Thoughts / hope street cards

Days for Happiness

This post is a bit late. Sunday 20th May 2016 was the International Day of Happiness. And to be honest it sort of just passed me by. Since 2013, the United Nations has celebrated the International Day of Happiness as a way to recognise the importance of happiness in the lives of people around the world. The UN just launched 17 Sustainable Development Goals that seek to end poverty, reduce inequality, and protect our planet – three key aspects that lead to well-being and happiness.

I have some mixed feelings and thoughts about ‘happiness’. Mostly because so often we see - and I have fallen into this trip over and over again - that striving for happiness often leads to people feeling the opposite. Reasonably miserable. Have you ever fallen into the cognitive-happiness-expectation trap, where you think - ‘When this happens? When I have this? When this is resolved? Then I will be happy?’ Only to arrive there and things not to be all that much different to how they are now.

But mostly, I worry when we humans place too much emphasis on just one of the emotions available to us over all the others.

All of our emotions – and when I talk about emotions in this post, I’m referring only to those that are in the spectrum of ‘normal’ experience and functioning. I’m not discussing the emotions that can cause significant impairment, distress and mental illness – can be seen as reactions to what happen to us day by day: the people we meet, the experiences we have, the challenges we face. Sometimes these emotions act as alarm bells warning us we’re in danger of being harmed. Sometimes they reward us with feelings of joy and euphoria. Often they send us darker signals as well, like sadness, disappointment or anger, alerting us that something isn’t quite right or a something needs to be learnt.

When we look closely at happiness, it is all lovely and good, but it doesn’t actually teach us much about what it means to be fully human and fully engaged with the life we lead and the world we live in. For most people, it’s not all that difficult to handle the emotions of satisfaction, pleasure, euphoria, contentment or triumph. But dealing with sadness, suffering, disappointment and failures is much harder. But if we give ourselves time to experience them, reflect on them, learn from them and reflect on them, we learn things. And we become stronger. If we ignore them and focus on instead only on the experience of happiness, the opportunity for resilience and growth can be lost.

My concern is that if we become obsessed with only experiencing happiness, we might become scared of sadness. And that makes us much less resilient as individuals, as families and communities. The important truth about being human is that all of our emotions are really, really important. They are instructive. They are trying to teach us things about ourselves and the world. Sadness is not only as authentic an emotion as happiness, but it’s also far more instructive. The fleeting moments of bliss and joy, make sense only because they represent such a contrast with the experience of pain, trauma, disappointment or sadness, or even with those times when we might feel ourselves trapped in a tedious or dull routine. It’s vital that we become aware and acknowledge these feelings for what they are. And it’s quite okay to feel them. They’re trying to tell us something.

If people are encouraged to pursue happiness single-mindedly as their primary goal, either they are going to risk surrendering to the delusion that it’s possible, or they’re going to be frequently disappointed and frustrated. Neither is healthy.

As a person who has experienced some pretty significant episodes of major depression, I’ve noticed that a number of people in the general community there’s a perception that the opposite of depression is going to be happiness. This is just not right. For someone recovering from depression, sure moments of happiness will be great. But more importantly, coping with the really difficult emotions is going to be way more important. This is where the strength and resilience is going to come from.

So when I went to do some research into International Day of Happiness, these were the thoughts/cynicisms coming with me. Are there things we can do to increase our experiences of happiness? Hell yes! But I’ve always been a bit cautious about promoting them as a single mode of action for improving general health and wellbeing. Because I really do believe all the emotions are important.

But when I downloaded my ‘Action for Happiness’ guidebook I was way impressed. These weren’t quick fixes for instant gratification. These were evidence-based practices that when consistently applied to ones life can improve not just feelings of happiness, but other things as well. The beauty of these ‘happiness’ activities is that if you’re open to these ideas who knows what aspect of the human experience you’ll uncover.  

The ten actions (in a very brief and neat numerical list) are:

  1. Giving – do things for others
  2. Relating – connect with people
  3. Exercising – take care of your body
  4. Awareness – live life mindfully
  5. Trying out – keep learning new things
  6. Direction – have goals to look forward to
  7. Resilience – find ways to bounce back
  8. Emotions – look for what’s good
  9. Acceptance – be comfortable with who you are
  10. Meaning – be part of something bigger

You can find further information on these ideas, the evidence behind them and easy tips for implementing them into your life at www.actionforhappiness.org. Who knows what you might uncover.

