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We're only human
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How do you be a human first and a professional when it’s required?

In this episode, we speak with Jamie, a social worker in the mental health world. Jamie shares his unique perspective on what it’s like to experience his own mental health challenges and how that’s shaped the way he now works as a clinician and a person. Jamie talks about burnout, knowing when to take a pause and drawing on our humanity when facing distress.

Come and listen with:

Lucy (She/Her) – A big fan of pickleball, ice cream and storytelling

Rachel (She/Her) – Social Worker, Dialogical Practitioner, mad footy fan and wildly passionate about transforming the culture of mental health services to be person-led and human rights informed.

Incredible artwork @sharleencu_art


EPISODE TRANSCRIPT – We’re only human

LUCY    This podcast has conversations around different mental health experiences that may be distressing for some people. If that doesn’t feel like something you want to explore today, you might wanna visit another podcast and come back to us another time. 

RACHEL    discovery college acknowledges the traditional owners of country throughout Australia and recognises the continuing connection to lands, waters, and community. We pay our respects to Aboriginal and Torres Strait Islander cultures, and to the elders past and present. They have never ceded sovereignty.

LUCY    In this podcast, we share stories that help us learn from each other, connect us, and inspire growth. We want to acknowledge that this way of being, of coming together to share knowledge and stories is a tradition that has already existed on this land for hundreds of thousands of years as a part of the culture of First Nations people. 

RACHEL    discovery college acknowledges the views shared in these podcasts are about mental health experiences, but are not a substitute for professional mental health advice and support. The views in this podcast are not the views of Alfred Health, but are the views of the individuals we’ve had conversations with.

LUCY    The stories we share on this podcast aren’t just stories, but memories of the people who have bravely shared their experiences with us. Remember to take care of yourself as you listen, as well as to take care of the stories that you hear.

MUSIC

RACHEL    Extremely human is a conversation about the profound experience of extreme states. When we speak about extreme states, we wanna explore a more humanistic way to understand people’s experiences that aren’t always shared by others. 

LUCY    Each extreme state holds different meaning for each person, including those related to psychosis, depression, grief, and addiction. As we chat with a variety of humans, we explore the important question, how can we respond to distress with greater compassion and humanity? Welcome to the first episode of the Extremely Human Podcast. My name’s Lucy.

RACHEL   and I’m Rachel. In this episode, we speak with Jamie, who’s a social worker in the mental health world. Jamie shares his unique perspective on what it’s like to experience his own mental health challenges and how that’s shaped the way he now works as a clinician and a person. Jamie talks about burnout, knowing when to take a pause, drawing on our own humanity when facing distress. Just a little shout out the guitar music that you hear throughout this episode is also by Jamie. Really hope you enjoy the episode.

MUSIC

RACHEL      Welcome, Jamie. Uh, thanks so much for joining us today.

JAMIE         Thank you for having me.

RACHEL      I wondered if you could tell us about yourself.

JAMIE    Uh, my name is Jamie and I’m a social worker. I’ve been working in the mental health sector for, um, close to 15 years, and mostly working in youth mental health for the last decade. I’m happily married, father of two, and absolutely a adore a family and love cooking, play guitar, try to surf. I’m a comic book geek, um, and proud of it, <laugh>. And yeah, I’m really excited just to be here today to talk about this stuff. I think it’s a cool idea. Yeah,

RACHEL    We’re pretty happy to have you here too.

LUCY    I first wanna start by apologising for the state of my voice. I was, um, at a music festival on the weekend, and speaking of extreme states, there were many people there in an extreme state.

RACHEL    I bet there were. 

LUCY    Yeah. <laugh> the good kind. So we wanted to ask everyone this question before we start the podcast. This is a bit of a warmup question, and feel free to answer it as lightly or as deeply as you choose. So the question is, can you tell us a disproportionate reaction you or someone you know has had to something?

JAMIE    I can. So I’ve got two examples that I’ll offer up. The first one is to do with my children. My son, who’s five years of age, and recently we were at a party, a family party at lunch, and he’d forgotten to bring his sonic the Hedgehog toy. He completely lost control of his emotions and had, I hate the word tantrum, but if the shoe fits, sometimes you gotta wear it. He really lost control of his sense of surroundings, of his sense of boundaries, um, of his sense of his own behavior was just completely what others might consider disproportionate to the moment and to the distress. There was a lot of crying and yelling and a lot of eye rolling from my family. And I, yeah, took Charlie out and we had to speak about it, and he drew a picture of Sonic, and then that pulled him through. But I guess that comes down to perspective about what is disproportionate. And I think the point that I see is that it’s only disproportionate to those that aren’t within the extreme state. So having a disproportionate response to an extreme state, to me, is very much a, a witnessed statement rather than a lived experience, if that makes sense.

