental illness, and I accept this, but the concept of it doesn't sit easily with me in many ways and I would welcome the opportunity to explore alternate ways of conceiving of my suffering and possible paths to healing. It isn't the stigma of it (although, sadly, there continues to be stigma)--it's just not a fit and doesn't do justice to the nature of what I have suffered and the ways in which I've survived it. In my view, people who have been affected by trauma to the point of developing a trauma-related "mental illness" are not necessarily sick or weak (though there shouldn't be any shame in either of those labels--I just don't feel they fit me). My most helpful way of viewing myself is to see that (1) I'm incredibly strong but (2) the ways in which I've had to be strong have depleted me in many ways and are often not well-matched to the society and conditions in which I have to live, which has resulted in (3) me feeling perfectly normal suffering in response to both the original experiences and the poor way in which it's recognized/handled by the people and social structures around me. So maybe it's the world around me that's sick when it comes to trauma-related suffering, not me. Yet it's a world in which I have to live, so the label of "mental illness" will have to do for now since it's the only way my suffering can currently be meaningfully acknowledged. I've made my peace with it and see no shame in it (I'm proud to stand with those who are mentally ill, whether it's from trauma or some other cause, and will defend others in characterizing their experience in whatever way most does justice to it);
  • I don't think mental illness and physical illness are "the same," at least not always, although I'm confident there is plenty of connection between them, some of which we understand and some of which we don't, but that doesn't mean I don't think they should be cared about the same way. I think we can explore similarities and differences without reducing one to the other. I think we can use metaphors and analogies without getting overly attached to them. I think we can learn more about the mind by comparing it to the body and vice versa, as well as exploring the ways in which they may be inextricably linked.
But those are just my views based on my experience. Maybe these things exist on a continuum. I've made the point before in other contexts: the mind is a very complex diverse thing (or non-thing, or whatever). Mental health conditions are incredibly diverse, and can affect us in very different ways. And the ways in which we are affected may vary even further depending on our history, our degree of privilege, our connection or lack thereof to others, our physical health, the conditions in which we have to live/work, etc.

Maybe you have an illness and I have an injury or something else altogether. Maybe something can be partly understood as an illness  but also have so many other dimensions that need to be addressed that don't readily fit that framework. Maybe for some of us, a focus on one dimension is enough, while others need to be treated more holistically or focus on some other aspect(s) of the way in which their condition affects them.  Maybe your condition is readily treated by medication, while that's not the right option for others (including me) for a variety of reasons. Maybe some people are really helped by therapy while others would rather take medication. Maybe the usual medical treatment options won't do anything for those who continue to be ostracized, oppressed, and harmed by the conditions in which they are forced to live/work. Maybe some mental health conditions are very much like physical illness or injury and some are less well-suited to that comparison....

Maybe we can never know for sure, so we all just need to do the best we can to inform ourselves about the known pros and cons of various options and approaches, reflect on what's important for us, and proceed in a way that feels safe and right to us. Maybe even how we conceive of physical health isn't always perfectly straightforward so the attempt to reduce mental health to physical health blunts our understanding of both in a way that fails to adequately capture their mystery, diversity and complexity. Or maybe there is indeed a beautifully simple"correct" answer out there just waiting to be found, but we'll never get there if we don't allow for real dialogue and diversity: because the "truth" can't be something that erases and ignores the ways in which these things may be experienced differently for many of us.

My view: we need to learn to live with some uncertainty and curiosity as we explore these important issues. We need to talk to and listen to each other, especially those who are differently situated and often silenced. Medical science doesn't automatically have the answer to the mind/body problem, or what it means to have a fulfilling life, although it can certainly contribute to both of those questions. Nor is it free of biases that have long excluded the perspectives and realities of those who have suffered the most.

Until we have all the answers my view is that we need to focus instead on the deeper questions like "Why should we care?" "Why should we help?" "Why should we allocate resources to reduce the suffering of others, whether from mental or physical causes?" Do we really care about mental health only if it's comparable to physical health? Or does the care come first (for those of us who "get it") and then we try to shape our discourse to artificially fit the framework that we think will most motivate others to care?

Why not have a discourse that's transformative rather than reductive? We care not because someone is "sick" as opposed to "weak," or "ill" as opposed to "injured," but because we don't think people should have to suffer needlessly if we can help it. Why don't we focus on that and talk about what it means for us to care in this way, and go from there? That way we won't have to leave anyone out just because they don't "fit" the way we've framed their experience. There will still be difficulty and we won't get around having to characterize these things in some way, but we can at least welcome all voices to the discussion and acknowledge the absence of easy answers rather than silence those whose perspectives differ from the one we've adopted.

