Trauma and Lawyers’ Mental Health

Sunday, February 16, 2020

Earning Trust by Respecting Our Fear of Engaging with Mental Health Care

After a very damaging healthcare experience (that I don't see myself recovering from for quite some time), I wrote a couple recent blog posts as a bold declaration of the kind of healthcare I require going forward, along with a (partial) explanation of why anything less will not only fail to assist me, but will be damaging and re-traumatizing.

The funny thing is the boldness of my declarations can be contrasted with the actual helplessness of my circumstances and options, since the system doesn't seem to be set up to allow for my needs.

It shouldn't really be a lot to ask. What I need is so basic. I'm not asking for access to expensive treatments. I'm just asking to be treated as an autonomous individual, worthy of consideration, dignity and respect, who gets to decide basic things, such as (1) whether to agree to a suggested treatment, (2) whether and to what extent to engage in an assessment process, and (3) the pace at which to do so. I'd also like some say in how the information about my background and needs is gathered from me (for instance, I'd like whoever provides future treatment to me to work collaboratively with the very qualified professionals who have been providing mental health assistance to me over many months, who have earned my trust and know me well.)

I'm not asking to be given more and faster: I'm asking to have less pushed on me, and for whatever I'm offered to slow down to a pace with which I can feel safe and comfortable. As a precondition of any assessment or care, I need flexibility and I need my boundaries honoured and respected. I'm not asking for this because I'm being demanding and just want things done my way or else. It's because I know with certainty that anything that doesn't honour those limitations of mine will not only be unhelpful, but will be deeply damaging to me (as I've recently experienced).

Yet so much mental healthcare and mental health messaging and regulation seems to be built on pressure, dictatorial "prescriptive" attitudes, dehumanization and outright coercion.

First, with respect to diagnosis: If I go in for an evaluation or treatment of my trauma, I'm not consenting to a wide-ranging invasive deep-dive examination of every aspect of my personality and psychological make-up. I'm not there because something is horribly wrong with me as a person and clueless professionals need to take apart every aspect of my personality querying--with a great sense of mystery and wonder--what it might be. I'm there for what should be very plain and obvious reasons to any compassionate and understanding professional: because of the things that have happened to me. It should be no mystery what needs to be addressed. I wouldn't go to a hospital for a broken leg and get a full-body evaluation, including of incredibly intimate parts of myself, just to see if perhaps I'm mistaken about the source of the damage. It's disrespectful, invasive and insulting. It also causes more injury (for reasons partially explained in previous posts). Me declining to participate in such a process isn't me resisting treatment. It's me protecting myself from further harm. If an examination of my broken leg included a process that involved breaking several other bones in my body first as part of the diagnostic process, you can bet I'd say no to that treatment too....

Second, with respect to establishing trust before proceeding with anything: I have respect for mental health professionals but I'm entitled to some basic dignity and privacy. I don't need to be a doctor to be confident that the power to take someone apart and tell them everything that happens to be "wrong" with them through invasive assessment measures, some of which may have arguable validity, isn't something that should be exercised over an already fragile person, suffering from obvious causes that need to be attended to, as a precondition of them getting treatment for the issue that brought them there. An already fragile person shouldn't have to surrender any more of her dignity and privacy than she's already had to through the things that have happened to her, unless truly necessary. A traumatized person shouldn't be asked a bunch of questions "Have you ever felt x, y, z," designed to find inherent problems with her "mood" or "personality" with no regard for the traumatic experiences that caused her to experience "x,y,z" on past occasions. Moreover, no one, especially a traumatized person, should be asked to surrender such private aspects of themselves before the time has been taken to build trust, comfort and safety. Diagnostic questionnaires should not be handed out in a waiting room with impossible-to-answer questions that don't allow for explanation ("yes, I felt x before, but only as a direct result of trauma") before a traumatized person has ever even met with the professional in question, let alone established a sense of trust and safety with them. No steps should be taken until the person is ready for them and consenting to them. Because doing so to someone who has already had their boundaries violated is itself a source of further harm. If a professional doesn't understand this, then the whole process is questionable from the start, and no one should wonder why some of us will resist that.

Third, with respect to understanding power dynamics: our mental health system allows for an incredible amount of power to be exercised over those who are suffering. Mental health professionals should know and expect that many of us will therefore be terrified and perhaps justifiably unwilling to engage with them, especially if we've already been damaged and had "worst case scenarios" of betrayal and abuse of power happen via trauma. We can be hospitalized against our will and any number of invasive potentially permanently damaging and profoundly traumatizing "treatment" procedures forced on us if we encounter the wrong professional who mistakenly feels the threshold for doing so has been reached. I've been assured this is very unlikely to happen to me, as I'm nowhere near that threshold, but that doesn't stop me from being terrified of it. All it takes is one risk-averse professional who misinterprets something I say. Instead of dismissing these fears, the basis for them should be reduced by truly protecting people against the prospect of them ever being used and slowly building trust with people before engaging with them if that's what they need to feel safe. Each time I encounter a professional who is careless and dismissive in how they engage with me, that fear grows because all it takes is to encounter that kind of person at the wrong moment in a vulnerable state and the results could be catastrophic. Even if professionals "know" that no such danger exists with them, they need to understand and validate our fear that it could and let us slowly build our trust with them before doing anything (not as a precondition to treatment that fearful patients hope for, but as part of the treatment process itself).