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Let's Love a bit more Lismore

Please note - Some may find the content in this article distressting or triggering. For support or information call: Lifeline 13 11 14, Suicide Call Back Service 1300 659 467, Kids Helpline 1800 55 1800, MensLine 1300 78 99 78.

Something undoubtedly tragic and devastating happened in our home town this past week. And despite the tragedy that unfolded, I was really saddened by some of the ways in which some parts of the community – a community that I am a part of – responded to this.

From what I have gathered from news reports, events unfolded as such - Gun shots were heard by neighbours. Police were called. Neighbouring houses and the school were evacuated. It was identified that a person with a gun was inside a house and had intent to harm himself. Emergency service personnel were called in to help. The road remained closed and the neighbouring houses and school were kept empty. Unfortunately the incident ended with the man passing away.

Devastating and tragic. I send my heart out to the family, friends and loved ones of this man. I send my sincerest thoughts and condolences to all the police and emergency services who I am sure did all they could at the time in this situation.
And there were two things that really upset me in how we – as the community - responded to all of this.

Firstly, following a week of Hope Street Cards waxing lyrical about the improvements of suicide reporting in the media and utilsing diverse images to portray mental illness, the reporting on this incident was pretty horrendous. Despite being informed that this was a “self harm” incident, the local rag continued to refer to this as a “siege”. Which I believe means –

the act or process of surrounding and attacking a fortified place in such a way as to isolate it from help and supplies, for the purpose of lessening the resistance of the defenders and thereby making capture possible.

I am fully aware that guns are really dangerous. But there was a lot of police and emergency personnel on the scene. And they weren’t “attacking”. They were “negotiating”. Rightly so too.

My main problem with the use of this word to describe what was going on, is that this only perpetuates the myth that people with a mental illness are violent. Siege is a very strong and very violent word. And for a long time, societal beliefs have held that mental illness and violence go together. But they really don’t. Having a mental illness does not mean someone will be violent. People receiving effective treatment for a mental illness are no more violent or dangerous than anyone else. It is much more likely that someone with a mental illness will hurt themselves, or be hurt by someone else. The media plays a big part in the way we think about mental illness. However, news and entertainment media often make the link between mental illness and violence seem much stronger than it is. There is a weak link between mental illness and violence, but many wrongly believe all people with mental illness are violent. And the reporting of this event, purely through their choice of one word, will only keep this myth going.

Secondly and most significantly, I was so very devastated to read and hear the thoughts, opinions and beliefs that some of my community members had about this event. I’m not going to repeat such comments.

I realise that for people who have never contemplated suicide, a drive against something as basic as the human survival instinct is incomprehensible. But, try and sit with this for a moment. The only thing our brain and body wants us to keep doing is surviving. All of our functions are trying to do this all the time. For someone to feel the only option is to override our one main need, the pain must be impenetrable.

And what sort of things did a lot of people on social media and in the street have to give this man who was most certainly experiencing inexplicable pain? I can tell you it wasn’t compassion, support and love. This man was a son, brother, father, partner, friend, colleague, community member. And now he, and all that he had to offer us and others is gone.

Lismore – your community is really struggling at present. The suicide rate on the North Coast is 24.9 per 100 000, with Lismore being considered a ‘hotspot’ by the Black Dog Institute. This is well above the state average, which is also way too high (8.9 per 100 000).

There are people whose need to die will overcome any treatment and prevention input. But the majority of people who attempt suicide don’t go on to die by suicide. Things can stop them. And these things can be talking to friends and family, getting professional help and feeling supported by others around them to see that their lives are still willing.
The thing is, suicide can be prevented much easier if widespread community efforts occur early. Well before it gets to the point where someone feels so alone and in such pain that ending one’s life becomes the only option. Currently suicide takes twice as many lives as traffic accidents, but road safety gets twice as much funding as suicide prevention. Lifeline is calling on the Federal Government to double funding to programs and you can sign it here.

But there’s so much each of us can do at home. Every day. Perhaps it might be time to stop buying into the myths surrounding suicide Lismore? Maybe it's time to stop pretending there is nothing we can do and nothing we should do for the people around us crying out for help? At the very least, it must be time as a community to really try and treat our sons and daughters, brothers and sisters, friends and family, neighbours and community members with a bit more compassion, support and love. Because we really never know what internal battles they might be fighting.

