Being a mental health professional, or social work professional, who also experiences mental health problems. It’s tricky. People outside of services judge, and so do people within services. It raises all kinds of questions about shame.
I think this is something that has partially shifted for me within the last year. I’ve written before about not being able to sit in the waiting room at the eating disorder service because of the fear of bumping into my colleagues. Being in day service has forced me to face this fear, and now, I care a lot less if I do see someone from work in the building. I do see people, and it’s still uncomfortable, but I don’t actively hide anymore. Maybe it’s just exposure over time, or maybe it’s because I’m a little more accepting of my own difficulties, or perhaps it’s the ongoing acceptance of (and openness with) those who do know, love and respect me, that makes the possible judgement of others a bit easier to bear.
I do still vacillate between shame (‘I’ve still got this problem after so many years’, ‘people will question my professional judgement/not respect me/see me as weak’) and a sense of acceptance (‘I did the best I could at the time’, ‘no manager or colleague has ever questioned my practice’, ‘my experiences give me more compassion/passion’). And some people do value lived experience as a strength. Personally, I’d argue that we all have lived experience of one form or another, but that might be a topic for another time.
I wonder what it is that leaves me crushed some days and feeling fairly content on others. On ‘good’ days, I don’t really feel the need to justify myself. My eating disorder is something I’ve struggled with and (importantly) functioned with, for a long time. Some traits associated with ED’s (perfectionism, drive, a strong awareness of others’ needs) can be a strength when channelled into the right areas. On those days, I don’t feel the need to justify myself by saying that ‘I’m getting better’ – as though I’ve done something dreadfully ‘wrong’ by having an eating disorder. It’s life, I wouldn’t judge or blame someone else for struggling, and if people want to judge or make short sighted assumptions, that’s their problem, not mine. I recognise that my ED developed as an attempt to survive some fairly tricky experiences, and I defy anyone to have similar experiences and emerge unscathed. It just isn’t what happens to humans.
On other days, I do feel judged, very ashamed, and frustrated with myself. It stops me sharing and it makes me close up. On those days I do hide. I ran out of a group recently because it involved seeing someone I worked with briefly as a colleague, years ago. (They likely don’t even remember me). I felt embarrassed to have an eating disorder, I didn’t want to be ‘seen’, it felt too exposing. I don’t think that’s an unnatural reaction, but it does say something about how people generally perceive mental health and how much I’ve absorbed that into myself. Stigma does exist, within and outside of services, and we do internalise that.
If I could explain my understanding of my difficulties so that people have a greater sense of it’s really about, I don’t think I’d mind colleagues knowing quite so much. We all want the power to define our own experience and tell our own stories. For me, the problem is, at least partly, to do with labels and stereotypes. What does an ‘anorexic’ look like? What mysterious ‘behaviours’ do they do. Aren’t they selfish, self absorbed and ‘weak’. I don’t think I am, at least not always, but I also know many people do think people with eating disorders are those things. There’s also the need to protect myself from thoughtless comments – what if people do think I look fine (or worse, too big) and that sets off an onslaught of uncertainty around further weight gain/the need for weight loss. I also don’t want my colleagues wondering whether I’m ok every time I refuse a biscuit. I don’t want to have to justify my behaviour. I don’t want my professional or personal judgement questioned or, conversely, to be treated with kid gloves. It’s demeaning.
And what about the resources a person gains from experiencing adversity and moving some way through it? What about the courage it takes to appraise a situation honestly and ask for help? What about the empathy that develops from sitting in the ‘other’ chair and being on the receiving end of services or therapy? What about events that precede the development of mental distress and the way those may contribute to a person’s sense of identity and understanding? What makes ‘professionals’ so inherently different, that we expect ourselves to be immune to the impact of relational trauma, adversity or plain old stress? Speaking personally, I wouldn’t want a robot who feels nothing to be my therapist. I want someone who can empathise, see my strengths, who is strong enough to ‘be with’ me, help me to contain the things I find almost intolerable and who has confidence in my ability to (with support) find a way forwards.
When there is shame, we don’t talk, and when we don’t talk, misunderstandings remain. Not everyone sees mental distress as simply part of being human. And to me, that’s the problem. As long as we keep ‘othering’ people, setting particular coping strategies or experiences apart as something inherently wrong or ‘different’, shame and silence will always be there, and that prevents us from connecting with each other, and probably also prevents us from healing.