As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see:  

Wednesday, March 4, 2020

I'm not ok; you're not ok (and that's ok)

Sometimes someone points out that I'm being very openly vulnerable here in a way that may make some people uncomfortable because these things aren't usually discussed in such a raw and open way, let alone by someone in my profession.

The motivation is generally kind--to protect me from damage to my relationships and professional standing. Undoubtedly, some people are uncomfortable about these topics and would prefer not to have to acknowledge them. By being so open about it, I'm disrupting the usual order of things. Some people will judge me for that. Some people will avoid me. Some might dislike me.

I know all of this all too well, and always have. Sometimes the pain of it deeply affects me. Other times, I'm defiant and try not to care, but always I'm aware of it. There are no illusions here.

But here's the thing. I'm not okay with the usual order of things. I need and choose to talk about the ways in which I'm not okay.

Not because I think being open about it in my particularly raw and defiant way will help me. Not because I enjoy the attention (if anything, it brings me the wrong kind of attention and judgments). But because I know I'm not the only one who is not okay and I'm no longer okay with agreeing to remain in hiding and isolation.

So, yeah, I'm not okay. If I'm being honest, I've probably never been "okay" and possibly never will be. I come from a background in which many things are profoundly not okay in a way that never fully leaves you after you've lived through them and been exposed to them. That's been a part of my reality for as long as I can remember. Despite having "overcome" it in so many ultra-"resilient" ways, I carry it with me. I function in spite of it, but it's never far behind me. It's a permanent fixture in my life and history and I refuse to be ashamed of that. In addition to a substantial amount of suffering, it gives me compassion, empathy, wisdom and strength that I'm no longer willing to be silent about.

The other thing I know: I'm not the only one who isn't okay. I don't know how many others there are, but I know they're out there. Some I've met through my advocacy on this issue and I've found that it is an indescribable comfort to be able to communicate with others who "get it." Not only do we gain comfort from knowing each other, because we don't have to feel so alone, but we also get to see that  the "not okay" are often the kindest, strongest, most amazing people on the planet and we realize there's no reason to hide who we are anymore even if some others may not get it.

Whether it's a small or large number, the "not okay" are my main audience. Those are the ones who may need to hear not only that "it's okay not to be okay," but also "Even when you're not okay, you're not alone. You're not broken. You can still contribute and be strong, amazing and full of light and power, all the while not being okay. You don't have to hide the parts of you that are suffering for the comfort of others. You can show the world your darkness so that they can understand your light."

So that's me: I'm here. I'm not okay. I'm trying to send a message to others who may similarly not be okay. We don't have to hide from each other. We don't have to hide from the world. If we want space to share what we're experiencing and advocate for a better understanding of the ways in which we and so many others have suffered and are suffering, we should be free to do so.

I'm not okay, but I'm here, and I'm refusing to surrender the space and visibility to which I'm entitled.

If you're not okay, I'm here for you. You aren't alone. You don't have to put yourself out there in the way that I do, but if you want to, I will stand with you in claiming the space and visibility to which you're entitled.

If we can't always be okay, maybe the next best thing is to be not okay together 💓.

As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see:  

Sunday, March 1, 2020

The Curse of the Complicated, Part One (It's Okay to Be Cautious About How and When You Will Entrust Your Trauma to Someone Else)

I can't speak for everyone's experience of trauma, but for me the essence of trauma is how complicated it can be, how personalized, how individualized.

Speaking as someone with repeated instances of trauma, I can say that it didn't just injure me in some static readily comprehensible way. It infected and fused with me in ways that grew more complex over time. My defensive responses are highly complicated and impossible to comprehend without an understanding of the events to which they're reacting.

I didn't want to be defined by my trauma (because society doesn't always seem to allow much room for those who are, even though there's so much to be learned from us, as I explained here), yet so much of who I am was built on that foundation, in response to it: the things I'm ashamed of, the things I'm proud of (note: sometimes the two are identical and I'm simultaneously ashamed and proud of the same thing, more often than you might guess). It's impossible to know me without knowing that history, my way of understanding it, and my way of responding to it, and yet I've had to keep it almost entirely to myself. 

Specifically with respect to my survival, in my inner world, I'm like a mad genius in an internal hellscape with buttons and levers of different shapes, sizes and colours everywhere in absolute chaos. Although I couldn't exactly explain it to someone else, if I don't press and pull them in the right (yet ever-changing) sequence at the right time, the entire world will be at risk of collapse. It's more of an art than a science. Something I do so well because I've learned it over time. Sometimes I'm a bit slow or press the wrong one, and my whole inner world shakes and shifts and I have to scramble to initiate emergency sequences to re-stabilize things. There's always a cost when that happens, and it happens frequently, but intuitively so far I somehow have known what to pull and press and when because I've lived it; because it's mine; because it's me. I'm an expert in keeping the system running. I've proven I can do it.

