Using Your Mental Health Diagnosis To Avoid Changing Behavior

For the month of July we are switching things up a bit and giving more personal examples of each topic we discuss while still answering questions and giving information about the topic and how things could have been handled better. In today's episode we are talking about instances where one partner uses their mental health or neurodivergent diagnosis as a shield to avoid changing their behavior or taking accountability. 

Transcript

SPEAKER_02 0:00

Welcome to July, where we are changing things up and doing our episodes a little bit differently this month. We're shifting our focus to bring you more of a dialogue, bringing personal examples, taking a lighthearted approach to bringing real issues to light. We will be breaking down our own experiences, having having some fun with the messy realities of life, and sprinkling in practical suggestions on how those situations could have been handled better. Today's topic is using a mental health diagnosis as a shield, turning a tool for healing into a license to cause harm. And I'm your co-host Sam.

SPEAKER_01 0:50

And you're listening to Pathway to Empowerment, where we believe in thriving, not surviving.

SPEAKER_02 0:58

So, Shalee, you see all varieties of people in your practice. I do. Do you I have some examples of somebody using a mental health diagnosis or a neurodivergent diagnosis as a shield to avoid changing their behaviors or taking accountability for things within a relationship?

SPEAKER_01 1:27

So it within a relationship and individually as well. So yeah, I have a lot of I've been doing this for a lot of time. So yes, I have a lot of examples where that happens, and you would probably not be surprised to know that we use that as a way to navigate the world anyway. If I can shift blame to someone else, then I don't have to own it. Or if I can shift blame to a diagnosis, I can then not own it. So it happens frequently. It happens in parent-child relationships, it happens in friend relationships, it happens in coworker relationships, and it happens in intimate partner relationships where a partner will get a diagnosis. And a lot of times what I see, not always, this is just one example, but a lot of times one of the big ones that I see is somebody that has been diagnosed with borderline personality disorder or BPD. Okay. BPD is characterized by not being able to self-regulate, to create chaos in everybody's world and not be able to navigate it yourself, which gets them out of a lot of trouble, right? Or or makes it so that if it wasn't me, if I didn't have BPD, then I wouldn't do this. I wouldn't act this way. I've had a lot of times where even in a therapeutic session where I've said, hey, I really want to challenge you to do X, Y, or Z. So the last one that I was working on, I'm like, you know what? I really want to challenge you to get outside of yourself and learn what emotions you're having so that you can then start learning how to regulate them instead of counting on someone else to regulate them for you. And the person says, Oh, I can't do that. I have borderline personality disorder. As if that was that shield that they wear, right? That we just talked about. And so one thing that happens typically when I push back with a borderline personality client, I'm saying, yes, you, yes, you can. You can absolutely challenge this. They'll fire me. They'll find fire me as their therapist because if I'm pushing back and they have to take some accountability that they don't know and they don't feel safe or comfortable with, they will use that as a way to not do anything. Well, she's just a really bad therapist, so I can't go see her anymore.

unknown 4:17

Yeah.

SPEAKER_01 4:17

Does that make sense? So the reality is when we have clients that try to weaponize or try to shift blame because of a diagnosis, whatever the diagnosis is, we have to tread very, very carefully and we have to teach their partners, their family, their friends how to tread carefully as well. So, with that, one of the things that I love to do is get everybody in the mix and learning DBT skills. So then they can learn how to manage it and and modulate their existence together in an in a more beautiful managed way. So that's one one one time that but I I want to tell a fun story. So years and years and years ago, I had I had a client who would blame shift and more, let's see, most of the people in my office had had this person. Because again, a lot of times if if they're holding it as a shield, they're going to move therapist to therapist to therapist to therapist, right? So they came and they were my client for a while, and my office got really, really, really loud. And the office got really, really, really quiet. And by the time we we ended our session, I opened the door and there was probably 15 to 20 people like around my office because they were so worried about the blame shifting and this this individual getting really loud in the session. But it didn't bother me because again, like if you understand like why the person is doing what they're doing, if you understand why they're shifting the blame or that they can't own the behaviors and they need somebody else to be the owner of them, it doesn't, it doesn't affect you personally and you don't get scared, you don't you get any of those things that we typically do in relationships. Does that make sense? So it was kind of a fun experience for me because it was like they were like, ooh, we were kind of worried. And I was like, ah, it's just fine, you know.

SPEAKER_00 6:38

Yeah.

SPEAKER_01 6:39

We're just working on on owning our behaviors, and sometimes we get loud when we do that.

SPEAKER_02 6:47

I'm not a therapist, but I've been in therapy environments. And a lot of uh what I see a lot of the time in ADHD specifically. Like you'll ask a client to like in a group home, whatever setting to do X, Y, or Z, and well, they can't do it because they can't focus because they have ADHD. That's one that I I see consistently.

