CW as the subject matter might be heavy for some.
To begin with I’ll clarify that I have been the recipient of a lot of vulnerable people confiding in me in my life. I know what it is like to have people suddenly dump very serious and upsetting problems on me, unsolicited. I also suffer from a lot of trauma myself, and so being trauma dumped on can be triggering of my own trauma. So yes, I can understand why trauma dumping is frowned upon and considered toxic.
However, perhaps in the age old tradition of terms being taken by the general public and misinterpreted into something almost the opposite of it’s meaning, I see the term now constantly thrown in a harmful way around by the general pubic. The term “Trauma dumping” is now used to shame those with trauma who are reaching out for help at their lowest. It’s used in any situation where someone opens up about their traumas.
There is something very messed up about a society that pretends that “You shouldn’t keep everything to yourself, it’s okay to ask for help.” That in turn punishes and shames people who finally do ask for help as “Eww, stop trauma dumping. Your problems are a burden on me actually, so shut up and suffer in silence or pay someone to fix you! You’re selfishly dragging down us healthy normal people!”. I think this will lead to a lot of people in society being taught to hide their problems out of fear and shame. It feels wrong.
Anyway, I can understand if this is a hot take and maybe I am projecting. I can understand both sides, but ultimately it leaves a sad pit in my stomach thinking that vulnerable people are made to think no one cares about them.
The demonising of empathy is scary. Real “Don’t show pity for the homeless, they’re just taking advantage of your kindness.” hours.
Yeah, often it’s weaponized as a “don’t kill the vibe” thing to avoid any discussions of anything that is vaguely mental health related. Trauma dumping is a specific thing where a person unpacks a ton of unresolved trauma onto an unwitting and unconsenting audience but saying “Yeah, I had childhood cancer and it was really tough - not knowing whether you’re gonna make it, seeing every other kid around you apparently having a ‘normal’ childhood, and being treated like a pariah or being tiptoed around because people act like you have the stench of impending death on you really messes with your brain at such a young age” isn’t trauma dumping, especially if it’s just discussed as a matter of fact and it doesn’t come with any major emotional content with it. But people can treat that like trauma dumping just because it’s confronting to hear and they don’t want people to share things that are difficult. (Think about it in terms of talking with a partner about a tough day at work vs talking to a therapist about something deeply traumatizing that feels very present - one is more autobiographical and one is squarely in the episodic memory category.)
What’s worse is that this weaponization of the term isn’t even like what you’d get from someone with low/no empathy, who might just say “that sucks” or they might change the topic or they might ask about it from a place of intellectual curiosity. But when the term gets used as an bludgeon, it’s basically saying “I don’t want to engage with feelings of empathy, not that it’s being demanded of me by the other person, and instead of just owning it instead I’m going to pathologize it and put the blame on the person speaking for my own experience of discomfort so I don’t have to feel bad about feeling bad that I don’t want to feel bad.” It’s a lot of layers to it and it’s just gross.
Maybe I have a dark sense of humor but I’d rather someone joke and say something like “Aren’t they supposed to get rid of the cancer and leave the good bits though? Did they mess that up when you were their patient?” than to do the whole “Erm yikes, sweaty! I’m upset at you because you are making me engage my empathy, despite not soliciting it, so I’m going to blame you for how I feel - don’t you ever do that to me again!” kind of borderline-DARVO shit.
i have to agree with the general sentiment that too many people are quick to throw around clinical-ish terms without being clinicians. not that clinicians are somehow better than us regular humans, but in theory they can be suspended from treating people if they go around being too obviously full of shit. so they have professional guardrails, while most of us don’t.
there’s more than enough trauma to go around and not everyone has access to quality professional support. there is something extra cruel about telling people to reach out, but also creating a mechanism to slam the door in their face when they do so in an inconvenient way. though i think part of that is because so many are white-knuckling it through our days already, and therefore vigilant for that last straw of give-a-fuck that will break them and put 'em in the streets.