It's a terrible way to live. It's exhausting and lonely. I've longed for rest. I've longed for support and assistance. At an even more basic level, I've longed, if nothing else, for the reality of what I'm facing to simply be acknowledged and seen. For empathy.

Someone might point out how unsustainable and painfully limiting the above scenario is. "You can't live with that kind of burden." "Let someone help you. Reach out."

Oh, what a fantastic option that would be. I've dreamed of it so many times. To be able to let someone in. To be able to trust someone else to carry some of that burden or help guide me in doing so. To take over some of the tasks to allow me to rest. Or even just to keep me company in a meaningful way while I continue to carry the burden myself.

But here's the problem. It's not that easy. And I have to be careful. I can't let someone in (either in a personal capacity or in a professional "helper" capacity) if their first impulse will be to boldly and heroically start pressing buttons and levers (or dismantling the whole system I have in place) on the basis that they know best without even taking the time to know why I've had to put that system in place and the nuances of what dangers it's responding to.

Don't get me wrong. I'm not saying my system is perfect. I have no doubt it isn't. Undoubtedly, some of those buttons and levers are no longer necessary--harmful even. But if I'm wrong about which ones they are, the results could be catastrophic. And since I can't stop pressing buttons and levers in a fast-paced sequence that never permits any rest, I can't take the time to explore the ways in which I might be able to simplify things and reduce the pressure.

But it's not all wrong. It's worked for me. It's kept me alive and functional for a very long time. Experiences that could easily have destroyed me didn't. I'm here. I'm "resilient." I realize my defence mechanisms need fine-tuning, and maybe even major re-assessment and repair, but they're what's kept me alive. I will not give up on them or discard them unless I'm very sure that is what needs to happen and I have some reason to trust in whatever is being offered to replace them.

Maybe if I were already in a state of systems collapse, getting help would be easier. I could just say--"It's a total wreck--here you try." But it isn't. I'm functioning in important ways. It's not stupid or silly for me to want to protect the coping mechanisms and inner wisdom that have saved my life over and over again on a daily basis.

So in the above circumstances, what do I need? I don't need someone storming in like a caped crusader, poking and prodding in a trial-and-error-sort-of-way, saying "Hey, let's see what this button does?" I don't need someone bringing in their own magic "tool" that I've never seen before, that requires me to collapse my own system in the blind faith that theirs might work better (even when statistically their method fails to work for a lot of people, and mine has worked for me, albeit imperfectly, my whole life). At least without taking the time to know me and learn my system of survival, and engage in dialogue with me why their tool might help me better than my current system does (or how it might augment but not replace it).

I need people who understand that it's impossible to know what I need to heal without knowing the elaborate ways in which my own mind and body have both protected and damaged me over a long period of time. I need someone who knows that this takes substantial time, patience, care, and collaboration: an exploration of the many ways in which my complicated history of trauma and my body and brain's way of responding to it have forged their own pathways in my inner landscape and have left unique elaborate imprints on my body, brain and spirit.

Or if the capacity for time, patience, and care are limited, among acquaintances and professionals (as they so often understandably are), then I need them to understand the import of this limitation and the danger it poses to me, and proceed with great deference and humility. When they don't have the time to learn how to help navigate and repair the system I already have in place, they can simply and humbly assist by asking, "What do you need?" Perhaps they can be a momentary extra set of eyes or hands to help ease the strain on me as I continue to keep my inner world operational. Maybe they can help me get a bit of rest by offering to perform some of the tasks I would otherwise have to do to keep myself functioning. Such assistance would be no strain on their own limitations at all, if only they're willing to help in a way that reflects humility and faith in my understanding of my own inner world.

That doesn't mean I don't understand and appreciate that "specialists" exist. People who've, broadly speaking, seen people with similarly complicated inner worlds and have a great deal of knowledge that could really help me. I would love the assistance of people like that (and fortunately I now do have such assistance). They can be incredibly valuable. Their general knowledge of how systems like mine can often work--the type of damage often seen, the kinds of tools that often help--is incredibly valuable. But not if they ignore the particularity and complexity of how it actually works and has evolved for me. I know that this is delicate and complicated work because I've been living it every day for years and decades. A push or pull in the wrong direction can have severe consequences for me. I don't care how much general knowledge someone has. The ways in which I've been affected undoubtedly follow some general patterns, but also have highly specific effects on me in ways that are very consequential to me. If an "expert" doesn't have the humility to listen carefully to me and learn from me, then they are just as dangerous (if not more so), then someone who purports to have no such "expert" knowledge. Moreover, in my view, the fact that they take such an approach shows they don't actually understand the true nature of their supposed area of expertise. There are many general truths about trauma but the one I know for sure, for me at least, as I've outlined above, is how highly personal it is: how it has taken who I am, in all its particularity, and fused itself with me. You can't know my trauma without knowing me. Without knowing my story in all its rich detail.