LUCY    Absolutely. Because when you’re in it, it just feels so

JAMIE    Proportionate.

LUCY    Proportionate and appropriate. Yeah. Especially when you’re that age as well,

RACHEL    When you’re that age. Yeah. Although I can think of a few disproportionate reactions I’ve had, and I look back and they were disproportionate. Yeah,

JAMIE    Yeah. In hindsight. Yeah, absolutely.

RACHEL    Jamie, you’ve already started talking a bit about this, but what does being in an extreme state mean to you?

JAMIE    Uh, yeah, it’s a, a really big question. I think firstly, the term extreme state is quite a broad phrasing, and I think it’s a really useful umbrella phrasing because it can encapsulate any individual’s experience. So I guess my understanding of an extreme state is one in which you lose a sense of autonomy and choice the agency or control, whether that be you lose control of how reality feels that you become unfamiliar to yourself. But it could also be on the other end of the spectrum where you find yourself in an extreme state of bliss or, um, happiness. Perhaps. A good example could be when someone’s under the influence of, of drugs and or they’re experiencing an episode of mania where their mood is so elevated and their energy becomes out, out of their control. Extreme states don’t have to necessarily mean a distressed state or a happy state. It’s a state of unfamiliarity. That’s the way I sort of look at it, that you feel unfamiliar with yourself in the moment.

LUCY    I feel like extreme state might have some negative connotations or people kind of like, it might be some fear around that, but just as you violated, people can have the opposite experience where it’s just pure bliss or you just feel maybe so outside of yourself, but in a really like, liberating way.

JAMIE    It’s, yeah, it can be such a freeing experience. And, you know, coming from both a lived experience and a mental health professional perspective, sometimes, sometimes an extreme depressive state can be the most familiar and comfortable thing in the world, even though you don’t necessarily have the agency to pull yourself out unsupported, sometimes it’s not always completely unwanted. And same with, uh, if someone’s in an elevated or manic state, a lot of people we hear say, you know, I, I don’t want to lose this high. It feels wonderful, but the consequential sort of behavior that can occur in those extreme states can be challenging for other people around them and risky for themselves as well. And I think that not all extreme states involve risk, but they certainly can. And that’s part of what makes it fascinating as a clinician to talk about this stuff. And also from a lived experience perspective of experiencing extreme states. And I think as, as Rachel was saying, we’ve all been there to some degree or another, so to explore this sort of content, it’s just well overdue and it’s lovely to talk about. Mm-hmm. It really is.

LUCY    Have you ever like, found yourself in a extreme state? Is there a particular point of your life or being with someone else in their life that comes to mind when we’re talking about these? 

JAMIE       Yeah, there’s lots of examples that I could offer. I guess from, from a professional perspective, I think we find ourselves in what could potentially become extreme states. And certainly earlier on in, in my career, I found myself in extreme states of panic and anxiety in the space of not knowing how to respond to someone who themselves is in an extreme state of distress or, um, or an extreme state of, you know, elevated happiness and mood and, and even mania. The more I was able to spend time with people in extreme states, the more I realized what a naturally human experience it needs to be viewed as in, in order to be helpful in that space. So as a clinician, I think we spend time around people and we find ourselves wanting to find the on and off switch at times to just help to change, to fix.  That can be a risky place to be because that’s potentially where burnout can live for clinicians. But there’s also been times where, you know, unfortunately, and not, this is not just mental health, but in the helping professions in general, you find yourself working with people who are feeling threatened and therefore do become aggressive. And that puts us in an extreme state of, of hyper vigilance sometimes. And learning how to live and be thorough and humanistic and ethical and supportive while holding yourself in that extreme state is something that I think really comes with time or time plus lived experience. So I think from, from that clinical perspective to, uh, some personal experiences, I’ve had a history, um, long ago where I was deep in addiction with drugs and alcohol and knew that there was going to be a breaking point for me. And I was lost in an extreme state of panic and remorse and guilt and unhappiness. 

