Kay Redfield Jamison and the battle of competence versus empathy
Hey guys, remember that time when Robin Williams killed himself and everyone cared for approximately 30 seconds? Remember how everyone had an opinion about it, too? Awesome. Well, in the course of that 30 seconds, Kay Redfield Jamison (notable for being one of the first professionals in the field to disclose her struggles with her own mental health, and author of An Unquiet Mind and Night Falls Fast: Understanding Suicide) wrote an op-ed for the New York Times that pissed me off. I wrote a rebuttal, but by the time I was done, the NYT had closed comments on the matter. It just occurred to me, however, that those sorts of things are what this blog is for (fancy that)! So, here it is in all its glory, still shockingly (not shockingly) relevant two months after the fact:
Kay Jamison has been one of my heroes since I was in my early 20s, struggling with a mind that was self-destructing in ways I could neither properly describe nor understand. She gave me a lamp with which to navigate the darkness. But as I’ve grown to better understand my mind and my history over time, and through my work in suicide awareness over the last four years (especially with my peers in the burgeoning suicide attempt survivor movement), her work feels—to me—too cold, too clinical, too focused on a rigid insistence on [controversial, potentially damaging] medical-model based treatments. She focuses on what worked for her, rather than informing her public that there are many options, and not all of them include the pills Big Pharma pushes at us (and before you ask, no, I am not averse to medication; in fact, I am happily medicated in a way that makes me feel like a semi-normal, functional human being for the first time in my adult life, but that doesn’t mean it is or should be an option for all of us) or zapping our minds into oblivion.
She says competence trumps empathy in addressing suicidal depression. I call bullshit. Yes, competence is important, but what about the key fact that only 10% of mental health clinicians in the US can claim it? Competence in the short-term is unrealistic. Sadly, it’s something we need to strive for in the longer term. There are only two states in the entire US that mandate training for suicide intervention. The laws need to change. The discrimination against those who deal with mental health issues, which is just as prevalent among mental health clinicians as it is the general public, needs to be eliminated first.
Jamison underplays its importance here, but empathy is key. It cannot and should not be considered secondary to competence. The ability to empathize with those struggling with emotional pain is incredibly powerful—and useful to both clinicians and society at large. Empathy leads to greater understanding or, at the very least, a desire to understand, a desire to walk that clichéd mile in the shoes of someone else. The ability to empathize can lead clinicians to strive for competence, instead of “firing” clients in crisis out of a fear of liability (yep, that’s a thing). It can lead to a larger desire on the part of the public to learn how to help their loved ones should they ever, god forbid, struggle with a suicidal crisis. Empathy is the tool we need to hone to eliminate discrimination and quell our fear of suicide and of helping those dealing with suicidal thoughts.
Jamison offers no solutions (her words are about as inspirational as a dirty sock), so I will. Here’s what will help in the shorter term:
- Let’s empower the public through breaking down the myths and educating them about suicide. How do we talk about it? What are the resources? How can we help?
- Let’s encourage the media to be a powerful force in doing so (and to use the guidelines set forth for ethically reporting on suicide: http://reportingonsuicide.org
- Let’s speak up when we hear people further perpetuating damaging ideas about those who struggle with their mental health—and that includes putting celebrities like Henry Rollins and Gene Simmons in their place (I have lots of feelings on this matter).
- Let’s encourage celebrities and other folks with high profiles to share their experiences, as well. Their words are powerful. They have reach. Let’s encourage these people to use their platforms for good (endangered species need help, for sure, but let’s try and redirect some of that philanthropy and good will).
- Let’s lobby for mandatory, in-depth (6 hour trainings are not enough) suicide intervention training for mental health professionals across the country. It’s pathetic that licensing bodies have barely even considered this yet. How is it not in every single curriculum across the country?
- Let’s use firsthand accounts of those who have lived with these experiences to inform research, lawmaking, and media, and to show that suicide is not a problem of the “other,” but that it can affect any one of us.
- Let’s develop age-appropriate crisis intervention training programs for school-age children K-12. The reality is that we can’t protect them from this. The next best thing is to educate them.
- Further, let’s develop crisis intervention training programs for everyone, and let’s make sure they’re financially accessible, relatable, and widely disseminated. ASIST and QPR, among others, are wonderful tools, but difficult to access.
It is downright shameful that Robin Williams had to die for this country to take notice of a tragedy that strikes over 100 times daily. Let’s remember him as the man he was—a man who inspired laughter—but let’s also use his death to make a change. Suicide is a problem. For all of us. Let’s do what we can to learn about it. Let’s take care of one another.
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