The only "experts," "friends," and "helpers" I can trust are the ones who know that they don't know what I need yet. They may have ideas, hypotheses, and hopes. But most of all, I want them to see me, believe me, and listen to me. I need to know they aren't just going to burst into my inner world and start heedlessly and arrogantly stomping on and rearranging things.

So the lesson from the above: in my view, if your experience of trauma is like mine in this general way, then you don't need to be sorry for doing what you feel you must to protect yourself and your inner survival system of buttons and pulleys. You needn't feel sorry for honouring the ways in which your coping tools have kept you alive. You needn't feel that you are doing something wrong or failing if you need to proceed slowly, and take your time to be sure of your next steps before entrusting your trauma to another person, worldview, or treatment approach.

 If your trauma is like mine, it is not a broken leg that someone else can treat without your input in accordance with readily accepted protocols. It is complicated, it is personal, it is you. You have a right to have a say in how you move forward. You have a right to be the director of your own healing.

In saying the above, I'm not saying "don't reach out," or "you can do it on your own." I'm saying that it is okay to be cautious in deciding what supports will work for you. It is okay to take the time and space to figure out what you might feel comfortable with  (however, as I alluded to above, sometimes if the collapse and strain are too much, we may need or want to temporarily surrender our directing role, and that's okay too).

Bottom line: It's not wrong to put our trust in others. It's not wrong to let go of our burdens and hand them over to trusted people if that feels right for us. But it's also not wrong to honour the complexity of our inner world and system of survival by proceeding at a pace and in a way that feels safe for us. Whatever works to help you feel safe is one more step towards self-protection. Feel free to honour that rather than feel ashamed of it. If you're not ready for something, that's okay in my books . You can use your own inner wisdom to decide what other steps might work for you in the meantime while you move forward at your own pace in figuring it out (as I wrote about here).

I've had the benefit of professional assistance for a year now. It's been absolutely life-saving and I can't imagine how I would have survived this past year without it. In that sense, I'm a huge proponent of encouraging people not to feel they have to do this on their own. But the reason that professional support has been so helpful (rather than damaging) to me is that I was very cautious about whom I trusted. I was very limited. I had boundaries and I honoured them. So I'm also in favour of encouraging people to do their research and reflect on what feels safe for them, and to trust their own intelligence and self-knowledge in doing so.

We often can't heal ourselves entirely on our own. Our inner systems of survival are reflections of our brilliance, resilience, and wisdom, but they can also become painfully unwieldy, isolating and unsustainable. They can harm us at the same time as they keep us alive. It's okay to need the support and care of others to re-calibrate and re-align them. We can only do so much on our own. But we have a right to be directors and partners in that process.

As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see:  

Sunday, February 23, 2020

We Shouldn't Have to Choose Between Support and Respect

Hello again, it's me:

A competent adult professional who happens to have a mental illness (see my story as I summarized it in a recent article here).

I've done some pretty okay things in my life. I graduated from high school at the top of my class (not relevant to anything whatsoever--I just never find any reason to share it). I earned a 4 year BA(Hon.) in 3.5 years, then got my MA in Philosophy.

I then got full funding to attend a PhD program at Northwestern University (and got admitted with funding into every other program to which I applied, except for one where I was wait-listed). That program was derailed for me because of the severity of my trauma-related suffering, but rather than give up, I wrote the February LSAT, got an excellent score, applied to the law school of my choice, was awarded an entrance scholarship, and attended there in September. I would have been permitted to return to my PhD program had I wished to, but I chose law school instead.

Despite my continued suffering, I also then earned a law degree (which included taking an extra semester of co-op education), got called to the bar, became a lawyer, and have practiced for 15 years (at both the trial and appellate level). No big deal, right?

So why all the icky bragging? I usually try not to do that, I swear Why do I feel this need to preemptively assert my competence like some kind of insecure teenager?

It doesn't come naturally to me to have to put my "competence" on display like this. When I first started as a lawyer, especially when I was a young female criminal defence lawyer, I loved to be underestimated and found ways for it to work well for me. I knew that if I did my work, I would be able to show how competent I was rather than having to strut around demanding it to be acknowledged. Being understated worked for me.

