Updated: Dec 3, 2020
Here is the script for my recent talk at TEDxMcGill. The video is available on YouTube.
For the past 8 years, I have been training in a martial art called Brazilian Jiu Jitsu. For those of you who might not know, we do this sport in a kimono-like uniform called a gi and the gi is crucial because we grab the fabric in different grips to help us achieve and maintain positions.
About a year ago, I was training at my home gym. My partner was someone I was familiar with and I felt comfortable. We started our round of sparring and he grabbed a sleeve grip, causing my gi sleeve to ride up my arm. He looked down at the scars that run lengthwise up and down my wrist. Without seeming to give it a thought, he asked “What…..d’you try to kill yourself or something?”
I looked at him and, calmly, I said; “Yes.”
I could see the shock on his face. I could see all the gears turning in his head as he realized how gauche his question was. I could see his surprise at receiving an honest answer. That’s because we don’t discuss suicide. We don’t discuss mental illness.
I’ve often had people stare at my scars. They’re most often too shy or too afraid to ask about them but they’re fascinated. They kind of don’t want to know but they kind of do want to know. But most often they don’t ask. Sometimes they give me a knowing look; sometimes they shake their head or they pat me softly on the shoulder.
I once wrote in a poem “I wear my insides carved into my outside. The ugliest parts of me are on display and people...they stare.”
This man stared because my scars are unusual. He stared because they were something he couldn’t understand. He stared because stigma informed his opinion of me based on what I’ve lived through.
Because we can’t see mental illness, we refuse to acknowledge it. We refuse to talk about it out loud, and most importantly, we refuse to allow people to be honest about what they experience. When confronted with it, we are awkward, we shy away, we lack compassion. Someone’s brain chemistry doesn’t show itself on their skin, in their breathing or as a broken bone. And if it can’t be seen, it mustn’t be real. It is perceived as a choice, it is seen as a failure, it is seen as everything but a medical condition.
This is stigma.
Stigma silences us. It stops us from speaking up. It stunts discussion and creates discomfort and judgement. And the thing with stigma is it’s insidious. It creeps in as we form more and more opinions and misconceptions and eventually grows into something much more harmful and dangerous.
Stigma comes from two things. It comes from shame and guilt. Shame is created by judgment and lack of compassion from others while guilt builds internally as we judge ourselves for what we perceive as shortcomings. Stigma informs how we react to mental illness and it informs how we support each other.
Let’s back up for a minute.
Let me ask you a question:
“How are you?”
Think about that for a second. How many times today have you heard this question? And how did you answer each time?
Questions are how we request information from one another. They are how we gain a better understanding of the world around us. In social contexts, they’re how we gain a better understanding of each other.
Think about your daily interactions for a second. Think about how often we are asked this question:
“How are you?”
And how do we reply?
We are constantly giving automatic, perfunctory replies, assuring people that we’re “fine” and “good”.
What are we accomplishing with this? Are we truly communicating anything? Is there an exchange of meaningful information?
We are essentially lying to each other. We are failing to share the full truth of what we are feeling; we are failing to share the full truth of what we are experiencing. We have developed social standards and boundaries around what we are willing to discuss and how open we are willing to be. We’ve decided what is acceptable to share and what makes us overbearing, or rude or awkward.
When it comes to mental health, especially suicide prevention, these social boundaries are an obstacle to overcome. Research has shown that talking about suicide out loud, openly and candidly greatly reduces the chances of someone who is suicidal going through with an attempt. Yet, we dismiss thoughts of suicide as attention seeking, as exaggeration or drama. So what can we do? How do we change the norm? How do we address this stigma?
“Pushing the envelope” means pushing limits to embrace an experience that radically changes the way we think. It means challenging ourselves to question what we currently know and believe. “Pushing the envelope” is how we shift paradigms and truly learn and grow. It means changing for the better, it means gaining a deeper understanding that allows us to make more informed decisions and contribute further to the society in which we live.
The shift I am proposing starts with you and me. It starts with each person in this room, choosing to push the envelope of those social boundaries. This is one of the most powerful ways we can make headway and start combating stigma. This is one of the most powerful ways we can start effecting change when it comes to mental health.
The last time I tried to kill myself I needed 14 stitches.
The time before that I was in a coma for days.
I tell people I didn’t go to graduate school after finishing my Bachelor’s degree because I was sick. I tell people I didn’t start my career until my 30s because of health problems. This is all true but omitting the fact that these concerns were psychiatric avoids judgment, doubt and stigma. I once worked with a woman who said of her ex-husband: “He spent two weeks in the psych ward. He’s a total psycho.” Spending two weeks in the Critical Care Unit to recover from brain surgery would never qualify you as such. We don’t give mental health patients the same kind of respect of benefit of the doubt.
If I told someone I didn’t attend graduate school because of a traumatic injury that required treatment and rehabilitation, they would feel for me. They would try to imagine what that feels like, the discouragement, the pain, the struggles of recovery. If I told someone I didn’t attend graduate school because I was struggling with suicidal thoughts that led to a serious attempt, they would most often be shocked, they wouldn’t know what to say and would be grappling with making that fact fit within their paradigm of what is an illness, what is a valid struggle, what warrants compassion over judgment.
