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My Approach to Mental Health Messaging: Embracing the Contradictory Multitudes, Sept 2020 post

(Originally posted on another site on September 13, 2020)

I'm relatively new to acknowledging that I have a mental health condition. I have mixed feelings about what it means. Sometimes I embrace it. Other times I feel it fails to capture what I'm experiencing. Sometimes I reject the label altogether; other times it helps to have a name (even a far from perfect one) for what I'm going through. It helps to connect me to a community of people with experiences similar to mine.

As for healing, I've embarked on the path slowly and cautiously. I've researched my condition and I've also done a lot of soul-searching before choosing what treatments to accept and reject.

Within me, there is enormous ambivalence, complexity, and nuance. I don't see this as a problem. Embracing and examining these apparently contradictory multitudes within me is part of my path towards self-knowledge and healing.

Since acknowledging myself as someone living with this experience, I've also managed to connect with others who have similar conditions. Brilliant, wonderful, amazing people I'm so proud to know.

In some ways, their experiences are very much like mine. Yet we can also have very strong opinions/feelings about what what healing should mean, what the essence of our suffering is, what kinds of treatments we should try, etc.

Just as I embrace the seemingly contradictory multitudes within me, I embrace them in my newfound community.

It's part of what it means to be human: to not have to be reduced to one dimension. To get to be seen and heard in all our shimmery glorious brilliant agonizing terrifying contradictions. To me, PTSD means one thing. To someone else, it may mean something else altogether. It may depend on the moment we happen to be in, the history we happen to have, our cultural and/or socioeconomic background, and any number of other things. Our condition is important but can't be understood separately from the ways in which it intersects with all that is unique about us.

We can find connection in the common threads we identify, but there is no solace for me in that if there isn't also room for profoundly difficult questions about which we may disagree.

Personally I've noted that the highly individual, seriously complicated way in which trauma affects me is a reflection of the nature of the experience of trauma, which is something that can shake our entire being and send shockwaves throughout our whole brains, bodies and spirits. Because it strikes at our foundations and can have wide-ranging disparate contradictory unpredictable effects, our subjective experiences of the same type of trauma(s) may share a lot of similarities but also have dramatically different manifestations and meanings. I think of it like an earthquake. It all depends on how you were situated when it struck, your pre-existing strengths and vulnerabilities, how it happened to unfold, which parts of you happened to get repaired first, as well as so many random factors that can follow. For some, the essence of an earthquake experience may be the fires it caused. For others the damage could have resulted directly from the shaking itself. For others it could be the loss of all their material possessions. And, of course, for any one person it can be all those things and so much more.

Some may find a refuge during or afterwards that may mitigate the impact, while others may be caught out in the open. Some may experience the event with others in ways that shape the experience, while others may experience it completely on their own.

And for those of us with Complex PTSD, it was not one earthquake, but numerous events that shook us in the same or differing ways, some striking just as we were trying to repair the damage from the previous one. If I had to point to one defining feature of the experience for me, it would be its complexity: the way it strikes at the core of everything and sends ripple effects throughout all aspects of my life in ways that aren't possible to understand without knowing me as an individual.

Naturally, there will be similarities but we do no one any service if we try to erase the differences.

I can't speak about other conditions: some may be more straightforward. And perhaps some people may even have a relatively straightforward presentation of PTSD that can readily be generally understood. I am not equipped to speak to others' lived experiences. But nevertheless no condition exists in the abstract: rather they all affect individuals who have their own histories, vulnerabilities and strengths.

So when it comes to mental health messaging, my approach, informed by my own experience of complexity:

1) Platitudes and generalized directions/slogans may help some but can cause actual harm to others. Just because something works for you, or even works for a lot of people, doesn't mean it will help someone else. Presenting it as a universal truth or directive can be profoundly stigmatizing and harmful for those who have a different experience. Sometimes the reason people have a different experience is because they come from a very different background than the majority around them. If we want to create inclusive messaging, our messaging should come from a place of humility. Even when it seems like something so obvious and basic, please consider that it may not be so simple for many whose experiences have not been like yours. Just to speak from my own experiences, being directed that people who love themselves are better in x, y.z ways is profoundly harmful to me, since my ability to love myself has been problematized and damaged (perhaps permanently, perhaps not) by my experiences of trauma. Such slogans and mantras send a message that I am less worthy as I am, which only compounds the harm I've already experienced. And being directed in a catchy overly-simplistic slogan to embrace self-compassion as if it were an easy thing to do is similarly harmful because my experience of my condition has made that road very dangerous to me (I might attempt it but only with careful planning and guidance) and it's possible I will never be able to travel it. Cutesy slogans about how you have to love yourself before you can care for others are damaging, not to mention questionable in their accuracy, both morally and factually. There may be a place to have nuanced philosophical conversations about who is "right" about such questions, but platitudes/slogans/directives that ignore the underlying complexity aren't the way to do it.