Yet now it feels unsafe not to find ways to hold up my "competence" like a shield.

Because now I'm someone with a mental illness.  

Now there are stigmatizing assumptions and outright discrimination to deal with. And it's not just hidden discrimination--it's discrimination that's still openly preached and perpetuated by powerful, perfectly mainstream, people and organizations. It's discrimination that could result in a loss of my career, my opportunities for professional advancement, and even the loss of my liberty and right to make personal treatment decisions for myself.

Sometimes it feels like my only defence is my competence. So I find myself waving it around in an awkward unaccustomed way like the only self-protective tool at my disposal. "Respect my competence, please...."

Yet it's weird because I know that I'm the same me I've always been. The same me that has--successfully--been a member of this profession for a decade and a half. I shouldn't have to prove myself again just because of my diagnosis.

But the stakes are high, and the threats are real.

 Even as I know I have to protect myself in this manner, I also realize that asserting my competence makes me uncomfortable for another reason. It feels like having to straddle a question rooted in an unfair dichotomy: Which is it? Are you competent and worthy of respect? Or are you vulnerable and in need of accommodation/protection?

Any move I make in either direction threatens to tear me apart, and also undermine the interests of others like me who may be differently situated at the moment. I fear that by making a display of my competence ("Oh hey, look at me, continuing to practice with serious health issues--so there's no problem that needs to be accommodated here!"), I may be undermining the very legitimate interests of others who, understandably, just couldn't remain competent under those same pressures: whose vulnerability asserted itself; who need support and accommodation to take time off and then return, or need to be supported in deciding whether this profession is even healthy for them. I never want to suggest in asserting my competence that there is anything wrong with vulnerability or those who succumb to it, temporarily or permanently.

And even for me: I succeeded in maintaining my professional competence. But the cost was extremely high for my well-being. It shouldn't have needed to be that high. There were times when I wondered if it was too high and if I should step away. If this profession had greater sensitivity to vulnerability, it could have substantially reduced the toll on me of maintaining my competence all those years. I will never get back what I lost. It's not okay. My continued competence doesn't mean there was never a problem.

So here's my bottom line message: Drop the dichotomy and stop making us choose between your respect for our competence and your support for the ways in which we are vulnerable. 

If we want diversity, inclusion, wisdom, insight, and strength in our profession, we need to stop reinforcing the distinction between competence and vulnerability. It is absolute nonsense. We are all human and therefore can become vulnerable at any moment. We need to stop acting like vulnerability is some kind of aberrant ticking time bomb that we can weed out, rather than a basic feature of our shared human condition that we all need strategies to face, manage, and eventually gracefully yield to. We don't do the profession or public any favors by reinforcing the myth that only some of us are vulnerable. It's dangerous and inaccurate, and leads us to avoid the real issue of how we *all* need to face the prospect of our collective and individual vulnerabilities throughout the lifespan of our careers, relationships, and lives.

As I emphasized in one of my uncharacteristically (😄) optimistic posts, "We Can Be Heroes," it is absurd for us to weed out those we identify as vulnerable on the unfounded assumption that their vulnerability makes them a liability. The vulnerable are the ones who have made it to this level despite facing hurdles many others could never even imagine let alone endure: they are the battle-tested, bad-assed warriors that this profession should welcome, embrace, and learn from. The idea that vulnerability should be equated with diminished competence is therefore laughable (or at least would be if the potential consequences of having our competence questioned in that manner weren't so severe).

Moreover, since the already-vulnerable are also the ones who have had to face the reality of the human condition in the most profound ways, they have the insight, wisdom, empathy and understanding this profession needs in facing the very difficult issues being adjudicated before us. We should be doing everything in our power to recruit, elevate and support them.

So, yes, I am declaring my competence and insisting that no one reduce me to just my vulnerabilities. Nothing about the ways in which I'm vulnerable permit the assumption that I'm less competent than those around me. Only my actual performance can tell you anything about my competence. But I'm also not allowing my vulnerability to be ignored any longer just to maintain my shield of competence. I deserve support for the ways in which I'm vulnerable (as do we all), and I deserve credit for the ways in which I've persisted despite those challenges, which is why going forward, I insist that any assessment of me (and others) look at me in my wholeness. Listen to me and learn from me, and I promise to do the same for you.

And if we can all start seeing and listening to each other that way, we'll be so much the better for it--and, with that enhanced understanding of what it means to be humans who can simultaneously be vulnerable and strong, worthy of both respect and support, at the very same time,  we will be better-equipped to serve the very human ideals, individuals and organizations to which we have dedicated our careers.

As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here

I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic):

For some of my external writing on this topic, see: