People With Mental Illness Need More Than Just Talk

See Author Article Here

Philip Moscovitch writes frequently on mental health and mental illness. He is working on a book about life with psychosis – for those experiencing it and those around them.

It’s nearly Bell Let’s Talk Day. You know, the one day of the year when social media is flooded with messages urging us to talk about mental health and to feel good about doing it.

But as the father of a young adult who has experienced mental illness, campaigns like this make me want to scream.

On its Let’s Talk website, Bell boasts about donating money to “mental health” – the words “mental illness” rarely appear – and uses inane slogans such as “Mental health affects us all.” Money from the campaign goes to causes including “fighting the stigma”, a vague-sounding goal that puts the onus on people facing prejudice to end the discrimination against them.

Canada has no shortage of mental-health advocacy and awareness groups. In my province, the Mental Health Foundation of Nova Scotia holds an annual gala fundraiser, complete with local celebrities and politicians. The organization’s key platitude: “#changingthewaypeoplethink.”

And in late November, the Canadian Mental Health Association published a blog post encouraging readers to “keep your mental health top of mind” by putting together a “workplace wellness box including things that help reduce stress and put an accent on feeling well.” What kinds of things? Oh, you know: colouring books, essential oils, fidget spinners, tea. Leading mental-health expert Stan Kutcher, who has since been appointed to the Senate, tweeted in response: “You got to be kidding. Right?… Please tell us that this is not what our mental-health advocacy has become.”

It’s hard to argue with raising awareness and fighting stigma. But those things don’t do much to help people who are living in precarious housing or trying to find a way to pay for anti-psychotic medication, which can cost thousands a year.

There is little evidence that these kinds of campaigns have any significant effect on changing people’s beliefs or behaviour. A study published in the medical journal The Lancet in 2015 said that when it comes to medium- and- long-term effectiveness of anti-stigma campaigns, there is “some evidence of effectiveness in improving knowledge and attitudes, but not for behavioural outcomes.” In other words, people might change the way they think – but not how they behave.

Even worse, the campaigns could be counter-productive. “The more we emphasize how widespread the stigma of mental illness is,” said psychiatrist Ross Norman at a 2013 conference in Montreal on early psychosis treatment, “the more we may be reinforcing people’s stigmatizing responses.”

My son, who has been open about his recovery from psychosis, knows this flipside of fighting stigma and how appearances are inherently built into how people respond to someone else’s mental illness. “Even as a privileged person, you are marginalized when you have a mental illness,” he said at a 2017 talk at a coffee house in Nova Scotia organized by a group advocating for better funding, community support and more creative solutions in mental-health care. “There were nights when people I thought were my friends wouldn’t let me sleep at their place, I thought I was alienated from my family, it was minus-15, and I was just walking down the streets of Halifax with jeans that were frozen to the bone, unable to go anywhere and sleeping in underground parking lots.”

One mental-health professional – who has a diagnosed mental illness and asked to remain anonymous because of potential career repercussions – told me she used to appear at awareness fundraising galas but doesn’t anymore. “You become kind of a dancing monkey.” she said. “I’m there representing people with mental illness because I can put on a dress, look like a middle-class person, speak at a fancy event and not make people uncomfortable … Meanwhile, people who are not being served well by the system would not even be allowed into the room.”

Indeed, despite years of anti-stigma campaigns, most of the people I have interviewed about psychosis don’t want to use their real names, for fear of the personal and professional consequences. Asking people with mental illness to reduce stigma by telling their stories potentially exposes them to more discrimination.

I’m not suggesting groups devoted to raising awareness don’t also fund worthwhile programs and services. They do. But they don’t emphasize the kinds of fundamental change we need.

It does no good to raise awareness if you have an underfunded mobile crisis team that only has the capacity to go out on calls for 12 hours a day, or if patients wait months for assessment, or if you can’t provide stable, supportive housing for those who need it so they can recover and carry on with happy and productive lives.

Let’s talk about that.

PTSD And Complex PTSD: What Happens When You’ve Lived In A Psychological War Zone

ThoughtCatalog’s Link!

Normally when we think about “PTSD,” our minds jump to those who’ve been in combat. While it is certainly an issue for those who’ve been in real-life war zones, Post-Traumatic Stress Disorder (PTSD) and Complex PTSD isn’t just exclusive to war veterans. In fact, many survivors of childhood emotional neglect, physical or emotional abuse, domestic violence, sexual assault and rape can suffer from the symptoms of PTSD or Complex PTSD if they endured long-standing, ongoing and inescapable trauma.

These individuals face combat and battle in invisible war zones that are nonetheless traumatic and potentially damaging. According to the National Center for PTSD, about 8 million people can develop PTSD every year and women are twice as likely than men to experience these symptoms.

What Are The Symptoms of PTSD and Complex PTSD?
There are four types of symptoms that are part of PTSD and some additional symptoms for Complex PTSD as listed below. Complex PTSD, which develops due to chronic, ongoing trauma, is more likely to occur due to long-term domestic violence or childhood sexual and/or physical or emotional abuse. Around 92% of people who meet the criteria for Complex PTSD also meet the criteria for PTSD (Roth, et. al 1997).

It is recommended that you seek professional support if you’re struggling with any of these symptoms, especially if your symptoms last longer than one month, cause great impairment or distress and/or disrupt your ability to function in everyday life. Only a licensed mental health professional can diagnose you and provide an appropriate treatment plan.

1. Reliving and Re-experiencing the Trauma
PTSD: Memories, reoccurring nightmares, persistent unwanted and upsetting thoughts, physical reactivity, vivid flashbacks of the original event can all be a part of PTSD. You may also encounter triggers in everyday life – whether it be something you see, smell, hear, that brings you back to the original event. This can look different for every survivor. A sexual assault survivor might hear the voice of someone who resembles her assailant and find herself reliving the terror of being violated. A domestic violence victim might find herself being triggered by someone raising their voice. Triggers can be seemingly minor or overwhelmingly major, depending on the severity and longevity of the trauma endured.

Complex PTSD: According to trauma therapist Pete Walker (2013), you may also suffer from emotional flashbacks where you ‘regress’ back into the emotional state of the original event and you behave maladaptively to the situation as a result. Walker states that for people with Complex PTSD, individuals develop four “F” responses when they are triggered by emotional flashbacks: they may fight, flee, fawn (seek to please) or freeze. These responses are protective, but they may end up further harming the survivor because the survivor might fail to enforce their boundaries or may use excessive force in protecting themselves.

2. Avoidance of Situations That Remind You Of The Event
PTSD: You go to great lengths to avoid anything that might potentially trigger memories or feelings associated with the traumatic events. If you were in an abusive relationship, for example, you might isolate yourself from others or stop dating in an attempt to avoid being harmed by others.

If you were raped, you might avoid situations where any form of physical contact might arise, whether it be getting a massage or being affectionate with a romantic partner. If you suffered bullying, you might avoid places where group activities are likely to happen, such as large parties or even certain careers that might require high levels of social interaction. This avoidance can include trying to avoid trauma-related thoughts, too; you might keep yourself persistently busy so you don’t have to face any thoughts regarding what you went through.

Complex PTSD: Throughout your life, you may go to excessive lengths to avoid abandonment and resort to people-pleasing or “fawning” behavior. This might result in you having trouble setting boundaries with others, standing up for yourself when your rights are violated and becoming enmeshed in codependent relationships. You might be hypersensitive to signs of disapproval or micro-signals of abandonment.

As therapist Pete Walker (2013) writes, “The Abandonment Depression is the complex painful childhood experience that is reconstituted in an emotional flashback. It is a return to the sense of overwhelm, hopelessness and helplessness that afflicts the abused and/or emotionally abandoned child. At the core of the abandonment depression is the abandonment melange – the terrible emotional mix of fear and shame that coalesces around the deathlike feelings of depression that afflict an abandoned child.”

3. Skewed Belief Systems and Negative Perceptions, Including Self-Blame and Toxic Shame
PTSD: There is a shift in your belief systems and self-perception after the traumatic events. You might suffer from low self-esteem, depression, excessive ruminations, negative self-talk, memory loss related to the trauma, decreased interest in activities you used to enjoy and a heightened sense of self-blame.

Complex PTSD: Individuals with Complex PTSD may struggle with guilt, a sense of toxic shame and feeling different from others or even defective in some way. They may have a heighted “inner critic” that develops as a result of any verbal, emotional, physical or sexual abuse they went through in their lifetime. This inner critic might judge everything you do or say, prevent you from taking risks or pursuing your goals, can lead to a sense of learned helplessness and can often mimic the voices of any abusers you encountered, especially if you had toxic parents.

4. Hyperarousal and Hypervigilance
PTSD: You develop an excessive sense of alarm concerning your surroundings. You may experience a heightened startle reaction, increased irritability or aggression, engage in risky behavior, and have difficulty concentrating or sleeping.

Complex PTSD: Survivors with Complex PTSD can struggle with emotional regulation, suicidal thoughts and self-isolation. They may engage in self-harm, develop substance abuse addictions, and have a hard time trusting themselves and their intuition. They may end up in unhealthy, abusive relationships in what trauma expert Judith Herman calls “a repeated search for a rescuer” (Herman, 1997). They may have a deep mistrust of others but also a heightened attunement to changes in their environment as well as a hyperfocus on changes in microexpressions, shifts in tone of voice or gestures in others.

Treatment for PTSD and Complex PTSD
Treatment for PTSD and Complex PTSD requires highly skilled therapy with a trauma-informed and validating counselor who can help guide you safely through your triggers. Based on research, effective treatments can include some form of trauma-focused psychotherapy such as prolonged exposure therapy (PE) which involves facing the negative feelings you’ve been avoiding, cognitive processing therapy (CPT) which teaches the client to reframe their thoughts about the trauma, or Eye-Movement Desensitization and Reprocessing (EMDR) therapy which involves processing the trauma by following a back-and-forth movement of light or sound. You can learn more about treatments for PTSD here.

Keep in mind that not every treatment is suitable for every survivor and should always be discussed with a counselor. Supplemental remedies may include trauma-focused yoga and meditation to heal parts of the brain affected by trauma and release trapped emotions in the body (van der Kolk, 2015).

Although PTSD is manageable with the right support and resources, recovery from Complex PTSD is admittedly a more lifelong process as it deals with trauma that usually originated from childhood, further exacerbated by traumas in adulthood. Grieving the losses associated with the trauma or traumas experienced is an essential part of the journey.

It is important to remember that healing has no deadline and that recovery is a cyclical, rather than linear, process. Every survivor recovers in their own way and is worthy of the support it takes to get to the other side of healing. TC mark

Read This If You Find Yourself Confronting Narcissistic Abuse

*Warning: If you’re experiencing physical abuse, expect it to continue or escalate. Get help immediately.

Narcissist Assh*oles
^Reblogged from here

We’re all capable of abuse when we’re frustrated or hurt. We may be guilty of criticizing, judging, withholding, and controlling, but some abusers, including narcissists, take abuse to a different level. Narcissistic Abuse can be physical, mental, emotional, sexual, financial, and/or spiritual. Some types of emotional abuse are not easy to spot, including manipulation. It can include emotional blackmail, using threats and intimidation to exercise control. Narcissists are masters of verbal abuse and manipulation. They can go so far as to make you doubt your own perceptions.

The Motivation for Narcissistic Abuse

Remember that narcissistic personality disorder (NPD) and abuse exist on a continuum, ranging from silence to violence. Rarely will a narcissist take responsibility for his or her behavior. Generally, they deny their actions and augment the abuse by blaming the victim. Particularly, malignant narcissists aren’t bothered by guilt. They can be sadistic and take pleasure in inflicting pain. They can be so competitive and unprincipled that they engage in anti-social behavior.

The objective of abuse is power. Narcissists may intentionally diminish or hurt other people. It’s important to remember that narcissistic abuse stems from insecurity and is designed to dominate you. Abusers’ goals are to increase their control and authority while creating doubt, shame, and dependency on their victims. They want to feel superior to avoid hidden feelings of inferiority. Understanding this can empower you. Like all bullies, despite their defenses of rage, arrogance, and self-inflation, they suffer from shame. Appearing weak and humiliated is their biggest fear. Knowing this, it’s essential not to take personally the words and actions of an abuser. This enables you to confront narcissistic abuse.

Mistakes in Dealing with Abuse

When you forget an abuser’s motives, you may naturally react in some of these ineffective ways:

Appeasement. If you placate to avoid conflict and anger, it empowers the abuser, who sees it as weakness and an opportunity to exert more control.

Pleading. This also shows weakness, which narcissists despise in themselves and others. They may react dismissively with contempt or disgust.

Withdrawal. This is a good temporary tactic to collect your thoughts and emotions but is not an effective strategy to deal with abuse.

Arguing and Fighting. Arguing over the facts wastes your energy. Most abusers aren’t interested in the facts, but only in justifying their position and being right. Verbal arguments can quickly escalate to fights that drain and damage you. Nothing is gained. You lose and can end up feeling more victimized, hurt, and hopeless.

Explaining and Defending. Anything beyond a simple denial of a false accusation leaves you open to more abuse. When you address the content of what is being said and explain and defend your position, you endorse an abuser’s right to judge, approve, or abuse you. Your reaction sends this message: “You have power over my self-esteem. You have the right to approve or disapprove of me. You’re entitled to be my judge.”

