Accountability

     Accountability AKA taking responsibility for one's actions. Humans are taught to be accountable by good parents as soon as they're old enough to play with other children. This idea of being responsible for one's actions is one of the big life lessons educators hope their students learn, that ministers hope their parishioners can take to heart, that bosses hope their workers come equipped with, and that mental health professionals hope their clients can grow into. In other words, having accountability is extremely important on a personal and societal level.

    Having accountability is so important, yet, people with mental health conditions aren't always held accountable for their actions, particularly by their loved ones. I get it. It can be difficult for loved ones to navigate the changes that come with the sudden onset of symptoms, the diagnosis, and the subsequent trial and error process of finding the right therapeutic approach and the right medications. So, many times our loved ones will be more lenient with problematic behaviors in an attempt to be understanding while they're waiting to figure out what's going to be most helpful. That can be a good thing as we all need extra compassion, understanding, and leniency from time to time.

    Many times, though, the need to be seen as understanding can go too far. Sometimes, loved ones will make excuses for problematic behaviors and use the mental health condition as the excuse, even after a treatment plan is in place and the adjustment period has long gone. As in, "He hit you because he has bipolar disorder, and he just can't control himself sometimes." Or, "She yelled at you because you touched X, and you know that triggers her OCD." Or, "They only have a substance abuse problem because they have depression, and that's the only way they can cope." I personally know someone who says things like, "Well, you trigger my anxiety and depression, and then I turn into an asshole. That's just the way my symptoms present themselves," because other people let them be this way, and now their mental health condition has become an excuse for poor relationship skills.

    That's...not actually how it works.

    Living with a mental illness IS NOT an excuse to treat people poorly. If someone is treating you poorly and blaming it on a mental health condition, please note that the Diagnostic and Statistical Manual (AKA the DSM) doesn't list "being a jerk" as a symptom of any mental health condition. I had a professor at university say something along the lines of, "You can't always control how you think or feel in a situation, but you can ALWAYS control your behavior." So, stop making excuses for them, especially if the excuse is their mental health condition. People always have the choice between treating people respectfully or treating people poorly. Accountability isn't supposed to fly out the window in the name of being understanding.

    If someone is having problems in their relationships or problems functioning in society, that person has the option to take responsibility for their actions and address the issue in treatment with their therapist. If they do not address these problem behaviors and work to correct them across all of their relationships, that is a choice, and they chose not be accountable. That person is then choosing to willfully continue that harmful pattern of behavior. That choice had nothing to do with their mental health condition and everything to do with their lack of accountability and lack of care for the people their behavior is hurting.  

    Also, that whole pattern of, "I have a mental illness which basically means that I can be a jerk and pretend that I can't help it," hurts more than just the people in that one person's life. It hurts EVERY SINGLE PERSON in the world that lives with a mental health condition. The mental health stigma already tells society that mentally ill people can't have normal relationships, and so by choosing to treat people poorly and then blaming it on a mental health condition, the person is just allowing that piece of the stigma to become more widely believed and more deeply ingrained in society.

    I'll end with this: Having a mental health condition isn't a free pass to treat people in an unkind way. Yes, trying to be understanding, sympathetic, and lenient when someone is learning how to live with a mental health condition can be a good thing, but when that leniency turns into making excuses for problematic, hurtful, or abusive behavior "because they have a mental illness" that is no longer good. That is enabling, and it helps the other person avoid taking responsibility for their actions. How someone treats other people is always a choice, whether they have a mental health condition or not.

Christian Faith and Therapy

     I've been feeling a bit more reflective this past week. In particular, I've found myself reflecting on my faith journey and my mental health wellness journey, and how those two things work with and inform each other. I've been thinking about what it has been like for me to be a Christian with a mental health condition, mental health treatment, and how many Christian faith communities deal with mental illness. 

    I don't usually get personal in this way, but for today's topic I feel like maybe I should. So...just some background information: I have always been a religious person, and I will probably always be a religious person. I spent a lot of my early adult years searching for the place that felt like it "fit" me. I was raised in a pretty conservative Baptist family. (Seriously, I come from a family with what feels like (to me), a LARGE number of Gospel singers and preachers.) I converted to Catholicism in college. Then, in my mid-twenties I found my true "fit" in the Episcopal Church. Although I haven't felt up for going in a while, it's still the first place I want to go when I'm stressed for too long or things feel like too much because I feel at peace there.

    There still seems to be this idea in many Christian faith communities that people have to choose between their faith and getting treatment for their mental illness. I haven't heard this idea spoken out loud by any modern pastor or priest, but it still pervades the American culture of Christianity, especially in rural places and fundamentalist-leaning churches. It's an idea that whispers, "Oh, you're going to therapy INSTEAD of just talking to the pastor? Oh, you're taking MEDICATION?  Oh, you're choosing to believe in SCIENCE instead of having faith in GOD?" WHAT KIND OF CHRISTIAN ARE YOU?" (The implied answer here is: "not a good one.") It feels a little bit like the Evolutionist vs. Creationist debate all over again, except this time, the stakes are people's mental health and their actual lives instead of what somebody can teach in the classroom. 

    It doesn't have to be like this, though. In fact, it shouldn't be like this. Your priest or pastor isn't a therapist. He/She/They are a religious leader. They aren't qualified to be a therapist (unless they have a dual degree and a dual career as a mental health professional and a pastor), and expecting them to have more than a passing knowledge of how to manage mental health topics isn't fair to them. That's too much weight to expect someone without the right training to carry. Your religious leader CAN definitely be part of your support system, though. That's what they're there for. Not to treat, but to support. (I do wish I saw something mental health-related in church bulletins or bulletin boards like a crisis center number or the number for local community mental health organizations listed for anyone that needs them.)

    It also shouldn't feel like faith and science are mutually exclusive ideas because they aren't. I mean, you go to the doctor for heart problems, and you still have faith and are still a Christian. So, you can go to a mental health professional for brain chemical problems and still have faith and be a Christian. Also, God can lead you to a mental health professional just like God can lead you to any other right choice that you pray about. You can also still pray about your mental health while undergoing treatment with a mental health professional. (I pray all the time that God helps me figure out how to help myself and that God helps me find the strength to hang in there when it gets tough.) Just because I pray doesn't mean that I don't believe in or trust the therapeutic process. You can trust in both, at the same time, without lessening the "effectiveness" of either of them.

    I'll end with this: Even today, many Christian faith communities have a hard time recognizing mental health conditions as actual health conditions that need specialized treatment instead of some moral or faith crisis that can be solved by a heart-to-heart with the pastor or priest. In some areas, seeking mental health treatment can be seen as a rejection of one's Christian faith, but that isn't the case. You can still keep your faith and get treatment because science and faith actually aren't mutually exclusive ideas. God can lead you to a therapist just like God can lead you to the right job, spouse, or any other decision you pray about.