I got this question over on the EHAB Tumblr:

Can I ask why it’s not good to define yourself based on your mental illness? I mean I understand that I am complex and interesting beyond my depression, but sometimes I feel like people who say things like that are trying to get me to stop talking about it/get over it. Can you explain what you think the goal of “you are not your illness” mantras are?

The simple answer is: because you are not your farts. Building your identity around mental illness symptoms is no different that building your identity around farting.

Farting is the result of things your organs do, influenced by genetic and environmental factors and the decisions you make each day, just like mental illness. Understanding the genetic and environmental context and the impacts of your decisions, empowers you to make choices that limit the amount of farting in your life. Or empower you to increase the amount of farting in your life. If you know something makes you fart, and you do that thing all of the time, you’re going to be farting all of the time. This happens with our brains, too.

But farting is transient. There’s a deeper identity you have beyond that. There’s a YOU that exists when you’re not farting and it’s the same YOU that exists when you are farting. You can build your identity around farting if you want to, but people are going to expect it from you. You’ll have to make that transient thing permanent. But maybe there’ll be a day when you really don’t want to feel bloated and smell farts anymore. Maybe you decide you’re sick of that thing that makes you fart and you don’t want to do it anymore. But now everybody expects it of you. That’s who you are! That’s what you told them. You’re a farter! Keep farting!

The same happens if you build yourself around mental illness labels. If your identity and relationships are built around things you hate, you’ll be amazed at how the things you hate seem to follow you around.

If you only see yourself or others through diagnostic labels invented by committees with vested financial interests in promoting those labels, you can end up creating a totalizing filter that skews your perspective on everything you experience. It becomes an oppressive microscope through which we examine every aspect of our world. New job? I need to find one that won’t trigger my social anxieties. New relationship? But what about my codependence issues?! Coworker said something you thought was offensive? They must be stigmatizing me! Going on a trip? But I might have a panic attack!

Managing the labels becomes an all-consuming compulsion. Sometimes those labels are helpful when they enable us to access help. But our brains can change. It’s possible to outgrow the labels. I’m somebody who used to stand in front of his stove to make sure it didn’t spontaneously erupt in flames and would see people in the crosswalk get crushed by cars and their blood and guts spread across intersections. At that time, many labels could get stuck on me and many were, but none of them apply anymore and holding onto them would provide absolutely no value or support to the actions I take each day to do the things that matter to me. So I want to encourage you to entertain the possibility that there is actually nothing permanently wrong with you (or me). You just have a brain. Carving a mental illness label in stone and chaining it to your brain ignores the reality of your brain’s capacity for change.

Everybody has varying levels of improvable mental health (because everybody has a brain), just like everybody has improvable levels of physical health (because everybody has a body). And mental health is chronic, just like physical health—we need to take care of both everyday or else they worsen. Sometimes we run into challenges with our brains, and those are very real challenges. But those challenges are things we overcome on the path to doing the things we want to do in life. We don’t have to let those challenges become us.

8 Responses

  1. Hi Mark,
    Luckily I’m not labeling myself with OCD, but as I’m recovering from a very bad period of irrational thoughts….the problem now is the emotional damage (low self-esteem, low confidence, feeling lost and the list goes on……) caused by this past episode. So how to deal with those feelings? and how to convince myself that they’re a by product of what I’ve been through, not ingrained feelings.

    Note: I was very confident and happy before the mentioned phase.

    1. There are two things I’d consider in a situation like this: 1) It’s helped me to recognize that chasing feelings like confidence and self-esteem is no different than chasing any other feeling. If somebody were doing things to chase a feeling of safety, that wouldn’t end up any different than somebody chasing a feeling of high-self esteem: they’ll just end up with the opposite feeling. So I found it really helpful to ditch the idea of confidence or self-esteem. There are just things I do. And I can do those things with any feeling. Feelings can just come along for the ride while I live my life. In general, with mental health, it can be really useful to focus on actions.