Seeking Understanding. This can drive your behavior if you desperately want to be understood. It’s based on the false hope that a narcissist is interested in understanding you, while a narcissist is only interested in winning a conflict and having the superior position. Depending upon the degree of narcissism, sharing your feelings may also expose you to more hurt or manipulation. It’s better to share your feelings with someone safe who cares about them.

Criticizing and Complaining. Although they may act tough, because abusers are basically insecure, inside they’re fragile. They can dish it, but can’t take it. Complaining or criticizing an abuser can provoke rage and vindictiveness.

Threats. Making threats can lead to retaliation or backfire if you don’t carry them out. Never make a threat you’re not ready to enforce. Boundaries with direct consequences are more effective.

Denial. Don’t fall into the trap of denial by excusing, minimizing, or rationalizing abuse. And don’t fantasize that it will go away or improve at some future time. The longer it goes on, the more it grows, and the weaker you can become.

Self–Blame. Don’t blame yourself for an abuser’s actions and try harder to be perfect. This is a delusion. You can’t cause anyone to abuse you. You’re only responsible for your own behavior. You will never be perfect enough for an abuser to stop their behavior, which stems from their insecurities, not you.

Confronting Abuse Effectively

Allowing abuse damages your self-esteem. Thus, it’s important to confront it. That doesn’t mean to fight and argue. It means standing your ground and speaking up for yourself clearly and calmly and having boundaries to protect your mind, emotions, and body. Before you set boundaries, you must:

Know Your Rights. You must feel entitled to be treated with respect and that you have specific rights, such as the right to your feelings, the right not to have sex if you decline, a right to privacy, a right not to be yelled at, touched, or disrespected. If you’ve been abused for a long time (or as a child), your self-esteem likely has been diminished. You may no longer trust yourself or have confidence. Seek therapy, get support.

Be Assertive. This takes learning and practice to avoid being passive or aggressive. Try these short-term responses to dealing with verbal putdowns:

“I’ll think about it.”

“I’ll never be the good enough wife (husband) that you hoped for.”

“I don’t like it when you criticize me. Please stop.” (Then walk away)

“That’s your opinion. I disagree, (or) I don’t see it that way.”

“You’re saying . . .” (Repeat what was said. Add, “Oh, I see.”)

“I won’t to talk to you when you (describe abuse, e.g. “belittle me”). Then leave.

Agree to part that’s true. “Yes, I burned the dinner.” Ignore “You’re a rotten cook.”

Humor – “You’re very cute when you get annoyed.”

Be Strategic. Know what you want specifically, what the narcissist wants, what your limits are, and where you have power in the relationship. You’re dealing with someone highly defensive with a personality disorder. There are specific strategies to having an impact.

Set Boundaries. Boundaries are rules that govern the way you want to be treated. People will treat you the way you allow them to. You must know what your boundaries are before you can communicate them. This means getting in touch with your feelings, listening to your body, knowing your rights, and learning assertiveness. They must be explicit. Don’t hint or expect people to read your mind.

Have Consequences. After setting boundaries, if they’re ignored, it’s important to communicate and invoke consequences. These are not threats, but actions you take to protect yourself or meet your needs.

Be Educative. Research shows that narcissists have neurological deficits that affect their interpersonal reactions. You’re best approach is to educate a narcissist like a child. Explain the impact of their behavior and provide incentives and encouragement for different behavior. This may involve communicating consequences. It requires planning what you’re going to say without being emotional.

Get Support

To respond effectively requires support. Without it, you may languish in self-doubt and succumb to abusive disinformation and denigration. It’s challenging to change your reactions, let alone those of anyone else. Expect pushback when you stand up for yourself. This is another reason why support is essential. You will need courage and consistency. Whether or not the narcissist makes changes, you’ll get tools to protect yourself and raise your self-worth that will improve how you feel whether you stay or leave. CoDA meetings and psychotherapy provide guidance and support.

Living With High-Functioning Depression

50767701_2122982204476700_669509058402713600_n
We Aren’t As Okay As We Say Or Seem
8 Things People with High-Functioning Depression Want You to Know



The Dilemma of High-Functioning Depression

“High-functioning depression, or dysthymia. may be harder to detect than major depressive disorder (MDD) because the people living with it are often high achievers who make you think everything is all right all the time.”
The Dilemma

“This Is What It’s Like To Live With High-Functioning Depression”:
–Vice Article


More to come on High-functioning anxiety!

Good News Network: The Psychology of Healing Addiction, Abuse, and Trauma

The Psychology of Healing Addiction, Abuse, and Trauma

A bunch of resources worth checking out!

#happynews