Allowing for Complexity and Nuance When Discussing Trauma and Mental Health

Like so many aspects of the human condition, mental health and trauma are complicated. I know it's an obvious point, but it's one that we have to make a conscious effort to keep in mind whenever we discuss them. It's important because we need to find a way to appreciate the struggles of some without erasing or ignoring the struggles of others. In particular, we need to learn to feel compassion and understanding for those who suffer extreme and very visible effects of mental illness and/or trauma without erasing those who have experienced mental illness or trauma but have not suffered those same ill effects (who have perhaps suffered in other less visible ways).

In my view, for this reason, as one example, we need to be cautious in making statements like: "If you had experienced trauma like that in your life, you would be [for instance] addicted to drugs too." I've heard statements like this from well-meaning people who rightly want to call attention to the plight of those who are suffering greatly. The sentiment underlying this statement is one with which I take no issue. Mental illness and trauma can in fact explain why so many people suffer tragic outcomes as a result of their efforts to cope, for example, by using unhealthy substances, etc. We absolutely must call attention to and take very seriously the roots of these outcomes in mental health and trauma.

But my only point is that even when we are rightly passionate about this issue, we need to be careful about how sweeping our statements are. We need to be able to still capture the above sentiment without removing the other possibilities from view and defining them out of possible existence: e.g., the possibility of resilience, and the possibility of other kinds of suffering that don't manifest in such visible ways (e.g., the apparently high-functioning person who might even be our colleague).

In this sense, when it comes to mental health and trauma, sometimes even a compassionate approach can exacerbate stigma if not carefully expressed. Words matter. Expressing a tragic outcome as inevitable, even when intended as an expression of deep empathy, can, in my view, risk increasing stigma in the following ways:

• For those struggling with those same issues, and trying really hard not to succumb to a tragic outcome, hearing people express failure as inevitable can be deeply damaging for obvious reasons.
• For those who already hold stigmatizing views about people who experience mental health and trauma, statements like this reinforce the stigma, since it suggests that those who experience mental illness and trauma are inevitably going to end up in a tragic outcome and therefore there's no point in giving them the same opportunities as others.
• For those who are in fact in the midst of experiencing such an "outcome," expressing it as their inevitable fate can suggest that they have no hope of overcoming it. In my view, it also risks occluding the full depth of their life story by suggesting that what happened to them was simply the inevitable outcome of their mental health or personal history. It can be incredibly dehumanizing to simply be looked upon as a statistic, even if the intention is compassionate.
• Such statements assume that the person towards whom the statement (e.g., "if you had experienced that kind of trauma, you would be over there not here") is directed is someone who has not experienced such challenges, which we have no way of knowing. Not only could this be harmful to that person if that assumption is mistaken, it can also be harmful to those who hear it to realize that there is a shared assumption in the group (e.g., well-functioning members of society in general, or the legal profession in particular) that a precondition to being conceived of as potentially being present in the group is the absence of a history of such challenges. This can be incredibly damaging to hear: not only am I not visible in this group, but there is a shared assumption that it is impossible for me to be here. Moreover, it sends the message to the person whose suffering is in fact being acknowledged (e.g., the person who is addicted to drugs) that they are conceived of in that same way: as incapable of being part of the group that is offering them such apparent compassion but whose members can't even conceive of their possible presence among them (an inherently "othering" attitude).

For this reason, even when it is difficult and it may seem to be a finicky point, I feel it's incredibly important for us to find a way to give expression to and show compassion for the tragic realities faced by many who experience mental health and trauma without erasing the complexity, nuance and full range of possibilities that remain available to people who have faced such challenges. As always, I'm not sure what the answer is, since these are tough issues. Perhaps it's as simple as keeping the focus on the person towards whom we are rightly showing compassion and their actual life story rather than allowing any "us v. them" attitudes (even compassionate ones) to enter into it.

Although it may seem very self-interested for me as a lawyer to talk about lawyer wellness (and I acknowledge that self-interest certainly plays a role for me in doing so), the above concern is one of the reasons why I feel we need to spend real time and energy focusing on the well-being of ourselves, our colleagues and the profession. Not only is the compassion and understanding we show each other important for its own sake, it also helps deepen our empathy for all who suffer by revealing the full depth and complexity of these issues rather than permitting us to adopt an othering stance, where our empathy is flattened by a declaration of the inevitability of the fates of those who suffer. If we define our own possible suffering out of existence, then we won't be able to empathize in a nuanced, non-stereotyping way with those who suffer the most tragic outcomes.

It's also why I'm so passionate about my view that acknowledging our collective and individual vulnerability is equally important as acknowledging our privilege (https://traumaandlawyersmentalhealth.blogspot.com/2019/07/embracing-our-vulnerability.html). In my view, we need to do both to be genuinely inclusive.

It's difficult work and there are no easy answers, but I feel that paying careful attention to our language and what it might be concealing from view is a good place to begin.

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): https://www.clawbies.ca/2019-clawbies-canadian-law-blog-awards/

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

• https://www.canadianlawyermag.com/news/opinion/a-more-inclusive-discussion-on-the-impact-of-trauma-on-lawyers-mental-health-is-needed/276166 
• https://www.cbabc.org/BarTalk/Articles/2020/February/Features/Speaking-Up-About-Trauma-and-Mental-Health    
• https://www.canadianlawyermag.com/news/opinion/changing-the-conversation/326240