Moreover, such power can also be wielded in relation to mental health by non-medical professionals, so those who engage with mental health professionals may also fear those implications (even if they're comfortable and safe with the particular professional offering services). Professional regulators and employers may not be as understanding about mental health as they should be. Consequences can result. Family and friends may not be understanding and supportive.Social exclusion may result.

So it's a big deal to submit oneself to "assessment" and "care" by a professional and the system in general. Instead of urging, persuading and pressuring us to "reach out" anyway, professionals need to focus on their side of the equation by ensuring that as little "reaching" as possible need be involved in "reaching out" first. Slow down. Let us go at our pace. Build trust before doing anything if that's what we need, so that reaching out won't have to feel like extending our limbs over a steep cliff with no confidence in what might happen next. People are afraid for a reason. Because this is a big deal. Understand and honour that first and every step of the way and then maybe more people will feel comfortable taking that leap....Otherwise, respect our choice to maintain a distance that feels safe to us until we are ready to risk moving forward.

I have a lot more to add but I'll just arbitrarily stop there (because my coffee is done and my dogs feel entitled to a walk today....)

Overall, I'll just say this. Many of us struggling with trauma and mental health are afraid. Please stop condescendingly telling us we shouldn't be. Stop gaslighting us. And start honoring, understanding and slowly counteracting that fear at a pace that feels safe for us. I know many won't be happy with my messaging here since encouraging people's fear is seen as a barrier to them seeking treatment (which is why so much mental health messaging glibly says "Oh, hey there, don't be afraid. Reach out. It's okay. We won't hurt you...."), so maybe I might seem to be fear-mongering by describing the profoundly negative impact that such responses to me "reaching out" have had on me, especially recently. To them I say, many of us suffering are already afraid and have had that fear reinforced by experiences we've actually had. You're not going to be able to talk us out of it. We have reasons for that fear. Telling us to let it go won't make it go away. For some of us, the only safe way forward is to name, honour, and respect that fear--to give ourselves permission to feel it accordingly and refuse to engage with professionals who don't likewise understand and honour it the way we need them to. To me that's not silly or self-destructive or an indication of my unwillingness to be helped. It's health-promoting: it's self-protection and -care, which is exactly what I need. I'm proud of myself for asserting it despite the reality of how little choice I actually have right now.

Providing people with a way forward that allows them to proceed in spite of their fear, not by suggesting they're "crazy" and "wrong" to feel it, but by earning their trust slowly and assuring them that their fear will be respected at each step of the way is what will enable people like me to reach out. So I'm not sorry to be asserting that here. I'm not telling anyone that they should be afraid. I can speak only for myself. But if so many people are afraid, maybe their fear isn't the problem. Maybe it's the reaction to it that needs to change....

What I've articulated above isn't radical, or at least shouldn't be. It's basic trauma-informed care. It takes thought, caution, self-awareness and care on the part of those providing services, but it's completely possible to accommodate. So I won't apologize for insisting on it.

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:

Saturday, February 15, 2020

Trauma: The Agony and Healing Power of Reconciling Our Vulnerability with Our Autonomy/Defiance

I have a mental health diagnosis. It's helped me a lot to have one, because:

It tells me I'm not alone in what I'm suffering;
It gives me a shorthand way of communicating what I'm suffering, so I don't have to go in circles trying to explain to others who may not get it or with whom I can't share more than a very basic explanation (e.g., because they're not willing to hear more or I'm not comfortable sharing more with them);
It gives some validation to me and my suffering--I'm not "weak" (whatever that means--not that weakness should necessarily be considered a moral failing, unless it is in some morally relevant way)--I have a mental health condition;
It enables me to get the help I need and if I ever require some kind of accommodations, or health services, it gives me a basis upon which to seek them (since unfortunately that seems to be required for insurers, providers, and regulators, to see us as having any "rights" or entitlements--we have to be able to point to a group to which we belong, and in this case for me it is based on a particular identifiable health condition); and
It enables me to find a sense of community with those who may share that same diagnosis and learn from others what may have worked for them (which may possibly help me too)

However, I want to be clear about one thing: I am not just a diagnosis. It may be a huge part of how I see myself--or not. I do not agree to surrender my autonomy in exchange for it. I am whole and complex.

It's the paradox of being human: In some ways, I have been and remain so vulnerable. I didn't get to choose a lot of what happened to me. It helps me to recognize this. There's no shame in being vulnerable, human and fragile. It isn't my fault that I experienced many adverse effects from the things I've experienced. It isn't my fault that those effects have in many ways been difficult to overcome. I don't blame myself or others for being profoundly impacted by such effects (or at least I know I shouldn't blame myself and struggle to find ways not to). We are humans, not gods. Things that happen to us affect us. Things that happen within us (due to our biology) affect us. Our conscious mind and sheer force of will can only do so much to control that. Some of us have to experience this more than others since some of us have the privilege of controlling what happens to us more than others, but it is ultimately true for everyone.

Yet, in other ways, no matter how much I suffer, I retain some measure of freedom and power to define myself that no one can take from me, and I'm not prepared to surrender it to them, regardless of how much people purport to be "helping" me in requiring that I do so. But ahhhh do I ever need help....

Trauma for me is the painful collision of those two realities: on the one hand, I have been and am so vulnerable. On the other hand, I refuse to surrender my sense of agency in making sense of what has happened to me: my right to articulate for myself what that vulnerability does and should mean for me. But my agency can also be a source of pain, since, taken in abstraction, it can demand that I take responsibility for all things, and often seems to demand that I see myself as having more control than I do.

The anguish for me is in those two realities: I don't always get to decide what happens to me. Even more troubling for me, I don't even always get to decide how I respond to it, since what happens to me can deeply shape my internal experience and sense of who I am. It would be naive to overstate how self-determining I am. Yet, despite that vulnerability, some room for self-determination remains. It's shaky ground to be on, as my level of actual control is constantly fluctuating, while my need for agency screams to be recognized and respected, even if self-punishment is the cost.

And the path to healing for me is in finding a way to reconcile those two seemingly irreconcilable realities that I've not only become deeply conscious of through my experiences, but that my body and brain have also repeatedly had no choice but to be jolted and injured by. Even when my smug genius of a conscious mind thinks she has the answer (especially when she reads lots of Hegel and Dostoevsky), my brain and body both can't help screaming at me in paradoxical anguish: I AM RESPONSIBLE, YET I AM VULNERABLE!!!! My mind declares: "I can choose how I respond to things" at the same time as my body and brain whimper: "except when I can't because I'm a fragile human in a world and body/brain I don't fully control." Being a human suuuuucks.....(cue "add to dictionary" here because I'm gonna say that a lot).

There's some comfort in knowing our inherent human limits, but also considerable fear, agony, and self-blame. If I am self-determining, then I'm responsible. If I suffer, it means I've failed. If I don't survive the way I feel I should have, it means I'm nothing but vulnerable. I failed. I failed. I failed.

As if it isn't enough to have to think it, I have to listen to my body and brain scream it at me every time a new situation presents itself that in any way reminds me of those past "failings." Being a human suuuuucks.....

I'm vulnerable so I need help and support. I've been harmed by the things I've experienced, and I need help healing those wounds. I can't do it alone, at least not completely. I am a fragile being, an infant, a baby bat (from now on I'm working baby bats into everything I write, because for me they are the epitome of vulnerability yet perfection). Reaching out for support from others is a critical part of healing.

But I'm self-determining, and my surviving sense of agency, meaning, and defiance in the face of what I've experienced is everything to me. Not only is it what has enabled me to survive to this point, it's also (paradoxically) the part of me that has been most wounded and is most deeply in need of nurturing and support. It's the proud general I sent into battle to fight against everything that stood against me, but also the part that sometimes had to retreat and lie down in defeat horribly injured when it couldn't help but be overcome by forces that stood against it. So when people offer me support (bless those few who try), then it needs to be in a way that affirms my autonomy--at the same time as acknowledging my vulnerability (in a way that helps treat the wounded general's injuries and helps it get back up into action)--or it will only further damage me: the treatment will actually be a further source of injury. It can't be something that reduces me to a series of questions on a diagnostic questionnaire or gives me only one path to healing with which I must comply. It can't be someone who tells me what I "must" do, or what my purpose in moving forward "must" be (e.g., "be happy"), and assumes they know what I need without acknowledging the need to carefully listen to me and learn from me. I need my vulnerability supported at the same time as my autonomy is also supported. I need to be cared for in a way that acknowledges the paradox of being human that is the core of what was injured and problematized for me in my experiences. Until mental health practitioners understand this, and constantly check their behaviour and attitudes in view of it, they will be a threat to me, and I won't engage with them.That is my first critical step in caring for myself. It isn't a resistance to being treated, but the ultimate act in self-protection.

In the same way as "helpers" who only emphasize or overemphasize vulnerability are a threat to me, "helpers" who focus exclusively on my "responsibility" are no use to me, because they fail to give due regard to the ways in which I've been vulnerable, thereby reinforcing the shame and self-blame I'm already so prone to feeling and have so deeply internalized. Such "helpers" and "sources of inspiration" suggest that I can be worthy of assistance only to the extent that I deny and denounce my inherent human fragility and the particular ways in which I've been damaged. They want me to sustain myself on fiction, on an incomplete vision of my humanity. I will reject that sort of assistance too.

So healing from trauma for me is all about acknowledging and honoring vulnerability at the same time as supporting my inherent autonomy/defiance in the face of what makes me vulnerable and human. The only people who can help me will be those who embrace and nurture both. If you think that sounds really difficult to do, you're right. That's why it's so painful and that's why I've suffered so much because of it. That's why I can trust only those who are ready and willing to face that painful paradox rather than offer easy answers.It doesn't mean I blame those who don't or can't yet see it that way (as I said before, bless everyone who tries to help, even if I feel their help misses the point of how I've been injured and is therefore dangerous for me). It just means I respectfully choose not to entrust my healing to them.

In the meantime, not to fear, Dear Reader, there are a growing number of trauma-informed "helpers" who understand the above, who are willing to step into the breach with us, and help us learn to live with the paradoxes that afflict us all as human beings, and are particularly damaging to so many of us who've experienced trauma (I'd say all, but I don't want to purport to speak for everyone--so you decide). I'm lucky to have found that kind of assistance (while also very unfortunate to have been damaged and re-traumatized by some of the wrong kinds of "helpers" for me along the way).

