Why can’t I own my own mental health problems when I’m so vocal about the importance of others opening up about theirs?
As a keen advocate of cultivating a society where mental health is something we can all feel comfortable to discuss, I’ve become pretty bad at doing this myself. This didn’t happen overnight, but over time I’ve gone from a keen Undergraduate peer supporter who would openly discuss my experiences of therapy with my fellow peer supporters, to qualified clinical psychologist who can’t remember the last time she did this. Only recently, a junior colleague opened up about their own brushes with mental ill health as a teenager and I did my best normalising and empathising and trying to make her feel ok that she had brought this up, and not rebuffed in any way. It wasn’t until later that day it occurred to me that I failed to respond with the “me too!” of my peer supporter days, and it hadn’t even occurred to me at the time that this could have been an incredibly important time to self-disclose.
So it got me wondering, how on earth did this happen? It was certainly never an active choice. I didn’t wake up one day and decide to build a wall around my personal experiences and never let anyone in. Here are some ideas I came up with that may have contributed to a gradual distancing from my dual identity.
Was I ill enough?
To give some context, my breakdowns happened when I was a teenager, and later during my Undergrad. My main problems were increasing anxiety, which eventually plummeted into a depression and very low self-esteem. I was the epitomy of “presenteeism” – I barely missed a day of school or, later, University but I trudged on surrounded by a thick fog, numbed to everything around me, and disconnected form everyone around me. I never a got a CAMHS referral, despite very much needing one, but was in the fortunate position of my parents being able to fund private counselling. Between that and a very understanding GP, I scraped through with no lasting effects on my grades or career prospects. Having never experienced “the system”, I often feel like a fraud if I mention my struggles with mental health. The only medication I ever took was St Johns Wort, and I never made it to CAMHS, let alone a ward. But I broke down at a young age, and still feel those vulnerabilities now. I often feel like I’m trying to swim upstream to keep myself well, but the majority of my struggles take place inside my own mind and unbeknownst to those around me, save for my closest friends.
Lack of role models
Throughout my entire time in training, and pre-training, not one of my 8 Supervisors, brilliant as they were in other ways, disclosed any hint of personal experience of mental health problems. The one who came closest was open about the fact they had recently lost a parent, and how this impacted on them at work sometimes, especially when working with families, or themes of death. I don’t think it was a coincidence that this was the supervisor I felt closest to and was the only one I felt safe enough to cry in front of (after a particularly heart-breaking meeting with the wife of a man with a terminal illness). I realise supervisors aren’t there to be your therapist, and they are under no obligation to share personal details if they are not comfortable with it. However, I don’t feel I ever really had a space to explore how my own personal and professional identity interwove and how I might deal with clients who reminded me of experiences I had been through. I literally had no framework of how to even bring this up.
The problem with social constructionism
So throughout my training, through exposure to different lecturers, supervisors and TED talks, I came to believe that fundamentally the literal interpretation of “mental illness” as a concept was completely false. There is likely no Schizophrenia gene, no chemical imbalance, no brain disorder that convinces you your life is terrible when it isn’t. People break down when the external demands on them far exceed their internal resources to cope with them, or put another way, the “symptoms” of mental illness are a “sane reaction to insane circumstances”.
So, all that said, this line of thinking makes it very hard to reconcile my own stress and distress with the factors that cause it, and subsequently communicate this in a way that I am able to receive the right support. In a previous job I worked in an incredibly stretched NHS CAMHS service. There was a vicious cycle of poor staff retention and high sickness rates, due to stress, with the knock on effect being that there simply weren’t enough staff in the system for it to run in the way it was intended. Because it had been noted that the service was failing, new policies and demands were being emailed out to staff on a weekly basis, with no option for discussion. I repeatedly brought my concerns to managers and senior colleagues, only to be met with gaslighting – “this is the case in every CAMHS service don’t you know” – it isn’t. Now if I had gone to my managers on the day I had a panic attack before going back in to work after a weeks leave, what would their response have been? My assumption was that all of my previous complaints would somehow be minimized and explained away as me not being tough enough to hack it, or worse, hysterical and not worth listening to. So I stayed quiet.
The problem with social constructionism is it doesn’t tell you how to seek help when you’re stuck in a broken system. Understanding is great, yes, but you can’t go to your GP and explain that your workplace is suffocating and ask them to change it for you. Instead, you’re expected to go and say you’re depressed and anxious, as this is an explanation society understands and can accommodate for.
Moving forwards
I’d like to finish by saying I’m in a pretty good place at the moment. I couldn’t fix the broken system I was in so I’ve moved to a new service. It’s early days but it already feels more containing and I’m excited about the potential paths this new role could lead down. I was so glad to find In2gr8 online and have spent the last few weeks doing some soul searching and reflecting on my own relationship with help seeking and duel identity. I’m excited to see where this path could lead too.
If you identify as a mental health professional in nursing, psychology, counselling, psychotherapy, art therapy, psychiatry, occupational therapy, social work with lived experience of mental ill health, and wish to be a part of a peer group with others, join us at www.in2gr8mentalhealth.com.
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