Wednesday, October 30, 2013

Martyrdom Just Gets You Shot: Why Sacrifice for Family Isn't Always a Good Thing

In my workshops on psychological well-being, there's one question that keeps popping up: "Should I still support my family? I already feel drained and stressed but I don't want to be a bad son/daughter."  The question typically comes with frustration, resignation, and not a small amount of guilt. Being the sole breadwinner, or at least someone who single-handedly takes on major responsibilities at home, is paradoxically a position of power and weakness.

Now, before I start answering this question, let me say at the onset that I've been always impressed by Filipinos' (and Asians' in general) love of the family. I think one of the reasons Pinoys are resilient is because we know that no matter how hard life gets, there's family to come home to. Those who live in individualist countries tend to suffer more anxiety and mental health problems, presumably because they're cut off from a major support system. So the ability and willingness to sacrifice for family?  Definitely a value worth preserving.

But as with anything in life, excessive is not a good thing. Healthy families take care of the well-being of all individual members, not a select few. Society may pat you on the back for being the responsible and considerate one, but if you're no longer able to live your life, you're actually not being responsible or considerate ---- to yourself. Family care needs to be balanced with self care.

So here are some guide questions to help you muddle through the sticky business of self-sacrifice. It won't apply to every family with a "tagasalo" (catcher) but it can be good starting point when making decisions about how long and to what extent you should help out.

1. What are you giving out of choice and what are you giving out of pressure?

There are people who take on the tagasalo role and yet they're perfectly happy. The reason is, they know the sacrifices they're making are freely chosen, and this gives them peace even if their sacrifice comes at a price.

So ask yourself, did I make a choice to do what I'm doing? If yes, what are my reasons for making that choice? Will I make the same choice again given the chance? True, choices can be difficult to make, and sometimes you're forced by a situation into a choice you don't like, but taking ownership of a decision is the first step towards settling into a particular set-up.

Now, there are tagasalos who only do things because (a) family members will get mad at them if they don't, (b) they're worried other people will call them ungrateful, or (c) it's the only way they know how to get appreciated. If these are your reasons, for sure you'll feel depressed and frustrated all the time. You'll feel taken advantage of and/or manipulated by guilt.

In these cases, you have to know how to identify and defend your boundaries. You may have to engage in a heated discussion with family, true, or you may have to survive gossip and whispers.  You may even have to struggle with feelings of worthlessness. But some issues do need to pass through rough waters before it can get resolved. There's nothing wrong with family members fighting, for as long as they fight fairly! Being afraid to rock the boat is not going to get you anywhere.

2. Are you overfunctioning because someone is underfunctioning?

Your intentions may be to help your family but if what you're actually doing is nursing irresponsibility, or at least complacency, you're doing your family more harm than good.

So look at each member of your family and see what each one contributes to the pool. Your parents may have asked you to shoulder your little sister's tuition and allowance, but if your sister is old enough to take part-time work to earn extra cash, let her. You may actually be doing your sister a favor as you're teaching her self-sufficiency. You have a brother who job hops, resigning from work everytime he encounters something he doesn't like? Stop feeding the monster by not making him face the consequences of his actions.

Now this is the tricky part: even when tagasalos realize they're creating dependency, they would still resist change. They feel bad making loved ones take on extra tasks --- "kawawa naman ang kapatid ko kung pagtratrabahuhin ko din."  They have lost faith that underperforming family members will actually pull through. They don't have the patience to wait for others to find their feet. Or they've gotten used to the "perks" of being the responsible one (e.g. the praises, the power to make decisions) that letting go makes them feel all lost. When this happens, you have a lot of self-processing to do.

I always tell clients that families are systems designed to survive. Hence, if you decide to trim down the bills you're taking on, your family will find a way to find the money --- especially if you stick to your guns and let others hit rock-bottom. In fact, letting go of the tagasalo role is often the catalyst for new ideas on how the family can survive. You might even get pleasantly surprised with the discovery that loved ones are actually stronger and more competent that you realize.

3. Can you prioritize self-care?

But what if all of your family members are actually overfunctioning? Sadly, this situation happens. Sometimes the family's needs are greater than all the members' ability to respond. When a loved one has a chronic illness for example, understandably you may have to work double even triple shifts to pay hospital bills. When the family business fails, adjustment has to be made by all concerned. Death of parents may force the eldest of the family to set aside his own dreams and take charge of the household.