I'm also lucky to have my Hegel and Dostoevsky to draw on, along with every other source of inspiration that speaks to me and helps me understand the paradox that afflicts me. We can't control everything with our intellect and conscious minds, but we can nurture and defend our right to nevertheless struggle and remain defiant, at the same time as we find ways to support and care for our vulnerability. It isn't easy but if there's healing to be found, in my personal view, speaking only for myself, then that it starts (but perhaps doesn't end) there.....

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:

Sunday, February 9, 2020

Why Trauma-Informed Care Is So Important to Me

There's a lot of excellent stuff written out there about the importance of trauma-informed care. I'm not going to be able to add anything to it, except to make some first-person observations about why it's so important to me, and why any non-trauma-informed approach is so harmful to me. I personally had a profoundly damaging experience a couple days ago and this is me taking the opportunity to vent without going into the details at this time of that interaction.

I have trust issues arising from a history of repeated trauma. Due to a combination of luck, privilege, resilience, and skill, I've nevertheless managed to be very high-functioning in many ways. Yet, in other ways, my participation in life has been severely limited (particularly my personal life as I alluded to here).

My sense of self therefore includes two components: the functioning resilient version of me (the me who has made highly functional choices and adaptations in the face of things that could easily have broken me); AND, the me that is nevertheless still deeply suffering, highly limited, and could really use some help/support/understanding, but is hesitant to seek it out of fear of my boundaries/safety being violated as they have in the past.

If I'm going to receive help, as a basic precondition of ANY kind of intervention, it needs to honour and directly engage the strength, wisdom and self-knowledge that got me where I am. It can't require me to surrender the sense of agency and safety that are essential to my continued survival. Those adaptations and skills of mine are far more important than anything medical science has to offer me. Instinctively I know this with absolute certainty, and the more research I do, the more sure I feel of it (Medical science has its limits. Treatments are available but there is no one obvious "cure" that works for everyone. Also it can't dictate what counts for me as a meaningful life worth living--I get to choose.)

That's not me being a pessimist failing to act in the interest of her own mental health: that's me protecting and valuing myself and my own survival, which are absolutely critical preconditions in healing and nourishing my mental health. Declaring and maintaining that boundary is an act of strength that promotes my mental health. Anyone who in any way suggests otherwise is not acting in my interest (no matter how much they say they are and/or suggest I'm being stubborn in resisting them and the supposed "cure/treatment" they're peddling, whether based on conventional medicine or some alternative). I'm right to withdraw from them, even if they might technically have something to offer me, if only they had approached it in a respectful non-re-traumatizing-and-demeaning way. I will not give up what is most precious and necessary to me in exchange for some trial and error treatments that may help me, or may not. (Because guess what? Medical science hasn't found one foolproof cure, let alone a one-size-fits all approach, for complex trauma that everyone agrees on. That's why new and innovative treatments are being researched all the time. We all have to just make the best informed decisions we can.)

I will not entrust my mental health survival to someone who doesn't recognize or show an interest in my own expertise regarding my lived experience, and who attempts to suppress rather than nourish and learn from my own story of agency, dignity and strength, thereby killing the part of me that enabled me to survive, and re-traumatizing the part of me that was most threatened by what I've experienced.

My agency (powerful and strong as it has demonstrated itself to be) is what got me here. It's what keeps me living, breathing, striving and functioning, despite what I've been through. I'm the one who defied the odds in that sense. No medical professional did that for me. If any medical professionals genuinely value my well-being and want to be part of my "recovery," they need to take their proper place on the treatment "team" the absolute and only leader of which is me. Everything that happens needs to happen at my own pace, when and if I feel sufficiently informed and ready to try it, no matter how slow or ill-advised or stubborn some medical professional deems that to be (and in fact if they use those latter terms to characterize my ultimate act of self-care in protecting my own sense of agency in the way that feels right for me and proceeding at a pace that enables me to maintain my sense of safety, that alone will tell me they aren't trustworthy). Me needing time and space is not an obstacle to me receiving care--it is the very first thing in need of protection and nourishment before any other options should be canvassed or presented to me. Anyone who won't provide that to me is a danger to my mental health, and I will self-protectively act accordingly to remove such a person from any involvement in my care.

I'm not saying I will never put my trust in what may be professionally recommended to me. I understand that professionals have expertise and skill in areas that I don't. I'm saying I will only do so once a professional has earned my trust by showing that they honour my right to choose whether and how to proceed (including the option to slow down, take a break or stop altogether at any point without having to give a reason), and once the information they have given me satisfies me that the intervention they propose is something I feel safe and comfortable trying at whatever point in time feels okay for me.

So to be clear: the failure-to-accept-care when autonomy hasn't been affirmed and honoured isn't the fault of those in need of assistance for declaring a critical self-protective, agency-affirming boundary--it's the fault of those around them failing to assist them (and thereby actually harming them) by refusing to be deeply respectful of, responsive to, and nourishing of that essential health-promoting boundary. Boundary violations like that are what traumatized so many of us in the first place, leading us to need to seek out support despite our fear of being violated like that again. If medical interventions are going to replicate the harm, then us rightfully rejecting those interventions is an act to be celebrated and supported, not criticized or suppressed. We are not stubborn. We are not stupid. We are self-protective, strong and demanding to be treated better than we have in the past. Those are acts of healing we are attempting to engage in and attempting to enlist our providers to partner with us in nourishing. If that attempt at connection fails, the failure is not on us. Any professional engaging with us (and failing us in that critical way) needs to pay attention and learn how to do better.

