Mental Health

Making wise choices when we talk about mental health

Suzanne Venuta

From "The Language We Use" issue of Visions Journal, 2018, 14 (1), p. 20

Several months ago, I was out on the water with my dragon boat team. Two of my team members, both of whom work as health service providers, were talking to each other about a patient who had arrived at the hospital in crisis the night before. Throughout their conversation, the two made disparaging remarks about the patient, her condition and the family member who had brought her in, suggesting that the episode was a cry for attention rather than a real health crisis.

We live in a small community; anyone on the team could have known the family these two were speaking about. As I listened to their conversation, all I could think was, “Wow, if anyone on this boat was considering reaching out for help about a mental health issue, this would certainly change their mind.” I understand my teammates probably needed to let off some steam, but this was not the right time or place. Would they have made these sorts of remarks about someone who had just had chemotherapy, or about someone who was the victim of a car accident? Not likely.

There were 20 people on the boat that day. I’ll bet at least half of them knew someone who had a mental illness or had experienced a mental health challenge themselves. It was discouraging to see two health service providers so thoughtless when it came to the power of their words.

Words.

We use words thousands of times a day, often without even thinking about it. We use them to communicate what we want, how we are feeling, where we are going, what we are doing. Sometimes, we have lots to say. At other times, we may find it hard to find the right words to express ourselves in particular situations.

Words do not simply communicate information; they also have the power to help, heal and harm. We have all been taught from a young age to avoid hurting other people’s feelings with our words. But how often do we really examine closely how the words we use affect others?

In my day-to-day life, I have been on the receiving end of words that both harm and heal, especially in the context of living with a mental illness.

I live with complex post-traumatic stress disorder, depression and dissociative identity disorder (DID). Living with a mental illness can be challenging. During the challenging times, I am especially aware of how people’s words can help or harm.

Dissociative identity disorder develops in early childhood as a coping mechanism to deal with overwhelming or traumatic events. In my case, it was a response to severe abuse, neglect and abject poverty. Whenever my DID is triggered by a traumatic event, a second “identity” steps in and deals with whatever is going on. When the event is over, my “normal self” returns and carries on like nothing happened. I often have no conscious memory of the identity shift or I’m not even aware it has occurred until after the event.

When I am in crisis, others do not see me at my best. I have difficulty finding the words to express what I am really feeling; I’m in pain, and I feel lost, alone, scared and absolutely exhausted because I have been trying to hold it together for so long. I used to frequently have thoughts of self-harm and suicide. During those times, I worked hard to stay safe, avoiding harmful coping mechanisms (like alcohol) and focusing on living minute by minute. This kind of self-care is exhausting. Sometimes I needed to call on my family and community supports for help, and in the past, I’ve had to be hospitalized.

While in crisis, I have been told more than once that I was acting a certain way because I wanted attention. On one occasion, I was asked by a psychiatric nurse if I had tried praying. I just looked at her in disbelief. I had been seeking help and support, and her remark made me feel like I had done something wrong. It was as if she was saying that I wasn’t trying hard enough, that I was flawed, that my illness was a direct result of my connection (or lack of connection) with God—if I tried harder or prayed harder, I wouldn’t be ill. I have been told, by practitioners and non-practitioners alike, that dissociative identity disorder does not exist, that it’s a made-up illness—despite the fact that it is in the Diagnostic and Statistical Manual of Mental Disorders and there are researchers who study it and practitioners who encounter it.¹

Needless to say, none of these remarks helped me in any way, especially during difficult times, when I felt particularly vulnerable.

But I have also experienced words that helped me through these challenging periods—statements like “I can’t imagine what you have been through or what you are going through right now, but I’m here for you and you are safe” or “You did the right thing, asking for help.” Other helpful comments include “I am sorry you are experiencing this” and “If there is anything I can do, I’m here for you.” These supportive, non-judgemental remarks open the door for conversation.

In times of crisis, no one can really “fix” things. Perhaps this leads to people feeling frustrated; maybe that’s where their negative words come from. But what I need in those times are words of kindness and compassion and, most of all, acceptance. You don’t need to understand what’s going on, but you need to know that I am suffering and terrified. If someone beside you on the sidewalk suddenly went into cardiac arrest, what would you do? Most likely you would stay with them until the paramedics arrived. You would tell them, “I’m here, you’re not alone; help is on the way.”

In addition to having lived experience of my own, I am also a parent of a child with mental health challenges, and I have heard hurtful words in that capacity as well. Once when my son was having a really hard time with depression, I took him to the emergency room. I overheard one nurse say to another, “Well, look who his mother is—another attention seeker.”

This kind of remark is unacceptable—from anyone, but particularly from a health care provider. I was seeking help and supports for my son, who was spiralling down and finding it hard to carry on. He was no longer the happy-go-lucky, laughing, motivated, sharp-witted young man I knew and loved. We were reaching out for help—just like anyone else experiencing a health crisis—but no one said, “I’m here,” “You’re not alone” or “Help is on the way.” No one opened the door for conversation. Instead, we were left to deal with this on our own.

It also would have been meaningful if someone came up to me and asked how I was doing through all of this. As a parent, I was undergoing my own stress. I was worried beyond belief. I hadn’t slept, and I was emotionally and physically exhausted. It would have been nice if someone had asked, “How are you doing? Have you been eating enough? Have you been drinking enough water?” This sort of genuine concern would not have solved the problem, of course, but such a connection would have buoyed my spirits and given me additional strength as I sought care for my son.

This is how powerful our words can be, even when we are not aware of their effect on others. We all need to pay more attention to how the language we use has an impact on those around us, particularly when it comes to mental health issues and addiction. This includes me: I’m sure my words have also harmed or healed when I haven’t been fully conscious of their power. I remind myself each day to be mindful and to choose my words with care. I also try to remember that sometimes things can’t be “fixed,” and when that is the case, the only way to support someone is with our words. It is in those times that our word choice matters most.

Choose wisely.