SPEAKER_01 7:20

Can't sit still. I can't go to group because I can't sit still. Yep. And you know what? They they don't really like about that song, because that's a there's another funny story. There there was this really amazing co-worker I had who she's now passed away. But she she understood ADHD and she also understood bipolar disorder because she had been diagnosed with bipolar disorder. And sometimes that one is another big one that we see that gets weaponized, right? And so I had several groups of people that they were like, oh, we're we just can't sit still. Our group can only be about 20 to 30 minutes because we just can't sit still after that. Well, this this person actually, I had we had talked about it, and she's like, I uh I think I have something that might help. And at this time, this was years ago, when when it was really frowned upon to give clients anything sharp during a group or anything that they might hurt another person with. And I was like, Oh, I've we gotta make sure that we're really, really careful with that. She's like, Oh, I've got plastic ones. So what she did is she brought, she brought skein of yarn and a plastic crochet hook for every single person in the group. And she spent the first 10 minutes of every group after that teaching them uh how to crochet so that during group, we were doing group and their hands were busy, their minds were busy, and they couldn't have that, oh, I can't do it, I can't sit still, my mind won't let me mentality. And you know what the greatest thing about that song was they ended up making little little tiny knit baby caps for the NICU. So we would we would gather all of them up and we would this this amazing person that I'm telling you about, we would take she would take them and and take them to the NICU and and all over, not just in in our little area, but all over so that that's awesome, so that uh our groups actually like kept them occupied, kept them really, really engaged, and helped the community. That's awesome. So, you know, there's so many different things that we can do instead of weaponizing R or or sh blame shifting, right? We can do something completely different with that. Yeah. So it is kind of cool that when you when you get outside of the box, and this is for the person that has been diagnosed with something, as well as the people in their lives, and sometimes even as a therapist, we have to get outside of the box and allow things to happen so that they have a chance to learn different skills and practice them in applicable settings, right? So, you know, there's a lot of times that you hear of places that, oh, you can't do that there. But I've seen people in a church setting, I've seen people at a hospital setting, I've seen people in groups, like therapeutical sessions, like everywhere across the board, crocheting. There's nothing wrong with that. And what it does is it keeps your mind and your body occupied. And when that ADHD mind is occupied, guess what happens? You can focus better. They can focus better and they hear more. Yeah. So I've I've adapted to that by having having a basket full of fidget toys. I have paper that they can do like now. They have they have to be sure that everybody in the group knows they're not writing notes, they're not taking, they're not writing their names down or anything like that. But doodling is another big one so that they can stay focused. Yeah, that's a good idea. So those are a couple of the really fun stories from you know things that I've seen. Now, are there some scary ones too? Absolutely. But the reality is they're usually only scary because that person doesn't know how to navigate it and whoever they're with doesn't know how to navigate it.

unknown 11:52

Yeah.

SPEAKER_02 11:54

How do we separate the reason for harmful behavior from the responsibility to correct it?

SPEAKER_01 12:04

So when we have when we have an idea of what is wrong, right? We sometimes really struggle with looking at our part in it. Because if I have to look at my part in it, so again, sometimes I can't. Sometimes I don't have the skills. Sometimes I've lived with someone that blame shifts too. And so that's I've learned that as a coping strategy. So the very first step in having them actually be able to change that up and and stop that pattern of negativity to positivity, we have to address it. So we have to get to a place where this person understands that they are blame shifting or that they are wearing that label that says, don't mess with me, I have BPD, or I'm bipolar, or one of those statements that they believe in. And if you think about it, how many times, Sam, have you heard somebody say, Oh, I'm diabetic, or oh, I have cancer, or I've been diagnosed with, I have bipolar disorder. That's that's kind of the way we see things, right? But what I challenge people to do is say, okay, you've been diagnosed with something, but that doesn't mean that's who you are. So if we have to take away that platform, this is not who you are, which also then means I can't hold on to that as a reason to hurt someone, harm someone, or not take accountability for something. Yeah. So the first thing to do is have them start using different language around that. I have symptoms of bipolar disorder. I have been diagnosed with borderline personality disorder, not it's who I am. Does that make sense? So we have to change that verbiage for that to happen, for us to actually get to a place where we're not taking it and using it in a negative way. We're taking the information and we're processing it so then we can do something different with it.

SPEAKER_02 14:33

Yeah, and find the proper tools to help you with that.

SPEAKER_01 14:37

Well, first of all, we have to acknowledge that it isn't us, it's part of what we've done or who we've become to this point. But it doesn't mean it has to continue.

SPEAKER_02 14:50

Right. How do you advise someone in therapy to take responsibility for their actions without spiraling into toxic shame or toxic self-blame?

