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6 Habits Therapists Are Begging You to Break for the Sake of Your Mental Health
You might not realize these behaviors are sapping the joy and ease from your life.
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6 Habits Therapists Are Begging You to Break for the Sake of Your Mental Health
You might not realize these behaviors are sapping the joy and ease from your life.
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https://psyche.co/heal/fear-and-phobia
Exposure
Wracked with unknown fear, I’d never been able to sleep through the night. Then I went scuba diving
by Lindsay Lee Wallace
The first time I tried to breathe underwater, it almost didn’t work. I was beginning my first descent in open water – scuba-diving parlance for sinking, on purpose, into the sea. I was with a guide and another beginning diver, and as we drifted downward, each of my frenzied inhales was accompanied by a burst of bath-warm water. Growing up, I had been worshipful and wary of the ocean’s vastness, the way it went on forever. How was it possible, then, that every inch of that expanse was here, now, pressing in on me? My legs tingled as they dangled into emptiness. Silt and sand, stirred up by recent unusually heavy rains, clouded my vision, and my ribs seemed to constrict around my lungs.
You are fine, I told myself, blinking hard and swallowing more salt from Savusavu Bay. If you stop the dive, everyone will be mad at you.
Another few feet down, and I could admit that enduring other people’s anger was better than drowning. I jerked my thumbs upward, scuba for ascend, and we rose back to the surface. ‘I think there’s something wrong,’ I told Tua, our guide, breathlessly. ‘There’s water coming into my regulator.’
He examined the mouthpiece that provided my air during the dive, and I treaded water and prepared to be told to relax. That breathing a bit of water was normal. That I would just have to get used to it.
‘You’re right, it’s ripped,’ he said, smiling like believing me was a simple, obvious, easy thing. Tua had been diving for long enough – first for fun, then with the determination of an aspiring divemaster, and now as a lead guide at a resort named for a scuba pioneer – that it took him only moments to replace the rubber mouthpiece that had been letting water mix wantonly with my supply of precious air. We began our descent anew, this time with Tua holding my hand. It was a kindness, based on the reasonable assumption that, after my equipment issue, I might be scared.
And I am scared, of a lot of things. I’m scared of the ocean even though I adore it, even though I grew up swimming in it every summer. I am scared of the inside of my own mind, though I grew up swimming in that, too. A lifetime of watching my mom endure chronic illness without the resources to receive compassionate healthcare has left me scared of being unable to communicate, of being isolated, of being injured beyond repair. I am scared of the dark. And, most embarrassingly, I’m often scared to sleep, especially alone.
I’ve never been able to sleep well. In one grainy home video, my father is holding me and cradling my head. I’m over a year old, plenty mature enough to manage my own neck but refusing anyway. Probably because I’m tired. ‘She hates to sleep,’ my dad says to the assorted family members nodding sympathetically throughout the frame. ‘She just fights it and fights it.’
More than two decades later, there’s something reassuring about the video. Some part of me – the part that puts my phone in the kitchen at night, and barring that uses my phone to watch soothing videos, and barring that says f.ck it and doomscrolls while a Benadryl works its way into my bloodstream – takes comfort in knowing I’ve always been like this. That part can also admit it has gotten worse over time, even as I have learned to support my own skull. It’s not that I’m afraid of something specific, so much as that the vulnerability of sleep invites a sinister infinity of possibilities. When I’m alone in the dark, my mind reminds me that anything, something terrifying, could happen.
The darkness around me seemed to ripple with life, inky and aware and out to get me
Entirely by accident, diving immersed me in that fear. I never expected to scuba dive, so I didn’t know to be afraid of it until it was already happening.
But before I could dive in the ocean, I had to practise in a pool. It was heated, busy, and a few blocks from Times Square. There I met Karen, who explored shipwrecks and teaches aspiring divers as a way of letting off steam from her job conducting medical research for investment firms. Karen told me to put my head underwater and take my mask off, one of the basic skills required to get your Open Water Diver certification. I tried to comply, and wept. My fear was expansive and impressive – the kind I felt when I lay in bed at night and the darkness around me seemed to ripple with life, inky and aware and out to get me.
