Category: Destigmatizing Mental Illness

The Power of Pants

Recently I’ve been thinking a lot about pants. I’ve been thinking about what they mean, what they represent and what they can do.

Often when clients are dealing with a crisis, loss, or just feel weighed down by their emotions, they will tell me they don’t know how they will get through it. This is understandable and common. When our negative emotions are so strong and raw, it’s hard to remember that we can feel differently in the future, or that we have felt differently in the past. When a client tells me they don’t think they can get through something, I often respond, “You already are getting through it. You’re breathing, you’re sitting, you’re here, and you’re wearing pants.” That last part usually brings some humor into the room, and while that is some of my intention, I’m not saying it just to be funny. Putting on pants, or a dress or a skirt for that matter, is important.

Asking about Activities of Daily Living, or ADLs, as they are often referred to in the mental health field, is an important part of the assessment process. Do you shower? Get your laundry done? Can you cook, keep your room or home reasonably clean, and get yourself dressed every day? It sounds basic, and some clients initially laugh when I ask these questions. However, for anyone whose symptoms have been so overwhelming and intense that they are not able to keep up with ADLs, it is no longer possible to take them for granted.

On top of ADLs, many people go to work, take care of children, hand in research papers on time, and remember to call their mother for her birthday, even when depressed, during crisis, or while managing intense anxiety. Despite the intensity of these emotions, things get done. These people, who would be classified as “highly functioning” by a therapist, doctor, or society, usually do not give themselves enough credit. I’m often reminding clients that despite how bad they might feel, every morning they get up, put on pants, and start the day. There is a power in this, The Power of Pants.

Anxiety, depression, grief, loneliness, an unhealthy relationship or a bad job can all have a way of waking you up early, yet make you feel like you cannot get out of bed and face the day. Stepping out of bed, getting out of the pajamas or sweatpants, and putting on pants is a powerful step.  Even if the step feels very small, even if all you do is get into pants and sit on the couch to read, or go for a walk around the block to get coffee, you have taken that first step, which is the hardest one. The Power of Pants takes some of the power away from your symptoms, reminds you that symptoms do not have to define you, and shifts the narrative towards hope. Even if the shift it subtle, it is profound.

If nothing else, put on pants and see what happens.

What’s In A Name?

A friend and colleague has begun making plans for a private practice and was recently kicking around company names with a few of us over e-mail. As often happens in the field, the decision about how to refer to the work arose. Counseling? Therapy? Mental Health? Behavioral Health? At my various Social Work internships and jobs I’ve worked under each one of those departments, the role being the same but the name always changing. In my experience the name choice is always purposeful, can sometimes date the organization, might give you a quick glimpse into the mission, philosophy and style of the folks in charge, and might even give you a sense of the type of client a company or agency is trying to attract. That is of course, if you know what you are looking for. More often, it creates a great deal of confusion for the average consumer, client, patient, or however else you wish to be described.

As you can tell from my website address and my business cards, if I’ve ever given you one, I refer to myself as a therapist, the work as psychotherapy, and the field as mental health. My goal is to convey that I work to promote the health of the mind. My description would freak some providers or executive directors out. The fear is that saying things like “mental health” and “psychotherapy” scare clients away, make them think of crazy people, make them worry that you think they’re crazy, or that by coming to see you it means they are crazy by default. I have been told by former supervisors that “counseling” or “behavioral health” makes people less anxious, and more likely to come in.

>SIGH<

I’m not a fan of euphemisms. I don’t use nicknames to refer to body parts when talking with children, don’t like saying “passed away” or worse the medical term, “expired” when someone has died, I don’t whisper the word cancer, and I don’t refer to “the incident” when something terrible has happened. The whole point of a euphemism is to substitute a more comfortable word or expression for one that could make people feel uncomfortable or represents something unpleasant. But that’s the problem right there: many things people discuss in therapy, events from their past or their current worries ARE unpleasant. You don’t usually see a therapist because life was and is totally awesome. My worry is that euphemisms in the therapeutic setting support and promote shame, and so I want to avoid them. I think that’s where my knee-jerk objection to using “counseling” as a substitution originates. Why are we removing terms like “mental health” and “psychotherapy” out of fear they make people uncomfortable? How do we begin to destigmatize mental health if we avoid these terms ourselves? Shouldn’t we be leading by example, letting our clients know that working on your mental health is not something you need to be embarrassed or ashamed of?

Since I think they are good at everything, I’ll leave you with the World Health Organization’s definition of mental health for inspiration.

“Mental health is not just the absence of mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”