If this is the case, you have to accept the situation and grieve for your losses. Grieving is good; cry if you must, yell at the universe if you must. But this doesn't mean you have to have a bad life. Take regular time outs for little pleasures --- dirty ice cream with friends, a quiet walk in the park, quality time with your family. There are ways to get work-life balance if you're determined to have one. More importantly, articulate to your loved ones if you're no longer okay, and let them take care of you for a change.

Meanwhile, explore concrete plans on how you can get out of the situation you're in --- maybe take an investment course to get passive income or call on extended family members to help. You can cope better if you know there's an end to your sacrifices in sight.

Thursday, October 17, 2013

Post Disaster Psychological First Aid

The death toll continues to rise as rescuers sort through the rubble after the October 15 earthquake that struck the Visayas region. The Philippine government has already declared Cebu and Bohol in a state of calamity.

In anticipation of volunteers wanting to respond to post-calamity Visayas, here is a link to a primer on psychological first aid produced by the World Health Organization, World Trauma Foundation, and World Vision. You don't have to be a mental health professional to give psychological first aid, but there are guidelines to keep in mind when responding to persons affected by crisis.

Prayers for our brothers and sisters in the area including victims, survivors, and responders.

Monday, October 14, 2013

Mental Illness is a Disability --- When Will the Philippines Catch Up?

I've been looking for an article similar to this for a long time.

See, some 5 years ago, I took on a writing project for a US-based NGO that advocates for Persons With Disabilities (PWDs). While doing research for the series of articles I had to make, I came across US laws that specifically identified mental illness, such as Major Depressive Disorder, as disability. Like learning disabilities, mental illness is classified as a hidden disability.

What does this mean?

Being a disability, persons with mental illness are legally entitled to the same rights as those with other kinds of disabilities. These rights include discounts on basic necessities like medicines and food. It also means being entitled to reasonable accommodation in the workplace. Furthermore, companies are prohibited from asking questions related to mental health history without a concrete job offer. 

Sadly, our definition of mental disability in this country is limited to mental health issues related to loss of reality testing (e.g. schizophrenia) and mental retardation. Thus, rights for persons with mental illness are not accessed by everyone concerned. When will, say, diagnosed mood disorders be included as an acceptable definition of disability? For yes, those with these conditions can spend days, if not months, unable to earn a living. I know there were months, back when my mood disorder was at its peak, when I could not even summon the will to work.

An excerpt from the article worth reflecting upon:

It is also important to note that there is no mental health legislation for those with mental disabilities. The Department of Health does have mental health policies, but the Magna Carta for Disabled Persons is not specifically for mental disabilities. It provides for special rights and privileges for the physically impaired (their mobility is enhanced through sidewalks, railings, ramps and the like); the hearing-impaired are benefited by TV stations that provide a sign-language inset or subtitles, and telephone companies are encouraged to install special devices for them. The Magna Carta provides for the “mentally retarded” under the provisions on education. Mental retardation, however, is only one kind of mental disability. In fact, there are mentally disabled persons with superior intelligence—the complete opposite of mentally retarded persons. 

Why does this matter interests me so much?

One of the things that I've worried about being a person with Bipolar Disorder is surviving full time work in a company. I'm lucky, I have skills that help me become an independent service-provider, which means that I can basically control my schedule. I can, for example, choose to take a break when I feel an attack coming. 

But part of me also feels that if I can find a company understanding enough to provide reasonable accommodation I can thrive in the corporate world. Reasonable accommodation doesn't equate to special treatment --- key result areas are not watered down and only adjustments that don't represent "undue burden" qualifies. For instance, persons with diagnosed mental illness can request to take breaks based on need not on company schedule. If the job is flexible enough that there's room to take stress breaks, no harm is done. (You can learn more about reasonable accommodation here.)

Here's the problem: without a law protecting this right, dare you even raise the matter to management? Requesting reasonable accommodation is a tricky thing in a country where stigma against mental illness is strong. Ensuring that your request is kept confidential is another. Getting your co-workers to understand without feeling that life is unfair is something else.

It makes me wonder how many persons with mental illness out there are potential star employees. Probably a lot. Many persons with mental health conditions are smart, skilled, and hard-working. The question is: can the government protect them enough so that they can pursue a fuller life? Furthermore, can the state punish companies who refuse to do the right thing?

I am passionate about doing something about this. This is why I started Possibilities, I want to give workshops to companies about psychological well-being in the workplace that includes mental health advocacy.

Anyway, kudos to Ms. Corpuz for bringing this matter into public awareness. I pray for improved service to persons with mental illness in this country soon.