Dear mental health professionals: this is how you should help chronically invalidated patients.
I’m not in the industry myself, I just avail of it. And I’m seriously thinking of giving up for good. So please, even if you get mad at my words, LISTEN.
If you have any real compassion, and not just the facade I keep seeing, please, LISTEN. I’m asking one last time.
Yes, I’m bitterly disappointed with the industry. Should I be? Shouldn’t I be? I don’t know, and most importantly, I don’t wanna know. Not for now. Not for a long time. FIRST, I need to speak out. I need to allow myself to feel the politically incorrect feelings that you guys keep shutting down and dismissing and discouraging.
I mean… I get it. Ideally, every patient should be meek. It makes things so much easier. However, we can’t always have the ideal. In theory, no feelings are “wrong”. In practice, though… *sigh, big sigh*
Nobody wants to deal with the angry patient; the outraged patient; the person whose big feelings won’t go away with a simple comment. You prefer the sad ones, the depressed, the ones who don’t make “a fuss” and don’t have “an attitude” ever. Sure. It makes sense. It’s only human to dislike emotional discomfort, and what’s MORE uncomfortable than trying to help someone who has a bit of a temper? But I’m not sure it’s very wise to keep ignoring and brushing it off and refusing to deal with that. Sorry, I don’t. I know I’m not an expert in mental health, but my intuition is strong, and it’s telling me I have been treated unfairly for several decades by quite a few professionals in 3 countries, 2 continents and 2 hemispheres. I think it’s time I start listening to my intuition and stop dismissing it as “just a feeling” or “sure it might be cultural” or [insert excuse here].
No. There’s NO excuse. And I will not be apologetic this time. I hate having to be a “karen”, trust me, I’m usually the customer who eats the wrong thing because I’d rather not inform the waiter my order came wrong, I find a way to fix a bug in a new device myself before I talk to tech support, I don’t return clothing in the wrong colour unless I need it urgently, you get the idea. It’s not fear of complaining, I just couldn’t be arsed; I figure that I must have some responsibility and choose my battles, and that’s how life runs smoothly (high five to fellow “dismissive avoidants”, ✋). But when a problem starts repeating… And repeating… And repeating… Again and again and again, regardless of where I go or whose service I seek… There comes a point when I just have to cross my arms and say “ah, for feck sake now”.
The only caveat I’m making — feel free to consider it generous, at this stage — is that I don’t know if I’m uncovering something fundamentally wrong with the mental health industry, OR I just happened to be unlucky up to now. It happens! Life gets weird and some patterns repeat for no reason. So, it could be that. It goes without saying, “not all therapists”; Nonetheless, it absolutely was all therapists I encountered.
Before you assume, no, this isn’t just a personal vent (but feel free to judge it that way. Water off a duck’s back, if I earned a euro every time a therapist judged my words too soon without even bothering to reflect…). The only reason I’m bothering to publish this article is it could help open your eyes, so that you can help other people in the future. I’m good, I’m done, fed-up, I don’t wanna keep trying myself; But I can’t be the only one feeling this way.
Here’s the one thing to keep in mind: avoid invalidating the person’s reasoning or emotions.
Strictly avoid that. I beg you. It can’t be that difficult. I mean, I’m able to talk to people without invalidating them. So is a politician friend of mine every time he goes canvassing, and he has ZERO qualifications in mental health. Come on now.
Unless they tell you “the Earth is flat” or something else that objectively does not proceed, let them believe what they want to believe. (And even then, even in the case of factually wrong information, maybe it’s worth it to avoid invalidating at first. Therapy is about emotions, after all. It isn’t a lecture in discernment filled with objectivity and coldness. It’s not a Maths class, if you will).
“Oh but he/she/they is lying” — okay, AND?! What if this patient is lying? Aren’t they adult enough to deal with the consequences? Must we infantilise everybody?
It’s not fear of being lied to, is it? Let’s admit what’s actually going on here. It’s close-mindedness. Rigidity. My-way-or-the-highway antics. THAT is the recurring problem I’ve seen in therapists, and it’s annoying as fuck.
What I’m saying here could be helpful for every kind of patient, but I guarantee it’s especially important if you’re dealing with someone who has been chronically invalidated. A victim of gaslighting, for example. This “jumping straight to reframe” thing you guys do is triggering. Stop it. Let things simmer for a good while. I don’t care how well-intentioned you are, or how tried and tested this is, it won’t work on everyone. And I’m here speaking for the people this won’t work on — the chronically invalidated. I don’t care if you call it reframing and not invalidating; It feels like invalidating nonetheless. One must know not to be so proactive about it. Let the person ASK for alternative viewpoints first. Unless they have full-blown NPD or psychopathy, they *will* eventually ask. I promise you. (And if they do have a severe personality disorder, that saves you some stress too in the end of the day).
DO NOT devil-advocate. I can’t stress this enough.
“Oh but I must show this patient that their judgement of person X and person Y is unfair”.
Again: okay, AND?! Where is this going to take us?
An idealist would say, “oh, this will lead to positive insights, and to exercising empathy”. Sure, that’s a possibility, but you know what’s also possible (and far more likely)? Distrust in your therapy. Disillusionment with it, and giving up too soon. Because let’s face it, this isn’t about weighing objective realities on the scales of fate and deciding who gets to go to heaven or hell. We aren’t gods, that’s not our lane. We’re human beings. Drop this arrogance.
Instead, this is about building some rapport and showing this utterly scared and scarred person you won’t offer them more of the same gaslighting they suffered over and over. It’s being kind enough to gently pat on a wound with soothing medicine instead of pouring acid on it, if the metaphor helps drive the point home more clearly.