anecdote time (CW: suicide)
maybe around 2021, i knew this guy professionally. he was older, wife, kids, great and stable career with good benefits. i only knew him peripherally, in that he probably didn’t remember my name but i knew his. he seemed to have tons of much closer colleagues.
anyway, one day an email goes around informing us all that he had taken his own life. no real details, but there was a virtual gathering for friends and family to offer each other support. eventually the word got around that he had reached out to our supposedly top tier counseling services and requested emergency support for self-harm. not sure what was said or done exactly, but within 24 hours he had checked himself out of whatever and took his own life. i have no idea what, if anything, was going on with him or if he had ever had any struggles with mental illness. nobody did.
what struck me hardest was that someone with relatively great mental health support access/insurance/etc didn’t get the help they needed and seemed to be asking for in the exactly “correct” way to a professional support network established for that exact purpose. i really don’t know what to make of that, or what it means, but i endeavor to be more gentle with people in general (and especially IRL) and not always seek to operationalize people being OK vs not OK.
as in, we can still have firm boundaries with others and be gentle towards them.
[Big CW for all things mental health and suicide related. If any of this shit is difficult to approach then do yourself a favor and skip this comment.]
I’m partly loath to discuss this and another part of me knows that this is something that needs to be discussed and destigmatized, and it needs to be addressed because it goes almost entirely ignored. The problem is that in discussing what I’m about to, it has the high potential to discourage help-seeking behavior and there’s a tyranny of silence in the general discourse because people like me know there are huge issues but we also know that discussing these issues falls directly into vulgar antipsychiatry/antipsychology sentiment so there’s this situation where it’s like “We are doing a terrible job a lot of the time but you’re not allowed to critique the industry because if you do then the people we are failing are going to be harmed by it!!” Which, y’know, plain sucks because it shouldn’t be incumbent on the people accessing services to develop those services out of potentially massive iatrogenic attitudes and practices (for free, btw) when there is a massive, multi-billion dollar industry with some of the highest paid professionals and reams of academic literature being produced but there’s very little effort, especially in terms of clinical practice, to actually do better.
Like, if i take my car to the mechanic, I don’t have to coach my mechanic into how to do his job and praise him for shearing bolts because he sheared them more gently this time around and I don’t have to create value for his industry that he can then take for free and increase his economic position with. But for some reason, the mental health sector has this massive entitlement complex with this and, even more insultingly, there’s this endless cycle of consultation that goes nowhere so if any change does come out of patient advocacy and activism, it’s usually the case that it’s patients and carers who drag the industry kicking and screaming to do slightly better in one small aspect of their practice.
You can see why I rarely talk about this stuff right? Imagine you’re really depressed and you need therapeutic intervention but you’re feeling kinda hopeless then you read a criticism of the industry like that - you’re gonna be primed to feel negative towards support services and the risk is that you don’t engage or you disconnect from services, likely to your own detriment. The thing is, though, if the industry was good and it functioned well then my criticisms could be dismissed as me being a crank and it would be ignored like the single 1-star review at a popular restaurant that has a 4.7 average rating. I wish that was the case here.
In my experience, in a country that has very good mental healthcare compared to the rest of the world - it would have to be top 20 and it’s probably top 10, there is urgent care that does more or less what it’s supposed to and then there is the sort of occupational therapy for people who deal with phobias or lots of work stress or getting out of an abusive relationship or mild-to-moderate depression. None of these these things are insignificant and they all come with complexity, I don’t want to come off as if I’m denying that, but when it comes to the trickier end of chronic and severe mental illness clinicians tend to be utterly fucking useless. I have a really extensive history of childhood trauma that left me perma-fucked. I’m not going to go into specifics and to put it into context, if we put Epstein victims at a 7 on the scale then my experience would have been about a 5 or so - wretched by all measure but not nearly as wretched as some of the things that kids go through. Of course it’s not a competition and all child abuse is abhorrent and all suffering is relative to what a person experiences so I’m not trying to make a hierarchy here or to deny the suffering of others, it’s just to say that my experience of childhood trauma was “only” moderate compared to what others have been through so, as a case study, if clinicians are largely useless for me then how the fuck are they going to be able to help people who have been through “less”, let alone “more”? (I hope that people will read this charitably - I’m really not trying to argue that some people are more or less “deserving” or that the worst thing to happen to a person doesn’t feel just as bad as the worst thing that happened to me because that’s the exact opposite of what I’m trying to say.)