SPEAKER_01 15:04

That one's a hard one. Because we as human beings are hardwired for negativity. So if I do something, then I'm going to be shameful about it. So if I if I hurt you in any way by what I say to you, then I may go to that toxic shame as a way to distance myself from you and from what's been done. Okay. Does that make sense? And so we have to say, okay, just because I've done something to hurt you doesn't mean that I want you to be hurt. It means I didn't know how to do anything different in a way that helped you navigate it, what I was trying to get you to see or what I was trying to get you to feel, because I didn't know how to navigate it. Because I didn't know how to navigate my feelings and emotions about it. Hurt people, hurt people. And when that happens, we will use a lot of different things to keep us separated from each other instead of like looking at, oh wow, I'm so sorry. I that came out wrong. Can I try again? Yeah. Right? I didn't mean it the way I can see you are taking it. Does that make sense? Yeah. So that I'm not I'm not owning it as I'm as I'm the problem. It's what I said, thought, or did was the problem. And if we can get to a place where we think that my behavior, my thought processes, or my actions were the problem, it doesn't mean I'm the problem. And then I don't have to spiral into that toxic shame pit, which we usually see a lot when someone has grown up in a toxic shame pit too.

SPEAKER_02 17:04

Yeah. I think a lot of a lot of people automatically it's it's your instead of I did I made a mistake, I did something bad, it's I am I am the mistake. And I think that's naturally what a lot of people tend to the first thought to be.

SPEAKER_01 17:24

And then we want to push away from it and own all of the shame. So if I would if I were to hurt you and I could see on your face, or you said, wow, Shalee, that was really hurtful. Now I'm really hurt. I might be like spinning in the toxicity of, oh, you're right, I'm a terrible person. I can't believe I can't ever get this right. And if I fall into that shame loop, I'm not coming out. And guess what happens in that? You don't feel validated in your feelings because I've taken everything. I've taken I've sucked all the air in the room to myself instead of going, wow, I'm so sorry, Sam. I didn't mean to hurt you with that statement. I'm gonna really look at how I can do things different. Because then that's about you, not me having a toxic shame cycle.

SPEAKER_00 18:17

Yeah.

SPEAKER_01 18:17

Does that make sense, you?

SPEAKER_02 18:20

How can I tell if I am setting a necessary boundary to protect my energy versus using my diagnosis to avoid an uncomfortable but required task?

SPEAKER_01 18:33

The long and the short answer for that question is really you need to work with your therapist on boundaries and why you and what the motivation is behind why you're setting them. If I don't know why I'm setting it, who I'm setting it with, and what I'm hoping to get out of it, I probably have a different type of motivation. And so if I have a different type of motivation, it's probably not going to be beneficial. It's probably going to be detrimental. And if I've not learned boundaries or what they're what they are or how to set them, I might not feel comfortable and confident doing it, in so much that I continually set boundaries that I don't don't keep, and we go right back to that toxic shame cycle.

SPEAKER_02 19:27

Gotcha.

SPEAKER_01 19:28

So long and short, work with a therapist so they can help you with it. Okay.

SPEAKER_02 19:35

If I catch myself using my condition as a shield, what specific grounding or cognitive techniques can I use to stop avoiding the issue?

SPEAKER_01 19:47

One of my favorite skills for that is a DBT skill, dialectical behavior therapy, and it's the stop skill. I believe we've talked about the stop skill often. If not, we've we we go over it many, many times in our courses and in you know our workbooks and those kinds of things. But when we use the stop scale, it helps us really break that down. So because when you look at the stop scale, all DBT skills are acronyms. So S stands for stop. If I stop in my tracks, physically stop what I'm doing, it breaks the thought pattern. Okay. If that breaks the thought pattern because I stopped, the next one, which is T, take a step back. If I physically take a step back, that actually opens the room for me and opens my perspective to get a different idea of what's going in me, through me, and around me, which is the next one, which is oh, which is observe. I'm gonna then observe my thoughts, my feelings, my actions, my behaviors, and what's going on in my environment. So then I have a better idea and I have a better picture of what we do with the pee, which is proceed mindfully so that we don't make matters worse or hurt ourselves or anyone else. So if we will use that skill right there, it changes so many things. We don't we don't spiral into the shame cycle, we don't blame shift as much, we take a deeper look at what's going on so then I become aware and I can do something different.

SPEAKER_02 21:31

Okay. Awesome. Thank you, Chili, for sharing all these experiences. Of course. I know that bringing in real life examples really helps gain insight into these situations and how they can be handled differently, which empowers us to learn how to navigate and handle similar situations when they arise in our lives. Please click the link below to share your thoughts on today's conversation or suggest future topics of discussion. We love to hear from you. On Friday, we will be chatting about our experiences with shutting down a partner's valid emotional feedback by labeling it as triggering or unsupportive of our diagnosis. We'll see you next time.