Fortunately there are a growing number of professionals who know and affirm this. I'm not just making this stuff up based on my own stubborn quirks. Trauma-informed care is increasingly being recognized as essential for good reason. The above was just my own declaration about why I will accept no less and why I will not heed any criticism of me for enacting such a boundary. That boundary is the entire foundation of my healing and survival. I will not surrender it for some supposedly magic beans.

A note:

I've emphasized the ways in which I happen to be high-functioning here; however, my points aren't limited to the outwardly high-functioning. Everyone who is still alive with any sense of self and agency (no matter how damaged by what has been done to them) despite suffering serious trauma has done something amazing and deserves to have their sense of self and agency nourished, respected and protected. In fact, this is something basic that we all deserve as human beings struggling to cope in a difficult world in which we find ourselves constantly vulnerable to harm (even those who haven't actually been seriously harmed).

That said, anything I've said here should be read alongside my reservations re the ways concepts like resilience/survival etc. are discussed (as I wrote here and here).

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:

Wednesday, January 29, 2020

"Above and Beyond"

There's a trend in the legal profession (and others, I'm sure) when praise and accolades are being given out.

Typically those singled out for awards, extra benefits, and compliments are those who go "above and beyond." They do more than what's required, and have a "work ethic" beyond that of their colleagues (even when their colleagues are doing all that's required of them at a very demanding pace).

I'm sure a lot has already been said about this. I know I'm not the first to say we need to think carefully about the standard we're setting, and the impact it may have on employee and workplace wellness, when people feel they have to strive to put in superhuman efforts to fit in.

Let's assume for a moment that these "above and beyond-ers" are in fact superheroes. They can do it all without sacrificing their health or risking burnout. They consistently do more. Of course, this is worthy of some recognition but should it be the gold standard?

What message does it send to everyone else when this is the standard of greatness to which others are told to aspire? What is the impact on diversity, equality and inclusion initiatives when those who can do "more" than what is required consistently rise to the top? Who is being left out and/or overburdened? How can those who already carry greater burdens to begin with (due to disability or other systemic barriers) keep up without damaging their own health and/or sacrificing the other things that are important to them?

Wouldn't those who have to work less hard in the first place to meet the "required standard" find it easier to then go "above and beyond" it? Wouldn't those who have to use exceptional efforts simply to overcome barriers to their inclusion find it more difficult, if not impossible, to maintain that 110% standard. Why isn't 100% enough?

Diversity and inclusion are relevant to merit too, particularly when "justice" is the whole goal of the enterprise. Shouldn't any accurate assessment of merit need to recognize the people that give 110% just to meet the required standard without visibly going "above and beyond" it?

So here are a couple ideas for recognition that could enhance workplace wellness, diversity, equality and inclusion, which in my view would also enhance productivity overall since it would enable everyone to function better rather than encourage everyone to unrealistically chase a few standouts:

-The ability to maintain boundaries: Lawyer X went home every day at a reasonable hour, and resisted the pressure so evident among her peers to compete for highest standing in a way that put her own well-being at risk. She thereby demonstrated excellent judgment and strength of character, qualities that any organization should prize...

The ability to overcome adversity: Lawyer Y faced considerably more adversity/barriers in his life than his peers did. Yet he still made it to the same level and gives 100%....

Instead of expecting employees to go above and beyond, why not start putting that burden on employers to go "above and beyond" for employee well-being, and for the values the organization stands for?

Bottom line: let's remember all the other ways in which people can be "heroes," as I've written here.

Note: I'm not saying that those who face barriers are the ones who don't go above and beyond. In fact, the feeling may be ingrained in many of them that they need to do so, since they had to work so much harder to get to this level in the first place. They may already be suffering from "imposter syndrome" (which I wrote a bit about my perception of in my own case here) as a result and feel a need to work harder than everyone else just to keep their place. It's time we eased the burden a bit and allowed 100% to be enough.

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:

Saturday, January 25, 2020

Stereotyping the Mentally Ill as Inherently Problematic

This is going to be a bit of a lazy post since I'm almost done my coffee and need to start my day. So I'm just going to point to something I see as a problem and then maybe flesh it out later.

Speaking only for myself, I'm so tired of mental health initiatives that emphasize the "business case" for improving mental health in the workplace (or any other environment).

In the typical formulation of this, reasons are given why the "problem" of mental health needs to be addressed. Poor mental health, we're told, can cause decreased productivity, increased conflict/negativity/risk of error,....or whatever (implicitly insert every ill of society here) 🙄.

Certainly, there's some genuine good in these initiatives. Of course, increased mental wellness is a critically important goal. I personally would love it if our profession did a better job of supporting and prioritizing our collective and individual health. As someone with significant vulnerabilities, these initiatives would benefit me greatly by allowing a quality of life this profession has not afforded me before. I need and want them to happen. So if we want to encourage wellness-promoting initiatives, that's great. I'll cheer them on.

But in doing so, let's watch our language and check our stereotypes at the door. I don't care how great the initiatives are. I don't care how much people see "incremental change" as the only realistic goal and are therefore willing to advocate for them in whatever language gets corporate entities to pay attention: it's not okay to pursue these initiatives in a way that devalues a diverse group of people.

