Intention vs Impact (Are You Ill-treating People with Mental Illness) – Elizabeth Ita

I know it can be distressing to interact with someone who lives under the weight of mental illness, especially when they’re dear to you. People usually try, but sometimes, their ideas and behaviors are actively harmful, even when they are (or seem) well intended.

Speaking mostly from my lived experience , here are some thoughts.

1. Check your performative empathy

Let’s define empathy

About the only thing people agree on when they say “empathy” is that it’s a good thing.

Let’s make a distinction between empathy as an external performance, empathy as an internal reminder, and empathy as an analytical tool. You can read more about this here.

  • as external performance: any practice designed to make another feel empathized with. Examples include active listening techniques, use of validating language, etc. This performance, like any performance, may be “true” or not.
  • as internal reminder: any practice designed to reinforce any form of empathy in oneself.
  • as analytical tool: a linked set of practices including: recognizing common humanity, active consideration of others goals, searching for commonalities in different experiences to gain emotional understanding, etc.

I understand what it’s like to see someone in pain and to not know what to say or do. I know it can feel jarring and uncomfortable. A useful approach would be to say something along the lines of: “That sounds really hard. Thank you for trusting me to talk about this. I can’t fully understand, but I’m here for you. Please let me know if there’s anything I can do to help.”

Intent doesn’t matter. Effect does. Context matters, and sometimes our context is toxic. This toxic context takes good intentions and turns them to bad effects. 

2. Put things in perspective

“Look at everything you have!”

“How could someone like you be depressed?”

A more effective approach might be to remind us that feelings come and go. There were better times before, and there will be good times ahead. Behavioral scientist Nick Hobson refers to this as “pulling yourself out of the present,” meaning instead of trying to compare our struggles with those of someone else, we try to contrast how we feel now with how we might feel in the future.

3. Giving uninformed or unsolicited medical advice

Treatment is complex. Therapy, medication, and self-care all have a place in recovery.

Our brains need different things at different times. It’s damaging to suggest we’re failures for using a form of care you personally don’t need. It’s a little like saying, “Oh, you’re depressed? Well I cured my depression with air, ever heard of it?”

And by the way? People with depression aren’t completely unaware of nature. We’re also not ignorant of the benefits of nourishing food and moving our bodies.

But sometimes, that’s too much to expect of someone with a mental illness, and it often just intensifies our existing feelings of guilt and shame. It’s insulting to imply that if we went for a walk and downed a glass of orange juice, we’d be alright. (Besides, many of us have already tried these things.)

Healthy behaviors can certainly help us. But using language that pressures or insists it will cure us isn’t the way to go. Instead, if you want to be of service, ask what we need from you. And be gentle with your suggestions and encouragement.

So, what can you do instead?

JK Murphy suggests the following:

Help can look a lot of different ways. It might be listening as we talk through it or simply holding space for us and sitting in silence. It might be a hug, a nourishing meal, or watching a funny TV show together.

The most important thing I’ve learned about being present for someone ill or grieving is that it isn’t about me. The more I get caught up in my own ego, the less helpful I am.

So, I try instead to be a calming influence, to not insist or project. To allow someone to experience the weight of it all and to bear some of that weight with them, even if I can’t take it from them entirely.

You don’t have to have a solution. No one expects that of you. We just want to feel seen and heard, for our suffering to be validated.

Supporting someone with a mental illness isn’t about “fixing” them. It’s about showing up. And sometimes, the simplest gestures can make all the difference.

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