CRISIS SUPPORT 24/7
Lifeline: 13 11 14 www.lifeline.org.au
Suicide Call Back Service: 1300 659 467 www.suicidecallbackservice.org.au
beyondblue: 1300 22 4636 www.beyondblue.org.au
MensLine Australia: 1300 78 99 78 www.mensline.org.au
Youth Support Services
Kids Helpline: 1800 55 1800 (24/7 crisis support) www.kidshelp.com.au
headspace: 1800 650 890 www.headspace.org.au

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A Designer (Trudy) reports on 'Picture This' (an exhibition)

Working in a marketing agency, the amount of hours I’ve racked up seemingly trawling through online stock photo libraries is a number I don't even want to admit to. An often incredibly mundane task, that no one volunteers for, and “just looking for a couple of stock photos for a client” is never an efficient job. You're usually faced with volumes of unusable, staged images, that are never quite what you're looking for.

Not long ago I got to work on some branding work for a client who worked in a specific mental illness research field, and had to undertake one of these stock image searches. Not surprisingly seeking images representative of mental illness proved to be a huge challenge and often had me disapprovingly shaking my head at inappropriate tags on images and at the search keywords I was having to use. And I found that regardless, there were not a huge number of images that came back that were representative of either the client's or the wider Australian audience's genuine interests and understanding of mental illness.

 

It’s quite refreshing, therefore, to have been able to check out the small but mighty Melbourne display of ‘Picture This’, a research project conducted by SANE Australia and Getty Images. In 2015 the project sought to survey more than 5,000 Aussies to get an understanding of what they thought was a fair and accurate representation of mental illness. The results showed that we wanted to see ‘images of real people which convey a sense of both struggle and hope.’

Based on these responses SANE Australia and Getty developed a short list of recommendations for photographers and publishers, to guide a more accurate depiction of mental illness. Listed below, the five guidelines give realistic and appropriate best practice around the way we depict, tag and search for images - consideration that would truly help the communications industry to illustrate information better and support the right conversation going forward.

Recommendation 1: Human experience

Emphasise the human experience of mental illness rather than featuring abstract depictions.

Recommendation 2: Hidden adversity

Provide images depicting people from diverse backgrounds doing 'everyday' things while also illustrating a hidden experience of adversity.

Recommendation 3: Diversity of experience

Use a diverse range of images that represent isolation or pain. For example, images such as people in the dark holding their heads in their hands or standing alone in a crowded place. 

 Recommendation 4: Search words

Tag images with diagnostic terms (such as 'postnatal depression', 'bipolar') or emotions (such as 'sadness' and 'loneliness') to make them easier to locate via online searches.

Recommendation 5: Non-violent

Do not tag or associate image depicting violence (blood, knives etc) with mental illness.

To check out the recommendations via the Picture This exhibition, head to The Atrium, Federation Square Melbourne - showing up until Friday 18 March.

 Alternatively head to SANE Australia for all the project details.

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The #complimentbombing Experiment

Well that little experiment was a bit fun! For those of you who may not follow Hope Street Cards on the social media, this weekend just gone by we got together a super wonderful crew of volunteers all across the east coast of Australia to deliver compliments. From Brisbane to Melbourne, from Byron Bay to Canberra, little cards of complimentary love were left waiting to be found in the most extraordinary of places. (For images of the experiment check out our Facebook album ‘#complimentbombing’ or search #complimentbombing on Instagram).

“I can live for two months on a good compliment” – Mark Twain.

Compliments are one of the most special components of social life. They’re like little gifts of love. They’re not asked for or demanded and they tell a person that they are worthy of notice. Such powerful, powerful gifts.

After a weekend of giving little compliment cards to loved ones, strangers and just leaving them around for people to find (fingers crossed) here’s some of the things I learnt about complimenting this weekend:

  1. Giving compliments can give our mood a burst, by giving someone else’s a lift. The aim of these compliments was to spread some cheer outwards and whilst I’m sure it had some positive effects on the people receiving the compliments as the giver of the compliments I got some pretty sweet benefits. I felt awesome.
  2. Compliments can have an incredible power on someone. My favourite thing to do was actually watch the person’s face as they read the compliment on the card (sometimes this was from my stealth hiding position. I maintain this was not ‘stalking’, but ‘experimenting’). It was beautiful. On one occasion I saw a lady who returned to her car with a shopping trolley full of groceries and a toddler who was screaming. After unloading the groceries and the toddler into the car, she saw the compliment card and appeared somewhat upset that someone had left something on her windscreen. But when she read the card her face changed from what appeared to be agony, to a face of peace and calm and then even a smile came out. The effect of the words on that little card was quite breathtaking. I nearly cried with happy feels.
  3. By giving compliments you become better at noticing and then accepting compliments. For most my life I have not been very comfortable with receiving appreciation. In other words, I am quite good at discounting compliments. If someone compliments my outfit, I’ll be sure to alert them to the fact I’ve owned it for ages, I bought it second hand and that I had to mend it and I did a dodgy job. Such a response instantly sucks the positivity out of the air and can really deflate the person giving the compliment. At worst, it has the power to totally invalidate the person’s judgment. At the very least, things become a bit awkward. But this experiment really opened my eyes to how many compliments are floating around in the world. And how easy it is to respond appropriately – graciously. With a smile.
  4. It can feel really awkward to compliment a stranger. Initially, anyway. But with a little bit of courage and practice it gets way easier and is heaps of fun. Complimenting a stranger is a wonderful way to open up a conversation and a connection that probably wouldn’t occur otherwise. Because compliments make other people feel good, they’re probably more likely to associate that good feeling with you. Thus making awkward conversation with strangers’ way more comfortable. 
  5. When you pay someone a compliment you are looking outside of yourself. This seems pretty obvious and straightforward, but sometimes it can be easy to get caught up in all the goings on of my own busy/hectic/chaotic life. Focusing on and noticing the good qualities in the world around me was like a kind of cognitive training, a training in attention. And by taking notice of praiseworthy situations and efforts I was really able to cultivate an awareness of all the good developments that were happening. And once I became aware, there were heaps. And gee whiz they made me feel nice. Furthermore, when you acknowledge something special in someone, you are looking outside of yourself. People then recognise that you can recognise goodness and in some magical way, they begin to show you more of it (or you become better at noticing it!).

So there you have it, my five big learnings following a weekend of compliment bombing. Massive, massive gratitude to our wonderful team of volunteers who helped shared the love. You all took to the task with brilliant enthusiasm and energy and we adore you all for it!

And the compliments aren’t quite over yet! Tuesday 1st March 2016 is World Compliment Day and we’re going to do our best to make sure everyone gets complimented properly.

We have 10 packs or our ‘Positive Pocket Reinforcers’ or ‘Compliment Card’ packs to give away. To win one all you need to do is head to our Instagram (@hopestreetcards) or Facebook page (Hope Street Cards) and tag someone you know on the link provided with a compliment. The competition will be open all day – Tuesday 1st March. The authors of the ten most wonderful compliments will each receive a pack of cards to continue their complimenting adventures.

Happy World Compliment Day!

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Hope Street Cards Book Club - February

Hooray! It’s the second “meeting” (aka the post where Sam rants about a book she has read recently) of the Hope Street Cards Book Club. Did anyone out there decide to join in? Is anyone out there actually there?

So, the book for February was Rosie Waterland’s The Anti-Cool Girl. For those who live under rocks – or who are of the male gender – Rosie Waterland writes for the Mamamia Women’s Network and her recaps of The Bachelor are followed and adored by thousands of people (these recaps are the reason I am hooked on Bachie and his peen).

The Anti-Cool Girl is Rosie’s memoir. She was 28 years old at the time of writing it. But when your 28 years of living on the planet involve the complexities and chaos that come with: parents who have substance dependencies; the experiences of childhood sexual abuse in foster homes and parental death at a young age; responding to regular parental suicidal ideation and attempts; and, then coping with your own mental health issues, eating disorders and complex adult relationships – then 28 is definitely not too young to write a memoir.

 

I am thrilled that this book has been written. Whilst this story and these experiences are unique and not in any way common, in some respects this is a reasonably ‘typical’ story of a proportion of people in our society. The difference is that for a lot of these people they don’t have the language, the means, or the hope to get their story heard. But it should be heard.

