Stigma and Mental Health
Let me give you a scenario.
I want you to pretend you are a manager at a big bank. Today, you are in charge of hiring one more bank teller to interact with your clientele on a day-to-day basis. You meet two candidates, Jacob and John. To your delight, you are impressed by both candidates. Because you can only hire one, you decide to call their references.
First, you speak with Jacob’s reference. You learn that Jacob is an excellent worker. He is kind, patient, and a pleasure to be around. When you ask about absenteeism, you learn that, besides that month he spent in the hospital for his surgery, he has never been absent.
Next, you speak with John’s reference. You learn that John is an excellent worker. He is kind, patient, and a pleasure to be around. When you ask about absenteeism, you learn that, besides the month he spent in the hospital on the psychiatric ward, he has never been absent.
Now tell me… who are you going to hire?
Mental health – the stigma surrounding it is undeniable. While there is certainly no shame associated with healing in the hospital from a physical wound, individuals suffering from a mental illness consistently experience stigma associated with their injury. While it is not uncommon to hear individuals discussing their high blood pressure or back pain or chronic sleep problem, hearing someone discuss their manic episode or panic attack or binge-purge behaviours is substantially less common.
In any year, 1 in 5 Canadians will have a mental health problem. Look around you… unless you are alone, there is a strong likelihood that someone sitting around you has, or knows someone who has, a mental health problem. Do you know who? I am willing to bet that you don’t. We, as a society, don’t advertise mental illness. In fact, not only do we not discuss it, many of us don’t even address it. The stigma associated with mental health results in many of us either denying our mental health needs or refusing to seek assistance for these needs.
Where does this stigma come from?
It is quite natural, as humans, to fear what we don’t know, what we don’t understand, or what we can’t see. I think it would be fair to say that, for most of us, our relationship with mental health would fall into all three categories.
What We Do Not Know
Have you seen that episode of The Simpsons where Ned has a nervous breakdown? Guess what… mental illness does not look like that. The primary source of information on mental health for many has been the media, and the media does not always portray mental illness accurately.
What We Do Not Understand
It is easy for us to understand that, when we fall, our bones will break. When we eat too much fat, our arteries will clog. The cause-effect relationship is quite evident. Mental health is not so linear. For some soldiers, returning home from time spent overseas is a relatively smooth transition; for others, they are plagued with intense psychological distress, recurring nightmares, and intrusive images. The cause-effect relationship in mental health is much less clear, making mental health much less easy to understand.
What We Do Not See
Watching a physical wound heal is reassuring; we know we are getting better because we have physical proof. Mental illness is less visible. Fearing mental illness is like fearing the dark – we fear what we cannot see.
There are many myths that play a role in perpetuating our fear. I want to try to dispel some of them.
MYTH 1: Mental illness is just “in their head”
NOPE! With today’s sophisticated brain imaging technology, doctors can actually identify the differences in the brains of individuals suffering from some mental illnesses. Similarly, other conditions are due to changes in the neurochemical balance of the brain.
MYTH 2: People suffering from mental illness are dangerous
NOPE! They are no more dangerous than the rest of the population. People with mental illness are more likely to harm themselves or be harmed by others than to hurt other people.
MYTH 3: If you are diagnosed with a mental illness, you will have to deal with it for the rest of your life
NOOOOOOO!! With the right treatment, people with mental illness get better, and some recover completely.
MYTH 4: Medications used to treat mental illness alter the personality of the suffer
ABSOLUTELY NOT! Medications work by balancing the imbalance of chemicals in the brain that are responsible for specific mental health symptoms.
MYTH 5: Mental illness is due to a weakness in character
NO WAY! Mental illnesses are the result of an interaction between biological, social, and psychological factors. The desire to seek help is a sign of personal strength and courage.
I hope that wee bit of info has helped to clear up some misconceptions you may have had regarding mental illness. I also hope that you realize the important role each of you plays in re-scripting societal beliefs surrounding mental health and mental illness.
I would like to share with you five small ways that each of you can make for those suffering from a mental illness, identified by the Canadian Mental Health Association.
Five small ways I can make a difference:
~Quote of the Month~
“From the viewpoint of absolute truth, what we feel and experience in our ordinary daily life is all delusion. Of all the various delusions, the sense of discrimination between oneself and others is the worst form, as it creates nothing but unpleasantness for both sides.”
- Dalai Lama
“Control That Anger Before It Controls You!”
Have you ever been driving down the road only to have someone cut you off at the very last second? Have you ever come home and noticed that your sibling was in your stuff… AGAIN. Have you ever tried to rationalize with your parents who just don’t, regardless of how many times you try to explain to them, seem to get it?!? You feel your face flush. Your heart starts beating faster and it is a safe bet that your blood pressure is increasing a few notches. Your breathing becomes fast… you may clench your fists… you feel ready to pounce.