In many contexts, I avoid conversations about that part of my life. I avoid delving into the details because I know that a nondescript physical health problems will elicit sympathy and a modicum of understanding, while mental health concerns are likely to bring stigma, confusion and sometimes, judgmental questions. This is one place where I need to step forward, I need to confront my fear of stigma and make strides toward mental health awareness.
This is the paradigm we need to shift. We need to make mental illness and suicide an acceptable topic to broach in standard conversation. Only by being honest about our experiences and our struggles can we reduce stigma and create a safe discourse surrounding mental illness.
This is not without caveat. There can be nuances to where it is effective or helpful to have these conversations. What I aim to change is the idea that it is “appropriate” or “inappropriate”. I want to encourage the view that honesty, candidness and true human connection are always appropriate. If someone asks you how you are, responding that you have struggled with severe anxiety the past few weeks may not be able to be addressed in a 3-floor elevator ride. It is, however, not inappropriate to offer an honest answer. You could say; “I’ve had some bad anxiety but I have good supports available to me, thanks”.
What we need to change is the reaction to an answer like that. We need to change the way such an answer would make most people feel. In most cases, people would be taken aback. They would be a bit shocked and not know how to respond. We hold on to this concept of “over-sharing” and how it can be awkward to share too much information with people. While there is a place for this concept, it needs to be challenged in terms of mental health awareness because of one simple fact: physical health and mental health are currently treated very differently. Think about it: in the same situation is would be perfectly commonplace for someone to respond with: “I’ve had a bit of a cold but I’ve been resting and it’s getting better, thanks.”
How was your summer? – Oh, I broke my arm.
No one would be put off by that response. They would ask how, they would check in with that person’s recovery, they would show understanding.
How was your summer? – Oh, I had an episode of psychosis, it was really difficult.
Most people wouldn’t know how to respond to this, because we have not developed the social cues to manage such conversation tactfully – more often, we’re more worried about our discomfort with the subject matter than about the potential to empathize with someone. We need to train ourselves in empathy. Empathy can absolutely be learned. Human beings feel feelings. Almost all of us have the capacity to feel feelings and to connect with the feelings of another. We have an incredible propensity for being there for each other. Sometimes we just need a bit of guidance.
When it comes to mental health and mental illness, we need to learn to be comfortable with openness. Both in terms of what we share and in terms of what we receive. By becoming safe spaces for mental illness, we give people permission to seek help. We remind them they are worthy of help, they deserve support, they are valuable humans.
Mental health is underrepresented when it comes to health. It isn’t given the weight it should in terms of health assessments, check ups, education. We do not equip our children with adequate information to manage their own mental health, nor do we teach them to know when to reach out.
I am diagnosed with Bipolar disorder and Borderline Personality Disorder. Before my diagnosis, I knew very little if anything about either of these illnesses. I had never heard of BPD before. I just knew I was in pain. I knew something was different about me but I didn’t know what or why, which of course made it scarier and more overwhelming. Imagine how different things might have been if I could have put a name to my situation, if I had had the words to think about it, to talk about it, to understand my pain.
One of the main things I struggled with, and still do, are chronic suicidal thoughts. My suicide attempts stemmed from intense emotional pain that I thought I wasn’t strong enough to live through. Because of my illnesses, much of what I feel is magnified and the “cooling down” period after strong emotions is much longer. I live with highs and lows that can be very disruptive to my life. Because of my illnesses, everything I feel is intensified and my ability to rationalize those feelings or control my reactions to them is under developed. I lived like this for years, unaware that there was a reason for it. I spent years believing that if I tried harder I could be different; better… that I could be normal. I saw most people around me handling life without crumbling at every onset of emotion and decided that I must be doing something wrong.
I lacked the education and knowledge on mental health and mental illness to not only know that there must be a name for what I was experiencing, but also that support and treatment was available, and that I deserved it.
This is the challenge. To expand what it means to be socially apt, to push the boundaries of what is socially acceptable and appropriate to talk about. Mental health should be as ubiquitous in how we care for ourselves as physical health. And the best tool we have to do that is to talk about it. Talk about mental health, educate yourself on mental illness, be an empathetic, compassionate safe space for people to be honest and open about what they’re experiencing. Be honest about what you’re experiencing yourself.
Through my recovery, I’ve learned to be comfortable with sharing my story. I’ve learned that it can be extremely powerful in letting people know they are not alone, and allowing people to see a more human and real side of mental illness. I share my story in the hopes of encouraging people to understand better and to help combat stigma.
Combating that stigma requires open and honest conversation. Make mental illness an appropriate topic of conversation, something to check in about, something to learn about. If I can leave you with anything today, it’s that I encourage you to be open and brave. Be open in receiving people’s struggles, people’s pain, and people’s stories. And be brave in sharing yours. Mental health is health. Talk about it. You could easily save a life.