While I sipped coffee and munched on a croissant, a supervisor approached me. I had just finished performing ‘Funny You Don’t Look Crazy’ (my story of mental illness and return to work) for a quiet but wonderfully engaged group of managers at a breakfast training event.

He confessed one of the biggest barriers he, the managers and staff face is being comfortable talking about mental health at the company. “We know how to discuss physical illnesses, but mental health issues? Not really.” It’s one of the most common remarks I hear. We don’t have an accepted vernacular and we’re not practiced at it.

Silence kills

This discomfort can lead people to say nothing, ranging from not intervening when they see someone in distress or not speaking up when they need help for themselves. Enter the deadly (literally) silence.

Results from a University of Oxford study found leaving serious mental illness untreated can shorten an individual’s life by as many as 10 to 20 years, similar to the mortality risk of tobacco smokers. 1

I started performing my one person shows about my experience with bipolar disorder and recovery back in 2001. At that time, other than Margot Kidder and Kay Redfield Jamison, there were few people divulging the personal secret of psychiatric disorder.  

Over the last 15 years though, we’ve made good strides in addressing mental health and making it more common place to discuss. We have the “Bell Let’s Talk” campaign, Mental Illness Awareness Week in October and Mental Health Week in May, to name just three.

However, even with these awareness initiatives, the discomfort of discussing mental illness in the office remains, and silence ensues. Silence breeds fear, drives myths and lets stereotypes remain unchallenged. These then reinforce reasons (though unfounded) for individuals who are struggling to refrain from getting help.

Using data collected from close to 500 university staff and students, a 2014 Australian study found the “silence surrounding mental health problems permeates … environment(s) and impacts on help seeking behaviours… (and the) recovery and well-being of affected individuals.” 2

According to another study out of Toronto, silence has negative implications for relationships and productivity in the workplace as well. 3

Programs that raise awareness and aim to reduce stigma are important. But if people’s discomfort of discussing mental illness is never addressed, these campaigns will be of little long term benefit.

4 steps to create comfortable conversations about mental health

Whatever role you hold in your company, the following are 4 strategies to increase your comfort and effectiveness when discussing mental health.

1. Find Company Mental Health Champions. Share Stories. Get Real.

Safe, inclusive and supportive environments will stop the silence on mental health.

Elio Luongo, Chief Executive Officer and senior partner, KPMG in Canada in a Special to The Globe and Mail agrees. How they went about that was a first in corporate Canada.

In 2017, they created the role of Chief Mental Health Officer (CMHO). They enlisted, Denis Trottier, an audit partner who has “lived through clinical depression while maintaining a successful career”. 4

Having an individual willing to disclose their own experience with mental illness and recovery can open up dialogue, change perceptions and create comfort faster than any other kind of educational program. Patrick Corrigan, one of the foremost experts in stigma research, found in study after study, the most effective method to change attitudes about mental health is what’s called contact-based behavioural health anti-stigma interventions. That is, “people with lived experience of mental illness or substance use disorders interact with the public describing their challenges and stories of success.” In fact, this kind of approach is twice as effective as an educational program alone. 5, 6

At Coast Capital Savings, then CEO Lloyd Craig, shared his devastating story of losing his son to suicide. Craig was a pioneer in workplace wellness initiatives and the Credit Union became a model for workplace mental wellness. In a short time, measures they took, which included Craig sharing his story, produced noticeable results. 7

Discomfort around mental health will only dissolve when people see it’s safe to share stories and ask for help. As Luongo puts it, it’s essential “we walk the talk, right from the C-suite level so that our people can be comfortable sharing their stories and talking openly about mental health at the firm.”

2. Be prepared for and accept the uncomfortable feelings.

Like difficult conversations that are…well…difficult. Uncomfortable topics are… well…uncomfortable. Paradoxically, knowing and accepting that something will be uncomfortable can make the experience easier to bear. Two studies out of Denver found accepting (versus avoiding) negative emotions was shown to be associated with reduced levels of anxiety and stress.8 Prior to talking about mental health, assume unpleasant emotions and sensations will rise within you. Your job is only to tolerate them, be mindful of those awkward feelings and continue the discussion. Preparing for them will make the conversation easier.

3. Practice talking about mental health.

Practice brings experience. Experience brings mastery and mastery brings confidence. 9, 10  Be intentional. Start with low risk situations. Take strategic opportunities to discuss mental health in casual conversation in positive terms. The more you do, the easier it will become. For example: decide that for each day over the next week, you will learn something about mental health and share it with others at work or on social media. Or choose to disclose something personal about how you stay mentally healthy. Let people know what you are doing and encourage them to join. Ask people what do they do to stay mentally well.

