It has taken me longer to write this post than I meant for it too. That's partially because I have been busy with unexpected fun things and partially because when I haven't been doing fun things I have been having a hard time concentrating. This difficulty in concentrating, along with a handful of other symptoms could be attributed to the intense energy waves coming in right now, or they could be used as the perfect segue into the topic that I wanted to talk about in this post anyway:
How Shifting to a Responsibility-Based Framework Helped Me Cope with Mental Health Symptoms
Before I actually get into this post a couple things:
First of all our personal belief systems (ie whether you believe the symptoms I'm about to describe are related to non-physical phenomena like shifts in energy or are symptoms of illness related to brain chemistry or thought-dysfunction or if you believe that those two beliefs can or cannot be combined) are things within our power to control or influence, and therefore choosing which framework to use or deciding to be open to several at once and not taking a solid position is a choice. In fact taking ownership of my own personal belief system is one of the most empowering responsibility-based choices I've ever made and significantly impacted my ability to cope with the things I experienced. This specific component, however, is not the main topic I want to cover in this post so I think I'll do a Part 4 and talk about blame and responsibility in relation to beliefs later.
Second I want to point out that I'm talking about how this perspective helped me "cope with" my mental health symptoms, not "cure" them. This is an important distinction because the symptoms have not stopped and I would be surprised if they ever completely subsided, but I am able to live a much fuller life now and even integrate the symptoms into that life and attribute that ability partially to this understanding.
Before I start (sorry for all these pre-post notes) a quick overview of what I am talking about for anyone who doesn't know me personally. I was diagnosed with social anxiety disorder and major depressive disorder with psychotic symptoms when I was 14. Later my diagnosis was changed to schizo-affective disorder with depression and agoraphobia with panic disorder. I've tried a long list of medications and been in therapy for most of my life. I have also been hospitalized 4 or 5 times (I can't remember) usually for suicide attempts. My current therapist told me that she doesn't really think I qualify for a diagnosis of schizo-affective disorder-- which is great news for me because it means that I'm doing well enough not to need that label any longer. Whether you want to argue that I was misdiagnosed or that I'm doing well enough for a different diagnosis, doesn't really matter for the purpose of this blog-- I only mention the diagnosis so that if you wanted to you could look them up and have an idea of the kinds of symptoms I am referring to. If you do look these disorders up most of the symptoms I have related to schizo-affective and/or psychosis are positive symptoms (hearing voices, seeing/ feeling things, delusional thinking, etc).
Okay-- phew-- long introduction...
Now, how do I want to write this without making it too much longer?
I'm going to start with this really quick idea: the concepts of blame and responsibility are very closely related to power. When we blame someone or thing not only do we create a sense of punishment and guilt, we also in essence give power to that person or thing. For example if you blame your job for you being miserable you are giving your job the power to affect your mood and/or your perception of joy within your life. I spent years oscillating between denying that my symptoms had any effect on my life whatsoever and blaming my character for everything wrong in my life and blaming my illnesses for all the things I could't do in my life (talk, go out, make new friends, keep friends, feel safe, concentrate, work, think-clearly, get out of bed, follow through on decisions, etc). When I blamed my character I set up a pattern of guilt that spiraled down to create a need for punishment and reinforced the idea that I was bad and deserved to suffer, but when I blamed my illness I gave all the power in my life to those symptoms and believed that I would never be able to function at all. Neither of these patterns was particularly helpful, they either resulted in me needing to destroy myself because my character was so flawed or me feeling constantly victimized by my fears, thoughts, emotions, and the things I saw and heard. So either I was a horrible person who had the power (ability) to do better, but didn't-- or I was a victim who's life would always be dictated by the current of symptoms.
Learning to separate the concept of blame from that of responsibility shifted things in a number of important ways. First of all, responsibility is solution based-- so instead of looking for someone or thing to blame I started looking for possible ways to improve things. Instead of thinking "is this right or is it wrong" or "do I deserve this or that," I started thinking "is this helpful or is this harmful?" It was really easy initially to take the "helpful/harmful" framework and turn it into a "right/wrong" one, so I had to practice letting go of the guilt and judgment associated with what I saw as "harmful". To do this I would say to myself something like: "that decision was harmful, but beating myself up over it is MORE harmful. Instead I am going to do something helpful, I am going to use this as an opportunity to practice forgiveness or compassion or self-love," and then I would focus on that.
The responsibility-based framework was also helpful because it didn't require a culprit for the symptoms I felt. If I was having a lot of anxiety one day I didn't have to sit there an think about the anxiety and wonder what had set it off, I could just say "I'm really feeling anxious today, what can I do to calm down?" Instead of going around in circles trying to pinpoint the cause of the anxiety and then eradicate it from my life, I just found something calming to do. If the first thing I tried didn't work I tried something else. If that didn't work I tried something else. Some days I just resigned to the fact that it was an "anxious-feeling" day and I was just going to stay home and give myself a break from trying to face my fears. Some days I realized that all I could do was let the anxiety pass on its own, and do my best not to take any destructive action while it did.
