Microaggressions and Mental Health

Microaggressions manifest as subtle but pervasive forms of prejudice. They may be barely perceptible, but microaggressions are damaging and dangerous. For many people, they constitute daily abuse. As mental health and social workers, it’s important to identify and confront microaggressions. Recognizing them will help you to challenge them institutionally, professionally, and personally.

Our ability to defend against microaggressions depends on vulnerability and resilience. For people who are already dealing with mental health issues, the impact of microaggressions can be overwhelming. Prejudice against mental illness is deep-rooted in our language and cultural norms. People don’t always realize the extent to which they are suffering from microaggressions. They can be painful, but hard to pinpoint. This is true in both clinical settings and our day-to-day experience of, and participation in, microaggressions.

Implicit and Explicit Bias

Mental illness microaggressions are varied. They often focus on either invalidating people’s experiences or blaming people for their condition. They may include an implicit or explicit assumption that someone may be violent, dangerous, and volatile. Or, helpless, incapable, and inferior. These are all alienating and damaging assumptions. They are also often inescapable for people dealing with mental health issues. Mental health microaggressions are perpetrated by family, friends, health professionals, and social workers.

Often, microaggressions relating to mental health take the form of a compliment. “You’re doing so well!”. Or, “but you don’t seem crazy?” They can be all-pervasive and are often ingrained within people’s daily experiences. This applies to all walks of life, from the clinician’s couch to the Christmas dinner table. How can we make space for working with microaggressions? How do we get better at noticing them, and calling them out?

Noticing and Confronting Microaggressions

We need to talk about microaggressions. Make space for talking about them with your clients. With your family and friends. Get more and more versed in knowing what to look for. You might ask yourself, do I experience microaggressions? If you belong to a minority group, you likely do. Do you notice when they happen, and what do you do to deal with them? Is there an element of prejudice at play, in the way that someone is speaking or being spoken to? How might you help to challenge that? Listen to your clients. Unpack the specifics about the types of microaggressions that they experience.

Combating with Vulnerability and Resilience

Once you’re able to identify what a microaggression looks and feels like, you can start to work with them. Work with your clients, your colleagues, and friends to legitimize microaggressions. Define clear boundaries to help them feel competent when addressing everyday prejudices. This may involve challenging people head-on, or it may mean being better able to meet microaggressions with compassion. Removing their harmful impact calls for a combination of strength and compassion. Vulnerability and resilience can dissolve both the appearance and impact of microaggressions.

Barber, S., Gronholm, P., Ahuja, S., Rüsch, N., & Thornicroft, G. (2020) “Microaggressions towards people affected by mental health problems: A scoping review.” Epidemiology and Psychiatric Sciences, 29, E82. doi:10.1017/S2045796019000763

Mindfulness-Based Relapse Prevention: Addiction Recovery in a Post-Pandemic World

The pandemic has made addiction recovery harder than ever. Recovery programs, which are often an essential lifeline, have been disrupted or canceled. Treatment has become even less accessible. As in-person services have lessened, addiction specialists are combining mindfulness and cognitive-behavioral release prevention skills to help people stay sober.

Mindfulness-Based Relapse Prevention helps resource individuals who need support. By cultivating mindfulness techniques, you can begin to foster a self-care system.

Here are five steps to adopting Mindfulness-Based Relapse Prevention. These can help support recovering addicts in the absence of interventions and group-based therapies.

1. External Orienting

The first step in cultivating a mindfulness-based approach is external orienting. This means sitting and noticing the world around you, and how it makes you feel. You might feel the chair beneath you, the earth under your feet. The color of the sky outside the window. How a tree moves in the breeze. Notice these things and anything else that draws you in. Is there one thing that brings a greater sense of stillness, or of connection? Writing down what you notice can help to develop an awareness of how you respond to different external triggers.

2. Internal Resourcing

Once you are comfortable with external orienting, you can begin internal resourcing. This means recognizing how you experience external triggers in your body. Creating a body map can help: draw a basic body outline, then tune in to your body. Notice how you feel, where there’s tension, where there’s ease. Mark these on your body map. Tune back in. See if you can breathe into areas of tension. Can you release pressure? Can you change your inner experience? Mark any changes on your body map. Spending five minutes a day doing this can help to create mindful awareness. You will develop body literacy and notice how your body responds to different triggers.

3. Urge Surfing

This helps people in recovery to notice their urges and cravings when they arise. Noticing means that you can start to be curious about these urges. What triggers them, how long do they last, how might you make them subside? With every successfully surfed urge, you become a better surfer. You create new neural pathways which will help you to navigate the next wave. The next wave may be bigger and longer, or smaller and softer, depending on what triggered it. The point is, no matter how big the wave, every time you practice surfing with mindful awareness, the better you get at it.

4. Stay with what arises

For many addicts, the need to control or fix situations is at the root of their addiction. This may be because you have learned that this is how you handle triggers, by reaching for the bottle, the pill, the release, to ‘help’ manage it. By letting whatever arises run its course you can unlearn these addictive habits. Mindfulness is about learning to stay with what arises. Without judgment or attachment.. When you stay with what arises, you can develop responses that are solution-based. Not problem-focused.

5. Solution-based responses

Mindfulness allows you to stop, notice, and witness urges and cravings. If you can remove yourself from the story, then you can regain control of your narratives. Pausing provides you with an opportunity to respond with intention, kindness, and compassion. It stops the automatic reaction. You can better communicate your needs to yourself and others. It will help prevent the urge to drop back into addictive behaviors. Mindfulness can enhance your ability to cope with emotional distress. You become more confident in your ability to respond with a solution-based approach to the triggers and challenges that are a part of modern life.

It seems that the pandemic might be a part of modern life for a while. Mindfulness-Based Relapse Prevention is a solution-focused response to the pandemic itself.

Enkema, M., Bowen, S. (2017) “Mindfulness practice moderates the relationship between craving and substance use in a clinical sample.” Drug Alcohol Depend, doi: 10.1016/j.drugalcdep.2017.05.036