Karen, kind and efficient, tried to have me descend alongside her to the bottom of the pool, but I felt the water pressure constricting my chest and thought of freak aneurysms, heart attacks, nitrogen bubbles slipping insidiously through my bloodstream. Karen added an extra day to my training to compensate for the meltdowns I had before and after each skill level, and I eked out the progress needed for stage one of my certification.
Which brought me to stage two, in the ocean off the shore of Fiji. Forty feet of water filtered the reds and yellows out of the world and cloaked everything in shades of shifting blue.
I let go of Tua’s hand all on my own.
Almost everyone who has post-traumatic stress disorder (PTSD) also has trouble sleeping. And, according to at least three therapists – including the one I immediately quit seeing in sophomore year of college after she delivered the initial diagnosis (sorry, Urania) – I have PTSD. Specifically, I have C-PTSD, or complex post-traumatic stress disorder, which results from extended, repeated trauma as opposed to an isolated event.
Whether it’s a violent home environment, systemic discrimination and cruelty, or the malicious tangle of a healthcare system that gleefully profits while the sick slowly suffer, it’s not good for children to see their caretakers brutalised. Especially when that brutality is ignored or accepted.
It wasn’t good for me to see my mom suffer – neither the most memorable hospitalisations and injuries, nor the small, constant indignities. It was something about the repetition, stretching out interminably in front of us even as it pressed ever closer in the years before her death. It was something about treading water, being told to relax and get used to it.
I’d spent the time leading up to my first ocean dive terrified that I’d be unable to discern a real problem through the murk of my free-floating fear, and certain that, if I did encounter one, I’d be unable to communicate it. If I was being honest with myself, I’d been nursing some version of this concern much longer than just the lead-up to the dive. And then, my heart hammering and my every breath bringing salt water along with air, my fear had come to pass.
It’s something about the pressure, which emulates a weighted blanket or a womb
But I’d asked for help and been listened to, believed, offered a solution. Now in the ocean, I felt the water pressure like an embrace. Coral spiralled below and towered above us, an unlikely architecture of branches and fans tended by tiny fish. My fear dissipated skyward with the bubbles of each exhale. That night, alone in a bed almost 8,000 miles from home, I slept soundly.
Maybe it shouldn’t have been so simple. Maybe, it was. There’s not a lot of research into the relationship between trauma and diving, but what does exist suggests the benefits go beyond what I’d initially assumed: that people who can afford regular diving trips can also afford really good trauma therapy. Some organisations of military veterans and disabled divers swear by it, as does a therapist and neuroscience PhD candidate I spoke with once, who says diving saved her life. It’s something about the pressure, which emulates a weighted blanket or a womb. It’s something about the relative sensory deprivation of immersion, which has been documented by studies focused on reduced environmental stimulation therapy to ease anxiety and depression. It’s something about the health benefits of nature and the unparalleled awe it incites.
The day after my first dive, Tua informed us there would be a night dive that evening. It was scheduled for another member of our group who needed it to secure an advanced certification, but we were all welcome to join if we wanted, which of course I didn’t. I may have unexpectedly overcome my fears by day, but I was still the same person who’d lain in bed countless times barely breathing, feeling menaced by lightlessness. I didn’t want to be at the bottom of the ocean at night.
Yet I heard myself say yes. The sun set and we descended with it, this time holding flashlights. This descent was more chaotic, our flashlight beams swinging haphazardly and illuminating sand and tiny organisms swirling in the water around us but not much else as we made our way to the seafloor and settled on our knees. I tried hard not to think about the miles of dark water, pressing in on us from all sides.
