This is an edited extract of a blog post by Polly Chester.
Read the full piece here.
I’ve learned that knowledge of mental health practice can give us a dangerous and false sense of galvanization against what we advocate for.
The conversation I had with the previously unknown general practitioner who recently assessed me said something to me that will always ring in my ears:
“The fact that this is happening to you now will stand you in good stead for mental health practice, because you know how it feels to be ill.”
The following ten points are the reasons why I think that experiencing mental illness can make you a better mental health practitioner.
A good mental health practitioner…
1. Practices with empathy
Empathy is key in treatment. The empathetic mental health practitioner does not abuse their power by trying to ‘fix’ the person or give subjective advice. The empathetic practitioner listens to and feels with the person. They stand with the person in the darkness and provide optional strategies that will empower facilitation of recovery. The practitioner knows that the person is the expert on his or her mental health recovery. Everyone has the tools, but sometimes needs education regarding how to use them.
2. Understands loneliness in all its complexity
Loneliness isn’t exclusively regarding disconnection between persons with their family, social networks and communities. Loneliness may indicate disconnect between a person and their own soul. The loneliest feeling of all is harboring resentment for the self. The astute mental health practitioner will provide pathways not necessarily for gaining self-knowledge in the postmodern sense, but for the person to connect with their values and fall in like with themselves again. It is only then that relationships will flourish in broader contexts. Being surrounded by friends whilst hating oneself is a very lonely place to be. It’s the job of the practitioner to facilitate opportunities for inner reconciliation for the help seeker.
3. Can help you identify the micro, meso and macro structures in your life that may be causing mental illness
In conjunction with psychotherapy, a systems approach to assessment is crucial in understanding the etiology of mental illness. Treating the presenting, micro symptoms of illness is not good enough in isolation; meso and macro elements must also be taken into account. For example, symptoms of depression and anxiety may be resulting from breakdowns in interpersonal relationships, but a lack of community participation and lack of a sense of belonging in a meso context can result in social isolation that can affect the interpersonal sphere. More broadly, a sense of contemporary weltschmerz can lead to feelings of despair over the person’s lack of control over the injustices of the world that we live in. Macro level discontent can create a sense of hopelessness that is mutually exclusive with being unable to see how to make a difference to humanity on as global scale.
4. Knows the importance of taking one moment at a time
“The next four to six seconds. That’s all you have to worry about.” – Is one of the best instructions that ever been given to me. The next four to six seconds is all we can cognitively handle at one time, yet we try to jam in the past and the future as well, making an utter mess of things. Exploring strategies to engage in one moment at a time is the best thing we can do, especially for a person in crisis. We need to enter each moment with calm indifference in order to be able to manage the next to the best of our ability.
5. Knows: Thought > belief > event > belief > thought
Good old cognitive behavioural therapy (CBT). The principle of acknowledging the impact of our beliefs between thought and events, and vice versa, is vitally important in understanding how misleading the stories that we write in our own heads can be. As mental health practitioners, we must pay attention to the messages that are being relayed in interpersonal communication, rather than the emotions behind them. If we react to the emotion, our interpretation is clouded by subjective beliefs. In order to hear our people, we must respond to the message rather than react to the emotion, then pass on this technique to the people we are helping.
6. Knows that a helpful stranger is a more objective listener than a friend
Not only do we tire of haranguing our friends and family with our woes – they tire of us. Professionals are paid to hear people out and help us sort through our issues. Professional supervision is pertinent to good reflective practice. We all need guidance, even if we have the strongest support networks in the world. If people come to us for guidance, wouldn’t it be foolhardy of us not to support one another during times where we need professional and personal support? It’s not a submission of weakness, but an assumption of strength to use the social support of those around you who are best equipped to help.
7. Treats the symptoms of illness, whilst recognising the whole person
A person is not infinitely characterised by their behaviour during a period of mental illness because during that time, the behaviour is not representative of their whole self. The mental health practitioner recognises that mental illness does not define us, but is the result of biopsychosocial factors that have led to a state of crisis. Once the etiology of the illness is recognised and accepted, recovery can be facilitated and the people can know themselves, and let others get to know them once again.
8. Respects self-determination in treatment methodology
Everyone reserves the right to choose whether they take medication in order to aid mental health recovery. Medication will be the right choice for some, and not for others. Exploration of whether or not to use medication should be a collaborative engagement between the practitioner and the person. Each person should be treated as the unique individual that they are, and their treatment not defined by the most expedient option in the eyes of the psychiatry industry.
9. Cuts through the bullsh*t
Friends will listen to us bang on and on about regrets and the terrible decisions we’ve made that have led us to where we are, in an uneducated but well meaning encounter group fashion. What we may actually need is for someone to say: “Stop beating yourself up about the past for no good reason, because it’s sending you into a sympathetic nervous system response mode whilst you’re actually in no imminent danger.” When someone explains the neurological processes behind how the amygdala floods the brain with cortisol upon our own request as if pushing a panic button, we can forge new neural pathways through psychotherapy to stop this from happening. It’s a relatively simple process to counteract, but it takes time and dedicated practice. Having someone on hand who can help cut through the self-sabotaging bullsh*t and recognise the cognitive processes behind needlessly engaging the fight or flight system is indispensably helpful. Help the person build the new cognitive pathways that will guard them against unhelpful thinking styles.
10. Provides pathways for learning from mental illness
Reflection in action is key. As a mental health practitioner who has learned valuable lessons from bleak times, what of that subjective knowledge can you interpret objectively, and pass on to the people who need you? Insight is key to mental health recovery. You might need to assist the person to stimulate their thinking, but there are always lessons to be learned from mental illness. In line with the strengths perspective, we can take experiences in our stride and practice with increased empathy. We need to teach the people who need us how to show themselves the same compassion.
I believe that we will all experience mental illness; just as we will all experience disability, to some extent during the life cycle. This doesn’t mean that we are weak or incompetent. It makes us human, and better equipped to help others, with the benefit of practical knowledge.