The only thing I could do to take myself out of that extreme state, I knew that I had to get help, but I didn’t know how to. So in my extreme state of not really being in control, of making what some would say good choices or smart choices, I called up my boss without putting much thought into it and said, I’m an addict and I’ve gotta go to rehab. Because if I didn’t make a choice that was unstoppable, then I would never stop. So I had to put something in my way, something radical, in order for me to demand change of myself, put it out of my control, I’d already lost control in that state. I guess it was almost handing over control to someone else out of desperation. And that set forth a chain of events that pulled me out of that extreme state of, of not living, of just trying to be around, but not really enjoy my existence. 

And I was lucky enough that the boss that I called up and spoke to was turned out to be a recovering addict himself, and sent my six-month renewal contract to the rehab center, which was one of the purest forms of empathy I’ve ever experienced in my life. And one of the most inspiring things as well, because for someone of in such authority to show such grace and, and empathy helped me realize that my experience that I’d put myself in through different circumstances wasn’t unique. And it wasn’t to be demonised, it was to be worked with, and it was something that I could return from. Being in the, in the thick of an addictive life, I would say is one of the most intense extreme states I’ve ever lived in, because it went for a long time. I went from about six to eight months of never being who I was and not wanting to be that person either. 

LUCY    Do you think he would’ve ever asked for help if you hadn’t have hit rock bottom?

JAMIE    Uh, no. No, I don’t. I, I think I couldn’t ask for help. So I tried to hit the self-destruct button because I think at the core of my mind, calling my boss up to say that was going to wreck my life. And I was just so lucky that it didn’t, and it steered me to a course of recovery. But since then, when I’ve found myself struggling with my own emotional, spiritual mental health, I’m much more confident now to say, I do need some help here.

LUCY    Does that give you some faith when you work with young people that you may have seen hit rock bottom, that sometimes it can be a bit of a transformational place for people?

JAMIE    Oh yeah. Yeah. I mean, it, it, it’s never nice to see someone hit rock bottom, but having the, the privilege to be the person at the bottom of the well waiting, there’s something that’s what, you know, keeps me going in, in the kind of work that we do, is wanting to be that person that has non-judgmental arms that will catch someone hopefully, or at least lift them up. And I find that some of the most inspirational conversations that I have with young people and hear the most inspiring responses and input from them is when they’re at rock bottom, because there’s nothing left to lose, but the truth, you know, it’s all they’ve got left.

RACHEL     I was gonna ask, Jamie, you’ve sort of answered it, but how do you think that experience translates into how you are as a clinician?

JAMIE    There’s not much that walks through the front door of, of a health service or a mental health service that I can’t relate to in some form. I can’t pretend that I know what people are going through, but I’ve walked my own miles and I take the memory of, of the struggle of, of those miles that I’ve walked with me wherever I go, not as a weight on my shoulder, but as a reminder that hard times, as naff as it sounds, is like sands through the hourglass. They do pass if, if you can sit with them and understand and recognize them for what they are, which are moments and experiences that don’t define an individual for who they are, but rather it’s defining of the moment that a person’s experiencing. Simply never defining someone by their current behavior or situation is probably one of the most helpful things that I’ve ever experienced. And that’s what I try to hold in my own practice, is if someone is in an extreme state, well that’s probably a symptom or an effect of unfortunate circumstances. It’s rarely a choice that they’re making to act out in a way that is uneasy or offensive for others.

GUITAR MUSIC

RACHEL    So Jamie, I’m just trying to think a bit more about what happens when someone’s in, in a heightened state of distress or an extreme state of distress. Mm-hmm. <affirmative>, you know, what do you think happens for those around the person or those that are called to help?

JAMIE    Yeah. I, I think a, a sense of professional purpose and maybe a little bit of a heightened sense of urgency to be responsive and to do the things that we’re trained to do. Sometimes there can be perhaps more of an application of theory rather than applying their knowledge to the moment in front of them. Mm-hmm. <affirmative>, I, I think sometimes professionals, um, in general, and, you know, this is without judgment at all, but can see distress as a black and white state. Mm-hmm. <affirmative>, and, and if it’s in this extreme distressed state, respond according to the book and apply the theory and the knowledge, the low and slow and the de-escalation. And sometimes de-escalation is not always the best first thing to do. Mm-hmm. <affirmative>, if someone has an experience that needs time to expel itself, to exhaust itself, or, or to simply have that distress expressed in a way that they feel they need to in the moment then jumping in with de-escalation and, you know, tell me how you feel and all that sort of good stuff that has its place. I think sometimes rushing to that approach can be perhaps sometimes missing the human element of, of what’s happening in front of you with someone in distress. You know, sometimes we need to sort of try to read the room more and, and listen to what’s going on and have a look around at what’s happening and perhaps what’s not happening as well. Mm-hmm. <affirmative>, you know, um, I think sometimes we can under think how we treat distress by going to our toolkit. Mm-hmm. <affirmative>, maybe it’s not time to bring out the toolkit, so

RACHEL    Mm-hmm. <affirmative>, what would we do instead?