2) That is not to say I don't think it's helpful for us to share our experiences and wisdom so we can learn from others what has helped them and choose whether to try it ourselves. but we can do this in a way that allows for differing perspectives and experiences. Instead of saying, "Do X," we can say "X has helped me," or even "Many people have found X helpful, so you may wish to try it and see if it works for you." Or "I used to feel X, but I found that when I opened my mind to Y, it was very healing to me, and here is how I did it. I'm sharing it because perhaps it may help others too." Sharing of experiences and individualized wisdom is far more helpful (in my view) than sharing of platitudes, directives, and slogans. Unlike directives and slogans, sharing of personal experiences takes away the potential blaming and stigmatizing. It is simply an offering to others: here is what has helped me. Perhaps it could help you too. It doesn't deprive the recipient of whatever wisdom it may contain, but it leaves open the possibility of different experiences so as not to exclude or erase those who may have a different perspective, perhaps for very valid reasons. It allows us to find areas of connection while also leaving room for us to be who we are and heal in our own ways.

3) So my ideal mental health messaging is anything that cultivates (or at least doesn't undermine) a zone in which we can listen and share, without judgment or preconceived ideas about the "correct" answers and approaches. Where we can be individuals and also find connection amidst the nuance and complexity. Where we can note trends and apply what we have learned from them without closing our minds to the fact that some among us may have very different experiences. I try my best whenever I make an outwardly directed mental health utterance to ask myself: am I promoting or undermining this aim? It won't be perfect (especially when tweeting with limited brain cells and limited word counts) but I strongly believe that the value of such a space is far more important than any possible message or directive. So much harm could easily be corrected simply by rephrasing in a more open and humble way. This applies both to mental health professionals (who often see themselves as imparting the fruits of what they know based on their studies and what clients have told them) and to those who speak from lived experience (who have hugely valuable information to share but sometimes can lapse into speaking as if the approach that helped them heal is true and necessary for everyone).

4) Finally a point about language. I think we should aim to eliminate egregiously stigmatizing, historically demeaning and harmful language, but in my view the ultimate goal shouldn't be to find the least stigmatizing language: it should be to create a culture in which mental health variations are understood with such empathy and nuance that we don't have to fear that a failure to use the "correct" term will cause harm. I feel like it's a privilege to exist with an identity that allows for a feeling of safety in being able to withstand numerous diverging seemingly contradictory ways of describing oneself. We don't worry so much about the correct ways of describing what it's like to not have a mental health condition. People who are free of such a condition are permitted to describe themselves in all kinds of ways without having to consult their "community" first. Rather than find the best, least stigmatizing language for a mental health condition, we need to get at the root of why we feel this is necessary in the first place. We need to remove the attitudes that create ugly language in the first place and force us to constrain our "acceptable" language within narrowly policed boundaries. Speaking only for myself, it's exhausting to navigate and is a harm in itself to be sent the message that there is only one right way to feel about and describe my condition. The inability to allow for differences and contradictions within a shared identity without undermining the worth of those who share it is in itself a major harm we need to address. It shows how fragile the "non-stigmatizing"window is if it can survive only highly specific ways of viewing and describing a condition. For instance, some will say we shouldn't describe ourselves as "suffering" from a disability, but for me suffering is an absolutely essential aspect of my condition. I suffered trauma and I suffer its after-effects every day. It doesn't mean I'm not strong and I haven't "survived" but someone can't understand the way I experience my condition if they don't grasp the incredible suffering it involves and the barriers that suffering creates. So why can't we have both? Why are we limited to one way of identifying and speaking about ourselves? Why are we all forced into the same boat rather than being allowed to remain on and describe our own while still remaining in community with others? Is it because we have to collectively shrink ourselves in social space and speak (as well as be spoken about) in one voice despite the variety and complexity in our experiences? In my view, that's the harm we need to address: not the language, but the constraints placed on us when we ask the question of what language we must use and avoid to "fit" within our community and not "stigmatize" it.

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