I've made the point so many times in different contexts, but I'm going to keep repeating it until it is understood: mental health is an incredibly broad ideal. Mental illness can manifest itself in a gazillion different ways, some of which bear no resemblance to each other. My mental illness can result in one behaviour, while my colleague's illness can result in an exactly opposite behaviour. Even with the same mental health condition, sometimes the actual manifestations in external behaviour can be as different as night and day. One person might consistently throw herself into her work, becoming a compulsive reliable over-achiever (resulting in awards for giving 110%), while another could withdraw and feel paralyzed by a fear of failure (resulting in a drop in productivity).

Consequently, ANY generalization you want to make about the impact of having unaddressed mental illness in the workplace is going to cause me to raise my eyebrows, roll my eyes, and tune you out 🙄. I'm going to be especially irritated if this is done in a way to cast the mentally ill as inherently problematic. So just don't do it, please.

Also, when mental illness is characterized as inherently problematic, let's not be surprised when the "high-achieving" people who suffer from it (but are capable of concealing their suffering) don't feel comfortable seeking help and/or speaking out. When we overemphasize the "negative" ways in which mental illness can manifest itself, we make it less safe for those who are high-achievers to reveal themselves as suffering. We also leave their suffering unaddressed since the unique ways in which they are suffering may or may not be captured by the "business case" aimed at rooting out "problematic" manifestations of illness. By targeting only the suffering that affects productivity, we fail to address the situation of those whose suffering may not affect the bottom line (and may in fact enhance it).

At the very same time as we say we are trying to "stop the stigma" we therefore reinforce it by overemphasizing the "problems" caused by mental illness in the workplace while de-emphasizing or failing to acknowledge altogether the benefits to a workplace of including those with mental illness (given the many strengths those who have experienced mental illness have demonstrated and the contributions they are capable of making).

And if those who can conceal their illness do so because of stigmatizing stereotypes, the supposed data we have on the risks of mental illness in the workplace will be unreliable. Mental illness in the workplace will become visible only when it can't be hidden: when it has in fact had a negative impact. Our negative stereotypes will therefore be self-reinforcing, resulting in incomplete data about the impact of mental illness in the workplace.

Further, when eradication of a problem is the goal, it puts inclusion at risk. I can't be the only one who fears that bottom-line-focused employers who are being told they need to improve mental health because mental illness in the workplace is just so incredibly problematic in umpteen different ways may also see a "business case" in seeking to avoid hiring people with past or present mental illness, or vulnerability to developing one so as to cut the "problem" off at the source. It also can't be surprising then when regulatory bodies point to the stereotype-infused data about the negative impacts of mental illness in the workplace to justify measures that further dehumanize the mentally ill by forcing them to disclose their mental health histories (as if such histories render them inherently problematic for the profession) and then demand them to jump through extra hoops (surrendering privacy about deeply personal matters in the process) to prove their worth even if they have never done anything wrong and have achieved everything required of them to make it to that point in their careers. This further dehumanizes and stigmatizes the mentally ill and makes those who can hide/deny that they suffer from illness more inclined to do so rather than seek the help they need.

So yes let's address the benefits of promoting mental health in the workplace. But let's NEVER do it on the basis of stereotypes and questionable data. Let's critically examine every assumption we make before we make any case for any initiatives. Let's acknowledge the lengthy and ongoing history in our society of dehumanizing and discriminating against the mentally ill, depriving them of their autonomy, and devaluing their strengths, thereby forcing many to hide their suffering. Let's adopt a stance of radical humility to reflect that history. Let's stop making assumptions ("evidence-based" or not, since the "evidence" is going to be incomplete/inadequate since many hide their illness and don't seek help) and start actually listening to what people tell us about their experiences, strengths, vulnerabilities and contributions. In other words, let's embark on a process of discovery, rather than assume we know the terrain in advance.

Instead of pointing to why mental illness needs to be reduced/eradicated, let's change the script. Let's discuss why people with all manner of states of mental health on a broad spectrum deserve to be treated holistically as individuals with diverse strengths, needs and vulnerabilities. Instead of talking only about the "problem" of mental illness, let's emphasize the benefits of including those who have so much to offer who might otherwise be excluded.

I referenced at the outset that this was a lazy post. I'm not citing evidence for my claims. My mental health condition was hidden (including from myself) for a long time. When it became evident that I needed to address it, I felt incredible fear about the implications of doing so (the stereotypes and discrimination to which I would be subjected) that nearly held me back from seeking a diagnosis and professional support. I'm therefore keenly aware of how many people suffer in silence and never get to be included in the "data" about mental illness in a professional environment. The data is flawed, and I'm not that interested in hearing about it until those who resort to it adopt a sufficiently humble and critical stance in relation to it.

None of the above was intended to detract from the fact that mental illness can indeed cause real and heartbreaking problems for many people, especially in a society that does not provide adequate support and validation for those who have different needs and strengths due to mental illness. Those whose function declines as a result of mental illness deserve to be treated compassionately and we should do all we can to support them. But we should never see ourselves as doing so to rid ourselves of a "problem." We should do so because we care about supporting those human beings in our midst, and acknowledge that despite their suffering they have real value. In doing so we should also be prepared to acknowledge that perhaps, more often than we think, the suffering individuals aren't the "problems" at all. Rather the problem is a system designed not to support and include them.

