By Kathy Morelli, LPC
I thought I had outed myself. I thought I had reconciled my clinical self and my public self. I'd written about my struggle with postpartum depression, starting with PsychCentral's World Mental Health Day 2010 Blog Party.
Then, in early May, Lauren Hale asked me to be a guest on #PPDCHAT, which is an online Twitter support group for women struggling with perinatal mood disorders. Lauren asked me to talk about how part of the healing journey is in telling your story, being heard, accepted and held in support by others in a safe community.
I realized I hadn't really opened up about myself in a chat ever. I had hidden behind my blog posts. I was still wearing my buttoned up "therapist suit."
Therapists are trained to not tell our stories. I was told over and over again not to share anything about me, to go so far as to not have personal pictures in my office, as that would interfere with the therapeutic technique (mystique?) needed for my clients to heal.
Ha! Interestingly, part of the reason I went into clinical mental health was because of two very inspirational books written by two mental health professionals who both struggle with mental illness and also have very public and illustrious careers. Kay Redfield Jamison, Ph.D, of Johns Hopkins University and Peter C. Whybrow, M.D, of the University of California have both published books about their personal experiences with mental illness. Dr. Jamison has bipolar disorder and Dr. Whybrow has suffered from depression.
So back to drinking the Kool-Aid. In graduate school and while at work, it was frowned upon to discuss your personal life at all, let alone your struggles with mental illness. I think this part of my professional training caused me to experience even more shame about my past struggles. Heaping shame upon shame. And, just to be clear, I'm not talking about running on at the mouth during my sessions with my clients about myself. I'm talking about feeling ok with more transparency about who I am and not feeling stigmatized.
In the first place, I experienced shame I had depression earlier in my life, which was successfully treated with brief medication, and a longer term of interpersonal and mindbody therapies. Years later, when I gave birth to my son, postpartum depression set in darkly for two years. In my personal life, I kept a lot of this to myself, only discussing it with my husband. I didn't feel comfortable talking about it.
Having a circle of understanding friends is important in prevention and recovery from depression, but I lived in a quiet self-enforced vacuum of shame. Eventually, I again recovered using interpersonal and mindbody therapies.
Do you think I'm exaggerating about the stigma around mental illness?
Did you know, according to the World Health Organization, depression is the fourth leading cause of disability worldwide? Worldwide?
Let me ask you, what color is the depression ribbon? Um, you don't know?
When's the last time you heard about a walk for depression in your local community? How about never?
Confused by this disconnect?
Research consistently shows that persons with a mental illness, such as depression, deal with both externalized (others) and internalized (self) shame. Research shows that we stereotype people with a diagnosis of mental illness as someone low-functioning, someone who can't hold a job. Feelings of uneasiness and fear, rather than feelings of compassion bubble up. Think about your own reactions to the words "mental illness" (Corrigan et al, 2010).
What does this mean to a new mother who is feeling depressed, anxious or fearful? She is probably experiencing deep self-shame and is afraid to reach out to others. And she probably has her own erroneous beliefs about the nature of mental illness.
Have you heard the phrase tend and befriend?
Shelley Taylor and her colleagues at the University of California say that females under stress will "tend and befriend," According to Taylor and her team, women have a neurohormonal pathway response to stress, previously unidentified, which is as natural and primal as the ancient fight or flight response. The tend and befriend response enacts social and bonding behaviors, making fight or flight less likely to occur. Tend and befriend is a protective, inward response where women with young quietly draw together in a tight group and perform such tasks as care-taking of the young, communicating with other women, as a way to manage threatening or potentially harmful situations. It is one way women reduce stress, isolation and fear.
MotherWoman is available as a wonderful way for women to naturally tend and befriend in nurturing community.
Back to outing myself. As I began to go about tending and befriending in my nurturing online communities, I wondered why I was keeping my real self a secret. I was afraid to be my real self, as my therapist self was only supposed to be authentic to a degree. The disconnect between my real self and my therapist self was taking a toll. From my experience, I now believe the secretive nature of the mental health profession contributes to the stigma of mental illness. This secrecy surrounding the authentic self of the therapist perpetuates the idea that mental illness is a mysterious condition, cloaked in darkness, rather than a medical condition that can be helped with treatment.
Stigma contributes to the shame that I suffered from depression and the deep shame I experienced when I had postpartum depression, as I had a baby to take care of and somehow having PPD marked me as not a good mother. Back when I had my postpartum depression episode, eighteen years ago, there wasn't a whole lot of support for new moms, and not a whole lot of readily available information about postpartum depression.
Today, a MotherWoman group can help fill that need in communities. Today, there are also numerous supportive online communities of mental health bloggers, composed of both interested activists and mental health therapists.
But we still have a long way to go. If we shine a light on mental illness and label it as the disease it is, we can help remove the underlying shame and unspoken stigma about mental illness, and help people get the treatment and support they need.
Corrigan, P.W., et al (2010). Self stigma and coming out about one's mental illness. Journal of Community Psychology, 38(3), 259-275.
Taylor, S.E., et al (2000). Biobehavioral Responses to Stress in Females: Tend and Befriend, Not Fight or Flight. Psychological Review, 107(3), 411-429.
Author's Bio: Kathy Morelli, LPC, is a licensed marriage and family counselor in Wayne, NJ. Kathy specializes in helping women and their families with the emotions of birth, pregnancy, postpartum and in the adjustment to parenthood. Author and blogger, she is the author of the BirthTouch® series of books on motherhood. She writes at her own blog, BirthTouch®, is co-hosting the Postpartum Support International's May 2013 #PSIBLOG Hop, and has served as a Guest Editor for the Lamaze Science & Sensibility blog. Visit her at birthtouch.com and kathymorelli.com
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