This last example brings me to the idea of power and responsibility. Where blame tends to give power away (except for maybe when you blame yourself for something which gives you power but also punishes you for having that power and misusing it), responsibility is focused on what you actually do have power over in any given situation. It is important to note that we do not have complete power over every (or even most) situations, but we usually have some power over some aspect of ourselves in any situation we find ourselves in. From a responsibility-based perspective, the goal is to assess what you have power over, what you would like to have power over, and then take action based on that power to resolve a situation to the best of your ability. In circumstances related to things like habits, health, and goals, you might start off with a relatively small amount of power, but in time you can build that power up. Sometimes there is a limit to the amount of power you will ever have over a situation in your life and sometimes the level of power available to you fluctuates moment by moment.
In my case when it comes to mental illness I realize that I do not at this point (and likely never will) have the power to stop the symptoms completely. I still have panic attacks and I still see, hear, and feel things that other people don't. I don't have power over these things and therefore cannot truly take responsibility for them-- but, I do have the power to reduce their frequency by monitoring and adjusting to my level of stress in a given situation. I also have the power to take preventative measures and improve my level of resilience so that the symptoms show up less frequently and I recover from the quicker. There are several techniques I have used to reduce the impact of the symptoms I experience on my day to day life and I think that I will do a separate series of posts discussing some of those techniques.
As an overview, though, what I started to realize was that even when I was functioning at a minimal level I learned that there were things I could do to move towards gaining a greater level of power over my life. The first time I learned this (even though I didn't define it in this way at the time) was when I realized that I could stop self-harming. I couldn't control the urges to hurt myself at the time, or the pain that built up from not acting on those urges, in fact the first time I experienced that kind of build up of emotion and desire to cut but didn't act, it felt like an impossible battle. I cried, wrapped myself like a cocoon in a blanket, and told myself I would not leave the bed until I was certain I could do so without harming myself. I knew that if I let myself move at that point I would cut, but I recognized that I had the power to choose not to move at all until those feelings passed. The next time those feelings came up I did the same thing, and again and again and again. I just cocooned myself and refused to move until I felt safe. I didn't have the power to stop the feelings, but I had the power to keep myself safe in spite of them.
This concept applies to other symptoms in different ways. There was a time, for example, when I didn't have the power to lift the heavy, curtain of grief and despair around me. I saw a YouTube video at that time that talked about how carrying your body in a different manner could elevate your mood. I had also learned about this in psychology classes. The video I watched suggested standing in a yoga "power pose" for 1-5 minutes a day. It was a super-hero pose where you stand with your legs a little more that hip-width apart, put your hands on your hips and try to keep your back straight and chin up and smile. This was supposed to encourage a sense of confidence and positive emotion. I aimed for 5 minutes (who can't stand in one position for 5 minutes?) I barely made it to 30 seconds before I got overwhelmed at sat back down. I didn't have the ability to even stand confidently for a full minute at the time, but I did have the power to stand like that for 30 seconds. So that's what I did. I stood for 30 seconds and then the next day it was too overwhelming, but a few days later I had the power to try again and I did. I stood in that pose for 30 seconds and then I did it two days in a row, and then three, and then five and then I was able to stand there for a whole minute. That was one way that I built up a sense of power. I wasn't ready at that point to take responsibility for my entire mood but I was ready to take responsibility for those 30 seconds a day and make progress towards increasing the sense of power I had over myself.
I could go on, but I think you get the idea. The point is that I learned that even though I don't have the ability to control or stop the symptoms I experience, I do have the ability to address areas where they cause dysfunction by taking small steps or actions. I also have the ability to make the people in my environment more aware of my symptoms (if I feel it is safe and helpful to do so) and to take steps in case I need an "escape route" (for overwhelming social situations) or flexibility (in case I have days where I just need to stay home) or key people that I can ask for help when seemingly simple tasks become too hard. I may not be able to predict or stop really terrifying, difficult symptoms, but I do have the ability to set "safety nets" for myself in case I get to a point of crisis or need help. From this view I am not responsible for my symptoms and don't have to feel guilty about the fact that they exist and sometimes interfere with things I am doing, but I can take responsibility for taking steps to reduce the impact of those symptoms on my life.
Remember responsibility is not about blame. It is about looking at what you can influence in a given situation and deciding whether or not to use that influence to improve a situation. There is no right or wrong way to do this, but taking responsibility for your life means that you realize that you have a certain level of power over your life-- and though you can't control or influence every aspect of your life you can decide how to apply that power to move in a direction that you find happy and fulfilling and acceptable-- or you can choose not. The level of power you have to influence things may vary moment to moment or from one situation to the next, but whether you have a lot of power or very little, how you choose to use that power is up to you.
That is the basic overview of the application. I know that it is a lot easier said than done which is part of why I think it is important to stay away from blame when you are dealing with things like health concerns. Even if choosing not to blame is the only power you have at the moment, you can still choose it and in doing so choose not to create a greater sense of guilt and despair. It is much easier to write a list of techniques or come up with a theory than it is to break through really intense symptoms, but realizing that there was some power-- even if it was small and fleeting-- helped me. So maybe recognizing that such power exists no matter how small and inconsistent it might be at the moment, will help someone else find a way to make their life less painful or find a solution that they didn't expect.
That is all I have to say on this topic for right now. I think I will add one more post about blame and responsibility in relation to beliefs before moving to a new topic and sometime in the near future I might add some techniques I found useful for managing some specific symptoms related to anxiety, depression, and psychosis. So if that is something you are interested in please check back for those.
Thank you for reading.