If you sense that your child wants to open up more but is struggling; these questions are great conversation starters. The purpose would not be to solve the problem but to just listen.
Talking about mental health is something we all know we should do to varying degrees, however nobody really tells us how. As a certified counselor and therapist who works with young people in schools as well as seeing private clients of all ages across the UK, I would like to share how to speak about mental health. I interviewed young people who suffer with their mental health for the purposes of this article and with permission have included their responses anonymously.
Talking about mental health often goes hand in hand with diagnosis and medication. The NHS largely places people into categories of anxiety, anger, low mood etc. Whilst there is no denying the benefits of having a clear cut diagnosis, unfortunately many people do not fit neatly into these categories. This can lead to people getting less effective treatment, becoming misinformed about their illness and essentially feeling helpless and alone.
Two people who have anxiety can have two completely different experiences. One person can have a panic attack and overwhelming thoughts and one can dissociate (feel cut off from sense of self and reality) and self-harm. According to the NHS the treatment for both of these people would most likely be the same (CBT and/or SSRI medication) despite how different their symptoms are. The NHS are providing a service to the masses on a very tight budget and are undoubtedly doing the best they can with the resources they have. NHS treatment must be standardised, i.e. the same for everyone and the effectiveness must be as easy to empirically test as possible. The issue with this is no two people experience mental health exactly the same way and thus a more personalised intervention is required. Many people undergo therapy with the NHS and when they have not made as much progress as they hoped for, they start to lose hope and think that therapy is not for them and does not work.
In my practice I like to pinpoint exactly how each client experiences their “problem pattern”. I’d like to know what happens, when, how, for how long and where. For example, instead of “I have anxiety about swimming” I’d ask questions to ensure I get a list like this – “when I hear the words swimming pool my stomach starts turning, I get this tight feeling in my chest, I start seeing myself drowning in the pool, I start thinking about the fact my legs will seize up when I’m in the water and how quickly I will drown, I can smell the chlorine and all I can think about is if the water touches me I’m in danger”. Clients report that just me probing for the very specific details of the problem is in itself so relieving. They feel heard, understood and less overwhelmed as a result. Not only this but the problem starts to become more digestible, rather than a huge, overwhelming, confused bundle of emotion, there is a beginning, middle and end with clear elements that make up the problem (see how you can use this technique during the mental health conversation below).
So when you hear “it’s time to talk about mental health” it’s not as simple as discussing a diagnosis. There’s so much to talk about and explore. As Aldophs notes in his book, “The Neuroscience of Emotions”, emotions are one of the most apparent and important aspects of our lives, yet have remained one of the most enigmatic to explain scientifically. Largely this is because experiencing emotions is such a subjective experience. Scientific study of emotions is a piecemeal and confused discipline. It’s interesting then, that we as a society believe we understand others and see them as they are, failing to recognise everyone’s unique experiences. As Scott Killoby writes in his book “The Unfindable Inquiry” the idea that we see the world and the people in it objectively is very much just an illusion of reality.
You are never really seeing another person exactly as he or she really is, your view of people is limited to what you think, feel and sense in the moment.
You are seeing them through a ‘reality tunnel’ or lens that is made up of your personal experiences (memories, your personal history, your culture, your worldview, and your psychological and emotional traits along with various other influences).
This is so powerful and crucial to keep in mind during the mental health conversation. It’s so important to stay curious rather than assume that you already understand. Your neighbour’s experience of depression is not going to be the same as your cousin’s, whose experience will not be the same as your daughter’s. “The greatest enemy of knowledge is not ignorance; it is the illusion of knowledge.” (Daniel J. Boorstin). With this in mind, it’s important to actively listen to what the other person is saying patiently, remaining curious about every detail of their experience. As best as you can, try to drop all preconceptions or beliefs about mental health or the diagnosis that your child may have and instead listen with a fresh outlook. Perhaps try to really engage and empathise with your child’s unique problem pattern.
Questions you can ask to do this are:
– When does the problem (or the feeling) start?
– How long does it last for?
– How do you know when it’s stopped?
– What thoughts do you get?
– What images do you see?
– What feelings in the body come up?
– Is it always as intense every time it happens?
– Are some times better than other times?
– What makes it better sometimes over others?
If you sense that your child wants to open up more but is struggling; these questions are great conversation starters. The purpose here would not be to solve the problem but to just listen.
It helps the child to really explain what’s happening for them and will most definitely contribute to their sense of being heard and validated. Bear in mind that these questions are quite probing and your child may not want to disclose all of this straight away, or at all.