4. Make it fun and be curious.

This sounds counter intuitive, even improbable, maybe even insensitive. Make mental health fun? Yes. Even though mental illness can be a heavy subject that doesn’t mean learning about it, or creating a supportive environment, has to be. I consider myself to be an mental health icebreaker of sorts. I use a lot of humour as I share my personal experience with anxiety, depression and psychosis. Yes, I’ve managed to find something pretty funny about running down the street naked while in a psychosis – I think flirting with the ambulance guys has something to do with it.

Self-deprecating humour goes a long way to help people feel like they don’t have to walk on eggshells. A lighthearted and respectful approach opens dialogue up as well as people’s hearts and minds. The more serious we are about a subject, the more cautious we are asking questions and the more difficult it is to discuss.

Start simply. Hold short lunch n’ learns that explore well-being, host interactive workshops that offer strategies for mental wellness and self-care. Focusing on mental wellness first, can prime the pump for mental illness topics.

Silence is not golden. Speak up.

Michael Landsberg, former sports host of TSN’s Off the Record , lives with generalized anxiety disorder and depression and is a staunch mental health activist. He says: “When we talk openly, frankly and honestly about mental health, we’re one step closer to healing.” 11

The silence around mental health will only be broken if we take the risk to speak up. Every time we make a decision to talk about it, and not remain quiet, the more healing is possible. This means healthier companies, stronger communities and more vibrant families.  

How do you speak up about mental health at your work? Comment below and let me know.

For more Mental Health resources, tips & tools, sign up for my newsletter.

© Victoria Maxwell

References

1. University of Oxford. “Many mental illnesses reduce life expectancy more than heavy smoking.” ScienceDaily. ScienceDaily, 23 May 2014.

2. Curtin University. “The silence of mental health issues within university environments: a quantitative study.”: Archives of pychiatric nursing, Vol: 28, Issue: 5, Page: 339-44 Publication Year: 2014

3. University of Toronto. “Mental Health Issues and Work: Institutional Practices of Silence in a Mental Healthcare Organization” by Sandra Moll; Doctoral Thesis, 2010 

4. “Corporate Canada needs to help break the silence on mental health”  by Elio Luongo; Special to The Globe and Mail; January 31, 2018

5. Corrigan, P.W. (2012). Where is the evidence supporting public service announcements to eliminate mental illness stigma? Psychiatric Services, 63(1), 79-82.

6. National Academies of Sciences, Engineering, and Medicine. 2016. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change. Washington, DC: The National Academies Press. 

7. “Employers Who Are Walking the Walk” by Donna Panitow; Reprinted from “Workplaces” issue of Visions Journal, 2009, 5 (3), p. 29-30

8. Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Shallcross AJ, Troy AS, Boland M, Mauss IB. Behav Res Ther. 2010 Sep;48(9):921-9. doi: 10.1016/j.brat.2010.05.025. Epub 2010 Jun 1.

9.  Conger KJ, Williams ST, Little WM, Masyn KE, Family Research Group B. Development of Mastery during Adolescence: The Role of Family Problem Solving. Journal of health and social behavior. 2009;50(1):99-114.

10. Why a Sense of Mastery is the Key to a Better Confidence?  by Evelyn Marinoff

11.  Michael Landsberg, quote: https://www.thelavinagency.com/speakers/michael-landsberg

The attitude of gratitude – yes, yes, we’ve all heard how it’s a good thing. But what if it’s not always easy to feel, especially if you’re in the midst of a depression?

Oh yeah, I can quickly rattle off a list things and people I’m grateful for. You know do the ‘Oprah Winfrey’ thing. Apparently, every night she lists 5 things she’s grateful for in a journal. By the way, if I was Oprah, I’d be grateful too.

What I’m saying is, it can be challenging to really feel and sustain the glow of gratefulness. What does it mean to feel grateful? Feeling being the operative word.

I know the things I’m grateful for. I know I’m fortunate (extremely so in comparison to the vast majority of people on the planet) to have enough food, housing, clothes, warmth, friends, to name a few. But knowing my blessings, is different than feeling blessed.

Real gratitude, what I call ‘affective gratitude’ (affect as in emotion) goes deeper than intellectualizing and moves into a physical experience of gratitude or, more accurately, into appreciation. So how can I get out of my head and into my body to experience appreciation? 

I did what most people do when they don’t know something. I ‘googled’ it. Guess what? There is scientific research on gratitude. Dr. Robert Emmons is the preeminent scientific expert on all things grateful.  Seriously – he’s like a gratitude scientist. That’s got to be an oxymoron. But no, he empirically studies gratitude: its benefits, power, how it’s cultivated. To watch one of his fascinating talks click here

His studies found that keeping a gratitude journal really does work. But for me, sometimes at least, it can fall flat. I wanted more than just the ability to list my blessings and redirect my thoughts. I wanted to learn ways into feeling more grateful.

