Author and mental health campaigner Rachel Kelly looks into the stress caused by feeling powerless and the small steps we can take to regain control
In the 1970s, the Australian scientist Michael Marmot decided to investigate workplace stress. He thought he had found the perfect environment in which to do so: the British civil service, based in Whitehall. Who was more likely to have a stress-related heart attack? The boss at the top or somebody below him? Everyone assumed it would be the Permanent Secretary, in my mind marching purposely with a black furled umbrella and bowler hat, who would be burdened by having so much responsibility.
In fact, Marmot’s results revealed the lower the employee ranked in terms of hierarchy, the higher their stress levels and, in turn, likelihood of having a heart attack. The scientist discovered that the less control a person has over their work, the more likely they are to become stressed.
I think something similar happens when people are unwell. For the past five years, I have run wellbeing workshops for various mental health charities, schools and universities, in which I share the kind of lifestyle changes that research has found can help those with anxiety and depression. My experience is that you can tell fairly quickly those who will benefit: it’s the people who believe in their own agency. Unless people feel empowered that they can make a difference, most of my advice is a waste of time.
If I look back at my own experience of suffering from two severe depressive episodes in my thirties, I turned to the two main approaches that the NHS still offers – medication and therapy. In addition, I gradually built up a toolkit of other strategies, including eating with my mental health in mind and the consolation of healing poetry.
So many different treatments have been of benefit, and my lesson here isn’t to disregard either drugs or cognitive behavioural therapy or any other approach. But I do increasingly feel that underpinning my own current sense of calm and wellbeing is a belief in my own agency. Boosting my sense of self-empowerment is one I feel is at times neglected in the mental health world, where it is easy to become dependent on others, whether psychiatrist or therapist, and to feel powerless in the face of the diagnosis of a mental health condition.
Drugs require an expert to prescribe them, and often months waiting for an appointment. Equally, while therapy has its virtues, it is all too easy to feel someone else has the answer. My experience is that a really good therapist will be trying to talk themselves out of a job from day one: their role is to give you the confidence that you have the solution.
Feeling passive, and powerless to do anything about my condition, was part of being depressed. The more I discovered my own ability to take action, the better I felt.
This insight is the basis for my current approach to managing my own mental health and the one that seems to speak to others I work with. Every day I remind myself that I can make a difference. And actually, why shouldn’t we feel responsible for looking after our mental health in the way we know we need to look after our physical health? Yes, mental illness is just that, but it does happen in a context just like other illnesses do, and we can affect that context, big time.
The first step is to identify when you find yourself slipping into victim mode. Typically, when I’m feeling rudderless, I find myself believing that my successes or failures are only because of things I can’t do anything about, like luck or the DNA I was born with, rather than thinking that yes, good fortune plays a role, but so do hard work and practice. You need to challenge your belief that you can’t make a difference. You can.
One way I can regain this sense of my power is to make some quick small changes, the first being making my bed to my own satisfaction, the white duvet perfectly aligned and my pillows nicely plumped up. The act of achieving and controlling something as soon as you wake up puts you in the right mood to continue a sense of control throughout your day. The examples may not seem significant, but the act of taking control of small decisions in this way will give you confidence in your own power to affect larger decisions.
Powerful businessmen and women and politicians often adopt these tactics to establish a sense of control when entering a boardroom or unfamiliar environment. They might change the position of a glass, or alter the height of the microphone on a lectern, or reshuffle the papers in front of them.
Another step is to watch your language, and think how you could rephrase statements about your own powerlessness. Language itself can make us feel more of a victim and give our power to others. So instead of saying, ‘I’m at the mercy of my mood’, you might say, ‘I can choose how to respond to my mood.’ Or instead of saying, ‘I’m never going to get on top of all the work I’ve been given,’ you might say, ‘Over time I can learn how to manage my workload.’ Perhaps the most useful word of all is ‘yet.’ So instead of saying, ‘I can’t deal with this’, say ‘I can’t deal with this yet.’
This approach has led to my latest book, a practical workbook of ideas and exercises for readers to complete themselves. It was lovely to see a new energy in the workshops when people believed there was stuff they could do on their own, without having to wait for an appointment to see an expert. By filling in the quizzes, completing the drawings, writing themselves letters and creating poetry to handle difficult feelings, to mention just a few of the book’s psychological exercises, they became engaged and enthusiastic about their own ability to affect their recovery in a new way.
I’ve seen the difference over the weeks and months with those I work with when they believe they can make a difference. As people make small changes, they feel less dependent on others, more in control and therefore less stressed and depressed. It’s a result that Mr Marmot would understand.
Rachel Kelly is a writer, mental health campaigner and ambassador for Rethink Mental Illness and Sane. This article appears in the March/April 2019 issue of the Idler. Rachel’s latest book Singing in the Rain: 52 Practical Steps to Happiness is out now. Buy a copy here.