I've written before about reclaiming authorship and the power of language, largely through advocating for collaborative treatment in my journey and sharing my story through the language of my choosing. Working in healthcare, as well as accessing healthcare as someone with living experience of mental illness, I am very conscious of the power of language and its clinical usage. Terms and descriptions that we (as healthcare professionals) utilize to remain objective, identify a particular struggle that a patient is facing, and pursue treatment options, can be both helpful and incredibly harmful.
In my mind, a key part of "trauma-informed care" (a popular term in healthcare with sometimes seemingly little meaning felt by patients) is empowering how people in how they may choose to share their story, how we work with them to define their journey, and always following their lead in the language that is most useful for them (where possible.)
By no means is this a simple process, but in my experience, it is critical. For so many individuals who have experienced or are experiencing mental illness and/or trauma/traumata, authorship is often stripped away and given to authority. This process can replicate past trauma(s) even if the intention in the present moment is one of care. We cannot forget this when we are doing this work with vulnerable individuals.
What I want to share here is an example of reclaiming my own authorship around my journey in relation to a specific occurrence from the past, and the follow-up I have been undertaking these past few months. It feels vulnerable to share this experience, but I want to do so for my own healing. It's not about blame or specifics, I simply want to offer myself the apology and human-to-human communication I will never get in this instance of seeking reparation. This will be somewhat freeform, to protect myself and the situation.
For brief context, there are complaint/feedback opportunities for healthcare interactions that cause felt harm for patients in B.C.'s provincial healthcare system and across Canada. In pursuing my own, it took many years to do so because of shame and fear (which I still feel.) In doing so, I sought no punishment for others, I have simply wanted to communicate my experience as an opportunity for learning and reflection. I will never know if that occurs on a personal level because these are very formal processes and I am okay with that. I have only sought to communicate in this manner a part of my own healing and a statement that subjective experiences (even in the context of mental illness) do matter, even if there is no documented proof of exchanges.
This is not to say that my perception of exchanges could have been impacted by my mental state, which is why this is not about blame, it's about trying to continue shifting challenging healthcare interactions in positive and healing directions, where possible. Whether they were documented or not, I will never forget some of the language I experienced (and still experience) to describe my story. This piece is meant to be the space where I can choose my own language. Please be aware that this may be triggering to read and take care of yourself as you need to.
For those who live in my community, what may seem vague to others will likely make sense. That said, I do ask gently that specific comments or details that could identify the situation or parties involved be avoided. This process is about myself, not the other. Thank you.
(*Please note, I switch between "she" and "they" pronouns interchangeably. This is done with intention.)
Though I will see no balm to these wounds, I can shine a light of my own making upon them.
Though not captured with precision, the person (we'll call patient) was lost in a storm of fear and confusion - unsure how to go on living or where to turn. The past held them captive, memories of distress in the same spaces they were trying to build new memories upon.
The worry of another who reminded her of her mother and a moment of fragility collided, revealing the degree to which her sense of pain had driven her. The words were difficult to say out loud because they meant next steps that she knew would be distressing, and entering into a place she never wanted to ever willingly return to for the damage it had caused, and likely would repeat.
Regardless of intention, there is no way to truss up the impact of experiences of dehumanization, belittlement, and stigmatization that exist in certain spaces (even more so for marginalized individuals that experience these to a degree far beyond myself.) There will of course, always be some potential degree of pain in high stakes circumstances, but there's an unavoidable degree and then there is a culture of harm. This story is about the latter, through the patient's eyes, mind, being, and body.
Knowing the way they had been received before, they expected dismissal before even reaching the front door. What you quickly learn is that there is no time to "reach out for help" - if you do so, you are seeking attention in a maladaptive manner, you will be handed a diagnosis of hysteria because you fit a description already decided upon, without your consent or inclusion. You will be told that if you meant harm, you would have done so - why haven't you done so? If you meant sufficient harm, truly deserving of help, you would not be having the conversation. Come back when you are already gone. It's as simple as that. Is this a thinking trap or a repeated experience? Who gets to decide?
Even when a circumstance arises where someone is "seeking attention (also known as care, support, connection, etc...) in a maladaptive manner," there is a need that is not being addressed. The person is doing their best to address the need. Support is critical in some form, not dismissal which will reinforce the harm.
What one perspective names "stupid," to another reveals the pain of expecting to no longer be around for the consequence of any action. She knew the decisions could be framed as "stupid," but her pain did not care at that point. Her capacity for a sense of the future where this might matter, was gone.
They had long since learned to shut down any sign of emotion, especially when they knew it would only further reinforce the idea placed upon them of being young, being female (as decided by others), and being inadequately "resourced." The brain in states of distress goes one of two ways - fight or flight, freeze or fawn. Shut down was the way to survive, to sink the below the surface; to let the distress, the noise, and the coldness cut no deeper than it already had. They knew what to say, they knew it was likely they would just be sent home. They played the game that would get them home (out of immediate distress). Thankfully, those who knew them better, knew they needed more and ensured they received that as best they could.
The only comfort to be found was with others who knew the pain intimately: a band of brothers and sisters who could protect each other from the harms around them. A sign of "wellness" on paper was a survival tactic in practice. The only comforting human contact available.
There is no space to be or breathe or escape in a cage, even if it is intended as protection. The words about what you are, what you will amount to, what you are perceived as, float around the room as if you are deaf, not depressed. Are you even a person in this space? It does not feel like it and sometimes you lose sight of this yourself. It is only in the aftermath, in the processing that takes place when the trauma is no longer fresh that you know you have been human all along, despite the spaces that sought to make you as cold and clinical as they. There are reasons why, but the damage exists.
The question remains, where is the prioritization of objective language and the removal of human elements of care a benefit and where does it cause more harm than good? Where does it perpetuate a patriarchal model of care? Where can we meet in the middle as two forms of knowledge (living/lived experience and professional) that coexist with their own expertise? Where can the paradigm shift to include those it is designed to help?
I continue to shed the layers and the language of others through my own healing process. I would not be here without supports that have also inflicted damage. It is not me versus anyone, it us seeking fertile ground to grow together in the ways we can, and decide where we cannot.
I do not know (nor I can I control) if I will be ever be heard, but I can speak and I will continue to do so because I will not treat those working in the system (those I work alongside) as inhumanely as I (or others) have been treated at the hands of the system. I know people are not deaf, only that the system is damaged. I will situate the issues in the context of a system that is struggling in the same that my own struggles exist in the context of me, a whole person. I am not a diagnosis and the people within the system are not machines. If the language does not suit me, I will not take it on. I will address the heart of the issues that the system describes as defaults and dysfunction within me as a human being, which I describe as the things that have happened to me.
I take my power back piece by piece, word by word - my words, my story, my journey.
- S.
Comentarios