Note added afterwards: I’m not saying that no “business case” can or should ever be made, but that it should never be done by drawing on discriminatory stereotypes. We can identify a fair and proper “business case” only upon ensuring we aren’t relying on stereotypes. Any "business case" should include a recognition of the rights and strengths of the mentally ill, not just a one-sided focus on the ways in which poor mental health can sometimes undermine workplace objectives. It should also never take precedence over a proper rights-based discussion that doesn't leave it up to individual workplaces to decide whether they will properly accommodate their employees' mental health. Deciding whether to be inclusive and provide a safe working environment shouldn't be framed as a choice left up to individual workplaces.

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:

Saturday, January 18, 2020

We Can Be Heroes

Mental health issues are common in our society, as is trauma.

But, for the most part, we don't talk about them in a way that allows them to be real for us.

Often we don't allow ourselves to name them, even when they're clearly affecting us and/or those around us.

Instead, we grope around in the darkness as quietly as we can, hiding from them. We don't want to have to see them. We feel somehow that if we allow ourselves to acknowledge them as real, they'll be more likely to get us, or perhaps we will have no choice then but to face the fact that we are already in their grips.

And if they do get us (as they sadly often eventually do), sometimes we don't want others to know it, since maybe those around us will fearfully avoid us then too. Maybe the darkness will have tainted us for them, leading them to fear seeing things in us that they then won't be able to un-see in their own lives and selves. Maybe they'll fear that the contours and colours of their world will be forever changed by the experience.

For me, a world that many others never allow themselves to see has been within my view for a very long time. It wasn't just hidden in darkness. It had contours, details, sounds, smells, and colors, unmistakably different from the ordinary day-to-day lives that many others seemed to have had.

Even when I was able to partake in the ordinary world of "normal" "successful" people, the vivid details and sensations of that other world I'd seen never left me. Even when I was coping well, its shadows pursued me.

While I was learning how to be a lawyer, and then surviving the pressures of practice, I was also continuing to fight that battle. I never stopped having to navigate the hellscape of that other world while still functioning in the everyday world of lawyers (although sometimes I managed to make it less visible to myself, so I could live in denial of its influence, even while expending considerable internal resources to do so).

I became an expert in its dangers, landscape, hiding places, etc. My expertise-by-experience was never enough to enable me to fully escape it, but I learned how not to let it destroy me. I developed my own tips and techniques that worked for me at the time, and adapted them over and over whenever they failed.

In some ways I felt "weak" because I was experiencing something others around me seemed not to have to deal with. And if some of them were dealing with it, we weren't allowed to talk about, thereby preventing us from knowing who around us might understand what we were going through. The silence thereby promoted our further isolation.

Yet in other ways, somewhat selfishly, I felt frustrated because no one knew how strong I really was. I never got any credit for the battles I'd survived. Yet when I was too tired from my dual fight (my professional activities and my other struggle) and needed to take a break from my everyday activities, I would appear "defeatist" in the eyes of many others. Sometimes I laughed when friends called me this (because I wasn't up for learning how to bake or something). They had no clue what I'd been through or why I had to be selective about what non-essential activities I would take on, why my energy was depleted and I needed to get rest by sacrificing what wasn't absolutely necessary for my personal or professional survival.

Now I'm speaking out and refusing to acquiesce in being seen that way. Call me weak or defeatist if you'd like. Call me attention-seeking and whiny. I have no doubt many still will and I would be lying if I said it won't still sting and the resulting isolation won't still get to me, but for my part I refuse to allow that narrative to be imposed on me any longer.

In and of itself, that refusal to acquiesce can be a powerful act of defiance.

I haven't learned how to use that newfound power yet in a way that I'm confident will help others, but that's my goal.

Here are the ways I think we can use our power (once we are ready to claim it) to be "heroes:"

By showing others who may be affected that they're not alone or "crazy." They aren't the only ones who see and are affected by another world that those in the mainstream don't acknowledge, whatever it may be. They are part of a team.
By showing others that they don't have to see themselves as "weak." Just the opposite is true in fact. Permission to give that other world a name and a reality is permission to claim our victories as well as our defeats. Some of us have fought battles greater than most can imagine yet are stuck in a surface reality that gives those success stories (and the strength involved in them) no meaningful recognition. Being able to finally be seen for who we are can be a huge source of strength, as well as a tremendous gift we can give to others when we make space for them to do so as well.
By sharing what we have learned about strength and survival in those other worlds with others. If others will listen, we have expertise that could help save the world. Unlike fictional superheroes, many of us have fought battles that are real and what we learned from those battles (the tips/techniques etc. that helped us survive) could help others fight their own (provided we understand that everyone's battles will be different in some ways, so what we share can assist, but may need to be adapted/altered to suit others' unique challenges).
By showing others that there's someone they can connect to who "gets it," a source of solidarity/community/strength. The more of us that do this, the more strength there will be. We can start reclaiming our narratives on a grander scale and not only refuse to be branded as weak, but demand that our stories be seen holistically and that others stop "looking away" from what we have survived. We can have a place to celebrate our amazing accomplishments, the ones the world has refused to see, let alone honour.
By helping those who have no idea what we've been through, who may be fortunate enough to have lived a genuinely sheltered existence. We can do this by sharing our wisdom and strengths in a way that can be adapted to meet the challenges of the everyday world too (if only they'd finally be willing to listen to us and recognize the value what we can share/teach). Side-note: this is why so many of us are so damn competent at our jobs and why it is laughable to me when those with old-school attitudes suggest we may not belong amidst the pressures of the profession. Obviously we have to manage our load so we don't carry more than what is humanly possible (in addition to what we already have carried/are carrying), but we wouldn't have made it this far if we didn't have extraordinarily good judgment, strength, power and wisdom. That alone should earn us trust and respect, and displace any presumption of incompetence or "weakness." So let's rise up and make sure those calling the shots understand that....

