Watching out for oppressive mental health practice.

I received an email from an Australian psychology service yesterday which addressed the covid-19 outbreak and how we can take care of ourselves through this anxiety provoking time.

The email focused on points such as,

• Making sure that we’re getting enough sleep,

• That we’re eating well,

• That we’re managing our work-life balance,

• And tips on how to reduce inflammation and toxins in our daily lives.

These points are all really valid and important in caring for our mental health and wellbeing however, I was really disappointed to find no mention of discrimination and race-based fear and violence that has been such a big part of this recent outbreak.

This is what oppressive practice looks and feels like because there is no acknowledgment of the broader social climate when delivering mental health services.

When we are told that our sense of distress only occurs as a result of our own actions, (eg. I’m anxious because I’ve been really busy and haven’t been able to sleep much), we are reinforced this idea that our mental health is controlled only by ourselves and that external factors don’t play a role in how we’re feeling.

To explain this a little more…

I would say that right now, I’m feeling pretty anxious and have had trouble falling asleep every night. Yes it’s my responsibility and in my power to choose my thoughts, to filter out negative social media content, to do my nightly sleep hygiene routine, but I also know that I’m not sleeping that well because every day, I’m hearing about East Asians all over the world (people who look like me), being targeted and discriminated against. And like many East Asians, I am wondering when the day will come when I have to experience this.

I’m also feeling nervous about all the travel warnings - not because I’m unsure of whether or not my Europe trip will go ahead in September, but because my family lives overseas. What will happen if things get worse? What if something happens and I’m unable to travel? These are the kind of thoughts that anyone who’s life is spread across different countries would be thinking and perhaps subsequently, affecting their ability to sleep well.

And this is only my experience - a highly privileged, highly educated, financially independent person from a first world country that has no travel bans in place. Imagine the levels of distress in people actually from China/Italy/Iran, people who have chronic conditions, people who aren’t financially stable or people caring for their elderly relatives.

So, when a mental health practitioner tells me that I need to take care of myself by ensuring that I get enough sleep, without acknowledging the blatantly obvious social trends that are occurring, I feel like my experiences are not real or valid. I could follow all of her advice, but if I’m still experiencing discrimination, feeling disconnected from my family abroad, chances are I’ll still be feeling pretty distressed despite eating, sleeping and doing all the other things well.

And the problem with this is that it could potentially create further distress, “I’m doing everything right, as per a health professional’s advice yet, I still don’t feel well - what is wrong with me?” We might even turn to our Caucasian friends or colleagues who are actually feeling better from such advice and feel even more confused as to why I’m not able to sleep well.

Please let me stress that this is exactly what oppressive practice looks and feels like because such messaging further marginalises and weakens minority groups by perpetuating the idea that there is something broken about us. This is the kind of mental health support that is extremely white-centric (ie. only thinks about the experiences of cis-gendered, straight white people) and can cause more harm than good in our globalised and multicultural world.

So, how could this advice have been improved?

• Acknowledge that there are broader issues going on right now, like targeted attacks on East Asian people, xenophobia perpetuated in the media, fear of other people, fear of the unknown, fear of scarcity etc, that are affecting people’s mental health and wellbeing. Even if you think this is obvious, it is important to show that you at least can see what is contributing to people’s distress. Don’t shy away from talking about these topics because you’re afraid that you might say the wrong thing. Not saying anything is even more offensive.

• Remind people that the collective fear and anxiety that we are experiencing is a normal response to an abnormal situation.

• If you are choosing to remind people of self-care strategies (sleeping, eating, balancing things well), state that these are only small interventions that are designed to help to ease the burden of some of the bigger more pervasive issues going on. Do not imply that these self-care strategies provide the answer to easing people’s distress. Also make sure that you’re reminding people that it’s ok if their regular self-care strategies aren’t working right now and explain in detail why this may be the case.

• Encourage people to critically reflect on what is being portrayed in the media as well as their own feelings of fear. Support people to understand their experiences and invite them to express these concerns in health-promoting means (ie through therapy, through meaningful conversations, through music and art etc).

• Encourage people to exercise social connection in safe and simple ways. Remind them to check in with the people around them especially if they’re from a country that is gaining a lot of media coverage right now. Invite people to be warm and compassionate to others and remind people to step in (if safe to do so) if they witness any form of discrimination around them.

• Even if your whole mailing list is 100% Caucasian, straight, cis-gendered and able-bodied, you MUST highlight that the current societal and political environment is out of whack and encourage your readers to gain a greater awareness of the challenges that other people in the community are facing. Otherwise, you are only perpetuating their privilege and further oppressing marginalised communities.

Be mindful of noticing oppressive practice.

I wrote this article because based on the years of therapy training and experience that I’ve had, I knew that there was something wrong with the advice provided. However, not everyone has this privilege or awareness and they are the ones who suffer more at the hands of poor practice. If something that you’re reading or hearing doesn’t feel right, don’t be afraid to ask yourself, “why is this not sitting well with me?” and “is this person avoiding acknowledging my experience (or the experience of another group of people)?”

Everyone is doing the best that they can and I am sure that the person who wrote the email above had the best intentions at heart. Rather than getting angry and fuelling the situation with more hate and anger, I hope that this article can assist those both providing and gaining mental health advice during these crazy times.