The reason why I’m speculating that this covert invalidation habit could be a window into a deeper issue with the mental health industry as a whole (despite the caveat I made earlier), is it could be happening to EVERY patient ever and I simply don’t know because I’m not in their shoes to know. In that case, we’d also have to grapple with the possibility that not everyone sees it as a red flag. For example, the “meek” ones I alluded to could be suffering the same exact thing, but dismissing it as an okay thing because they’re so conflict-avoidant and afraid of judgement that they just give in to it every time. Their unconscious could be going like, “oh, I was invalidated now… But that’s normal, right? Nothing alarming, right? Everyone does that all the time to each other, right?”; Or WORSE: “Oh, I was invalidated now… But my therapist is right, I should hide this judgement of mine out of my conscious awareness because it’s bad and it’s ugly and I’m being a bad boy/ bad girl for even thinking it!” (Guilt and shame have been installed in their mind with success. *Slow clapping*). Meanwhile, people like me don’t take so kindly to it, and we’re considered problematic or difficult for complaining.
It’s only a hypothesis, but worth considering. I mean, it’s fairly plausible that a lot of therapists today are force-feeding people conventional morals under the pretense of “simply reframing” stuff… As if it helped anyone actually reflect on morality when you don’t even give them a chance to talk about what led them to stray from the conventional in the first place. This feels closer to silencing and manipulation, if you ask me, only it’s sophisticated and without real violence: it’s like “smother first, ask questions later”. Yikes. How very “compassionate”.
I know it may sound simplistic, or even childish, to let someone finish without interruption when they’re shit-talking someone else… But in my very informal experience with, ya know, NOT invalidating people, here’s what I’ve learned:
Gossip is a pattern. It’s never one isolated incident.
Allow me to explain: gossipers (the people who do in fact shit-talk others and should learn more empathy) do it all the time. They won’t just do it once in a blue moon in between long periods of theorising and trying to make more sense of the situations in their lives. In fact, the whole purpose of gossip is to judge somebody else at face value — so there WILL NOT be deliberation of any kind.
Therefore, if you’re dealing with someone who ISN’T a chronic gossiper (and DOES NOT need a moral lesson on learning to have more empathy), this person will eventually arrive at the point where they say “…but I could be wrong. Maybe I have my own parcel of blame too” or something along those lines. Guaranteed. But that’s when, AND IF, you let them speak and let them cool down without your unsolicited help.
Again: more open-mindedness, less rigidity.
Ya know… Sometimes I watch true crime documentaries, just because I enjoy the second-hand satisfaction of pretending I am the killer, and their therapist/interviewer is talking to me. Would it take going to jail to talk to one of those guys? I envy that. I want some of that non-judgemental and entirely descriptive approach. I wish I could sit in front of someone who won’t morally “put in a box” what I just said, and leave that conclusion for the audience instead. Just for once. Just for a change. It must be nice.
And mind you, I have no interest whatsoever in breaking the law. Not even in non-violent ways. I’m happy enough with the law as it is where I live (that’s why I moved here). Strictly when it comes to dynamics, though, I want me a true crime interviewer. Where can I go to find those?
This leads me to the next point:
Maybe, just maybe, mental health professionals need more morbid curiosity.
That’s what drives true crime interviewers to let a cold-blooded killer speak, isn’t it? Morbid curiosity. Both their own and the audience’s.
What if we had more of it, especially in less extreme scenarios? Is it really so bad to approach “impolite” or “not-very-nice” patients with a bigger degree of morbid curiosity and less self-righteousness? I mean, realistically, what’s the worst that can happen? We’re not talking about physically violent people because we’re not talking about extremes (like with an actual killer). I’m trying to apply this to more usual therapy scenario.
For example, instead of instantly reframing someone’s anger as “the sadness underneath” or “the sense of justice and loving kindness underneath”, let them rant. Let them curse like a sailor and reenact heated debates where they satisfy the need to RELEASE. Geez, it ain’t rocket science. Why do we demonise the expression of certain emotions so much? Is it really unthinkable to remind ourselves that we aren’t always civilised, prim and proper? Come on. We’re part of nature too. We have an animal side. And this animal side could be dealt with, but alas, we keep suppressing it and letting fear get the best of us.
If someone tells you the most heinous things about a third party, fucking listen. It’s not your place to dissuade them from “saying such ugly things and being so mean”. Oh I’m sorry, Charlotte, I didn’t realise this was an etiquette class. I thought I was in therapy, lol. In other words: yes, objectively, they’re being mean, but SO WHAT? Is it forever? Will they burn in hell for all eternity? Yeah, I didn’t think so either.
Pardon my French (throughout this article, also, lol) but sometimes the most therapeutic thing is to yell profanities at the motherfucking universe in a safe space as if you were the owner of all goddamn truth. Gradually, you’ll get out of this state. But I don’t think it should be “nipped in the bud” in order to save face.
For heavens sake! Saving face?! Really?! In a therapist’s office? And WHERE THE FUCK will you get honest about difficult feelings then? In real-life situations, in the form of passive-aggression and competition?
Do you see where I’m getting?
There’s something fishy with society as it is, and the problem is multifaceted, so I can’t and won’t attempt to address it in its entirety — but I hope this article sheds some light on a tiny contributing factor: the sad habit we all have of trying to look good to each other, whatever it costs. This comes in detriment of learning and improving ourselves to the point we wouldn’t only look good, but also be good. But in order to get there, I don’t think locking our skeletons in a closet under a bunch of strong chains and barricades will do the trick. Don’t blame me for saying that! Complain to Jung.