This story and these experiences are ‘typical’ of the majority of clients I have seen in a range of different mental health treatment facilities – disrupted families of origin, foster families, childhood sexual abuse, poor school attendance, community housing, parental violence, parental mental illness and comorbid substance dependence – a myriad of disturbing and painful emotional experiences that result in complex trauma. Reading parts of this book took me back to my own schooling days. I remember being in primary school and having full awareness of when the DOCS workers were at the school and when the principal would come with them to the classroom to take out the poor student, who always seemed to have trouble sitting still and obeying instructions. I remember feeling so very sad when these things happened and despite being fully aware that I found said student annoying, just wanting to put my hand up and say “I’ll take him home. My parents won’t mind”. Or in Kindergarten, when I used to be responsible for taking one of my friends, who was not one of the most well behaved students, to the principal’s office following some misdemeanour he had engaged in and every time we decided it would be best if he just left school for the rest of the day before heading home rather than go to the office. It was agreed between us two 5 year olds that it would be better for him to run away for the afternoon than to suffer the consequences of ‘troublesome behaviour’ both at school and at home. Eventually the responsibility of escorting ‘naughty’ kids to the office was taken off my shoulders.

My point is that these experiences are real for a lot of young children. And the consequences can be debilitating. More often than not, when someone experiences complex trauma in childhood the prognosis for later life is really not very good. Like, really not very good. It can often follow the trajectory of their own parents (and probably their parents before that etc. etc.).

The Adverse Childhood Experiences Study (ACE Study) is one of the most notable pieces of research into the effects of complex trauma in childhood and the correlated health and social issues as an adult. 17 000 participants were recruited from this study between 1995 and 1997 and were asked to complete an initial survey regarding childhood abuse, neglect and maltreatment and family of origin functioning. The ten types of childhood trauma or adverse childhood experiences (ACEs) identified were:

- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Mother treated violently
- Household substance abuse
- Household mental illness
- Parental separation or divorce
- Incarcerated household member.

ACEs are relatively common, with two thirds of the study reporting at least one ACE. The ACE Score is used to assess the total amount of stress during childhood and the study (which is still finding results) has repeatedly demonstrated that as the number of ACEs increases, the risk for the following health problems increases in a strong and graded fashion. These problems include: alcohol abuse and dependence; chronic obstructive pulmonary disease; depression; foetal death; health-related quality of life; illicit drug use; ischemic heart disease; liver disease; risk for intimate partner violence; mental health issues; multiple sexual partners; STIs; smoking; suicide attempts; unintended pregnancies; early initiation of smoking; early initiation of sexual activity; adolescent pregnancy.

So, back to the book. From her accounts, Rosie would have an incredibly high ACE score. And in adulthood she did go on to experience some of the issues mentioned above. But at 28 years of age, she’s made it through them and I get the feeling she’s in a really good place now, given the range of the experiences she has endured. So, how did she do it? Despite all the adverse childhood experiences how did she go on to develop a cult following based on her love for Osher’s hair? (Bachie ref. Sorry.)

There’s three things that especially stood out for me. The first is that it felt that throughout her entire childhood Rosie had a really strong sense of where she wanted to be and what she wanted to do.

“Since I had always assumed I would win an Oscar by the time I was ten (obviously for playing the lead role in one of my many works-in-progress, or Atreyu’s girlfriend in the sequel to The Never Ending Story, the kind of star treatment offered by this totally legitimate modelling operation seemed right up my alley.”

In a round about way, Rosie had hope and dreams. And this hope made her inner world really strong, so whilst the world around her was continually changing and offering up trauma after trauma, and instability after instability, she had her hope. And this, I think was a pretty massive protective factor in her life.

Secondly, I have a hunch that Rosie has not taken these deeply traumatic memories and just made them darkly comedic. Whilst, no doubt these experiences would have been incredibly traumatic – and I would expect that the process of reimagining them all to write this book would have been a totally crap task and possibly a chance to experience a traumatic response all over again – I get the impression that Rosie has somehow been able to see the humour in them. I think that this again would have been a big protective factor. Because humour makes us stand back a little and be a bit more objective and look at a really extraordinary situation and go WTF, this is absurd. And that absurdity, despite it being horrendous, can also be a bit funny. Can it not?

Thirdly, and I feel that Rosie makes a big point of this, there’s Mamamia. Waterland attributes a lot of her personal success and triumph to Mamamia and Mia Freedman in particular. I don’t think it’s the organisation so much, or its founder. I think that it was finding something that really brought meaning to her life. Something that helped her get out of bed of a morning. Being with an entire group of people who not only accepted her, but supported her which quite possibly led to enhancing her levels of self esteem and self confidence. When so many previous connections with people had been based on misused power and control, lack of trust and unstable attachments, the connections formed at Mamma Mia quite possibly would have been life changing.

And that’s something I think we can all learn from. Sometimes in the world of psychological treatment and in society at large, when we are faced with individuals and families where dysfunction and illness and complex trauma seem insurmountable it can feel like there are just too many barriers in the way to achieving any sort of positive outcomes. But providing someone with a positive connection is possible. It’s something they might not have experienced much before. And it’s something that can have a very big impact.

And in case anyone is still reading this rant, here’s my final summation.

The good things about this book:

  • Everything mentioned above.
  • The brutal honesty. Two incidents really stuck out for me: the memory where Rosie’s Grandad falls over and she wakes her Dad to help, with drastic consequences; and the memory where Rosie’s mum attempts suicide whilst Rosie watches from a window. Both of these scenes were harrowing to read. But both of these scenes really highlighted the honest complexities of supporting and living with someone with a severe mental illness.
  • The use of humour. Without it, I think this book would be much less accessible and not just Rosie’s voice and story, but so many other voices and stories wouldn’t be able to be heard.
  • The description “toxic butterflies” in relation to anxiety. She nailed it. I want to put it on a card.
  • Hello excellent role model for other ‘Houso’ young girls!
  • That the book ends with a sense of hope.

The less good things about this book:

  • Only one less good thing. Overall, the way language was used around mental illness was quite good. But when it came to substance use it was not so good. I really shudder when the term “addict” is bandied about. People with dependencies on substances face even more stigma than those with mental illnesses. When we call someone an “addict” we’re doing that thing where we label a person by his/her illness. By making no distinction between the person and disorder, we deny the individual dignity and humanity. We also imply a permanency to the condition, leaving no room for a change in status. Saying ‘drug-addict parent’ is the very same as saying ‘depressed parent’ or ‘cancerous parent’. I see the term ‘addict’ on par with ‘junkie’ (and what an awful way to refer to a fellow human by comparing them to rubbish!). ‘Addicts’ are purely people experiencing substance use disorders. They have an illness and they are humans. And most of these people go untreated for their illness. It wouldn’t surprise me if there was some sense of shame stopping them from accessing some help.

So, that’s my very long review. Loved the book. I will strive to be some sort of anti-cool girl.

Here’s your chance book clubbers – let me know what you thought of it. Submit your own review by commenting on the blog or leave your thoughts on our Facebook page (Hope Street Cards) or tag your photos and feedback on Instagram (@hopestreetcards) or with the hashtag #hscbc.

Next month we’re getting graphic. We’re going to check out ‘Living with a Black Dog’ by Matthew and Ainsley Johnstone. This gem of a picture book discusses how to best take care of someone with depression while looking after yourself. You can find it at good book stores. Happy mental health reading!

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Don't call me 'mental' .... please.

I highly doubt this will be the only time I write on this subject, given the number of times I have banged on (and on and on) about it, time and time again. Language matters. Big time.

Language shapes how we see the world. This is true for everyone. And for everything. Our perceptions and expectations are shaped by the words we hear and use. They are part of the underpinning framework of our lives. The words we choose and the meaning we attach to them influence so much. Our feelings. Our attitudes. Our beliefs. Words can makes us feel happy, beautiful, ecstatic. Words can also make us feel miserable, angry, guilty.

“If thought corrupts language, language can also corrupt thought”  George Orwell.

But the great thing is that we have a choice over our words. We have full control over the language we use to describe ourselves, others and the world around us.

Historically, the world around us appears to have found mental health conditions and experiences difficult to confront, treat and talk about. It wasn’t that long ago that people who experienced mental illness were abused, removed entirely from society, subjected to un-anesthetised electric shock treatments and had parts of their brains removed through lobotomy procedures. And with these treatments and the complex issues regarding explanations of mental conditions came a range of language to describe such people: ‘lunatic’, ‘psycho’, ‘neurotic’, ‘maniac’ etc. Luckily with the progresses of psychology and psychiatry in both better understanding and treating mental illness, the language has changed over time, with the words used expressing the prevailing views of society.

“Language is the road map of a culture. It tells you where its people come from and where they are going”.  Rita Mae Brown.

But I think we’ve still got a way to go. Unfortunately the use of particular labels to describe people and their behaviours is still hanging around. The problem is that the use of a label often implies a separation of ‘us’ from ‘them’. And this separation can quite easily lead to the belief that ‘they’ are fundamentally different from ‘us’ and that ‘they’ even are the thing they are labelled. ‘They’ can become so different from those who do not share a negative label, so that ‘they’ can appear to be a completely different sort of people. Our use of language is revealing regarding the use of labels to distinguish ‘us’ from ‘them’.