      2) The other thing I like to look at are beliefs I have about thoughts and feelings. Terms like “ingrained feelings” and “emotional damage” sound very laden with meaning but I don’t know what those mean. Sometimes, on our journeys, we walk down paths that we don’t like. But then, because we don’t like that path, we dig it up and carry the dirt with us, looking for a place to fix it and make it a better path that we do want to walk on. But then we’re just carrying around lots of dirt and that makes it very difficult to move around in the wilderness. So it can help to just drop that dirt and take a step in a direction we do want to walk in, on a path we do care about.

      Enjoy the steps ahead!

      1. Thank you for ur quick response.
        I really like your advice on focusing on actions. On the other hand, I don’t completely agree with what you said about feelings :
        ” I can do those things with any feeling”….it’s true to an extent but when feelings are annoying and causing you pain like headaches, it gets hard!

        1. That’s why we do all of this work to learn how to experience the stuff in our heads–the thoughts, feelings, physical sensations, etc–and then take action that we actually care about. That’s what my book The Mind Workout is all about. It is very intense to do these exercises, just like it’s very intense to do physical exercise, but if we stop exercising the moment we notice some discomfort, then eventually everything becomes uncomfortable. So it’s useful to have a structured plan for building up skills. Again, it’s just like physical fitness: we have to start small. We can’t expect to run a mile comfortably if we can’t run a half-mile. Something I found really useful was learning how to cut out compulsions by making simple changes that didn’t cause so much anxiety, often with things we wouldn’t even label as a “compulsion”. If we can make changes with things that don’t cause anxiety, we’ll be much more capable of handling challenging experiences.

  2. Another question:
    When you were at the stage you explained “I’m somebody who used to stand in front of his stove to make sure it didn’t spontaneously erupt in flames….” where you thinking “look at all those ppl around geeting ahead in their lives while I’m having this insanity? ….
    Although I’m healing as I said, this kind of thinking drags me backward…sometimes I feel like I’m from a different planet….
    What’s your advice? Knowing that I didn’t stop my life, I’m working and still want to build a career for myself.
    Thanks a lot.

  3. Hi Mark,

    I was wondering what your opinons were On treating health related problems? Is hypercondria treated the same as ocd with erp? Are they the same?
    I’ve had many OCD themes over the years, and am struggling with this one the most. I constantly think I’m dying, and the illness I believe isn’t causing it changes frequently, from brain tumour, to now testicular cancer.

    What I’m struggling with while trying to implement therapy teqniques, is the fact that we are told to be conscious of our health. For example, I had a random thought the other day; “what if I have testicular cancer?” Sure enough I’ve spent all day in the shower checking for abnormalities, unsure of what is normal and what isn’t. I’ll find something that I feel is abnormal, convince myself I’m dying, only to find actually it’s the same on both sides and then find something ELSE, and repeat the process.

    But we’re told to check, to be concerned etc. How do I know when to go to the doctor, or when actually symptoms are in my head? I can’t avoid all symptoms, surely, but then every time I’ve been it’s always just anxiety so using the doctors is just reassurance seeking .

    Any advice?

    Thanks!

    1. I consider them the same as any other compulsion. I find it’s useful not to judge different themes. They’re all just uncertainties your brain throws at you to get you to engage in compulsions. Something that’s helped me with health is to make sure I’m doing things to build health and fitness. Trying to avoid illness isn’t the same as building health. I can avoid everything bad that might happen and end up very ill because I haven’t spent any time or energy on health. Engaging in compulsions as a reaction to a fear would definitely make my health worse. It doesn’t make sense for me to purposefully harm my health out of fear of the possibility of illness. It’s possible to get over OCD so it can help to connect with a professional that has experience helping people recover. As you work on that, it’ll also be useful to look beyond the superficial topic of the theme. It’s very normal to be worried about things that might cause death. There are usually many other ways throughout our lives that we’re reacting to the fear of death. Those reactions might seem normal, but it helped me to recognize those compulsions I liked were fuelling the obsessions I hated.

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