Thoughts / language

Awareness (again)

It’s another day for awareness today. Are you getting a bit sick of me writing about these yet? Today – the 26th June – is the International Day against Drug Abuse and Illicit Trafficking. The United Nations, governments, non-governmental organisations, the media and citizens around the world will use this day to raise awareness about the impact of drug abuse and illicit trafficking of drugs. Apparently.

To be honest, I’m not sure we need any more awareness on this issue.

Because all the peoples that I’ve met and listened to at dinner parties and social events and at random occurrences during the day seem to have heaps of awareness. That is, if ‘awareness’ corresponds to ‘very passionate and unwilling to compromise opinions’ on the matter.

And as someone who has worked in the Drug and Alcohol sector for over a decade, sometimes this awareness and these opinions make me want to cry.

A little while back I had the weekly privilege of spending an evening with a bunch of beautiful souls. I was running a recovery group for people wishing to change their substance use. We’d spent the couple of hours, amongst other things, discussing love and fear and vulnerability and hope. As is often the case, I left the group with a sense of warmth in my being.

As I was driving home in torrential rain, I attempted to find a local radio station for a river/flood update. I came across some talkback radio. I should have changed the station. But I persisted. And I listened to the shock jock and an ill-informed listener from Gundagai discuss how Australia’s ‘War on Drugs’ had failed because the Australian Government had been too lenient on people who use and sell drugs. The alternative strategies they discussed included lifelong gaol sentences and the radio presenter called for “bringing back the guillotine”.

And the sense of warmth in my being died.

This shit makes me really, really sad. Because, believe it or not we are still talking about people. And these comments are dismissive and disdainful. They reflect a moral judgment that is a relic of a bygone era when our understanding of addiction was limited, when we didn’t have access to the evidence and research we do now. Yet, these are the ‘opinions’ of the ‘aware’ that we hear over and over again.

Scientific progress has helped us to understand so much about alcohol and drug use. And it’s complicated. No one ever chooses to become dependent upon a substance. Instead, a unique and complex combination of epigenetics, environmental stimuli, psychological factors and drug components form to create a melting pot of factors that can result in physical changes to the brain’s circuitry, which lead to tolerance, cravings, and the characteristic compulsive and destructive behaviours of addiction.

We also know that people who experience other vulnerabilities – mental illnesses, poverty, social disadvantage, homelessness, unemployment, intergenerational trauma and childhood sexual abuse – are more likely to experience substance use disorders. Yet this never seems to be mentioned in ‘awareness’ raising.

When we talk about drug and alcohol use disorders, without a thorough understanding of the complexity of the issue, or we offer quick-fix solutions or make large-scale generalisations we have the potential to cause wide-spread harm.

If we hold and express negative attitudes towards people who are suffering, we have the potential to increase the suffering infinite fold. Research has shown that when people experiencing substance use disorders feel judged or shamed they will not seek treatment for the disorder. Communities can become less accepting of treatment programs due to popular, but misguided, opinions regarding people using substances.

We might not always realise the effect our judgment might have on others. Judgement and shame can come as a result of the way a non-addict looks at, talks to or otherwise mistreats the individual who is suffering from an addiction or who once suffered from an addiction. This social stigma can deepen suffering. For many, it’s not just the fight of addiction, but also the fight against the stigma associated with it.

If you ask me, that’s the real ‘war on drugs’.

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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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