Why I Love Labels, Part 3

I truly love labels, but I also acknowledge that labeling a child can cause the child to self-limit. To combat this, I use two cool exercises with my students. I also use these exercises when I’m feeling limited, and they help me overcome self-stigma and stagnation.

The I Can List

A common exercise to improve self-estem in students with disabilities, diseases, or differences involves listing the things that the student can do despite or because of her diagnosis. When I use this exercise, I ask my students to begin by very specifically describing their illness. I’ve found that students with mental illness sometimes believe that they are limited in ways other than those included in their diagnosis simply because they are unclear about what their diagnosis really means.

After each student has identified and described her diagnosis, I have her list the things she can do in spite or because of her illness. It’s important to include personal things that are difficult or took a lot of work.

Child-Kiri would be in awe of the things I can do as an adult. I’d love to show her this I Can list:

I can…

live 3,000 miles away from my family and hometown
fly six hours to see my family
say “okay” and “I’m bored” without whispering or thinking “shut up”
sing onstage in front of tons of people
make new friends
spend the night away from my significant other without having unbearable separation anxiety
ride the subway UNDERGROUND and even in the dark!
wait calmly in a stalled elevator
navigate large crowds
etc.

Even if a student’s I Can list is very short, there’s merit in the exercise. Remember, it’s always amazingly beneficial to emphasize and reward partial successes. Also, have the student include accomplishments and abilities that aren’t directly related to her illness. For example, I can…

write pretty awesome fiction and creative nonfiction
sing
do the splits
etc.

Exploring Identity

The second exercise I use to help my students avoid self-limiting is an original activity I’ve yet to name. I love this exercise and use it all the time with students of all ages.

Step 1: Have each student make a list of ten (or whatever number is age-appropriate) of their most prominent traits. I like to have everyone write “I am:” at the top of the page. Be sure that each student includes both positive and negative traits. While some of the traits can be physical or external (I am beautiful or I am poor), most should focus on personality and ability (I am smart or I am bad at math).

Step 2: Ask each student to convince you, either orally or through an essay, that the traits they’ve listed do NOT in fact describe them at all.

Step 3: Have each student make a second list, this time of the traits they wish to embody. I call this the “ideal traits” list.

Step 4: Now ask each student to convince you that each trait on the list is NOT ideal.

Step 5: Have students revise their ideal traits list. You’d be surprised how often they convince themselves with their own arguments!

Step 6: Finally, have each student share an example of a time when s/he embodied each of her ideal traits. It’s important to end on a positive!

Much of what we think of as our “selves” seems to come from habit. We practice thinking of ourselves as smart or boring or disorganized, and we increasingly inhabit those labels. Labels are incredibly useful shorthand for complex realities, but they are not curses or life sentences. As the poet Dorothea Tanning said, “It’s hard to always be the same person.”

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Why I Love Labels, Part 2

Labels are limits. Labeling a child is limiting her. Children, disobedient as they may sometimes be, listen. So why would any parent want to label her child as mentally ill?

A label saved my life. A term, and a list of defining traits that flattened my complex human emotion into bullet points, saved me from a waking nightmare. I can’t overstate it. Words are pure magic.

Labels are limits, and they limited my panic. Knowing its name gave me power over it.

As an educator, I’ve been taught to use what’s called “people-first language” when describing disabilities, impairments, and differences. People-first means you say the person before the label: person with Autism instead of Autistic person. The idea, of course, is that people needn’t be defined by their conditions. If you read my blog or scan my website or follow me on Twitter, you’ll notice that I say “anxious kids” at least as often as I say “kids with anxiety.” First of all, it’s much shorter (and, on Twitter, that’s hugely important). But, more than that, I’m okay with using “label-first” language to describe my students because they are to some extent defined by their illness. And so am I. Anxiety didn’t happen to me. Anxiety is me. I have facets and layers and contradictions (upcoming post topic!) like everyone, but I can’t deny that the “self” that I acknowledge as “me” could not exist independent from childhood anxiety. Calm, prepared, responsible adult Kiri grew from panicked child Kiri, both because panic forced me to learn life skills that other adults lack and because my brain simply has anxiety wired into it.