Anger -- we all know it well (and some of us better than others). For some of us, it takes a lot to push us over the edge. For others, it happens all too easily. For some of us, we have developed techniques to calm ourselves down. For others, we usually end up in trouble due to this seemingly uncontrollable emotion. Lucky for the latter group, this does not have to be the case. Anger is a controllable emotion that, with the right techniques, does not have to be a negative experience.
Just a bit about our experience of anger… anger is, more often than not, what we in the psych biz like to refer to as a secondary emotion; that is, it is the result of another emotion. Think of the last time you were angry… what made you angry? Think about the event and the people involved. Consider your reaction and the intensity of your anger. Now, go beneath that… what else was going on for you? Chances are there was an underlying emotion driving that anger, such as fear, disappointment, jealousy, sadness, anxiety, loneliness… the list goes on. Remember the time you were angry when your significant other talked to a member of the opposite sex? I bet a bit of jealously may have been underlying that anger. Remember that time when you were angry that you got a failing grade on that test? I bet ya a bit of disappointment was underlying that anger. And how about the time your friend did not invite you to the party… you may have raged to her, but I would bet that underneath, you were really quite hurt.
So, if another emotion is driving our anger, what purpose does the anger serve? The answer is this: when we experience an emotion that threatens our ego (sense of self; who we are), we feel vulnerable. Rather than allowing ourselves to experience the pain and angst of that raw emotion, it is much easier to become angry. Anger allows us to feel in control and optimistic for change. When we become angry, we are motivated to do something, to make a change. Anger, then, can be viewed as a defense mechanism against other, more painful emotions. It is a shield we use to protect ourselves from feeling vulnerable.
Now on the surface, this appears to be a wonderful band-aid to our emotional wounds. Painful emotions manifest, and we slap a little anger on them to take away their power. However, much like a band-aid does not heal a wound, anger does not heal whatever primary emotion it is defending against. If you become enraged at your friend for not returning your call, the hurt you are feeling will still be present when the anger melts away. Failing to address the feeling underlying the anger increases the likelihood that the anger will reappear; prolonged states of anger are detrimental to both your physical and emotional well-being.
Another negative aspect of anger can be identified in our responses to this emotion. Anger itself is not negative; it is just a feeling and feelings are neutral. It is our responses to such feelings that can have negative effects on our lives. When that driver cut you off and you had to swerve to avoid colliding into his back bumper, it is not abnormal to feel enraged. But when you hang yourself out of the window yelling obscenities, thereby endangering your safety a second time… well you get the point.
I mentioned at the start of this entry that some people have developed ways to effectively deal with their anger… what does this mean? There are coping mechanisms that people can utilize to reduce the intensity of their emotions and allow then time to “cool down” before addressing the situation in a more effective manner. Below is a list for you to review. If you try one and it does not work, do not be discouraged! Anger is experienced differently from individual to individual and it is dealt with differently.
For more strategies, you can visit:
So… here is what I am hoping you take away from this…
Quote of the Day
Anger is a great force. If you control it, it can be transmuted into a power which can move the whole world.
The Necessity of Communication for Healthy Relationships
Love and Relationships
To love is universal; we all love someone, at some point in our lives. For many of us, our first experience of love begins in the home, from a parent or caregiver. For others, love may be realized from a role model or from a very close friend. Our early experiences of love give us the strength and support we need to develop into the individuals we are today. Our early experiences of love teach us that love is good – it is something we yearn for.
As we grow older, we learn that love can take on many forms. Robert Sternberg’s Triangular Theory of Love provides us the basis for understanding love in light of this realization. According to Sternberg, love consists of three components: INTIMACY, PASSION, and COMMITMENT. The intimacy component refers to feelings of closeness and connectedness in your relationship with another. The passion component refers to the drives that lead to romance and physical attraction. Lastly, the commitment component refers to both the decision to love someone and the decision to maintain that love. Different relationships can consist of different quantities of each component. For example, the relationships we had with our parents as children likely contained a balance between intimacy and commitment, whereas the romantic relationships we form with our future spouses likely contains a balance between all three components.
While forming new relationships in the context of young adulthood, it goes without saying that we will experience roadblocks in our quest for love. While we grew up watching Prince Charming dedicate his life to wooing the Princess, we later realize that, in reality, this will not be our experience of love. While there will be moments of utter joy and pure bliss, there will also be times when you feel like firing your shoe across the room at your partner (but please refrain). Love is not always a fairytale. Love is hard work.
