What is someone with mental health issues supposed to look like?
"You don't look like a psycho" is how a 'friend' of theirs once described a client who disclosed a fight with mental health issues. It is no wonder that people choose not to say anything. The daily fight that people with mental and emotional health concerns go through is one that is not made easier by others' reactions. ...and that is before one adds judgment.
What is someone suffering from emotional pain supposed to look like? How should someone, who is so mentally broken because they are simply trying to survive, appear?
Admittedly mental health issues being an invisible struggle is becoming more embedded into our consciousness, but there is yet a darker undertone that needs to be addressed. Those who manage to "hold it together" are often in need of the most support - and least likely to receive it. While with mental health issues, there is a small chance that someone close may realise something is not right, this is not always the case with emotional pain that can be inflicted - for example through psychological domestic abuse or coercive control, especially when one has been gradually isolated from their loved ones – or simply right now – when isolation is imposed.
The Guardian reports that the “Respect” phone line has had a “…26.86% increase in calls in the week starting 30 March, compared with the week before. The Respect phone line website recorded an increase in hits of 125% in the same period.”
Invisible pain, visible shield
In my piece on gaslighting I emphasised the importance of recognising that psychological manipulation leaves no mark on the body, although, over time, there is often a marked change in behaviour. However, depending on the person experiencing the abuse and often relating to whether they have children (ie. the need to put on a front), there is no such thing as a victim "look". And of course, the abused can be male or female.
"I’m wearing my doc martins, leather look trousers and a tee with a tan colour teddy bear coat to the floor and I’m sitting here wondering if I should change because I don’t look “victim” enough to get a non mol order agreed. I f****** hate that, not feeling like I’m going to be taken seriously because I look like I have my shit together. Truth is I feel ugly and weak inside. The clothes and the make up is all a distraction."
This extract is from the blog of a domestic abuse survivor, sharing her story in order to help others gain insight into the depths of pain and loneliness the psychological manipulation from the person you love can bestow. That is, the pain before she had to question whether she looked credible enough to be believed.
It made me question - do we really have to "look" a certain way before our experiences are validated? ...and how are we judged we if do not conform? Not only that but, what if the outer shell is all a person has left - are we really saying they need to drop the only shield they hold?
"A little more mascara"
"So when it's cold and when it's bleak I simply rouge the other cheek
For I can face another day in slipper satin lingerie
To make depression disappear I screw some rhinestones on my ear
And put on my brooches and tiara
And a little more mascara on."
(La Cage Aux Folles)
This is a moving song where Albin lets us into his coping mechanism - a little more mascara. Seeing beauty on the outside is the way he copes with breaking within. The saddest part of that is, the outer beauty is the very thing he is judged on, and often the very thing he, and the earlier blog author chastise themselves on most heavily because of all the messages that people like me send out emphasising the importance of "inner beauty". In these cases, there is little left inside to feel beautiful.
Psychologists often “block warn” against coping mechanisms - recreational drugs, compulsive shopping, sexual promiscuity because the damage is clear...But where do we put the "self care" of a little more mascara (not necessarily to hide a black eye, but to just feel a little bit normal)?
Is it a positive step because it gets you through, or a negative one because it covers up what’s going on underneath? One of the signs of depression can be a lack of care for one's appearance, encouragement to have a shower and face the day is seen as a positive step. For an abused woman, what if the only way she can hold it together for her children is to look like she’s “got it all”?
We too need to rethink.
We need to see through coping mechanisms – and we need to support clients in utilising them as healthy tools and not avoidance shields. Many things in moderation can be positive…but moderation is less possible when clients feel so low a sense of personal power.
If the mask is all you have, how can we ask you to drop it?
The way people cope is very different. We know that throwing oneself into work or sport can be a healthy distraction - and "overdrive" is often recognised at some point by someone close; but how do you see behind a painted smile? ...especially when that smile may have had a long time to be perfected.
We must listen more.
We must try to notice more.
And if approached with a disclosure we ask must more without judgment and signpost if we cannot help.
Have the strength to see your inner beauty:
If you know that presenting the "outer" is one of your protective mechanisms, be mindful of when you are focused on it so you can recognise that there is something you need to deal with.
Then reach out to one of those friends you know you can trust.
Recognise that people are often trying their best (even when they don't respond in the way you need), and any failures are often not personal - this could otherwise prevent you from trying to reach out again if the response is not what you'd hoped.
Always remember, if you need a shield, no matter what it is, you are still fighting - try to draw on that strength a little longer and reach once more - mascara or not.
Useful links:
If you need support with mental health visit MIND
Or with domestic abuse visit Women's Aid or Men's Advice Line
Dr Audrey Tang is a chartered psychologist and author. Listen to her podcast Retrain Your Brain here; and catch her practical masterclasses Psych Back to Basics on DisruptiveTV & Energy Top Up for resilience For quick tips and tools: click for SKILL PILL and Q&A videos and here for Media appearances. Twitter/IG @draudreyt