JAMIE    Have a bit of a self-scan to think, okay, I have a responsibility in this moment. How am I doing in this moment before I try to put myself into someone else’s situation, checking myself? Am I the right person at this moment to be getting involved in lessening someone’s distress if I myself are not in a state to deal with that? And that happens when you wake up before you go to work. Ideally, it should happen on the reg with your colleagues as well, to be checking in and saying, well, today you are on, on blue dot or Code gray, or whatever the emergency response role is called in your service to say, today’s probably not a good day for me to be holding it ’cause I got a shit sleep. Or I’m, I’m just, I’m feeling a little bit outside of my own skin today.

So, you know, let’s not put me in that situation. I, I think if you find yourself in that situation, hopefully you’ve been trained really well enough to manage your own triggers as well, because they can be quite triggering moments. So I think that comes down to having a real sort of awareness of, of what you bring to a situation like that and what training do you require to be able to separate your own noise from what’s happening in front of you. And I think there’s a real skill that can be glossed over in, in the professional world that it’s okay, do some management of clinical aggression training or, you know, understand how to hit the duress button and make yourself safe. They’re good safety measures and necessary, but how do you be a human first and a professional when it’s required? To me, that’s the order that, um, for my own professional way of working, that to me, that’s what needs to happen, is I need to be in the room as a human being with professional skills. 

But if my skills walk in before I do as a person, I’ve probably lost that person. When someone comes in in distress and they get someone who’s feeling overtired over-caffeinated stressed, that they’re bringing their own anxieties into the room, is that the best we can do for that young person who’s in distress? Probably not. And I think it’s our duty as a sector to make sure that the people we’re putting in those positions are the most respectful that we have to offer. Once again, as a profession, supporting honesty and humility and the bravery it takes to tap out sometimes is so important. 

RACHEL    Gosh, I really like the idea of bringing the human self before the skills into our response, but I’m kind of interested, Jamie. ’cause that requires a lot of clinicians, doesn’t it? Um, and you’re sort of talking about having a self-awareness of the response that we’re giving. Mm-hmm. What do workplaces like mental health services or teams need to do for each other to help us be able to operate like that?

JAMIE    I mean, there needs to be a round table of like-minded individuals in a team to create a culture that’s supportive and welcoming and understanding of the fact that we’re all fragile. You know, we’re all not promised tomorrow, so how can we just be there for each other and not, I mean, it sounds like a, it does sound like a freaking t-shirt, but, you know, I’d, I’d wear it <laugh>. It’s, you know, it’s gotta be there.

RACHEL   It’s, you know, I had this, I had this thought of, you know, that saying we’re only human. Mm-hmm. <affirmative>, I’ve never liked that before. ’cause I thought it was sort of not capturing what I think it should, but it suddenly makes sense to me. We’re only human, but it’s, it’s actually very important to be only human. 

JAMIE    Yeah. I mean, we, none of us are permanent, that’s for sure. Yeah. So yeah, I think acknowledging that and really encouraging that, um, that vulnerability is one of the strongest things we can do. You know, that’s what we ask the young people we work with to do, isn’t it Just, if you can be vulnerable with me and give me your whole truth mm-hmm. <affirmative>, that’s gonna give us the best place to start from. And if as workers, if we’re not doing that, then you know, have a day off <laugh>, stay at home and look after yourself.

GUITAR MUSIC

RACHEL    How would you like to see the way in which we sit with distress change in the future?

JAMIE    Look, I, for me, there’s something that needs to happen from kindergarten, from primary school, and I think it’s happening more, is recognising that mental ill health doesn’t discriminate regardless of who, where, or how you are in the world. And raising kids all the way up into adulthood through youth. All of the good stuff to be just as free to talk about an ingrown toenail as they are about anxiety or depression. It should be as common as biology and reproduction and maths because they’re all things that just exist. Because they exist. It shouldn’t be a niche sector. Um, and I think we’re coming out of that gradually, but I think that if we can approach people who are in extreme states, whether that be distress or otherwise, if it’s done with a lens of compassion that’s genuine, that you want to be there for people, it’s pretty hard to go wrong. I, I think that if we can be aware enough of who we are in the room and try to have a greater awareness of who we’re trying to help, rather than what their symptoms or behavior are saying, that will put everyone in a better position to manage that extreme state in a more respectful way. So, you know, peace, love, compassion and mung beans, <laugh>.

LUCY    It always comes back to the simple advice. It does. All we need is love. 

JAMIE    That’s right. <laugh>

RACHEL    Jamie. Um, I’m interested, you know, we’ve talked a lot about what it’s like to be with someone who’s in a distress state or an extreme state. Have you seen it done well?

JAMIE    Yeah. I, I think that I’ve been lucky enough to be a part of one version of managing distress that worked really well. I was working at a music festival when I was working for a mental health service and we were running a booth. There was a young person who came to the booth in an extreme state of panic. And the extreme states in this example, sort of multilayered this young man came in and he was white as a ghost and didn’t know what to do. And he wasn’t substance affected or anything like that. He was just having a real dissociative, disorienting experience. And it was completely extreme for him. And the people around him, his friends totally loving and respectful and beautiful. People didn’t know what to do to help him. And of course, in the booth there was many clinicians who each wanted to help.

And there was some sort of experiences of how do we do the best thing that we can? And there was an immediacy to some of the clinician’s responses, including, and the friend’s responses. And I myself live with anxiety and have done since I was a child. And when I looked at this guy, it took me back to a lot of the times in my youth and childhood and even young adulthood when I’d experienced those. I’m not inside my own mind. I’ve lost control of my functional capacity. And I remember the things that used to help me through that, which was basically someone being there. So, I politely got my way through the crowd of people that were trying to offer this guy support and just said, if, you know, if everyone could please just give us some space. And I introduced myself to him and he was scared, you know, of, of his own state of mind, and therefore anyone around him wasn’t making sense. 

And I said, can we just sit down on the floor together? He was, um, he was like, oh, okay. Is that what I should do? And I was like, well, it’s something we can do and I’d like to, so let’s just do that. And then I just looked at him and said, I’m not gonna talk to you about this. I’m just gonna hold your hand if that’s okay with you. I’m gonna put my hand out and if you’re comfortable to embrace my hand with yours, let’s just do that and be here in this moment together. So we did that and a couple of the clinicians gave me sideways glances as if, oh, what, what are you doing there? And some of the friends looked at me and kind of gave me this comforting nod, like, oh shit, of course. And over the course of about five or 10 minutes sitting literally just holding this guy’s hands in silence, he eventually came back to himself out of this extreme state of confusion and panic and, you know, we had a little man moment and he, he had a bit of a tear up and so did I, because it was just this beautiful human experience that didn’t require clinical intervention as much as an empathetic human response. 

About half an hour later, he came back to the stall and he gave me a big high five. And he said, yeah, I’m back baby <laugh>. And it was really great just to see that he felt so lost in this extreme state of not knowing, to just have a quiet moment holding hands with someone. It was a beautiful experience of watching someone go from an extreme state to an extremely happy state where he felt back in control of his own decisions and his own surroundings. 

LUCY    That’s epic <laugh>. I think that’s a good, um, way to wrap up. Thank you so much for being our Guinea pig. You’ve been so generous in your sharing and just wanna thank you. It’s been an incredible conversation. So thank you, Jamie.

JAMIE    No, thank thanks to both you. It’s been an absolute privilege and yeah, I think what you’re doing is really cool. So thank you for letting me be a part of it.

LUCY    Thanks, Jamie. You well, I think that was a great way to kick off the first episode of the podcast. Mm-hmm. <affirmative>, Jamie is such a legend.

RACHEL    Total legend.

LUCY    His voice is just so smooth, isn’t it? Yeah. It’s like a radio presenter, <laugh>.

RACHEL    It’s calming.

LUCY    He’s made for this. I’ve listened to this episode so many times. I never get sick of the story that he tells at the end about holding the young person’s hand and just that simple, simple gesture.

RACHEL    Mm-hmm.  Beautiful.

LUCY    It’s beautiful.

RACHEL    Yeah. You know what I really love about this episode is that Jamie’s really able to help us think about professionals as human. Mm-hmm. <affirmative>, you know, sometimes extremely human actually. Um, but you know, there’s lots of reluctance over a long time for professionals to bring their real selves to their work and bring their humanity and, you know, speak and acknowledge their own lived experience of distress. And Jamie does that so well and in such an inspiring way. And there needs to be more of it, I say.

LUCY    Yeah, I totally agree.

MUSIC

Thank you for listening to our podcast. If you wanted to stay in touch or learn more about discovery college, please head to our website, discovery.college.

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