Limiting others or ourselves to simplified categories is convenient, but unhelpful. As a species who generally hates to be bothered with thinking critically, it’s understandable why we’d eliminate the guesswork and immediately jump to calling ourselves “anxious”, or our mother-in-law as “anxiously attached”, or our spouse as having “social anxiety”. All of these may be true: we may experience bouts of anxiety in varying degrees or have a formal, psychiatric diagnosis of Generalized Anxiety Disorder. Perhaps our mother-in-law does demonstrate a buried desperation for her grown son’s approval, an approval she never received in her own childhood. And, lastly, our spouse may struggle in social situations to the degree that he feels symptoms of panic. Regardless of the diagnosis, ailment, or circumstance, our responses and our behavior are our responsibility. And suffering from something not only doesn’t make us an expert on it, but it does not offer exemption from behaving like a functioning adult.
“I’m just an anxious person” is not a burning confession or even much of a personality quirk anymore, but a thought-terminating belief. Thought-terminating beliefs are lazy, simplistic phrases that aim to stifle any further conversation. “It can always be worse” is maybe one we’ve heard before. These beliefs function as emotional cease-and-desist letters: they allow those who tolerate us to know that we’re somehow activated by what we’ve heard, that our beliefs or general behavior appears to be under attack, and we will retreat into conversation-termination should the questioning continue. For example, the individual who is told by his professor he must present a thoughtful presentation for his final may proceed to whine that he has “performance anxiety” or “public speaking anxiety”. With this, he’s not requesting extra support or even the chance to learn skills to better tolerate the impending final. He’s pissing over the territory that is his ego by masking a demand as a comment: “It’s too hard for me, so you cannot make me do it.”
This avoidance behavior is evident amongst practitioners as well as clients. Hell, it’s evident in the entire human species. And I can’t say I blame people; I’ve certainly tried to use my own ailments or circumstances as permission slips, as excuses, or as hall passes. But there’s a deeper connection to our negative symptoms in modern culture, one in which we surrender to the identity we and others dislike, perhaps because we’re too afraid of what the outcome might be should we simply behave like a normal person.
In a recent email thread, professionals squawked in unison about those pesky social norms that we all abide by but are apparently still oppressive to certain populations. “There is no normal!” “Normal is restrictive!” “Only people who aren’t compassionate force norms on others!” I’ve written about this in previous pieces, so I won’t go into depth as to how this is as delusional as it is narcissistic. What I will say, though, is such self-serving thinking shines a light on how the manner in which we address mental health is completely ineffective. Yes, there needs to be a norm. And yes, we’re all thankful for norms and we benefit from such norms, and denial of such does not change the reality that some people are, unfortunately, abnormal. Anyone with a legitimate mental illness will respond with an emphatic “Fuck yes” when asked, “Do you ever wish you didn’t have a diagnosis and were… normal?”
Similar contortions and creative spins occur in the realm of treating psychiatric disorders. In many clients, when their behavior escalates to the degree of dangerous, that of a health risk, or just plain disgusting, the field is quick to write these off as symptoms of a systemic medicinal issue. “It’s not behavioral. It’s psychiatric. Which means it’s not our fault it isn’t changing; it’s the psychiatrist’s fault for not getting the dose right!” The psychiatrist then becomes a swift scapegoat and easy “fall guy” when treatment plans inevitably fail to work. Treatment plans written to coddle and validate a person’s unhealthy sense of self cannot, and will not, ever work: they only appear this way because of incompetent practitioners whose greater aim is to “be seen as a compassionate person” than to actually behave like one. It’s quite similar to the entire idea of “acceptance” or “world X days” for various disabilities and mental illnesses--- the individuals with such ailments are not given the tools to better navigate the grueling reality that is life, but are told their ailment is the most interesting and sacred thing about them, and that anyone who fails to recognize it as such holds private ideals about able-bodied people being superior. I frankly cannot think of a better way to set a person up for failure than to tell them that “you’re just depressed, and once that stupid normie psychiatrist gives you your meds, you’ll be all better”. We can choose to address our problems as problems, not as quirky ornaments your kids made you in preschool that you’re compelled to like.
It's a brave step toward self-betterment to understand the ways in which our problems contribute to our suffering. And to take such awareness a step further toward action steps and gradual change? It’s something I wish more people learned at earlier ages rather than a decade into their careers or their marriages. But the act of awareness is not enough--- it does not operate as a universal hall pass when the going gets tough. “Well I just did that because it was a trauma response!” That might be true. My next statement is, “yes, and?” Yes, you are behaving in a certain manner because something terrible happened to you as a child, and for that, I do empathize. But it also doesn’t mean you’re entirely off the hook for the array of horrendous decisions you make and immature responses you produce in the face of adversity. The more we convince these individuals that a pill or a therapist or a self-help book is where they’re allowed to end their “journey”, the greater we’ll suffer when they inevitably become our bosses, our teachers, our co-workers, or our neighbors. Nobody likes a martyr.