The above is not to pressure any who aren't ready and/or may never want to take on such a task in addition to the burdens they're already managing. By definition, those of us who have made it this far are already doing more than enough. Surviving is enough. Nothing more is owed. But for those for whom taking action and speaking out can be a source of strength and power, it's there for us when we are ready to claim it.

What I envision when I try in my small way to help make space for others who may also be ready to speak is a world in which those who have suffered are given the space and the platform to share what they've learned. In doing so, they can be heroes in so many ways: paving the way for others; bringing light to dark corners of worlds we've previously refused to even acknowledge that so many of us are caught in; forging paths through dense bush so others can follow more easily; providing maps and guidance for others who are lost to find places to escape or take shelter....

Those of us outwardly functioning well can show that it's possible to succeed in the more conventional sense even while struggling with those other worlds, while those who have been "broken" or "damaged" (temporarily or permanently) can show that there's no shame in being affected by forces more powerful than us all--no shame in being human and vulnerable. The beautiful humanity in all kinds of stories can be honoured, celebrated, and--when necessary--mourned.

Most important of all, not only can we become heroes in this way, we can also finally become visible for the heroes we already are.

(For those who need a greater source of inspiration than my feeble words, here is Peter Gabriel's version of "Heroes:" https://www.youtube.com/watch?v=LsvuipGq2ns )

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:

Saturday, January 11, 2020

Imposter

There's a lot of discussion about imposter syndrome in the legal profession.

I've been reflecting on it a lot lately because in some ways it fits me. But here's what I've realized: I don't have imposter syndrome. I'm actually an imposter.

The feeling that I don't belong in this profession doesn't come from some syndrome. It isn't a problem with my perception.

I don't belong in this profession because this profession wasn't designed for people like me to (1) exist (2) show who we are; and (3) be accepted, supported and appreciated for it.

So how to change this? Is the answer just to say "Be yourself!" "Don't let the profession dictate who you can be."

Um, sure, okay, maybe to some extent, and I'm certainly trying now more than ever, but let's get real.

Being able to be ourselves in an environment that requires interaction with other people doesn't just depend on us being authentic. It depends on those other people being willing to put the effort in to engage with us as such.

For those of us with background experiences and personal circumstances that significantly differ from the "norm" (the default assumptions about who we are or might be), this requires time, sensitivity and attention from those around us. In many instances, they will have to put in the effort to learn about us (by learning more about us as individuals and/or learning more about the groups to which we do or might belong) to truly see us because we are not generally visible as who we are. This would need to happen not only on an individual level in personal interactions but also on a systemic one so the structures/culture of the profession support us in being our true selves (or at least don't force us to surmount endless obstacles just to participate), and thereby allow us to truly belong (rather than pretend to fit in).

One complication for those of us with trauma histories is that it may not always be possible or feasible for us to truly share much, if anything, about what's going on with us, even when it affects our vital interests. I call it "the curse of being complicated" and plan to elaborate on it in a future post. Briefly, being inherently complicated for me means I can't share really important things that shape my perspective because (1) others often don't feel comfortable hearing them and erect boundaries to protect themselves from me simply sharing who I am and what I've been through. Maybe they think it's too personal or just "too much" for them to handle hearing (as I wrote about here); (2) It's complicated and couldn't be explained quickly or easily--it would require time and effort on others' part to hear it; and (3) It's highly personal so I may not feel comfortable sharing it all, and there may be personal consequences to me for doing so. I described some of the barriers to sharing our stories here and here.

Yet keeping it private (i.e., remaining invisible) has real consequences, since our needs, challenges, vulnerabilities and strengths may not be possible to understand properly without knowing what we have endured, have overcome, and are still facing. When those highly personal aspects of ourselves have become injured, it can damage us in so many ways, not the least of which (for me at least) is by isolating us from others who don't understand and aren't prepared to make the effort to learn about what we have been through.

So how do we address "imposter syndrome?" I don't know the answer, but we could start by asking about the extent to which it reflects something real rather than imagined. If we don't feel we belong, is it because we are in an environment that actually doesn't truly permit us to exist and thrive as who we are?

Maybe there are things we can do individually to minimize its impact on us, but let's not pretend we have individual control over it when we often don't. For "imposter reality" the only way to heal the feeling of not belonging is to change the profession itself so it allows people like us to truly be ourselves while also having our needs met and our contributions supported and respected.

So, no I don't have imposter syndrome. I am an imposter. I often have to pretend to be someone I'm not in order to function here. Even when I don't actively pretend, the invisible forces and default assumptions kick in to cover who I truly am.

I'd love for us all to get to know each other and start being our authentic selves, but that isn't something that's just going to happen through individual efforts. It isn't just a syndrome we each can cure.

So let's start talking, listening, strategizing and taking action so we can all have the benefit of belonging.

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: