Last week, the 14th September was RUOK? day. It was pretty hard to miss. There was promotion everywhere, lots of articles written. At Flinders University there was a BBQ and information session. Even the Prime Minister (and his colleagues) were wearing their RUOK? badges during parliament whilst they yelled at each other.
The message of the day is pretty simple – to remind everyone to take the time to check in on friends, family and colleagues and see how they are doing. Lots of people suffer in silence, and the simple act of asking them how they are doing might provide an avenue for them to reach out and ask for help. Sometimes that simple act might be the difference between someone not speaking out and ultimately taking their own life, versus opening up and getting the help they need. The RUOK? website is still up if you want to learn more about their mission – https://www.ruok.org.au/
I meant to write a post on the day itself, but honestly, everyone was writing about it, and I didn’t think I had anything unique to offer. A lot of people wrote about the history and purpose of the day, encouraged people to talk to friends, family and colleagues, and explored what to do if someone you spoke to revealed that they weren’t doing alright. I didn’t have anything significant to add, so I held off writing anything.
In the subsequent days though I have thought quite a lot about the RUOK? concept and wanted to share a few reflections. This post is mostly intended to be for those who, if asked on the day, might have said “no, I am not doing alright”.
The emotional world sitting under everyday interactions
If you are anything like me, you have the following interaction, or something very similar, multiple times a day –
Someone: “hey, how you doing?”
Me: Yeah good, how are you?”
Someone “Yeah, good thanks”
Someone: So, about that……..(insert work, family, friend topic here)
It is the socially acceptable way to start a conversation where both parties just say they are ‘ok’ before moving on to the main topic.
I often think that if you could get into the heads of both participants though, it would be something a little more like this –
Someone: “hey, how you doing?” (“I honestly don’t really care, but feel like I need to ask, or otherwise I am just going to stand here at stare at you awkwardly”)
Me: Yeah good, how are you?” (“I’m not that great at all. I am having an existential crisis, my legs hurt and I’m worried that I am much closer to an age where I will have to wear absorbent underwear….. Oh shit, yeah, I am supposed to ask how you are doing as well”)
Someone “Yeah, good thanks” (“Phew! – he said ‘good’. This conversation will be quick. Am I good? I’m not sure. I’ve been eating my feelings all morning and have a stomach ache. I’m also a compulsive gambler and my dog just died. I ‘m actually pretty miserable.”)
Me: “cool…” (“I can’t believe I am still using the word ‘cool’. I really hope he just said he was doing alright cause I wasn’t listening”)
Someone: So about that…………(just quickly move on to the main topic)
The truth is there is a rich world of thoughts, feelings, sensations and events sitting beneath our everyday interactions. We tend to keep most it hidden, unless we are talking to someone very close to us, someone we trust. We particularly tend to keep the negative or distressing stuff well hidden.
We tell ourselves “they don’t want to hear my problems”, “they can’t help me”, “people wouldn’t understand what I am going through”, “everyone is better off if I keep my problems to myself”. We convince ourselves that our problems are too big, that people don’t care, and even if they did, they couldn’t solve them anyway.
For some people this gets to the point where on the outside, they are telling everyone (including people close to them) that they are ok, but on the inside they are a swirling mess of negative emotions and thoughts. Often the first anyone knows that the person is suffering is when their behaviour changes; for example, an angry outburst, bursting into tears, self-harm, or worst case suicide attempt.
Events like RUOK? day seek to directly address this distress under the surface by encouraging people to have more honest and open conversations with their friends, family members and colleagues. By asking “RUOK?” we are giving permission to those who have been holding their distress inside to speak out and ask for help.
It takes courage to day “no, I’m not alright”
On RUOK? day, I noticed a lot of the coverage was about the person asking the question: how to ask the question, when, to whom, how to respond if someone said they were not OK.
Much less was written about answering the question.
It struck me that for those of us who are struggling, RUOK? day could easily be interpreted as less about giving us permission to open up, and more about feeling pressure to open up. It’s almost like they are saying “well, if you are going to open up, this is the day to do it!” Part of me felt like it trivialised or ignored the significance of telling someone you are not doing alright. I’m not the only one to have thought about RUOK? from the perspective of the person answering the question.
It takes a lot of courage to speak up and say that you are not doing alright. It’s confronting to acknowledge that you are not coping, especially if you’ve created the impression for everyone that you are. It’s also confronting to accept that you’ve been unable to solve your problems yourself. We like to think that we are in control of our lives, and have the capacity to solve any problem that comes our way. Evidence to the contrary is hard to swallow.
There is also the issue that if you do speak up and say you are not doing alright, you get no guarantee that it will go well. You might get a really compassionate and kind response. But you also might get ignored, ridiculed, or lectured. The person you tell might get angry, or upset themselves and you quickly find yourself trying to support them. You might find the person’s response cold, calculated or indifferent. They might make you feel like you are just trying to get attention. You might find yourself more distressed after telling someone than before.
So how do I know when it is time to open up and to who?
The research suggests the first people we open up to are typically family or friends. This is not surprising as it is these people who are most likely to have noticed that you aren’t doing so well and are the people you most likely trust to open up to.
But knowing when and to who to open up to can be difficult.
Here are some observations I’ve made both as someone asking for help, but also as a professional providing help.
1) Sometimes you don’t make the choice – You might be totally committed to keeping all your pain to yourself and then someone asks if you are alright and before you know it, you’ve told them everything.
2) Not telling someone because you think they are also struggling can be a mistake – Often it is those people who have experienced inner pain as well who are best placed to understand what you are going through.
3) People will surprise you, both in good and bad ways – Some people who you thought would be really good supports are not, and people you didn’t even expect to be that supportive or understanding turn out to be your best champions. Don’t let bad experiences of opening up deter you from trying again.
4) Turning to professional help is not an admission that you don’t have the resources or supports to deal with the issues – Sometimes it is just easier to speak to someone who is not involved in your daily life.
5) Without doubt your mind will give you a whole lot of reasons why you shouldn’t open up and ask for help.
“they can’t help me”
“i’m not worth it”
“my problems are unsolvable”
“only weak people ask for help”
“people are untrustworthy”
“everyone would be better off without me”
I don’t mean to disrespect your mind, but it is wrong. I’m not saying you won’t have some bad experiences of reaching out for help, but on the whole, if you are not coping, telling someone will work out better than not. For those people that have wrestled their way back from suicidal feelings, reaching out for help was a critical part.
6) You don’t have to wait to be asked – You might think that everyone has noticed you aren’t doing well but are too afraid or uncaring to ask, but it might be that you are covering your distress so well that others haven’t noticed. Don’t immediately think that the reasons people are not asking is because they don’t care. You can take the initiative, rather than wait to be asked.
7) Opening up about you struggles doesn’t necessarily solve them, but it goes a long way – It’s pretty amazing what a good chat with someone can do, when you’ve been hiding your distress for a long time. Sure, it might not solve the underlying problems you are facing, but your perspective on this problems can change rapidly when discussed with another. In contrast, hiding our distress from others just compounds the problem further, cause we deprive ourselves of people’s emotional support, people’s suggestions for how to overcome the problem and people creating us some space in which to get help.
8) It’s not an easy conversation to start – If you are not used to talking to friends or family about stuff that is troubling you, you might find it unnatural at first. It might sound clumsy to transition the conversation from “how about the weather we’ve been having” to “hey, I am not doing so well”. Remember though, that we’ve all got a rich world of thoughts and feelings that sit below the surface. Whilst the person you open up to might be surprised that you are struggling, they won’t be surprised to hear that you’ve had a rich and complex world of thoughts and feelings going on in your head. They do to.
I don’t want to leave you with the final impression that I don’t believe in or support the RUOK? concept. Fundamentally I do.
Anything that promotes the discussion of mental health and well-being amongst friends, family members and colleagues I think can have positive benefits.
What I would say however is that RUOK? day itself is very targeted towards the person asking the question, not the person who might be answering it.
If you’ve been struggling and not been able to find solutions yourself, remember that opening up to someone (friend, family member, colleague, professional) is an important first step to a better life.
In this regard, you have a number of options:
For Flinders students, always remember there is the free and confidential counselling service – http://flinders.edu.au//current-students/healthandcounselling/counselling/counselling_home.cfm
Want to comment on this article, or ask me a question about the health and well-being services available to you as a student? Feel free to comment below, abuse me on Twitter (@Dr_Furber), contact me on Skype (search for ‘eMental Health Project Officer Gareth’), or email me (email@example.com)