Slips of the Lip
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Could Your Words Be Hurting Someone With Mental Health Issues?

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Slips of the Lip
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SLIPS OF THE LIP

We often use colorful expressions and casual references to emotional states and conditions to describe our lives. They are shorthand terms for the ways we experience our feelings and behaviors and those of others around us. Those terms that so easily roll off our tongues have the potential to deeply wound those who actually experience depression, anxiety or other forms of psychological distress. Rarely will people who actually struggle with these issues casually refer to “acting OCD,” “anorexing for the weekend,” or “going crazy for an evening.” Here are some ways to be more sensitive to those who may be experiencing mental health issues or distress.

Carol Povenmire, Ph.D., is a licensed psychologist with a practice in Pasadena, California.

Be Sensitive to Subtle Signs
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BE SENSITIVE TO SUBTLE SIGNS

It is often not obvious when people are in emotional pain. Many spend much of their energies trying to engage socially and at work in ways that minimize attention. They are getting through their days even as they might be experiencing panic attacks, waves of grief, moments of deep despair, problems maintaining their focus and attention, or triggers that activate prior trauma.

They are well aware of the stigma that is unfairly attached to psychological issues and prefer privacy about their emotional life even if that brings a sense of isolation during major portions of their day.

Other people with psychological concerns will reach out for support to a few trusted people. These support people might be close family members, friends, co-workers, neighbors or therapists. Whether it is a deeply private experience or one shared with others, at least 20 percent of the U.S. population has a diagnosable psychological condition in any given year.

Recognize More Serious Concerns
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RECOGNIZE MORE SERIOUS CONCERNS

When their psychological condition overcomes their ability to function, we might see someone’s distress manifest in clear symptoms of panic, rage, suicidality, or alarming behavior. In the U.S., 1 in 25 people has a serious mental illness that significantly disrupts their lives. For some, the symptoms are short-lived but intense, while others have more chronic challenges. The most dramatic and visible expressions of mental illness and addiction are seen in the homeless community, supervised treatment environments, and the prison system.

Step Up
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STEP UP

Chances are you know someone who is struggling right now with some version of psychological challenge. You might have been entrusted by them as a friend or family member, or you might be someone’s supervisor, co-worker, or neighbor who was made aware of their situation out of necessity. Whether you have been directly approached for support or your participation came from some other means, you have an important role to play.

Think Before Speaking
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THINK BEFORE SPEAKING

Being aware of the language that you use in your daily life is a good start. You might be inadvertently hurting those in distress by your unguarded use of words like “wacko,” “downer,” “lost cause,” or “freak.” Even if you are not referring to them at all, they may interpret it as your opinion or belief about them. Take a moment before speaking to ensure that your choice of language communicates what you intend and is free of hurtful implications.

Notice Your Need for Control
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NOTICE YOUR NEED FOR CONTROL

Hurtful comments and reactions often result from an instinctive fear that someone else’s intense feelings will overwhelm us and cause us to lose emotional control. It’s as if vulnerability is contagious, and you can’t afford to have your own awakened. Your own fear of losing control might cause you to say things like:

  • Snap out of it! 
  • Get a grip! 
  • Stop acting like this! 
  • This isn’t like you!

In that moment, someone’s expression of pain, anger, panic, or vulnerability activates our own need to appear fully in charge at all times. The attitude that we have about our own intense emotions, our fear and shame about vulnerability, and our powerful need for self-control all determine our receptivity to someone’s raw emotional state.

Notice Your Attitudes About Pain
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NOTICE YOUR ATTITUDES ABOUT PAIN

Your set of beliefs and attitudes that you have developed about pain might also determine your response to another person’s expression of pain. If you believe the appropriate stance is to be stoic or appear strong in the face of pain and hardship, your response to others is likely to reflect that. You might say things like:

  • Don’t be weak. 
  • Chin up. 
  • Pull it together. 
  • Pick yourself up. 
  • Stop whining. 
  • You’re just feeling sorry for yourself. 
  • Other people have it worse. 
  • These are first world problems.

If you judge yourself harshly for your tears or fears, you are inclined to condemn someone else’s. You might have received this type of response when you were struggling with emotional pain in your formative years, so you learned to dismiss your pain and to minimize the pain of others.