So I have really bad anhedonia. Really, really bad. There are times when I will try to do my favorite activities and I will get about two minutes into them and I’ll just… stop. There’s no motivation to do it. As an analogy it’s like being tired to the point of falling asleep but your favorite movie is on - there is no pushing through and watching your movie, despite how much you enjoy it when you’re awake, and even if you force yourself to stay awake to watch a bit of it, all your effort will be going towards keeping your eyes open and you won’t engage with the movie so you won’t get anything out of it.
When I describe my experience of anhedonia to a clinician, almost invariably they immediately jump in with advice and it goes something like this:
“What about if you do something that you really enjoy and let yourself experience that?”
“I don’t have anything that I enjoy at the moment.”
“Well, what about if you do something that you used to enjoy before the anhedonia got really severe?”
“That makes it worse because I feel like I experience the recollection of enjoyment of a thing that I am no longer able to enjoy.”
“Maybe your tastes have changed, that’s a normal thing to go through. What about if you try new things? You might find something that you enjoy now.”
“I have no motivation to try anything. When I try something, I put it down almost straight away because I do not experience any intrinsic reward or motivation to participate in it. If you gave me a list of activities right now, I wouldn’t feel drawn to do any of them. Heck, if you gave me a free round the world plane trip I’d sigh because then I’d have to pack my bags and plan the journey and it would feel like I have to drag myself through a ton of extra work and I’ll feel like a piece of shit because I won’t enjoy the experience and I’ll come off as ungrateful.”
“Alright, well why don’t we go back to the activities that give you that feeling of recollection of enjoyment - if you spend time in that experience then you might end up feeling some of the enjoyment if you allow it to come naturally in its own time.”
“I’d prefer not to because experiencing something that gives me the reminder that I’m unable to enjoy things makes me feel worse and more helpless. It’s like telling someone who is recently bereft ‘Why don’t you go to the places that you and your partner used to go to and participate in the activities that you used to do together - that might help you feel the joy that you had with them while they were still alive?’”
“Oh.”
“…”
“…have you tried yoga?”And this isn’t even something that is deep, unresolved trauma that we’re talking about here. (Obviously this is abbreviated and hyperbolized to give an impression but you get the picture.) Imagine if someone is feeling really severe acute suicidality or severe chronic suicidality and the best a clinician has is doing stuff around distress tolerance (which is great if your sensitivity to distress is “too high” but otherwise you’re heat-training the frog sitting in the pot of water or you are paradoxically creating circumstances for reduced help-seeking behavior and aggravating learned helplessness and the risk of experiencing it), it’s McMindfulness, or it’s pointless and counterproductive busywork which is only useful for people who experience transient suicidality that isn’t severe (for example “Why don’t you make two columns on a page and write down all the reasons you feel like taking your life and all the reasons you have for living?”)
I can’t speak for your colleague or what he was going through but there’s this paradox with clinicians where, if you go to them displaying signs of extreme emotional distress coupled with serious risk of suicide, then they handball you over to emergency services so that you can go through a couple of days or weeks of a catch-and-release program where they maybe stabilize you and then they throw you right back into the exact same circumstances that produced this episode but now you have to deal with reintegrating and you probably have to deal with a flurry of well-meaning people who need you to attend to their own emotional distress at learning that you were suicidal while you are convalescing from an extremely emotionally draining experience and/or stigma regarding seeking help for suicidality where you might risk ostracism or a break up or losing your job etc. etc.
