A Quest to Find Offensive Stuff

An occupational therapist colleague of mine, Victoria Prooday, recently posted an image on her professional Facebook page. The cartoon picture showed two people sitting at the opposite sides of a bus. One side of the road faced a sunny landscape and the person sitting on that side of the bus was smiling happily and taking pictures with her phone. The other side of the road faced a gloomy mountain and the person sitting there, observing the uninspiring view, looked sad and miserable. The caption under the picture read: “So much of our happiness depends on how we choose to look at the world.”

Victoria added a commentary that happiness requires a conscious effort and that there is always a choice that we can make in our attitude.

Within minutes, this innocent little inspirational post gathered comments from people accusing Victoria of shaming those with depression. The commenters passionately advocated against offering people with depression the tools to try and overcome their difficulties, explaining that this sent the message that depressed people are the ones to blame for not making the right choices.

One commenter stated (correctly) that depression was not a choice. She then inferred that, therefore, even evidence-based treatments for depression could be counter-indicated for some people who, instead, would benefit more from “compassionate understanding.” When another person, who experienced depression herself, commented that similar information to the cartoon helped her overcome her own depression, she was told that others may still be harmed by such advice.

As a psychologist treating anxiety and depression, I couldn’t help thinking about the implications of this relatively new, but very common attitude toward mental illness. It seems that there is a mob of people constantly browsing through anything that is said and written about psychological health with the goal of finding something shaming, triggering, oppressive, blaming, or offensive. And, alas, when we approach life with this attitude, we, of course, find what we are looking for.

The Unintended Consequences of Radical Acceptance Preaching

As these self-appointed mental health advocates are usually very vocal, many people, including health professionals and teachers, structure and censor their verbal and written communication with the goal of avoiding an outlash. Therapists often offer endless validation, instead of gently and collaboratively creating a roadmap for change. Psychologists provide diagnoses and recommend numerous school accommodations.  Teachers take the accommodations even further and often create additional adjustments themselves. Parents, believing that they should endlessly fight and advocate for their child against stigma and shame, negotiate further modified assignments and extended deadlines.  

Suggesting healthier nutrition? – You are fat-shaming. Offering strategies for weaning off an anti-anxiety medication? – You are pill-shaming. Proposing more structure, discipline, and routine for a child? – You are parent-shaming.

Unfortunately, the current over-zealous censorship inevitably leads people to believe that they are irreparably damaged, broken, or flawed, -- creating a feeling of worthlessness, helplessness, and hopelessness. People learn to believe that there is no internal agency for change and that all they have left is venting and relying on external accommodations. This disempowering effect is overlooked. 

Is Acceptance Necessary?

Does this radical acceptance have a place in helping a person move toward a better life? Of course, it does! It’s difficult to make progress without first accepting where we are right now. People need a non-judgemental, compassionate environment where they can talk about their pain. They need somebody to listen to them and to empathise. And accommodations are often needed – sometimes permanently, and sometimes temporarily.  

Is Acceptance Sufficient?

The point that keeps getting missed is that by themselves, the validations and accommodations don’t achieve much. They are necessary, but not sufficient. They are just the first step on the way to growth, recovery, change, and living the best life. The steps that need to follow are specific actions toward the life that a person finds meaningful. Choosing to see other people’s statements as offensive instead of approaching them in good faith leads to the loss of these essential nuances.

As a society, we have finally come to a very important stage of accepting mental illness. There is a lot of the much-needed talk about increasing awareness and reducing the stigma of psychological disorders. But should we just leave it at that? Or are there more steps?

A War on Change.

Meanwhile, somehow, the noble goal of acceptance and non-shaming has turned into a war on change. And, ironically, it has also turned into shaming the very people who have the ability to help the sufferers of psychological disorders.

This is how therapists and authors had to stop using the now-forbidden P-word (punishment) and replaced it with “consequences.” Recently, the “consequences” word has also fallen out of favour and parents are encouraged just to listen to the child and try to be understanding.

No wonder that we see so many parents feeling completely helpless about disciplining their children. They were led to believe that accepting the child the way she is would be enough. But it isn’t. Children need routine, discipline, and guidance.

Building internal strength and resiliency when coping with a difficult boss or family member are replaced by launching complaints about the boss and severing the ties with a “toxic” family member. Are those sometimes justified? Yes, for sure they are. But in many non-extreme cases, internal coping skills can be developed to handle those situations without being emotionally hurt. And, those skills are invaluable and transferrable to other problematic circumstances.

The evidenced-based strategies for depression (behavior activation, cognitive restructuring, learning to make steps toward values and goals in spite of painful feelings and thoughts) are suddenly considered shaming and judgemental. “It IS shaming to tell someone with depression that they have a choice about it,” the Facebook commenter proclaimed, quickly moving to calling “positivity advice” to be a “near-enemy of true compassionate understanding.” Yes, nobody chooses to be depressed. But within depression, addiction, and any other illness or life situation, there is always an element of choice of what to do about it. Sending the message that the choice is not there is dangerous and irresponsible.

The Only Way Out of Fear, Anxiety, Depression, Life’s Difficulties, and Pain is Through Them.

No amount of support or reassurance will help a person to overcome an anxiety disorder or OCD. Worse than that, as any therapist trained in the treatment of those disorders knows, accommodations and reassurance will make a person feel better for a very short time but will lead to a gradual worsening of anxiety.

Similarly, it is very difficult to overcome depression without increasing the levels of activity in spite of a complete lack of motivation to do so. And, going back to the example of school accommodations, in most cases those are temporary Band-Aid solutions and will not lead to any significant improvement without numerous other changes in the child’s routine, discipline, self-regulation, and nutrition.

I don’t doubt that the trigger-searchers’ intentions are noble. They would like everybody to accept themselves without changing a thing. On a deeper, psychological level, it also feels really good to perceive oneself to be a non-judgmental and accepting person. Unfortunately, it’s the psychological disorder's sufferers who pay the price for this beautifully-sounding un-nuanced ideology. 

And this is where the question of what compassion is comes to mind. Compassion does not mean enabling somebody so that they can experience a temporary relief which will lead to long-term worsening of their problem. If we have an honest look at ourselves, we do it to feel instantly better. It’s not much different from giving in to a toddler tantruming in a supermarket and buying him a candy knowing full well that it’s not good for him. But it sure makes us feel good, brings relief, and “resolves“ an uncomfortable situation.

Real compassion is tolerating our own discomfort while working to help another person to live a meaningful life in spite of their past and in spite of their painful emotions and thoughts. This is true kindness. In today’s climate, it also means, tolerating the implicit judgement and explicit criticism of well-meaning bystanders who recoil when they encounter pain and whose knee-jerk reaction, therefore, is to make it disappear.

Acceptance of our limitations and pain is only the first step. The next steps are identifying which value-driven direction we would like to move toward to, dealing with the obstacles that stand in the way, and committing to taking effective action to create a rich and meaningful life.

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Anna Prudovski is a Psychologist and the Clinical Director of Turning Point Psychological Services. She has a special interest in treating anxiety disorders and OCD, as well as working with parents.

Anna lives with her husband and children in Vaughan, Ontario. When she is not treating patients, supervising clinicians, teaching CBT, and attending professional workshops, Anna enjoys practicing yoga, going on hikes with her family, traveling, studying Ayurveda, and spending time with friends. Her favorite pastime is reading.

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