Notice Your Need for Solutions
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NOTICE YOUR NEED FOR SOLUTIONS

We often expect ourselves to have the answers when someone approaches us for support. It might seem as though they are asking for a solution when they request support, and we want to provide it. We also feel helpless when we can’t make things better right away. Unfortunately, our eagerness to help often results in response and advice or ideas that seem superficial or dismissive to the people who are hurting, sad, scared, or struggling with addiction. These types of answers sound like:

  • Just pray.
  • Be grateful. 
  • Read this book. 
  • Try yoga. 
  • Exercise more. 
  • Try harder. 
  • Just don’t drink.

If solutions were really that quick and easy, however, the person in pain would have successfully utilized them. It is likely that their anguish took time to become so problematic, and it will take time and more resources to resolve their concerns.

Notice Your Impulse to Second-Guess
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NOTICE YOUR IMPULSE TO SECOND GUESS

Recently diagnosed cancer patients and new mothers often describe fielding unwanted but well-meaning advice and directives from people they encounter. It’s as if that phenomenon of someone navigating a new situation stimulates our need to be an expert.

This also occurs when people are struggling with psychological concerns. It can take the form of expressing doubt about the value of psychotherapy or medication, skepticism about the particular treatment plan or qualifications of the professional, or even questioning whether any professional attention is necessary. At other times, we might establish our expertise on a situation or condition by identifying perceived similarities in our own experience or referring to assumed similarities with another person we know. These responses sound like:

  • I know just how you feel. 
  • My (brother, son, cousin co-worker, etc.) had exactly the same thing. 
  • Therapy is only for crazy people. 
  • You don’t need those pills. 
  • You don’t seem like you are depressed. 
  • The only thing that will help is cognitive-behavioral therapy (meditation, analysis, etc.).

There are considerable differences in how we manage our unique emotional experiences, what helps us to heal, and what interventions are appropriate. Resisting the strong temptation to offer unsolicited advice shows respect for that individual’s capacity to make sound decisions for themselves, even when they are in pain or turmoil.

Reach for Better Alternatives
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REACH FOR BETTER ALTERNATIVES

Knowing what to do is as important as knowing what to avoid. If you know that someone is managing a psychological condition, following are some suggestions for how to respond, what to say and helpful things to do.

Use Active Listening Skills
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USE ACTIVE LISTENING SKILLS

Active listening means giving that person your full and complete attention. You are hearing their words, noticing their body language and recognizing their feeling state. Active listening is also receiving with genuine interest and concern. Respond in a welcoming manner in your own body language, tone, and words.

Shelve the impulses to judge, change the person’s mind or express an opinion. Remember that they are describing their own situation, needs and experience. These are separate and different than yours.

Offer Support
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OFFER SUPPORT

Ask them what would be helpful. Offer concrete forms of help, such as running errands or taking tasks off of their workload. Also offer to be available to talk in difficult moments, as appropriate, and offer to check in with them on a regular basis to see if there are other ways to help.

Express Concern
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EXPRESS CONCERN

Respond with statements that validate their experience and recognize their strengths. These can sound like:

  • It appears that you are facing a very tough situation. I am so sorry to hear that. 
  • I understand why this has been so hard. This would stress anyone out. 
  • I don’t know much about this situation, but I want to help as I can. 
  • Knowing what I now know, I appreciate how thoughtfully (gracefully, courageously, etc.) you have managed this.
Communicate Respect
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COMMUNICATE RESPECT

Maintain the privacy of the communication. There are some rare situations in which a risk to someone’s safety and well-being will require further action. If that is the case, suggest that you will carefully consider how to support them, and you will need to consult with others who have more experience with this situation. Limit any disclosure to the most essential parties, rather than a broad audience.

Continue to treat the person in the same way as before. This disclosure does not change or alter your fundamental regard for their being.

Look for Growth
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LOOK FOR GROWTH

In the process of helping others, you have an opportunity to develop new skills and to learn a lot about yourself. All of us are likely to be in situations that test our resilience and to encounter feelings that overwhelm our coping strategies. The ability to be compassionate, responsive, and effective as a helper grows out of these moments when we are connected to our own pain, fear, or despair.