And then I let myself think about them anyway. Something terrifying could happen, my brain dutifully reminded me. Tua gestured for us to turn off our flashlights. Without giving myself time to fully understand, I did.
There was nothing. And then there were motes of yellow-green, illuminating the shape of Tua’s hand as it waved back and forth through the water and ignited bioluminescent plankton. Something terrifying is already happening, I answered myself, pushing my hands through the water as well and watching as they, too, were gilded with light and life. And it’s incredible. It’s something about immersion in yourself, the purest form of exposure therapy. It’s something about asking for and receiving help. It’s something about kneeling on the ocean floor surrounded by rippling, interminable darkness, save for the bioluminescence sparking from your waving hands.
Lindsay Lee Wallace
is a journalist focused on culture, health and technology. She has written and reported for outlets including the BBC, Teen Vogue, Xtra and Time magazine.
https://www.yahoo.com/news/why-forget-childhoods-120000676.html
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https://www.the-fence.com/no-scrubs/
No Scrubs
A personal essay from a writer who was once a doctor.
It was just me, in the fluorescent monotony of a hospital room, looking at my fifth patient of the day. She had stomach pain, tired eyes and test results that revealed absolutely nothing wrong. She was scared, frustrated and hurting. And for the first time, I felt nothing: a realisation that landed with the dull thud of inevitability. ‘This is it,’ I thought, ‘this is the day you stop caring.’
One of my mentors had warned me, years ago, when I was a fresh-faced junior doctor just out of medical school: ‘The moment you stop caring is when you know you’re burned out.’ At the time, I laughed it off, buoyed by the unwavering hubris of youth. Not me, I thought. I’m different. I’m built for this.
Do you remember January 2021? Many people choose to forget that month. The Christmas lockdown, hastily ordered from the prosecco-drenched offices of Downing Street, had been largely ignored. People were returning sheepishly to their towns and cities of residence, and those who hadn’t defied Boris Johnson’s half-hearted missive were not-so-silently judging those who had. The surge in COVID cases, passed around dinner tables with supermarket crackers and Brussels sprouts, was beginning to crest into a huge swathe of deaths. It would be the second-deadliest month of the pandemic. There was a strange atmosphere in the country, an unsteady mix of fear and frustration.
By this point, I, like many other healthcare workers, had replaced my initial fear with grim resignation, and a thick resolve to continue battling what was beginning to feel like an endless war against an ever-evolving enemy. My housemates and I – all doctors, all exhausted and dazed – had developed a new routine for dealing with the situation. We would wake, shower, steel ourselves and set off to our different hospitals. We would avoid small talk in the mornings. After work, we would come home, eat, distract ourselves with streaming shows and avoid talking about work at any cost. On the rare occasion that our days off landed at the same time, the three of us would cook together, then drink ourselves to oblivion, ignoring the horror that lay just out of sight.
I had taken to wearing scrubs while driving, to deter a police force that was enjoying exercising its new powers on black people (I was stopped on my way to work on two separate occasions). Once there I would change into my actual scrubs and make myself a coffee. Like many people, I had taken to yoga at some point in the previous year, in an attempt to harness the calming power of the wellness explosion. I would drink my coffee, and practise my breathing, pushing away the rising sensation that had started in my gut in April 2020, and was constantly at risk of boiling over into a full-blown panic attack.
Measures enacted to maintain our sanity were doomed to fail. A somewhat heavy-handed metaphor for this was our ‘wellbeing room’. It was an office in the bowels of the hospital, equipped with an uncomfortable sofa, some dying plants, and a Nintendo Switch chained to the wall. It literally went up in flames after someone left an incense stick burning unattended.
On this particular day, the beeps, shouts, moans and constant humming of the department that day were overlaid with a piercing, relentless fire alarm, courtesy of a distressed patient who had broken the glass in a moment of desperation. The fire brigade was quick to attend, telling us that, as there was no actual fire, they were unable to access the circuit board that would allow them to turn the alarm off and were, understandably, unwilling to let us start a fire so they could end the racket. So, with the alarm ringing in my ears, I started my shift.
