An Extension: A few more tips for engaging in mental health conversations

An Extension: A few more tips for engaging in mental health conversations

An extension of my previous post “7 Tips: When someone discloses about their mental health (or any challenge, really)”. Link to previous post:

8. Roll with the Resistance

We all want our loved ones to feel better and improve. We might be afraid or disappointed when it seems like they are not improving. Sometimes, with the best intentions, we want this so much we end up pushing for what we want to hear, rather than listening to their reality.

I used to watch some friends play-fight as they were learning Brazilian Jiu Jitsu. It was intriguing watching them grapple. I also learnt how much technique was involved, even when they’re clinging to each other on the floor. I’m not sure if this is a legitimate technique, but I’m reminded of the concept that while wrestling, it is sometimes more strategic to move with the opponent’s force than against.

Even the best of us have moments where we have asked questions in a way that is phrased around the answer we want to hear… “How are you feeling? Better?

Insisting, or even gently pushing someone to express a positive feeling or express improvement when it’s not really there… isn’t helpful. Try to shift your angle. Rather than telling them it will be better, or insisting they must feel some sort of positive emotion or silver lining… empathise with how hard, how impossible it must be for them to feel hopeful right now. This helplessness you feel is actually really insightful… it’s probably how they feel!

Roll with the feelings, rather than against. Reflect back what you hear. Ask about what you notice rather than what you hope is happening… “Hey, sounds like it’s been another hard week… do you want to talk about what’s been going on?”.

9. It will take time, and it won’t be a straight line.

Be patient, healing takes time.
And like most things in life, improvement doesn’t look like one straight upward line.

I find it helpful to remind myself that far more than I want them to get better, they want to get better. And reassuringly, far more than I know and love them, God knows and loves them.

10. Confidentiality

I know this is hard in a church, we’re a family after all. It’s understandable to want another older man/woman to encourage the younger man/woman who’s going through a tough time. Sometimes we don’t know what to say, so we want to ask a friend or think the pastors may have some valuable insight. Though we have the best intentions, err on the side of asking. If you feel like it would be helpful to tell someone else, ask them. And even better, encourage them to reach out themselves.

(Though of course, there are concessions around child protection and emergency situations. Do share if you are legally obligated to or are concerned for the safety of yourself, them, or others.)

11. It takes a village

I believe that people were designed by God to be in a relationship with Him, with other people and with the created world generally. One picture of the church is as the body, with each member having different functions yet needing one another to function as a whole. What an interesting image of the church, different yet dependent. Similarly, I find it’s helpful to view our helping desires, role, or helping period of time, as one season in our loved one’s journey. Whether obvious or not, I believe there are often various people contributing to the wellness and life of the friend you care about. There are also often many who would care if your friend felt willing to reach out, maybe this could be a conversation to have with them. Even as a counsellor, I know I’m one part of the picture. Many clients I work with have friends, family, colleagues, neighbours, other professionals, social workers, pets… take heart, and encourage them to see the wider network of support they have or could have.

As a helper, it’s okay to need help too. One of the fun facts people would tell me about counsellors before I started studying was that counsellors see other counsellors. Before I started studying, I thought it was funny and a little confusing. Was it because they were so much in their head that they started to have mental issues? With intense self-reflection, did they begin to need help? Was the work that difficult?

Being on the other side now, I have a little more insight. If I see a counsellor personally, it’s probably because I want to be heard and seen, to have someone to be with me in my concerns and help me explore my feelings and what to do. Especially as being a counsellor isn’t about knowing all the answers and giving advice… I too have my own personal issues! Sometimes there’s so much going on in my mind, I just need that space for someone to listen where I don’t have to worry about polite back and forth conversation. I also see a counsellor regularly for supervision, to keep me accountable and because sometimes I just feel very helpless and need another perspective. Yes, counsellors need counsellors! So, whether you are the helper or the helped in a relationship, both of you need supporters.

12. Know your boundaries

We’re all individuals that carry our own story. We each have unique sensitivities, hurts, and longings. Sometimes, someone else’s story or hurt, can trigger and open up our own story and hurt.

Part of being able to help others is knowing how much we can help. We all have things we are struggling with. It’s okay not to be able to support your friend because you just don’t have the capacity at the moment, or just feel like you can’t handle it.