We’re not exempt from consequences or accountability by virtue of being ill and recognizing ourselves as ill. And, to reiterate, being aware of our problems is crucial should we take any meaningful action toward improving upon them--- but it doesn’t magically occur through some divine intervention or hope. The “self-work” that is required to change our perspectives and shift our expectations is grueling: we’re faced with illogical and irrational rules we’ve created and a set of memorized behaviors we’ve accepted because they’re familiar. This is a concept called path dependence, in which past events constrain later decisions: an example is the QWERTY keyboard configuration. There are other keyboard designs far faster and more efficient than the placement of QWERTY on the keyboard, but we’ve grown so used to it that we don’t necessarily see a need to change it. Psychiatric labels have suffered similar complacence: we incentivize the unnecessary until it grows familiar enough that people see no reason to modify it. In a recent episode on Dr. Gabrielle Lyon’s podcast, and a veteran psychologist discussed the occurrence of PTSD in the general population, combat veterans, and veterans receiving services from Veterans Affairs. In the general population, about 8% of people are diagnosed with PTSD. In combat veterans? About 6%. For the men over at the VA? Over 50%. 50%?! Why is this?
Well, the answer is simple: we incentivize illness. The VA awards veterans a disability check, every month, for the rest of their life, so long as they continue to meet the criteria for having PTSD. Individuals who qualify for disability receive similar funding, so long as they can continuously prove their level of functioning is that which is “disabled”. Quite similar to the stimulus check we all received for doing quite literally nothing except whining, any person with even a single brain cell could understand the tragedy in this sort of messaging: if you’re damaged goods, you’re on the payroll. And the only way you can stay on the payroll is if you stay damaged goods. Don’t bother changing anything about it---we’re dependent on this system because it’s what we’ve done in the past, and our reliance on history has made people even more resistant to future change. It shouldn’t come as a surprise to any of us, then, when our system inevitably fails to keep up with the never-ending demand for free lunch.
This is further evidence as to why modern therapy, specificslly, is so detrimental: instead of taking beneficial clinical action and making attempts to separate the person from the diagnosis, we’re suggesting the opposite. You’re no longer a person with interests and passions and capabilities, but you’re a bipolar individual with social anxiety whose social battery is low and who struggles to tolerate adversity as a POC. To categorize people inaccurately and unnecessarily is to intentionally dismiss the very things that make them interesting and that make them… “them”. When we conclude for a person who they are based on superficial details and a will to end a conversation rather than open it, we’ve reached a verdict without actually, as author David Brooks puts it, “seeing someone”.
Identifying with our negative traits makes it that much less motivating to improve upon or eliminate them. In James Clear’s continuous best seller Atomic Habits, he outlines our tendency to use wishy-washy language as we transition into becoming our ideal selves. The individual who wishes to stop smoking, for example, is better off telling people “I don’t smoke” instead of “I’m trying really hard to stop smoking.” While the change is subtle and maybe even unnoticeable, the impact is immense: one statement exudes an ideal that we’re confident we’ll become, while the other is unsure of one’s ability to change. In a practical sense, the person who firmly states, ‘I don’t smoke’ is far less likely to receive further pleas to “just have one” or “you can start that tomorrow” than the person who “is just trying really hard to quit”. As the kids say: don’t talk about it, be about it.
Our mental health and the person we choose to be can be handled in a similar manner. Should we determine we’d like to improve upon our “social anxiety”, our first step is deciding that we do not have social anxiety. No, you are not “anxious in social situations”, nor are you “just an anxious person”. You’re a person who prefers to spend time in small groups versus large gatherings. You’re the one more comfortable observing than leading. And you’re capable of handling any distress that will inevitably arise when in the presence of multiple personalities, genders, histories, and temperaments. The internal nervousness you’re experiencing is not indicative of a disorder, but of you being just another human being that isn’t really that special.
I told myself for years, “I get panic attacks in the car.” It doesn’t take a rocket scientist to figure out what happened, then, every time I got in the car: I’d get a panic attack. The self-fulfilling prophecy is an expectation about ourselves that is powerful enough to influence our behavior, thus “forcing” the belief to come true. What if I told myself I didn’t get panic attacks in the car? In this way, if the panic attack did arise, I still wouldn’t be “the person that got panic attacks in the car”. I’d be someone who happened to get a panic attack, and I’d also remind myself I was a person who had the tools to appropriately manage it. The fact that it happened in the car is essentially moot. Subtle changes in how we see ourselves and our problems are truly all that’s needed for much of today’s supposed suffering.
We author the story we tell ourselves. As Henry Ford reminds us, “whether you think you can or you think you can’t… you’re right.”