When interviewing young people for the purpose of writing this article, most of them felt that their parents thought they knew more than they really did about mental health. In particular, they agreed that they wish their parents would understand that mental health is completely different for everyone. That’s why asking young people the details of their problem and understanding that their experience is very unique to them is so valuable. Many young people reported that their parents compared them to other people with the same diagnosis which was extremely invalidating and unhelpful. Parents often say “so and so has anxiety but still does x so why can’t you?”. Consequently, this led them to feel like they couldn’t open up to their parents for fear of being judged. If neuroscientists still have not reached a consensus about what emotions are, it’s very naive of us to believe that we understand the difficult and complex emotions of others. We are much less qualified to be making these judgments and assumptions. The wisest of people can see how much they do not know. As Confucius puts it, “real knowledge is to know the extent of one’s ignorance”.
One of the most important things to remember when talking about mental health is to be non-judgmental, empathetic and try to drop all assumptions and personal beliefs about mental health. Avoid using language that stigmatises or belittles mental illness. Here are a few examples of language that should be avoided when talking about mental health, all of which young people have personally received and found particularly unhelpful and hurtful:
– “You’re just being dramatic.”
– “You’re just lazy.”
– “It’s all in your head.”
– “You’re overreacting”
– “Calm down”
– “Just snap out of it.
– “Other people have it worse than you”
These phrases are dismissive and can make the person feel like their experiences and feelings are not valid. When we are unsure of why somebody is acting in a particular way it is easy to give them labels such as dramatic or lazy. However, this should be avoided as it only negatively impacts a young person’s well-being.
Some helpful phrases that you could use instead are:
– “I’m here to listen if you want to talk about what you’re feeling.”
– “It sounds like you’re going through a really tough time right now.”
– “It’s not always easy to talk about mental health, but it’s important to seek help when you need it.”
– I might not understand exactly what you’re going through but I want to listen to you and really hear you out”
– “You are not alone”
By using language like this, you are validating and showing empathy which helps a young person to feel comfortable opening up. Keep in mind that they are most likely going to be nervous, worried and possibly even embarrassed so the way you receive their words will have a direct impact on them.
It’s also important to create a safe and supportive physical environment. This might mean finding a quiet, private place to talk or setting aside a specific time to have the conversation when there will be minimal distractions or interruptions. Also let them know that you will maintain confidentiality (only if you’re sure you really will and make the exceptions to confidentiality clear eg safeguarding concerns).
When starting the conversation, try to use open-ended questions to encourage the person to share their thoughts and feelings. Some examples might include:
– “How are you feeling lately?”
– “Is there anything you would like to talk about?”
– “Is everything okay?”
If the person is hesitant to talk, offer support and reassurance. Let them know that you are there to listen, and that you are not judging them. Try to avoid adding pressure and saying things like “you have to talk about it”. The conversation won’t be productive if done by force. Instead, offer some resources or information about mental health, such as helplines (listed below). Always let them know that if they change their mind and decide they want to have a chat, the offer still stands.
Some common themes that emerged when interviewing young people was that they often feel that they cannot meet the expectations that are set out for them by teachers, parents, family and sometimes friends. This results in them feeling like a failure and that they have let others down. Furthermore, young people would like adults to understand that going through mental health struggles can cause exhaustion and a lot of the time it is difficult to relax and calm your mind enough to go to sleep.
Many young people reported that parents believe mental health “doesn’t happen to young people” and expressed the desire for their parents/caregivers to understand that just because it is not always tangible or visible, it does not mean it does not exist.
In addition, many students said their parents had a fixed perception of the “answer to mental health” which was not very helpful. They said their parents were not open to other more helpful ideas or solutions. They expressed their desire for their parents to be more open minded about mental health and to be aware that it’s not even fully understood by experts yet.
Young people are in desperate need of more compassion, understanding and validation towards their mental health struggles. You have no idea what somebody’s experience is like until you really talk to them about it effectively. As human beings we often use ourselves and our own experiences as a reference point to understanding others which is one of the biggest obstacles to really validating, understanding and hearing someone.
All young people I spoke to agreed that although growing up with mental health difficulties can be extremely hard at times, with effective support and open conversations, it’s a lot easier to cope with. Talking about mental health can be uncomfortable, especially for those who have never done it before. But with the right approach and a little bit of preparation, anyone can have an open and honest conversation. By showing support and understanding, you can make it easier for people to seek help when they need it.
|Shout||Text Shout to 85258||Giveusashout.org||24/7 text service|
|Samaritans||116 123||Samaritans.org||24/7 Helpline|
|YoungMinds||Text YM to 85258||Youngminds.org.uk||24/7 text service|
|Calm||0800 58 58 58||Thecalmzone.net||Helpline|
|Papyrus||0800 068 4141||Papyrus-uk.org||Under 35s helpline|
If you are interested in learning more about mental health or reaching out for support, please feel free to send an email to email@example.com