What's really rocking our boat?
As it's mental health awareness week and I am a practising psychologist, I felt compelled to put pen to paper or fingers to keyboard. It is truly difficult times and I have been made aware of yet another person in my community taking their own life. We are being told time and time again that we are in this together - an attempt to build solidarity and foster a sense of oneness maybe. However, as a recent meme so rightly put it – we are all in the same storm, but we are certainly not all in the same boat….some are in yachts, some are in flimsy rafts struggling to stay afloat, while others are drowning.
Our desire for fairness in treatment and standards is always directly challenged by the harsh reality that all things are not equal. So how we do deal with this? One way is we use language to demonstrate our good intentions. Going through the motions or paying lip service to an ideal is something we as a species have perfected. We use memes and well-crafted mission statements, company charters, values and mottos to inspire team moral, and demonstrate what we stand for. I worked some years ago in early childhood education and visited students on their practicums. I would always challenge the students to explain how the child care centre mission statement looked in actual practice! This is a very useful measure in any large organisation that aspires to some grand mission statement – how do their management treat staff, how do staff treat each other? It is also a good measure for each of us to reflect on - how does our own behaviour align with what we say? At an intellectual level it sounds awesome – we expect these wonderful statements to manifest great outcomes in our world because we have it written down; or we talk about it. The reality is when "things" rock our boat, at an emotional level we often can’t cope and the wheels slowly fall off the bus.
So what has a company mission statement got to do with mental health? The current mental health awareness campaigns, and people posting that they are there for someone who needs them, are both examples of socially popular 'mission statements'. The irony is in the same breath there are posts castigating narcissists and toxic people – yet these are the very people who are most likely calling out for help. There may be many genuine people out there offering support – yet this is frequently misguided because those in real need will rarely fit the stereotypical image of a needy person. It may be more truthful to say; I am here for you if you ask in a way that I feel is right and if you look like you need help.
This sounds harsh and it certainly isn’t meant to demean anyone out there providing support or help to those in need – it serves as a reminder to us that everything is not what it seems when it comes to people who need help. We are not all equal in how we express our needs. Whatever we deem as inappropriate behaviour could be an attempt to communicate a need and until we understand this key principle, we will continue to fail to see the warning signs of those who don’t fit our image of someone asking for help. The issue with our current system is we are trying to replicate a village-style approach to support, on a national level and this is doomed to failure because the basic ingredient is missing - secure, caring relationships.
The REAL ABS* framework for coaching places relationships at the forefront of everything else because without a few solid relationships, we are unable to function effectively - this includes our relationship with ourselves! A positive, relationship with ourself provides us with a buffer for dealing with a crisis. and a clear vision or mission or roadmap or whatever you like to call it is the icing on the cake. Mental health issues rarely occur for no reason and we need to be looking at why people behave the way they do, rather than trying to stop the unwanted behaviour! This is a twofold approach. We need crisis interventions sure, but we also need robust preventative measures that look at the bigger picture behind our spiralling mental health issues in the community.
In applied behaviour analysis we consider the ABCs of any behaviour before implementing an intervention
Antecedent (what happened just before)
Behaviour of interest
Outcome or consequence.
We also look at the bigger picture around the behaviour and refer to these elements as motivating operations – this could be the fact that the client has received bad news, had an argument with their partner, and didn’t get to bed until late the night before… all these factors contribute to the unwanted behaviour by setting the scene long before the episode or "behaviour". There is also the cumulative effect, or stacking, of multiple stressors over time. This is valuable information for any health care professional and for those supporting the person. The behaviour itself may manifest in a variety of forms, as an adult we get more skilful in disguising hurt, anger, rejection and fear. This is why the labels narcissist and toxic are so unhelpful - immediately we become judgemental and make assumptions as to the why. All behaviour serves a purpose for the individual and it may not be about anyone else at all! I have talked frequently about avoiding the use of emotive words such as revenge and control as functions. of behaviour The consequence or outcome could well be unseen by us and we are best to stick with the 4 basic functions of behaviour.
attention
escape or avoidance of something
sensory (it just feels good)
access to something (item, event, person)
We can also use this information to assess why some people cope so much more effectively with a crisis. What do they have going on that acts as buffers to support mental health? Another way is to ask what are the resilient factors in tact in people who handle stress and crisis? This is similar to the way mathematician Abraham Wald** tackled the issue of armouring planes in WW11. He was tasked with advising the military where to place more armour on planes, based on statistics and information gleaned from the planes that returned from air combat. In what seems like a counter intuitive move he stated that the armour needed to be increased where there were no bullet holes – highlighting the fact that obviously the planes that didn’t return had been hit in these locations! This is one way that could help us to assess our own survivability in “combat”. How can we increase the “armour” for some, based on the survival information from others?
We can scale this up to a community level and look at the contributing factors to mental health issues impacting on individuals collectively, and possibly help to armour communities, however treatment needs to be at an individual level - always. Our current lockdowns are a great example of a community factor that could potentially be tackled by looking at members in different communities who are coping, and exploring what they are doing. It sounds so simple and in many ways it is - it's just not easy. We need to ask the difficult question - why is this, but not today!
So, in the meantime, where do we start? And what's the take home message after all this? Here are a few...
There is no easy way out of the predicament we are in if we can't acknowledge and accept difference
Real changes that are sustainable and workable over time require social changes that also take time – consider the attitude shift to smoking and buying caged eggs and using plastic bags – it can be done. - if we care enough and value the change
As always it starts with individual efforts to build relationships, to recognise that “cries for help” do not look the same and may in fact look like arrogance and narcissism.
We need to take a practical approach, remove the stigma around mental health and begin to see it like we do a broken leg or an allergy – treatable and/or healable and possibly preventable!
Finally, we must remember not everyone will be a pleasure to help, they may well "rock our boat", but help them anyway - you may save a life.
* REAL ABS - https://www.katewinchester.co.nz/
**https://medium.com/@penguinpress/an-excerpt-from-how-not-to-be-wrong-by-jordan-ellenberg-664e708cfc3d