But if you go with high suicidality and you are stereotypically stoic because you are an older man who has been raised on hegemonic masculinity, you have a successful career and so you have learned that you have to suppress these things, you have kids that count on you etc. then a clinician will rarely take you as seriously as you need. They will give you advice like “Why don’t you take a weekend away with your wife and do something nice for yourself?” or they will tell you to exercise more. And if you’re at the brink and you are putting up the white flag to say that you feel so helpless that you’re done with a clinician and they respond with “Why not try jogging? Or how about if you go treat yourself and go to your favorite restaurant?” then that gives the very real impression that there is nothing that can be done to help and that you are completely alone in this struggle. To bring it back to the mechanic metaphor… [cont.]
[cont.]
[As above, big CW for all things mental health and suicide related. If any of this shit is difficult to approach then do yourself a favor and skip this comment.]
…imagine if you were having car trouble and when you brought your car in the mechanic said “Have you thought about tinting the windows? What about cycling - that could be fun!” then you’d feel pretty helpless, right? Except when it comes to mental health services you’re probably already feeling despondent and it’s not just car troubles that you’re experiencing, so it’s not like the fix is in any way easier and if the professionals you talk to seemingly have no idea then it’s no surprise to me that when people eventually reach out and they get really insensitive, useless advice they end up clocking out early. I can also imagine that your colleague sought help and the clinician directed them to go to emergency but when you’re saying “This is intolerable and I need a long-term strategy to address this because otherwise I’m done” and the professional you’re saying that to says “Lol idk, you’re too difficult to deal with because your suicidality is too severe - just go check yourself into a ward for a few days and then keep doing that over and over until you aren’t as suicidal. That’ll probably work I guess - not like I’d know anyway since your case is too difficult for me to work with. Okay, bye!” then you’re gonna feel pretty helpless.
So all of this is to say that there’s a suicide crisis and a broader mental health crisis and it routinely gets pushed onto spouses and partners, particularly women and femme people one way or another (if you know what I’m talking about, you know) and the people who are suffering from poor mental health themselves and that services that do exist have this ridiculous Goldilocks approach where you have to be this unwell and at this level of risk to work with.
Too severe? No thanks, seeya later.
Not severe enough? Try meditation or pet a puppy or something.
Very severe but not showing “sufficient” signs of distress? Lol ok, probably not worth the time - come back when it’s really bad.
Assessed as not being severe enough but showing “too much” distress? You need to learn ways to shut up and internalize this more.It’s infuriating and the thing is that psychiatry has had centuries to get its shit in order and psychology has had about a century an era of incredible scientific progress and yet they tend to either be capable of preventing the most severe, acute episodes of suicidality through the basics like monitoring people and chemical restraint or they are able to yap about “building connection” and “creating meaning” like Martin Seligman has created an entire career out of by, essentially, grifting national governments (while he isn’t consulting with the CIA to develop more effective torture programs.)
All of this is speaking as a longtime survivor of suicide and psychiatric services. I’d venture a guess that the only real difference between myself and someone like your colleague is that I’m more boneheaded. There isn’t any special qualities in particular that I possess that others should learn from or embody, I’m pretty sure I’m just a product of the survivorship bias. But psychiatry and psychology absolutely love patients like me, when they don’t hate me, because they can hold people like me up as a case study to claim legitimacy and to “prove” that their disciplines work. But honestly, if you catch me on a bad day and you press me for my honest opinion, most of the time I’m going to tell you that these services function mostly as a filter.
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First off I cackled my ass off at the Marty seligman hate - I’ve read one of his books (authentic happiness , I believe) and I can’t believe “positive psychology” has gained any sort of legitimacy.
I’m Seligman’s #1 hater. The reason why I think he’s so popular is because he poses absolutely no threat to the status quo - his advice is really individualistic (typical for psychology) and a government can adopt the language and borrow some of the aura of legitimacy through his work in psychology and his frameworks to act like they’re doing something about improving mental health except without actually making any changes to the way that the political economy works. His stuff is very bourgeois oriented too. I know that’s a typical communist slur to fling around but what the fuck sort of meaning does a gig worker who can’t afford healthcare have the opportunity to create? (Of course, they still have the capacity for making meaning, as we all do, but if you’re pulling 20 hour shifts at the ball-crushing factory just to barely cover rent and insulin then you’re structurally cut off from meaning making in any significant way by design.)