Then I asked myself what does gratitude mean to me? What does it even feel like for me? Do I know how to recognize it?  

I allowed myself not to know what gratitude means, to have no idea what it even feels like and to go from there. The aim was to explore, not necessarily to find. I gave myself 100% permission to be completely inept at counting my blessings. And off I went.

First a note of hope: When I’m not feeling grateful, it’s like the switch to that cluster of gratitude kind of emotions has been turned off and the power to said switch has been hijacked. But that’s good. Really. Stay with me. Even though I’m not feeling grateful, the switch and the source to experiencing gratitude are still there. It means it’s not being accessed, not that it can’t be.

The following are the steps that help me find the actual experience of appreciation, even if only in small doses. See if they work for you:

1) Close your eyes. You probably already got this but don’t do this while you’re driving. Sit (or stand) somewhere when you have time on your own. It can be in your home, or while waiting for the bus even (I don’t recommend the grocery line, it can be a bit unnerving for the cashier and other shoppers). 

2) Take a deep breath in (and out in case you’re wondering). 

3) Say or visualize the word ‘gratitude’ or ‘appreciation’ in your mind. 

4) Focus on your body – watch, is there tension when you focus on one of those words? That’s ok. 

5) Breathe and relax a little deeper. 

6) Mentally review things, occurrences, people, places that you have experienced in the last 24 hours, the last week or two, or even the course of your life. Ask yourself, what or who do you feel gratitude for? This is the tricky and sneaky part: let your mind review items you ‘think’ you’re grateful for and then as you see the item in detail, see if that translates into inklings of gladness, some small bubble of positive emotions or sensations of comfort in your body. Note where those sensations are, what they are.

Example: My “affective gratitude point” is this canvas my husband recently painted for me. A block of pure orange that now hangs in my office. When I think about it, I feel thankful he painted it for me. I feel a little burble of joy, usually near my navel and spreading out to my ribs and chest, when I see it in my mind’s eye. I feel a goodness about it and my husband.  However, I also feel vulnerable. Vulnerability comes with offering thanks. I recognize I am cared for by him, which underscores my interdependence with him. I feel this fragility with him and with others in my life, if I am courageous enough to go there.  Vulnerability is one reason why feeling gratitude can be scary and a reason why we (okay I) sometimes avoid it. Envy, jealousy, bitterness – way easier.

7) If you can’t seem to put your finger on a sense of appreciation, keep going. Keep exploring. Continue gently reviewing. Notice any resistance in your body, take a breath, then return to nudging out appreciation possibilities.  Start with things that you like, that even might seem trivial – trust me they’re not. Could be as simple as a piece of music you heard. Even in the midst of dark depression, push yourself, just a little, to lean into the places you think you might feel appreciation. When I’m in the thick of a depression, when all things seem forever bleak, it’s the feel of my duvet against my skin that I’m grateful for. One, because I’m spending more time in bed and two, if I give thanks to a comforter, it won’t ask for anything in return. It’s a duvet after all. It’s doing what duvets do best, keeping me warm. 

8) When you do hit upon something that gives you a sense of gratitude, notice what it is like: the emotion, sensations, the changes in your body. Do you relax a bit, or feel a sense of comfort? Do you notice your stream of negative thoughts stop for a split second? Be with that, for as long as you like or as long as you can tolerate.  

9) Take a breath, wiggle your toes (to get your bearings) and open your eyes. And give yourself a pat on the back. You just went into unknown territory – alone.  

I do this little practice either in the morning or as I tuck in to go to sleep, sometimes both and sometimes in the middle of the day. Because, even when it comes to something as ‘spiritual’ as gratitude, I need to make it concrete too. I need to make it a practice. I aim to find 5 things that I FEEL grateful for, not just know I’m grateful for. I started with 1, then 2, now 5 – give or take. Oprah can’t be all bad, right?

Like any other skill, it takes practice and a bit of effort to develop it. So that’s what I’ve been doing. And I’ve discovered, surprise of all surprises, when I focus (for 5 minutes even) on finding the feeling of grateful (‘affective’ gratitude) for one person, or thing or happenstance, my world shifts, just a tiny bit and I feel better, even if momentarily.   

Try it and see what happens. Leave a comment below to let me know. I need to hear other people’s experiences, or non-experiences as the case may be with gratitude. Thank-you! No really. I mean that. Thanks.   

© Victoria Maxwell