Like I mentioned, I think this is improving, however for a long time it has been commonplace to label someone a “schizophrenic” instead of saying he or she is a person with schizophrenia. For physical illnesses things are handled differently and people will usually say, a person has cancer. The person with cancer remains one of ‘us’ and has an attribute, while the ‘schizophrenic’ becomes one of ‘them’ and is completely defined by the label we affix to the person. In this way, language can be a powerful source and sign of stigmatisation.

It intrigues me how people use labels to describe their experiences of mental illness. When I was working as a psychologist, it was something I would challenge clients on and the relationship between their choice of words and recovery was fascinating. When I was a patient in a psychiatric hospital, it was one of the things I most commonly ranted about to other patients in groups as to how I thought they should speak about their own mental illness.

From my experience, the three most commonly asked questions (with common answers) that are asked between inpatients in a mental health facility appear to be:

  1. What’s your name?
    1. My name is Sam/Andrew/La-ah
  2. Where are you from?
    1. I’m from Brisbane/Lismore/Timbuktu
  3. What are you here for?
    1. I’m depressed/anxious/bipolar/psychotic/crazy etc.

More often than not, patients described themselves in terms of their illness. So not only does the wider community place these labels on ‘us’, but sometimes it comes from the individual themselfl. But mental illnesses are not adjectives. And they are not ‘us’. I am not defined entirely by a disorder. Just as no one would ever say “I’m cancerous” or “I’m urinary tract infection”.

So what’s the best thing to do when talking about someone else’s mental illness? Be respectful. Taking the time and making the effort to show respect for people who may have different backgrounds, life experiences and cultures from our own can really improve our ability to communicate. Maybe spend some time becoming aware of your own beliefs, stereotypes and biases about people who have a mental health condition. Be aware that certain words and labels can hurt.

Remember that all people are people first and foremost. Rather than describe the person as their illness, describe them as a person experiencing a certain something. E.g. Sam is experiencing a mental health episode. Remember that a lot of mental illnesses are treatable and manageable and as such may pass. Probably best then not to stick a label on someone  for a condition that may not even hang around.

And why not ask your loved one how they’d like the mental illness to be referred to? That too can work.

“The limits of my language means the limits of my world” Ludwig Wittgenstein.

 

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Why the 'hope' in Hope Street Cards?

I’m going to be entirely honest here. It wasn’t brilliant genius that led me to the name of this little card business. It was a bike ride home on a miserably cold Canberra evening. The idea for Hope Street Cards had been with me for some time, however I had been struggling with finding a name that wasn’t naff, lame or tacky. I mean, my sister’s hipster reputation was at stake here! I remember having a very negative internal dialogue with myself that evening regarding the state of the weather and catching myself attempting to disrupt these thought patterns as I cycled into my street. Thinking ‘Oh well, at least I get to live on a street called ‘Hope Street’’. Full disclosure. I got the name from my address at the time.

The more I thought about it though, the more totally appropriate it was. Because there really is not much more important a thing than hope.

I find it really difficult to concretely define or describe hope with the poetic justice that I feel it deserves. The dictionary says that ‘hope is an optimistic attitude of mind based on an expectation of positive outcomes related to events and circumstances in one’s life or the world at large’. Thanks dictionary. The psychologist Charles Snyder associated hope to the existence of a goal, combined with a determined plan for reaching that goal. Thus an essential ingredient for future planning, motivation and change. But it just feels like so much more than that.

Viktor Frankl, Austrian neurologist and psychologist, chronicled his experiences as a concentration camp inmate in his book ‘Man’s Search for Meaning’ (1963). Frankl’s observations and writings led him to discover the importance of finding meaning in all forms of existence, even in Auschwitz, which create a reason to continue living. He stated “It’s a peculiarity of man that he can only live by looking to the future” (p. 115). He warned that “the sudden loss of hope and courage can have a deadly effect” (p. 120) and observed that “the prisoner who had lost his faith in the future – his future – was doomed” (p. 117). Prisoners who Frankl observed as having lost hope reportedly died within a short time. That’s pretty massive.