Second, These couple comments really resonated with me. I’ve struggled with anhedonia since childhood and over the better part of a decade now have been piecing together an understanding of how depression (what I assumed was my main issue) manifested mostly due to being under the autism/adhd/ocd umbrella and never having an idea (until recently). And now that I know, I can be me! And anyone who doesn’t like it can kick rocks!
Anhedonia is really pernicious. I think it’s a bit of a silent killer, honestly. On the face of it, it doesn’t seem that bad - you don’t feel much joy. No biggie. Just keep at it and it’ll be fine, right? In reality, serious anhedonia can stop people from eating enough because they don’t even get any intrinsic reward from eating. For anyone who isn’t really across this experience. anhedonia can feel like how it is to fold laundry except it’s every task. Or like every meal is porridge or an unflavored protein shake. It’s hard to imagine for a lot of people (blessed) but how long would it take before you snap if every little thing you did in life felt like the weekly meeting on Monday morning at your office job - even the things that you used to enjoy? Anhedonia can be a slow grinding down but when it goes far enough, there is nothing left to grind away. But it never really feels urgent, at least to people on the outside.
I’m really glad to hear that you’re making progress on this front. It’s a heck of a battle.
I’m finally in relational therapy with my spouse and it’s been a game changer. Just unpacking our luggage with in a facilitated setting and affirming each others value has been amazing.
I’m really glad to hear that. For all of my criticisms of therapy, it comes from a place of wanting it to live up to what it has the potential to be - good therapy saves lives. It’s just so, so hard to find good therapy.
One of my closest friends (and groomsmen) drowned a couple months before my wedding - and I was finally able to admit that during the wedding I was only able to think about him and felt more sorrow than joy during that day. And it felt like taking off a weight - since every day since that I’d beat myself up as a bad spouse for having those feelings - but that’s (obviously) in no way how my spouse felt about me.
I’m really sorry to hear about your friend’s passing. I can relate to the feelings of inadequacy that lead to self-loathing because, at least in my case, I had a lot of experiences where I was invalidated. (I say a lot but really it was just one long stream of it rather than being discrete events.) It’s hard not to learn to feel wrong or broken or inadequate if you’ve only ever learned that how you feel is wrong and that you need to do better (especially when the “better” is vague and unspecified.)
One of the things that I try to use as a counterbalance to this is to consider how I’d feel about my spouse if they were feeling more sorrow than joy on their wedding because of the recent, tragic passing of a best friend or what I’d say to my best friend if they were in my shoes if I had passed away unexpectedly. Approaching it from that angle can be really helpful to reframe how I relate to myself by encouraging self-compassion and gently highlighting my own hypocrisy but not in a way that aggravates my perfectionism or feelings of inadequacy. Because that’s always the trap with feelings of inadequacy - the more you examine it and work on it, the more it can amplify those feelings of inadequacy. Of course there are ways to work through this but it’s unhelpful to try and resolve feelings of inadequacy by adding an extra layer by making yourself feel inadequate for being inadequate. And then you start adding another layer by feeling inadequate because you aren’t dealing with these feelings of inadequacy “properly”; you can get yourself into one heck of a mess trying to work your way out of that, especially if it’s a deep-seated part of how you relate to yourself. Which is where a good therapist can be invaluable.
Now I’m just rambling - but I’ve tried CBT (the behavioral therapy one), ACT (the behavioral therapy one), and others I can’t remember. But in all, what seems to work best is having a community of people who care for you, and knowing they do.
I definitely took a potshot at CBT and ACT and DBT in that comment above, although I didn’t name them directly. If they work for you then I’m genuinely happy for that. But I also have some big criticisms of them. CBT in particular is a dirty word for me lol. There’s a whole CBT racket running in my country, and I suspect this is probably the case for lots of western countries because it appears to be a model. But that’s a story for a different day.
In summary, death to capitalism
Agreed.