Conflict is inevitable in the context of a romantic relationship. Fortunately, we can develop skills that will aid in the resolution of such conflict. Time and time again, marriage therapists identify a primary source of conflict within the romantic relationship to be a deficit in successful communication between two partners. Sounds minor, doesn’t it? While communication skills sound very simplistic in nature, the next time you feel an overwhelming desire to throw a shoe at your partner, you may be surprised when you take a second to realize how many basic communication skills you failed to employ.
Communication Skills for a Healthy Relationship
Many studies have identified the correlation between successful communication and relationship satisfaction. I have compiled a list of important actions one must take to promote healthy communication within a relationship.
Quote of the Month:
Bad human communication leaves us less room to grow.
~Rowan D. Williams
Sternberg, R. & Weis, K. (2006). The new psychology of love. New York: Vail-Ballou Press.
ARE YOU A STRESSED-OUT SALLY?
“Oh my gosh, I have like five exams, I am so stressed!”... Sounds familiar? In December, we easily succumb to the joy and cheer of the holidays, thinking to ourselves, “I will worry about finals in January… that is a whole month away!” Then, after the turkey is eaten, the presents are opened, and the waking up at noon draws to a close, we find ourselves rubbing our eyes in disbelief, wondering where December went and thinking, “Oh no! It is January and I have not even cracked a book!” Your heart starts beating quickly, you might start to sweat a little, and you get that sick, twisted feeling in your stomach.
It is going to be a long month.
First of all, let me reassure you, this response is not abnormal, nor is it a bad thing! I want to talk to you a bit about the wretched experience of stress and what you can do to ease yourself through the treachery that is January.
First, let’s define stress. Stress is generally a state caused by bodily or mental tension that disrupts existing equilibrium. There are three stages of stress:
Stage 1: Your body releases adrenaline, your heart beats faster, you begin to breathe harder. Other physiological changes occur that allow you to deal with the situation that is causing the stress in order to return to equilibrium. We call this the Fight-or-Flight Response.
Stage 2: This stage occurs if the stress is prolonged. Your body becomes tired and begins to release stored sugars and fats from its reserves. This is when you start to feel pressured and tired. You experience anxiety, poor memory, and due to your compromised physical health, you may easily attract colds and the flu.
Stage 3: This stage occurs in response to chronic stress. Your body has nothing left to give. You experience insomnia, errors in judgment, and even personality changes. You are at an increased risk for developing a serious illness, such as heart disease, ulcers, or mental illness.
Stress can appear in many forms. It can be acute or chronic. It can be good or bad. It can be environmental, physical, social, or psychological in nature. One interesting component of stress that forms that basis of what I want to discuss today is that stress is a subjective experience. What does this mean? It means that your experience of stress – triggers, reactions, coping mechanisms – is unique to you. No two people experience stress the same way and in response to the same situations.
Take Stressed Sally, for example. Sally has five exams this month. To Sally, a lot is riding on these exams. I mean, the outcome of these exams could very well determine THE REST OF HER LIFE! If she doesn’t get an A in all of her classes, it will be catastrophic. I mean, she will never be able to show her face in school again. If she doesn’t get an A in every class, she won’t get a scholarship, she won’t get into university, she won’t get a good paying job, she won’t attract a partner, she will never have kids, and she will die alone. The thought of studying makes her sick. She cannot sleep, she does not eat, and she cries a lot.
Needless to say, Sally is stressed.
Then we have Calm Carrie. Carrie, too, has five exams. In fact, Carrie sits next to Sally in all five of the same classes. Carrie, too, wants to do well, but she does not experience any of the same symptoms as Stressed Sally. Carrie tells herself that, while it is important that she puts forth her best effort, a mark that is less than an A will be ok. She tells herself that her life will not be determined by the results of these exams. She wants to do well, and will surely study, but at the end of the day, a test is a test.
Can you identify the difference between Carrie and Sally?
The difference between Carrie and Sally is in their perspectives. Sally is engaging in a whole collection of cognitive distortions (see blog entry two) that are influencing her experience of stress: Overgeneralization, All-or-None Thinking, Jumping to Conclusions, and Magnification are a few of the obvious ones. Carrie, on the other hand, is a different story. While she still experiences stress, the stress she experiences is good stress; it will motivate her to study.
What is the difference between good stress and bad stress? Bad stress is debilitating; good stress is motivating. Bad stress is long-lasting and is detrimental to our physical well-being; good stress is short-term and does not affect our physical health. Bad stress leads to decreased performance; good stress leads to increased performance. We need good stress; it gives us the motivation to get out lazy butts out of bed in the morning and be productive citizens. Bad stress, on the other hand, we can do without.