And more recent, empirically-validated research backs the importance of hope up. Hopeful individuals have been found to make healthier lifestyle choices in areas such as exercise, eating and drinking (Peterson, 1988). They recover from illness and injury more effectively (Snyder, Rand & Sigmon, 2005) and have increased life expectancies (Maruta, Colligan, Malinchoc, Offord, 2000). They manifest less depression and anxiety symptoms (Cheavens, Feldman, Gum, Michael & Snyder, 2006) and experience increased positive mental health, personal adjustment, life satisfaction (Gilman, Dooley & Florell, 2006; Kwon, 2002) and sense of meaning in life (Feldman & Snyder, 2005). Obviously the benefits of possessing a hopeful approach to life are numerous and noteworthy.

During my first year of clinical psychology training, the importance of ‘instilling a sense of hope’ in conjunction with the client was taught as one of the key ingredients for providing successful psychotherapy. Some consider hope as one of the four most significant common factors in good therapy outcome (Hubble, Duncan & Miller, 1999). Irvin Yalom a guru in the world of psychotherapy teachings identified the instillation of hope as the first curative factor in effective group psychotherapy. Esso Lette observed: “Hope is crucial to recovery, for our despair disables us more than our disease ever could”.

During my very early training this knowledge made me feel slightly relieved. Being overwhelmed by anxiety at providing psychological treatment whilst feeling entirely inadequate, underprepared and paranoid I would end up ruining someone’s life, I thought, ‘well at the very least I think I can help someone feel hopeful’. And for the most part I could. There was one time though, when that sense of hope was so incredibly difficult to cultivate. Where the empathic response I had to a client’s traumatic past and current internal experiences left me feeling devoid of hope. I too felt hopeless. And it was gut-wrenching. And terrifying. And so incredibly sad.

That experience really affected me, because the guiding principle of recovery from a mental illness is hope – the belief that it is possible for someone to regain a meaningful life despite a serious mental health condition. And that recovery is not a linear process. Or an end result. It’s a process, ongoing adventure, one step at a time, that sometimes looks and feels like one big mess and is completely different for everyone. And it’s really, really, really hard work. Because there’s so many things you have to do that you often just don’t want to do (e.g., get adequate sleep, exercise, challenge unhelpful thinking patterns). And you have to do these things with no absolute certainty that doing these things will make you feel better. You need courage and commitment and a bucketload of hope.

But for someone who is experiencing a mental health condition there can be an overwhelming sense of hopelessness, so where can that foundation for recovery come from? At the launch of Hope Street Cards, Clinical Psychologist Jo beautifully described the benefits of having someone else “hold on” to that hope for you, when you yourself can’t. And I totally agree. At my darkest times my therapist – let’s call him Dr M – has held the hope for me. I’m not even sure he knows he’s doing it. But he will refuse to engage with me in any particularly ridiculous notions of my self-worth I might have. He does this very subtly and tenderly, but it is a gentle reminder that he doesn’t believe in such thoughts, he believes in me. And at times this has been enough.

At other times it’s been my family and my friends who have carried that hope for me. Just by being there they provided the gift of faith that I might be able to live well again. And what does that gift feel like? I think Emily Dickenson may have described hope best: “Hope is the thing with feathers”. And those feathers tickle your heart a little.

 

Smart things I quoted:

Frankl, V. E. (1963). Man’s search for meaning. New York: Pocket Books.

Yalom, I. (1985). The theory and practice of group psychotherapy. New York: Basic Books, Inc.

Peterson, C. (1988). Explanatory style as a risk factor for illness. Cognitive Therapy and Research, 12, 117-130.

Snyder, C. R., Rand, K. L., & Sigmon,D. R. (2005). Hope theory: A member of the positive psychology family. In Snyder, C. R. and Lopez, S. J. (Eds.). Handbok of positive psychology. (pp. 257 -267). New York: Oxford University Press.

Maruta, T., Colligan, R. C., Malinchoc, M., & Offord, K. P. (2000). Optimists vs. pessimists: Survival rate among medical patients over a 30-year period. Mayo Clinic Proceedings, 75, 140-143.

Cheavens, J. S., Feldman, D. B., Gum, A., Michael, S. T., & Snyder, C. R. (2006). Hope therapy in a community sample: A pilot investigation. Social Indicators Research, 77, 61-78.

Gilman, R., Dooley, J., & Florell, D. (2006). Relative levels of hope and their relationship with academic and psychological indicators among adolescents. Journal of Social and Clinical Psychology, 25, 166-178.

Feldman, D. B. & Snyder, C. R. (2005). Hope and the meaningful life. Theoretical and empirical associations between goal directed thinking and life meaning. Journal of Social and Clinical Psychology, 24, 401-421.

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