Some modes of therapy encourage patients/clients to imagine their illnesses as separate from themselves, and I find this tactic extremely useful, especially in children. However, I believe that it’s important to ensure that this kind of thinking doesn’t lead to self-stigmatizing. I am more than my anxiety, but I am my anxiety. I once had a peer ask, “how do I know what is my [mental] illness and what’s me?” While I understand and respect her question, the truth is, brains don’t work like that. Mental illness is, as far as we can tell, pretty complex. An anxiety disorder can’t be cut out like a tumor. Rather than trying to identify a disease-free self, we should focus on becoming as healthy as we can be.

I believe that teaching children to identify and label their symptoms and conditions is the single best thing you can do to facilitate recovery. However, there are definitely some risks involved in labeling children. Children (and adults) may internalize the limitations implicit in their labels and thus impede their own success. A child diagnosed with an anxiety disorder might, for example, believe that he cannot take risks. Part three of this series will include the exercises I use to combat self-limiting in my students, and myself!

This post continues the theme of the disclosure and destigmatization of mental illness. For more information about stigma, check out the Stand Up for Mental Health campaign by HealthyPlace.

Why I Love Labels, Part 1

The insert in a sample pack of Zoloft saved my life.

The Zoloft helped, too. So did cognitive-behavioral therapy, my family, and a couple great self-help books. But the first and most dramatic step away from agony and toward relief was taken the moment I read the insert beside a small cardboard blister pack.

The insert described a panic attack.

Nearly six months before I read that insert, I had my first real panic attack. An anxiety attack is different: the horror I felt when separated from my mother was emotional. Panic, alternately, is in the body. You suffocate. You trade hearts with a hummingbird. The beating isn’t heavy like when you run; it’s faster and wilder, and it hurts. It’s a punch from inside your chest, over and over and loud in your ears. Maybe sort of like drowning. And your hands fall asleep or go numb. You sweat, and you feel sick to your stomach, and you notice a million little signs of death, like how your tongue is choking you or the subtle pop of an artery exploding and wasting all your blood. Yes, there’s terror, but it’s bodily, from your core and in your veins. The fear isn’t in your mind, it’s in your brain. And, though sometimes the panic is triggered by a stalled elevator or news from North Korea, a panic attack is a narcissist. It turns you inward, dampens the world. Panic gets caught in its own reflection.

I was young, and it came without warning and then refused to leave, haunting me instead with convincing warnings about aneurysms and punctured lungs. I realized I was dying. Over and over, I realized it. The attacks, which last only a few interminable minutes, became more frequent and then constant. Eventually I was having several complete panic attacks every day, and symptoms of panic between each attack. I went to bed every night with my heart speeding and woke up every morning gasping and shaking. I never had a chance to catch my breath. I literally couldn’t get an hour of relief. It was like that for almost three months. My pediatrician, whom I begged for answers, told me it was anxiety. Ha! I knew anxiety. I’d been diagnosed with separation anxiety at five or six. This wasn’t anxiety, this was me dying! Obviously.

Finally, after a particularly awful night spent struggling to breathe, my mom took me to a psychiatrist. He listened to my symptoms and immediately identified my condition as Panic Disorder, something I’d never heard of. Medicine and therapy, he said, would fix it. I didn’t believe him, though, until he showed me the insert in the sample pack of my new prescription. It listed the symptoms of a panic attack: rapid heartbeat, feeling like you’re being smothered, dizziness, nausea, believing that you’re dying, feeling like you’re going crazy. Tingling extremities. Feeling dreamy and confused and pixilated.

My face basically exploded. “This is exactly what I have!” I said. “Every single thing on this list. All of them! Every day!”

“That’s Panic Disorder,” said the psychiatrist. And, just like that, my life was saved.