How we react to stress is also unique to us as individuals. Coping mechanisms are strategies we mobilize in times of high stress. Coping strategies can be negative (i.e. smoking, yelling, hitting others) or they can be positive. Below is a list of positive coping strategies you may want to employ in response to the stress that January will inevitably cause you.
RELAX! Take deep breaths. Massage tense muscles. Stretch.
TAKE CARE OF YOUR BODY! Never underestimate the power of adequate sleep, exercise, and healthy eating.
BE REALISTIC! You are not a super hero and you can not do it all. Set limits.
CONNECT WITH OTHERS! While it may seem like you don’t have the time to chat on the phone, support from loved ones is a crucial component of effectively managing stress.
MAKE TIME FOR YOU! Give yourself an allotted period of time to engage in activities that you enjoy. Let’s be realistic… studying is not a good time. If you give yourself intermittent breaks, you will return to the material renewed, refreshed, and better able to retain information.
Let’s sum this up.
Stress is inevitable. Everyone experiences stress differently. Perceptions/thought patterns influence the experience of stress. Stress can be good or it can be bad. Good stress is short-term and motivational; bad stress is prolonged and is detrimental to our health. How we react to stress can be either good or bad. Attending to your well-being is crucial in times of high stress.
Quote of the Day
Stress is an ignorant state. It believes that everything is an emergency.
"Don't beat yourself up over the holidays - Awareness of Fat Talk"
We live in a society brimming with Fat Talk. “Do I look fat in this?”… “Look at this gut!”… “Ugh, I hate my thighs!” These are all comments you have likely heard too many times, whether it be from your mother, father, a teacher, a friend, a sister, a brother, or that evil internal voice that likes to bring you down a notch the moment you start feeling good about yourself. We all engage in Fat Talk, in some form. Many of us engage in Fat Talk as part of our daily routine. And, not surprisingly, it leaves us feeling pretty bad about not just what we look like, but who we are.
Where does this Language of Fat come from? Go stand in line at the grocery store and you will be bombarded with a major perpetuator of society’s beauty obsession: the media. I took a break from writing this entry for you just to Google today’s latest news headlines in the entertainment world. Here we have it: “Kris Humphries Called Kim Kardashian Fat;” “Jessica Simpson in for 4 Million Dollar Weight Watcher’s Deal;” “Kate Gosselin Gets a Facelift” … like, seriously? The media bombards us with messages everyday that translate to this: if you are not beautiful, you are not worthy. Sadly, as a society, we have internalized this message.
Sandra Friedman, in her book entitled Nurturing Girlpower, has coined the term “grungie” to describe the negative voice that we have developed in response to our overwhelming desire, as a society, to be beautiful. “Grungies” are the negative things we tell ourselves about ourselves. They commonly appear in the form of “you are fat” or “you are stupid” or “you are ugly.” Underneath these statements are real feelings; when we do not know how to express ourselves or are too frightened to do so, we shift our focus from our internal needs to our external image. We turn to our Language of Fat.
Take, for example, the simple phrase, “I feel fat.” Feeling fat is quite different from being fat. Thin people feel fat and fat people feel fat. Nobody feels fat all the time. If someone felt fine at 5:00 pm and felt fat at 6:15 pm, that change that occurred was not physical; it was emotional (Friedman, p. 50).
Why do we do it? There are many motivations behind this tendency and individual answers may vary. One commonality, however, exists amongst Fat Talkers and it is related to our natural tendency as human beings to fear the unknown. Feelings are deep, unseen, and can be pretty difficult to figure out. Our appearance, however, is superficial, quite visible, and is rather easily manipulated. Why make yourself feel better by dragging yourself through emotional wreckage when you can simply book a hair appointment, buy a new shirt, and band-aid it all up?
I have a good reason: band-aids fall off.
Through ignoring our internal needs and focusing our efforts on our appearance, while we do achieve temporary relief, it is just that – temporary. Our internal needs will resurface, our external fix will wear off (or out), and we will find ourselves right back at (minus) square one… now adding frustration and a sense of hopelessness to the mix.
So here are the two messages that I am hoping you are interpreting from my rant.
First, it is crucial that we learn to challenge media messages that promote not only an unrealistic beauty ideal but self-depreciation and self-hatred. Secondly, it is absolutely necessary that, on a personal level, you learn to identify your tendency towards Fat Talk and refrain from covering your emotional experience with expensive clothing and bronzer.
Quote of the Day
What you do, the way you think, makes you beautiful.
~ Scott Westerfeld
Friedman, S. (2003). Nurturing Girlpower. Vancouver, B.C.: Salal Books.