As you listen, consider how you’re feeling, and build up an understanding of your boundaries.  Perhaps them talking about their anxiety is making your breath quicken and you feel unable to listen anymore, or listening to them talk about their grandchildren is a sore spot for you. Ultimately, you are the tool of support and listening. Notice, respond appropriately to look after yourself, draw a line if you need to, and turn them to someone else in the village for that conversation. It’s okay to say, for example, “Hey, I’m hearing that you both are having a hard time conceiving right now… that sounds really tough. If I’m honest, I’m going through a similar thing right now and I just feel a bit sensitive talking about it right now. Is it okay if you chat to ___________ about this, I’ve found her helpful to talk to too. Maybe we can chat more about this when I’m feeling a little better, I’d love to share and hear how you’re going too.” Keep reflecting and engaging with yourself. Go do something that helps you relax and feel good after.

13. If you see something, say something

What’s to lose in asking?

If you notice something, if something doesn’t seem right, ask.

14. Suicide isn’t a dirty word (*trigger warning: mentions suicide and self-harm*)

(Disclaimer: This isn’t a comprehensive how-to on having a conversation about suicide. There are very good resources available online if you would like to learn more. A quick google will list many sites with helpful information around myths, conversation starters, guides, and hotlines.)

How are you feeling as you read this? Even as I write, I feel tentative, uncertain about how frank I should be… suicide is scary and very taboo. And that’s why it is so important to make this point: suicide isn’t a dirty word. From my experience, it seems that the main cause for sensitivity around this topic is our sense of utter helplessness and fear… “What if?” we think, “What do I say?”. These feelings are totally understandable. Even as a mental health professional, I feel my heart rate go up when I ask “Are you thinking about suicide?” or walk alongside someone who thinks about suicide or engages in self-harm.

Let me bust a few quick myths:

  • Asking someone about their suicidal thoughts does not increase someone’s likelihood to attempt suicide and is not ‘encouragement’. Asking actually opens up a conversation.
  • Take mentions of suicide seriously. A significant number of people who mention suicide or discuss suicide have serious intention to end their life.
  • Access to support at the right time can help prevent suicide.

Overall, it relates back to tip 12. If you feel uncomfortable or unsure, it’s better to ask. Especially in matters of suicide, ask with direct language. It’s an important question to ask and it’s important to be clear and have clarity about their intentions. Ask directly and take mentions of suicide seriously. It may seem scary, but not asking is scarier.

If you don’t know what to say or feel overwhelmed, there are people that are trained to help. If they see a mental health professional, encourage them to make an appointment to talk about it. If they have a safety plan, talk about it with them. If they don’t, direct them to Lifeline or Kids Helpline (13 11 14 and 1800 55 1800). They’re available 24/7. If you don’t know what to do, you can call too and ask.

I’m not here to say, and honestly can’t, give you a guide to how this conversation will go or how to move forward from here. Remember, take a breath, you can’t fix it or make it go away, ask them what is helpful, ask for support for yourself, encourage them to speak to others (especially in this situation).

A caveat around confidentiality. Don’t make promises regarding secrecy. Even if it is a passing thought for your friend for now, if it escalates, you may need to tell someone. If you believe it is wise to tell someone else, try to discuss it with them and be transparent. Ask permission if you can. Use your discernment. Should parents, a partner, trusted friend(s), mentors, know? Of course, it is always best to ask the person themselves to reach out, but in serious and urgent matters of suicide (as briefly mentioned in tip 10), you cannot keep this private. If they are at immediate risk of harm. Call 000. Always.

I reiterate. This isn’t a comprehensive how-to on suicide and there are very good resources available if you want to know more. A quick google will list many sites with helpful information around myths, conversation starters, guides, and hotlines. Some helpful links:

If you yourself are feeling unsafe. Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636

This ends my series on mental health conversations. It’s been helpful for me to write these out, for clarifying my own thoughts and hopefully they have been helpful for you too. These 14 tips are by no means an exhaustive list. If you have any you’d love to add, I’d love to hear your feedback in the comments below. As a summary, the 14 tips mentioned have been:

  1. Take a breath
  2. Take your time
  3. Listen
  4. Reflect back & continue listening
  5. You are not their Saviour
  6. Ask if you don’t understand, ask how to help
  7. Pray
  8. Roll with the Resistance
  9. It will take time and it won’t be a straight line
  10. Confidentiality
  11. It takes a village
  12. Know your boundaries
  13. If you see something, say something
  14. Suicide isn’t a dirty word

by Vicky Rong