At this point in the second wave of the pandemic, we junior doctors were handed the grim task of risk-assessing patients who had been admitted with COVID. There was a checklist of criteria for us to assess whether someone would likely survive in the event of needing a ventilator. For each patient, I followed the same protocol, but it never became easier. I explained to families that their loved ones might not make it out, even as their voices trembled with hope over the phone.
That fifth patient of the day required less of me. A simple stomach pain with no emergency cause. All I needed to do was offer her some kindness, some gentle reassurance that nothing was urgently wrong, and refer her back to her GP for further testing. But as I sat there and felt nothing, that old mentor’s words joined the ringing of the fire alarm in my ears: ‘The moment you stop caring is when you know you’re burned out.’
Burnout doesn’t happen overnight in some Hollywood-esque crescendo of exhaustion. At first, it’s forgetting to eat lunch. Then it’s not bothering to call your mum back. Then it’s your fifth shift in a row where you don’t have the energy to ask a colleague how they’re doing, because you know they’ll ask you the same, and God help you if you have to put that into words. Burnout is a gradual erosion of everything you used to recognise as yourself. By the time that patient sat in front of me with their vague stomach pain and their quiet desperation, I had nothing left to give. I had become someone I never thought I could be: detached, numb, going through the motions like a robot on its last factory charge.
It wasn’t just me. The system itself – the NHS – was falling apart in a way that mirrored my own slow collapse. On the surface, it looked fine enough. For those on the inside, the underlying rot was impossible to ignore. There were 24-hour waiting times, nurses relying on food banks, and patients stuck in hospital for weeks. Corridors were turned into makeshift wards, filled with ‘beds’ that were actually chairs. First-year doctors were earning barely more than the London living wage. Some people think the NHS’s problems started with the pandemic, but that’s a comforting lie. The pandemic didn’t break the system; it just exposed what was already broken. And the same goes for those of us who work within it.
I used to pride myself on my empathy. My ability to connect with people; to offer kindness even on the worst days. But empathy, it turns out, is a finite resource. And when it runs out, it’s gone – at least for a while. So I tried the yoga, and the deep breathing exercises, even buying one of those guided meditation apps that promises inner peace for five minutes a day. None of it worked. The anxiety and the crushing weight of responsibility all followed me home like a toxic shadow.
Leaving medicine wasn’t just a professional decision. It was an existential one. Giving up my licence to practise felt like surrendering a piece of myself, like admitting I couldn’t hack it. I’d built my whole identity around being a doctor, and walking away felt like an act of betrayal – not just to my colleagues or patients, but to the version of me that had worked so hard to get there. But what choice did I have? Medicine had taken everything from me: my energy, my empathy, my ability to feel joy.
There’s a kind of unspoken martyrdom in medicine. The idea that you should sacrifice your health, your relationships, your entire sense of self for the sake of the job. That’s the culture we’ve created, and it’s killing us – quietly, slowly, until one day it isn’t quiet anymore.
In the months since leaving, I’ve started to rebuild. It hasn’t been easy. For a while I felt unmoored, as if I’d cut myself adrift from everything I knew. But slowly, I’ve begun to rediscover parts of myself that I thought were gone for ever. I’ve started writing again, something I hadn’t done in years. I’ve learned to sit with my feelings instead of running from them. I’ve even rediscovered my empathy – not as some superhuman ability, but as a quiet, fragile thing that needs protecting.
Most importantly, I’ve realized that leaving medicine doesn’t make me a failure. It doesn’t erase the years I spent helping people or the lives I touched. It just means that I recognised my limits.
For those people still working in healthcare: I admire you. And I hope, more than anything, that you remember to take care of yourself. For those thinking about leaving: you’re not a failure. You’re human. Sometimes, the bravest thing you can do is walk away.
William Rayfet Hunter
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